Why Do We Do What We Do: Common Hospital Practices Revealed

Posted on 27. Feb, 2015 by in Class Act, Clinical Questions

By Dana Zalkin

Peer Reviewed

A code is called on the overhead speaker and the on-call teams rush to the scene to see what awaits them. EKG leads are being placed, medications are being ordered, and labs are being drawn. A medical student stands with a bag of ice, ready to grab the arterial blood gas (ABG) and run it down to the lab. “Why do we put the ABG on ice right away?” the student wonders. But in this moment, while a patient teeters…

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Is “atypical coverage” really important in community acquired pneumonia?

Posted on 27. Feb, 2015 by in Infectious disease, pulmonary

In this study the inclusion of atypical coverage was not associated with reduced mortality but did result in shortened time to clinical stability.

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Deciding On a Parent’s Death

Posted on 26. Feb, 2015 by in Death and Dying, Doctors, Featured, Hospitals

The call from my patient’s daughter wasn’t the first time a patient or family member had revealed to me a plan for an exit strategy.

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Promoting Amphetamines for Over-Eating – What Could Possibly Go Wrong?

Posted on 26. Feb, 2015 by in clinical trials, conflicts of interest, deception, Evidence-based medicine, FDA, marketing, Shire, stealth marketing

Every day seems to bring the latest breathlessly touted innovation in modern health care.  The endless hawking of new health care wonders is beginning to inspire some skepticism, but maybe not enough.The Promotion of Vyvanse for Binge Eating Disor…

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Occult bacteremia

Posted on 26. Feb, 2015 by in Infectious disease

These are the people who get sent home from the ER then have to be called back because their blood cultures turn positive. In this study from a single institution it appeared to be a benign entity:

Methods

This is a retrospective cohort study (Septe…

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Primecuts – This Week In The Journals

Posted on 25. Feb, 2015 by in PrimeCuts

By Steven R. Liu, MD

Peer Reviewed

“And the award goes to…” – for those of you who watched the Academy Awards this week, you will have been an admirer of Neil Patrick Harris’ opening, his presence in the audience, and his underwear spoof of “Birdman”. The event made for glamorous viewing, and also included heartfelt speeches from winners about the lingering state of race relations, suicide, and equality for women among some of the topics.

In the journals this week…

Nitric oxide, antihypertensive treatment

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Alveolar proteinosis

Posted on 25. Feb, 2015 by in pulmonary

Case description and brief review.

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Introducing Dr. Staci Mandrola — @DrStaciM

Posted on 24. Feb, 2015 by in Hospice, Reflection, Social Media/Writing/Blogging

It took me four years to convince my wife, Dr. Staci Mandrola, to join Twitter. Like many (previously) analog docs, Staci was resistant. “I don’t need another distraction,” went one of the arguments. Yet I knew if she tried Twitter, she would love the medium. If you care about a topic, if you are curious, […]

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A gracious witness dies

Posted on 24. Feb, 2015 by in Uncategorized

Every CEO knows that he or she is totally dependent on one’s administrative assistant to get you through the day, the week, the year . . . and maybe your life.  Well, in my case, I also had an AA–Gail Serra–who had a remarkable ability to give m…

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I Just Want to Dance!

Posted on 24. Feb, 2015 by in Uncategorized

I recently had an idea that I wanted to sign my Doll up for some dance classes.  She is old enough for them, and with a quick google search I found >10 studios in the area! (And many more with a little driving.)  I called all of them. &nbs…

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The preemie grows up

Posted on 24. Feb, 2015 by in Uncategorized

One of my favorite blogs, going way back to 2007, was “The Preemie Experiment,” written by Stacy Carney Harbst.  How could you not be engaged by this story?The day my water breaks, with my first pregnancy, I was 23.0 weeks pregnant. The experimen…

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When is permanent pacing indicated for AV block?

Posted on 24. Feb, 2015 by in cardiovascular

I’m working through MKSAP 16′s section on cardiovascular disease. As much as I hate to be immodest, it’s a content area I think I know just a little something about, particularly in the area of electrophysiology. I was drawn to their statement on per…

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LaBiotechMap: Smart European Biotech Database

Posted on 24. Feb, 2015 by in biotechnology, medicine, startup

I came across an interesting website, LaBiotechMap.com, that creates a database of biotech startups. It’s really getting complicated to get a clear picture of where biotech is heading,…

Visit my blog to read the whole article and other news ab…

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$500K in medical waste–per week!

Posted on 23. Feb, 2015 by in Uncategorized

Here’s what half a million dollars in medical waste looks like.Shown below are the full page advertisements bought by hospitals in this week’s New York Times Magazine. According to the current rate sheet, the cost per ad is roughly $100,000.That’s abou…

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Time to nominate Sepsis Heroes

Posted on 23. Feb, 2015 by in Uncategorized

Its that time again, when the Sepsis Alliance is seeking nominees for its annual Sepsis Heroes awards:Do you know of a person who deserves to be recognized for his or her work in raising sepsis awareness? Do you know of an organization that has gone …

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Timing Discharges to Maximize Revenue – "Corruption" of Corporate Long-Term Hospitals?

Posted on 23. Feb, 2015 by in corporate physician, health care corruption, Kindred Health, mission-hostile management, Select Medical

A recent Wall Street Journal article that focused on a quirk in US Medicare payment rules that may be gamed by long-term hospitals also revealed the plight of physicians employed by such hospitals, and worse, the danger posed by such gaming to patients…

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Opiate withdrawal: usually benign but not always

Posted on 23. Feb, 2015 by in Pharmacology, toxicology

The main problem is when opiate withdrawal is precipitated (such as with naloxone) in a narcotic tolerant patient. Here is a case report and review.

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A new way to think about curing atrial fibrillation

Posted on 22. Feb, 2015 by in AF ablation, Athletic heart, Atrial fibrillation, Healthy Living, inflammation

The problem with AF treatment is that we do not (really) understand the underlying causes of the disease. Why does the heart fibrillate? What gets those pesky premature beats started? Why do intermittent episodes persist? Why does AF come back after shocks or ablation? AF has been thought of as its own disease. You have […]

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The Medical Futurist: Weekly Introduction

Posted on 22. Feb, 2015 by in medicine

Working as a speaker and consultant with medical technology, pharmaceutical and web companies; as well as universities and governments worldwide, my mission as The Medical Futurist is to make sure…

Visit my blog to read the whole article and other…

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Wachter offers The Digital Doctor

Posted on 22. Feb, 2015 by in Uncategorized

Only a person with the experience, depth, and judgment of Robert Wachter could take on the task of summarizing the impact of the digital age on the practice of medicine.  But very few people who might have such experience, depth, and judgment woul…

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PVCs can help in the diagnosis of myocardial ischemic syndromes

Posted on 22. Feb, 2015 by in cardiovascular

Here is a case presented at Dr. Smith’s ECG blog and a link to several more. As Barney Marriott was fond of saying, PVCs pay diagnostic dividends. Know them!

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Indian patients , doctors and Dr Google

Posted on 21. Feb, 2015 by in Uncategorized

Dr Aniruddha Malpani of Health Education Library for People (HELP) said, “While the digital medium makes accessing health information easy for patients, credibility remains an issue in India. Publishers need to take responsibility and make sure that on…

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IVF success story for patient from Kenya

Posted on 21. Feb, 2015 by in Uncategorized

Even before we got married, my then fiancé and I knew of the problems we would encounter with her conceiving. I had a major surgical procedure (TURP, transurethral resection of the prostate,for treatment of an enlarged prostate) that prevented her fro…

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Dear Mayo, Now let’s look at your MS Google ad

Posted on 21. Feb, 2015 by in Uncategorized

A few days ago, I asked if the Mayo clinic was exercising any kind of quality control over Google health care search results, which are reportedly now part of a joint venture between the two companies.  As noted on the official Google Blog:All of …

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Boston Dynamics Showcases Their Robotic “Animal Park”

Posted on 21. Feb, 2015 by in future, Robotics, technology, Video

If you ever wonder where the developments of robotics are heading, check what Boston Dynamics has been working on:

Visit my blog to read the whole article and other news about the future of medicine!

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Admission HgbA1C to help determine discharge diabetes regimen

Posted on 21. Feb, 2015 by in endocrinology, hospital medicine

From a study in Diabetes Care:

RESEARCH DESIGN AND METHODS This was a prospective, multicenter open-label study aimed to determine the safety and efficacy of a hospital discharge algorithm based on admission HbA1c. Patients with HbA1c less than 7% (53…

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Myths about Male Infertility

Posted on 20. Feb, 2015 by in Uncategorized

With infertility on the rise, it is but natural that there will be a lot of information and misinformation floating around. It’s also very natural for couples to assume that it’s the woman who has a problem. Whenever a couple can’t have a baby, its…

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When should parents be vaccinated against measles?

Posted on 20. Feb, 2015 by in conditions, Infectious disease, Pediatrics

“Nervous.” I’ve heard that word a lot lately. It keeps falling from the mouths of my families in clinic, landing on the floor with a silent thud. I mean, we have a right to be. We should be. It is one of the most infectious diseases on the planet, today about 400 people worldwide will have died of it, […]

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Do you want a doctor or a demotivated test-taking machine?

Posted on 20. Feb, 2015 by in Education, Surgery

Last week, my best friend took the recertification exam in anesthesia, the so-called MOCA exam.  Like a good doobie, she paid her $2,100, paid her nanny extra so she could study, took a day off in which she missed the funeral of a friend’s husband, and took the test.  Wow, she must be the most […]

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I am proud of our society. We provide care to everyone.

Posted on 20. Feb, 2015 by in Diabetes, emergency, Hospital, Physician

She is always a difficult admission. The long chart review. The vague complaints. The entitled attitude. The misdirection. These are expected. As is the cake at her bedside after a diabetic crisis. The two-liter soda after an emergent fluid dialysis. The urine toxicology was positive for cocaine. The staff knows her well. I know her […]

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