3.30.2007

Vein Viewer


From MedGadget:

Hey VeinViewer fans and victims of poorly trained phlebotomists, if you live near the Memphis-based Methodist Le Bonheur Hospitals you're in luck. In February, they became the first institution to begin wide-spread use of this new technology.


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Now if we can just get the nurses trained on one of these babies, maybe they would stop calling for IV issues constantly.




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On Cardiac Stents

From ABC News:

Doctors hoping to minimize chest pains associated with heart disease and perhaps even prevent heart attacks have long treated patients with stents, hollow tubes surgically implanted into blocked artery to prop them open.

Now a landmark study shows that while stents may improve blood flow, using them along with conventional drug therapies is no more effective at preventing heart attacks and other cardiac events than drug therapy alone. The findings, announced today at the American College of Cardiology conference, could have profound effects for patients and device manufacturers, since a staggering 800,000 Americans receive stents each year.


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My only comment is that the news media has done a really lousy job explaining that this data only applies to patients with chronic angina. I can see the patient in the ED having chest pain and ruling in for an MI and refusing to go up to the cath lab based on misinformation.




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Smokers Miss Work More

From SooToday:
Smokers clock up almost eight additional days of sick leave every year.

Smokers take an average of almost eight days more of sick leave every year than their non-smoking colleagues, suggests research published in Tobacco Control.

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So, does this mean that the nonsmokers get penalized by having to work an average of eight days more per year on average? So the "reward" for better health is more work!




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Bronchial Thermoplasty- A New Treatment For Asthma



From Fox News:

A device that zaps the airway with radio waves cuts moderate-to-severe asthma symptoms, a clinical study shows.

The device, the Alair System from Asthmatx Inc., is a radio-wave generator attached to a specially designed probe. During three procedures -- called bronchial thermoplasty -- the device is inserted into the airway. It zaps the smooth muscle of the airway, making it harder for the airway to spasm and close.

I'm not sure the pharmaceutical companies, like advair and crew, are going to think this is a good idea...


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3.28.2007

Computer Psychotherapy

Say "Hi" to Hal....

From BBC News:

Computer-based therapy should be available to all patients in England from April, says the government. Patients with mild depression or anxiety should receive therapy instead of drugs, but there are long waiting lists around the country.

A trial of one computer programme - 'Beating the Blues' - found it more cost-effective than other treatments.

But experts warned computer-based therapy was not for everyone and access to therapists also needs to improve.


So what happens when the computer detects suicidal ideation or plan? Does it send the robot to the house? Does this mean that prozac et. al. are out of business?




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3.23.2007

Smart As Einstein


Faster emergency room care for you and your family.

Imagine visiting an Emergency Room where they already know you! Your name, primary care physician, even insurance information is there ahead of time. That’s the idea behind ER pre-registration at Einstein at Elkins Park.



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Now imagine the Doctor not having to ask the names of the medications that you're on at 2:30 am...

Tipped through Medgadget.





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Coke & A Smile....Not!

From AHN:

New findings suggest that drinking any type of soft drink - even diet sodas - poses a risk to the health of your teeth, and dentists have recommended that people should restrict their soft drink intake to mealtimes.

According to new research by the Academy of General Dentistry, soft drinks and other sugary drinks are bad for the teeth because they harm the enamel, causing dental erosion that leads to loss of tooth structure.The researchers added that the phosphoric acid and/or citric acid content in diet drinks can also cause dental erosion, albeit significantly less damage than their sugary counterparts. They found that citric acid, which is the main ingredient in non-cola drinks, can be especially erosive.


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Apparently, the pH of some sodas is around 2.5 which you'll recall is quite acidic. No wonder it will take the paint off of your car, or the enamel from your teeth.





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Can't Afford To Be Sick

From USA Today:

When Janet Fredrick got breast cancer in 1998, she never thought she would face bankruptcy because of medical bills: She had insurance.

But her illness dragged out, then her income plunged when she went on disability. By 2005, her co-payments for treatment, including surgery, medications, doctor visits and hospital care, totaled about $8,000.

Such co-payments and deductibles, along with difficult-to-understand policies and complex hospital billing issues, are among the main reasons even people such as Fredrick who have health insurance can face devastating financial costs, says a report out today from The Access Project, an advocacy group that researches medical debt.


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This argues for significant health care reform.




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It's Not Just Smokin' & Drinkin'

From The Washington Post:

New "landmark" research finds that alcohol and tobacco are more dangerous than some illegal drugs like marijuana or Ecstasy and should be classified as such in legal systems, according to a new British study.

In research published Friday in The Lancet magazine, Professor David Nutt of Britain's Bristol University and colleagues proposed a new framework for the classification of harmful substances, based on the actual risks posed to society. Their ranking listed alcohol and tobacco among the top 10 most dangerous substances.


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Smarter Clothing

From Defense Tech:

A New Zealand-based performance athletic company has developed a fabric they say can actually analyze trauma to the body and beam telemetry data to a control center so medics will know where and how severely a trooper has been hit.

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At first glance, it seems like a great idea. However, they should probably direct their efforts towards better bulletproof vests and such as prevention is better than treatment. Also, no word on how well the embedded electronics hold up to gun fire.

3.21.2007

No Rush To Cut the Cord

From Canada.com:

New Canadian research shows delaying the oldest intervention in medicine - cutting the umbilical cord - is better for babies and that the benefits extend into the first year of life.

The tendency now in North America is to clamp and cut the cord within the first five to 10 seconds of birth.

But the new study says putting off clamping for a minimum of two minutes in full-term newborns reduces by nearly half the risk of anemia and boosts iron stores in infants for as long as six months.


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Superbugs Shutdown Hospital

From CTV.ca:

The superbug outbreak that has shut down an Alberta hospital is just one example of a phenomenon that is happening more and more frequently in Canada, says an Ontario-based infectious disease specialist.

Vegreville's St. Joseph's General Hospital, in east-central Alberta, has halted all admissions, cancelled out-patient day surgery and closed the sterilization room amid the outbreak of methicillin-resistant Staphylococcus aureus and the discovery of improper equipment sterilization procedures.

Dr. Donald Low, chief microbiologist at Toronto's Mount Sinai Hospital, says there wouldn't be a single hospital open in Canada if they all shut down over superbug outbreaks.


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If we shut down every American hospital with some MRSA, well, they'd probably all be closed...




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3.20.2007

Too Many Antibiotics For Sinusitis

From Reuters:

Evidence from national databases suggests that both acute and chronic sinus inflammation (sinusitis) is being overtreated with poorly chosen medications, researchers report.

Data from 1999 and 2002 collected by the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey suggests that there were roughly 14 million visits annually because of chronic sinusitis and 3 million because of acute sinusitis.

According to the Sinus and Allergy Health Partnership, acute sinusitis lasts for up to 4 weeks, while chronic cases last at least 12 weeks.

Hadley J. Sharp and associates at the University of Nebraska Medical Center in Omaha report that 83 percent of visits for acute sinusitis resulted in a prescription for an antibiotic, as did 70 percent of visits for chronic sinusitis.

"Prescription antibiotic drugs are being used far more than bacterial causes studies would indicate," the authors warn.


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It's really hard to do nothing sometimes in medicine.




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Beware of Reps Bearing Gifts

From MedPage Today:

Minnesota and Vermont require pharmaceutical companies to disclose payments of $100 or more to physicians and other health care providers, but both states have been accused of failing to deliver on that promise of transparency.

The two states are not living up to their pledges to make it clear to patients whether pharmaceutical company largess and gifts of various kinds might be influencing physicians unduly in the choice of drugs they prescribe, said geriatrician Joseph S. Ross, M.D., M.H.S., of Mount Sinai Medical School, in the March 21 issue of the Journal of the American Medical Association.

"The Vermont and Minnesota laws requiring disclosure of payments do not provide easy access to payment information for the public and are of limited quality once accessed," wrote Dr. Ross. "However, substantial numbers of payments of $100 or more were made to physicians by pharmaceutical companies."



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Of course, this just means that the drug companies will put more money into direct to patient advertising. Whether it's the nightly news where almost all the commercials are drug related, or pick up any popular magazine, and we can start to see the influence that these pharmaceutical companies have on our society.




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3.16.2007

Site Facelift

No, your eyes don't deceive you. You're on the same Doc To Doc you know and love. I just got around to a little facelift to clean up the interface and clear away the cobwebs a little bit. Feel free to comment below on anything not working though everything seems to have made the jump without an issue thus far.

Serious Screen


While the wow factor is pretty cool with this thing, once you get over that the question becomes, okay so what's this good for if it's not portable? Sharp believes that it'd be a killer presentation tool for business meetings. Instead of brainstoming and having people write their ideas on paper the team could write on the display and make it more collaborative and visual. Doctors could present images of X-rays and CAT scans to collaborate and circle stuff they see in the images.

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Ok, it's official, I really want one of these.





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On Fair Transplant Rules

From The Chicago Tribune:

For years, the system for parceling out kidneys to those who need transplants hasn't changed all that much. If you need a kidney transplant, you basically get in line and wait your turn. It may take two years or 10, depending on what part of the country you live in, among other things. A 70-year-old may get an organ before a 15-year-old. When your name reaches the top of the list, and a suitable organ becomes available, you receive the transplant, unless you're too sick to survive the surgery. This has been considered the fairest way to distribute a precious commodity in short supply.

But that system is inefficient. It wastes some kidneys. It favors some merely because of where they live. People with short expected life spans receive kidneys that could last much longer, and vice versa. It needs to change.

Fortunately, there's a dramatic new formula under discussion by the nation's organ transplant network that seeks to change how kidneys are doled out. Under this concept, doctors would assess the benefit of a kidney transplant largely by estimating the number of extra years of life a transplant could confer.


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Get Right To the Compressions

GEORGE BUSH the elder received one from a golfing buddy. Pierce Brosnan as James Bond laid one on Halle Berry in Die Another Day.

Now the famous kiss of life - a mainstay of resuscitation for 50 years - should be allowed to slip back into history, a large Japanese study suggests. It shows people who collapsed suddenly with cardiac arrest had a 50 per cent higher chance of surviving if someone gave them heart massage alone rather than alternating it with breathing into their lungs.

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Playstations To Aid Medical Research

From Tech News World:

The evolution of video gaming took another quantum leap forward this week with the announcement that researchers are now enlisting Sony's (NYSE: SNE) Latest News about Sony PlayStation 3 Latest News about PlayStation 3 (PS3) in the fight against diseases such as Alzheimer's, Parkinson's, Huntington's and several forms of cancer.

The Tokyo-based Sony said owners of Internet-connected PS3s will now be able to participate in a range of scientific experiments led by Stanford University's Folding@home program.

The Stanford program is focusing on how two-dimensional protein strands in the human body fold into the three-dimensional molecules, according to Vijay Pande, associate professor of chemistry at Stanford University and lead researcher on the project.


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3.15.2007

Trust Your Decisions To A Computer, Study Finds

A study by the National Institutes of Health (NIH) shows computers might do a better job than family members when it comes to guessing the wishes of critically ill hospital patients.

Researcher David Wendler, a bioethicist for NIH in Baltimore, made a surprising discovery when he compared the accuracy of loved ones versus computers in determining whether a medical patient would want to receive life-saving treatment in a dire emergency.

The issue strikes home to people whose family members have been incapacitated before signing an "advance directive" order, which specifies what treatments patients wish to receive if they lose the ability to make decisions. In situations where terminally ill or comatose patients do not have advance directives in place before, life and death decisions fall to their closest relatives and caregivers. These life or death decisions can be extremely difficult, especially when surrogates must guess at what the patient would have wanted.

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And how exactly does the doctor ask the computer if a feeding tube is appropriate? I'm not sure that can be easily programmed in.





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3.09.2007

Cell Phones Safe At Hospitals

From The Mayo Clinic:

Calls made on cellular phones have no negative impact on hospital medical devices, dispelling the long-held notion that they are unsafe to use in health care facilities, according to Mayo Clinic researchers.

In a study published in the March issue of Mayo Clinic Proceedings, researchers say normal use of cell phones results in no noticeable interference with patient care equipment. Three hundred tests were performed over a five-month period in 2006, without a single problem incurred.

Involved in the study were two cellular phones which used different technologies from different carriers and 192 medical devices. Tests were performed at Mayo Clinic campus in Rochester.


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Seriously folks, this has really gone on long enough. This is just one of those things that no matter how much data accumulates, fear of some wacko lawyer, and some random baseless lawsuit resulting in some payout will keep cell phones out of hospitals for years to come. Are the hospitals really that desperate to charge for that daily phone use as most institutions do?

Details Emerge In Massachusetts Health Plans

From USA Today:

Health insurance policies with monthly costs of $122 to more than $800 were approved Thursday by the board overseeing Massachusetts' new law requiring everyone in the state to carry insurance.

The lowest premiums will be paid by young adults, ages 19 to 26; the highest, by those over 55. The least costly premium for those in the middle is about $175 a month. The state aims to cover all uninsured, with subsidies for those below 300% of the federal poverty level, which is about $30,000 for an individual.

As the first state in the nation to require individuals to buy insurance, Massachusetts' plan is being closely watched.

"Everyone is watching, because the perception is that if Massachusetts fails to implement this, then it gives other people less confidence that it can be done," says economist Len Nichols at the New America Foundation, a Washington think tank.

The premiums are higher than some advocates say is affordable, especially when deductibles and co-payments are included.


When did eight hundred bucks a month become affordable, especially for lower income families? I think they're missing the point of catastrophic coverage at a cheap price...




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Score One For Atkins!

From ABC News:

A study in the Journal of the American Medical Association adds more information to the long-running debate about what kind of diet is best for weight loss.

Several recent studies suggest that overweight people might have more success with weight loss when they follow a diet lower in carbohydrates (and higher in fat and protein) than by following the standard guidelines for a lower fat, higher carbohydrate diet.

These findings have surprised and concerned many nutritional experts. Critics have correctly pointed out that these studies didn't involve enough people and were too short in duration to draw strong conclusions or to change standard recommendations.

This new study followed patients for one year — longer than many of the previous studies.


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This may all be true, but I still would miss my pasta too much...





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Don't Get Sick This Weekend

From Medical News Today:

Canadian scientists have found that ischemic stroke sufferers are more likely to die within seven days of admission if they are admitted to hospital at the weekend than during the week.

However, they do not want this news to cause delayed admissions. Their message to patients, carers and health professionals is to get the stroke patient into an appropriate hospital as soon as possible since the race against time is the greatest priority.


Maybe that data only applies to Canada?




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Unlocking Those Locked In

From Psychology Today:

It is the stuff of nightmares: trapped in an immobilized body, unable to move a finger or bat an eyelid, yet with sight and hearing and thought undiminished. The impulse to whisper, "I love you," or to scream, "I am in pain," is smothered by one's own unresponsive muscles. To the outside world, you are all but dead. Inside, you burn with life.

Neurologists call patients who are totally paralyzed "locked-in," and diagnoses of Lou Gehrig's disease or a brain-stem stroke are among the most feared of all neurological disorders. Doctors often counsel patients and their loved ones to opt against life support before becoming fully locked-in, because such a life is thought to be unbearable.

But a German neuroscientist has found a way to give voice to 11 patients around the world with a device that converts mental activity into computer commands. His experience has led him to challenge the prevailing medical assumption that locked-in lives are not worth living.


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3.06.2007

Choose Carefully...

From SF Gate:

An online report card is scheduled to be unveiled today in an ambitious attempt to compare more than 200 California hospitals on more than 50 quality measures ranging from maternity care to cardiac treatment and patient satisfaction.

While a dizzying array of hospital report cards already exists, the developers of the Web site CalHospitalCompare.org (www.calhospitalcompare.org) say it's the most comprehensive site for people to use when making decisions about where to receive health services.

"There is no other Web site ... that combines data from this many sources," said Dr. R. Adams Dudley, project director for the Institute for Health Policy Studies at UCSF, which collected and analyzed the data for the site.

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While it's always good to get more information into the hands of those can use it, I worry if folks can interpret it in a proper context. Will this encourage hospitals and Doctors to turn away their more difficult cases to protect their stats. Don't kid yourself, that could very well happen...




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3.02.2007

Mobile Clinical Assistant


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It doesn't look like it will fit in my white coat pocket!




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Health Care Concerns Rank At The Top

From Reuters:

Access to affordable health care is the top domestic concern among Americans and a majority say the U.S. government should guarantee health insurance to every American, according to a New York Times/CBS News poll released on Thursday.

While the war in Iraq remains the top overall issue among Americans, health care is the No. 1 concern on the domestic agenda, ranked as far more important than immigration, cutting taxes or promoting traditional values, the poll said.

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FDA Not Impressed

From The NY Times:

Medicine’s march toward remote monitoring of patients hit at least a temporary roadblock yesterday.

An implanted wireless device intended to continuously monitor patients with weak hearts — and then provide the data to doctors via the Internet — did not keep enough of them out of the hospital to prove its effectiveness, according to a panel of experts assembled by the Food and Drug Administration.

The device’s manufacturer, Medtronic, has been developing wireless data-gathering technology for implanted therapeutic devices like defibrillators and insulin pumps. It aimed to make the product reviewed yesterday, a device the size of a pocket watch and known as the Chronicle implantable hemodynamic monitor, the first major implant approved solely for diagnostic monitoring.

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Seemed like it should help...




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Peanut Butter Deaths Widen

From Consumer Affairs:

The death of a West Virginia woman may be linked to Salmonella-infested Peter Pan peanut butter, bringing to three the unofficial death toll from one of the nation's largest outbreaks of food poisoning.

Mary Halstead, 85, of Weston, WV, died Jan. 10 after becoming ill on December 23, 2006, according to her son, Larry Halstead.

Salmonella is especially toxic to children, the elderly, pregnant women and individuals with chronic illnesses and compromised immune systems.

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Risky Wrestling

From the New Scientist:

As if it is not rough enough already, wrestling may provide another, more insidious hazard for participants. It appears that sweat can carry the hepatitis B virus, raising concerns that wrestlers with the virus might spread it to others through cuts and wounds.

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