The Argonaut Project Charter

Posted on 17. Dec, 2014 by in Uncategorized

Yesterday, a group of private sector stakeholders including athenahealth, Beth Israel Deaconess Medical Center, Cerner, Epic, Intermountain Health, Mayo Clinic, McKesson, MEDITECH, Partners Healthcare System, SMART at Boston Children’s Hospital Infor…

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Mystery Quiz-The Answer

Posted on 17. Dec, 2014 by in Mystery Quiz

Vivian Hayashi MD, Robert Smith MD

The answer to the mystery quiz is pleural effusions, specifically, bilateral subpulmonic effusions. The chest radiograph shows a number of findings: (1) the apparent diaphragm shadow is in fact fluid sandwiched between the undersurface of the lung and the actual diaphragm (Image 2a, arrow); (2) the density of this shadow is homogenously white (Image 2a, asterisk) and differs from a normal diaphragm which has a graded density (Image 2b, triangle) due to superimposed air that progressively decreases towards the…

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CLER as mud

Posted on 16. Dec, 2014 by in Uncategorized

Back in April, I raised the question of why the ACGME was not publishing the results of its surveys with regard to CLER, Clinical Learning Environmental Review.  The program description states:CLER emphasizes the responsibility of the sponsoring i…

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How bad is it? It’s so bad that . . .

Posted on 16. Dec, 2014 by in Uncategorized

It struck me that this old Dilbert cartoon characterizes many hospitals.  The situation described may present a problem as they try to run ACOs to manage patient care under a risk-sharing model of reimbursement, especially when they must do so acr…

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When Gas Prices Go Up, So Do Motorcycle Accidents, Study Finds

Posted on 15. Dec, 2014 by in Preventive Medicine, News,

Shift to lower-cost transportation carries a hefty price

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Feel Younger Than Your Age? It May Help You Live Longer

Posted on 15. Dec, 2014 by in Family Medicine, Geriatrics, Psychiatry, News,

Researchers found death rate among young at heart was lower during study period

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Doctors Aren’t Discussing Sex With Heart Attack Survivors

Posted on 15. Dec, 2014 by in Cardiology, Family Medicine, Reproductive Medicine, News,

Study of younger patients finds they often get misinformation

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Timing of First Period Tied to Women’s Later Heart Risk: Study

Posted on 15. Dec, 2014 by in Cardiology, Gynecology, Neurology, Pediatrics, News,

Getting it earlier or later raised chances of trouble, experts think childhood obesity might be at play

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Indoor Tanning Tied to Burns, Fainting, Eye Injuries: Study

Posted on 15. Dec, 2014 by in Dermatology, Infections, Ophthalmology, News,

Women, whites account for majority of emergency room patients

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FDA Approves Blood Test That Gauges Heart Attack Risk

Posted on 15. Dec, 2014 by in Cardiology, Neurology, News,

The screen is meant for people without history of heart disease, agency says

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Outreach Program May Help Poorer Smokers Quit

Posted on 15. Dec, 2014 by in Family Medicine, Dependence, Preventive Medicine, News,

Efforts included phone-based counseling and free nicotine-replacement therapy

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New Test Estimates Risk of Heart Disease

Posted on 15. Dec, 2014 by in Cardiology, Pharmacy, FDA Approvals,

Agency says best results obtained for black women

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Drug Interactions Common Among Hospitalized Kids, Study Says

Posted on 15. Dec, 2014 by in Nursing, Pediatrics, Pharmacy, News,

Medication combos may cause side effects or reduce treatment effectiveness, expert notes

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Alcohol Before Bedtime Won’t Help Your Sleep, Study Finds

Posted on 15. Dec, 2014 by in Neurology, Pediatrics, Preventive Medicine, News,

Researchers advise against using booze to help get shut-eye

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All That’s White Isn’t Necessarily Propofol

Posted on 15. Dec, 2014 by in Uncategorized

With thanks to Saskatchewan’s Health Quality Council Chairperson Susan Shaw for the reference, please check out this short article on a near miss in a large community hospital.I have only one quibble with the author’s choice of language.  She says…

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Primecuts – This Week In The Journals

Posted on 15. Dec, 2014 by in PrimeCuts

By Joseph Plaksin

Peer Reviewed

This week, the Senate Intelligence Committee declassified a 500-page report that outlined and described uses of torture by the CIA to interrogate suspected terrorists after the attacks of 9/11 [1]. While CIA Director John Brennan tried to defend his agency’s actions, Senator Dianne Feinstein, who chaired the committee that released the report, described the CIA’s interrogation program “a stain on our values and our history.”

Amidst these new revelations, protests in response to the grand jury decisions in the deaths…

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Getting the skinny on skin conditions

Posted on 15. Dec, 2014 by in Uncategorized

I usually get nervous when something seems too good to be true, but every now and then the spark of human goodness comes through. Unless I am missing something, here’s an example, sent to me on Twitter by Dr. Howard Green, @DermHag, a dermatologist in …

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The language of lying – TED-Ed video

Posted on 15. Dec, 2014 by in Psychology, Ted Talks

From TED-Ed: We hear anywhere from 10 to 200 lies a day. And although we’ve spent much of our history coming up with ways to detect these lies by tracking physiological changes in their tellers, these methods have proved unreliable. Is there a more d…

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EHRs and Ebola in the Texas Health Presbyterian Hospital ED: the ED physician finally speaks out

Posted on 15. Dec, 2014 by in AHRQ, Ebola virus, EPIC, healthcare IT risk, Joseph Howard Meier, Silverstein EHR principle, Texas Health Presbyterian Hospital

At my Oct. 2, 2014 post “Did Electronic Medical Record-mediated problems contribute to or cause the current Dallas Ebola scare?” ( I had written:While I have no evidence …

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Why are so many IVF patients are unhappy with their IVF clinic ?

Posted on 14. Dec, 2014 by in Dr.Malpani, failed IVF, IVF clinic, IVF patient, Malpani, Malpani Infertility Clinic

I just received this email from a patients.” I , AV , 39years along with my wife , BN, 41 years have been married for the past 2 years. Hence we right away though of IVF treatment considering our age. We have been doing IVF treatment in a clinic in Ban…

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Randi Redmond Oster questions protocol

Posted on 14. Dec, 2014 by in Uncategorized

Back in April, Randi Redmond Oster sent me a copy of her book Questioning Protocol with the following inscription:My mission is to help make this book obsolete in 10 years!  In the meantime, I hope it helps others navigate the system.Well, I’ve fi…

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Pedestrian injuries from cell phones

Posted on 14. Dec, 2014 by in Uncategorized

You will recall the excellent advice of my primary care doctor, Amy Ship, when it comes to using a cell phone while driving.  Don’t!Now comes this story from Governing, about the dangers to pedestrians who are walking and using their cell phones, …

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Yale Medicine: "Straddling medicine and journalism, a former resident keeps an eye on the science press"

Posted on 14. Dec, 2014 by in Embargo Watch, Ivan Oransky, Medpage TODAY, Retraction Watch, Yale, Yale Medicine

As a Yale medical school alumnus (post doctoral fellowship in Medical Informatics 1992-4, faculty in Medical Informatics 1994-6), I receive their literary magazine “Yale Medicine.”In the current issue I just received is a story about another Yale med…

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New way to lose weight – color everything blue to suppress appetite?

Posted on 14. Dec, 2014 by in food, Psychology

The color blue suppresses appetite more than any other color. Apart from blueberries and plums, which are mostly purple, there are few naturally blue foods. The hypothesis is that in the remote past, when humans foraged for food, blue was a warning of …

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What is subacute kidney injury?

Posted on 14. Dec, 2014 by in Nephrology

From a recent paper:

Background and objectives The epidemiology of AKI and CKD has been described. However, the epidemiology of progressively worsening kidney function (subacute kidney injury [s-AKI]) developing over a longer time frame than defined f…

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Prevention of recurrent kidney stones

Posted on 13. Dec, 2014 by in guidelines, Nephrology, Urology

New guidelines are out from the ACP available as free full text here.From the guideline document:

Recommendation 1: ACP recommends management with increased fluid intake spread throughout the day to achieve at least 2 L of urine per day to prevent rec…

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I’ll take generic cancer treatment, please

Posted on 13. Dec, 2014 by in Uncategorized

Speaking of insipid hospital advertising in Jacksonville Airport, what’s the story about this one from Mayo Clinic?  Who on earth doesn’t offer personalized cancer treatment?And, why does it say “most” insurance plans accepted?  Why wouldn’t …

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Managing IVF Failure – a guide for gynecologists from Dr Malpani

Posted on 12. Dec, 2014 by in failed IVF, ivf, repeated IVF failure

This is talk I gave to gynecologists at a Conference on IVF organised by Shivani Scientific recently in Mumbai.IVF failure can be heart-breaking – both for patients and doctor !Need help in recovering after a failed IVF cycle ? Please send me your medi…

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Again, the Hospital CEO as Scrooge – Erlanger CEO and Other Top Hired Managers Get Bonuses Months After They Froze Employees’ Paid Time Off

Posted on 12. Dec, 2014 by in boards of trustees, Erlanger Health System, executive compensation, generic managers, perverse incentives

Less than two weeks ago, we discussed a series of cases in which there was a marked contrast between how well top hired managers of non-profit hospitals were doing, and how their institutions were doing.  Now another vivid example of this problem …

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NowIknowmemorial. Do you really?

Posted on 12. Dec, 2014 by in Uncategorized

Passing through Jacksonville Airport, we saw the advertisement above for a local hospital.  I guess I should be used to ads that suggest that robotic surgery has “quicker recoveries,” but this ad made me wonder what other assertions this hospital …

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