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Showing posts from December, 2012

Remembering 2012 - Top Ten Health

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As 2012 draws to an end, EverythingHealthwill reflect on our top 10 health and medicine events to remember.  

1.  The world did not end on December 21 as predicted by the Mayan Calendar,  but a new Age of    Enlightenment may just be beginning!!!   "Be the change"

2.   The Supreme Court upheld the Affordable Care Act ( ObamaCare) and President Obama was re-elected to carry out the most significant health care legislation since the creation of Medicare.

3.   As of this writing the United States "fiscal cliff" has not been averted and an automatic 26.5% cut in Medicare pay for physicians is part of that cliff.  Not good for seniors!

4.   Deaths from fungal meningitis and joint infections continue to be announced as the result of contaminated injectible products from the New England Compounding Center.  More stringent regulations and authority to the FDA will likely result.

5.   Nine Medical Societies published a compendium of 45 clinical tests and procedures that ar…

Hillary Clinton and Subdural Hematoma

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Addendum to the post below:  New reports show she may have a venous blood clot in a vein that goes to the brain, rather than a bleed under the skull known as a subdural hematoma.  The treatment is quite different as venous thrombi (clots) are treated with blood thinners.  The information below is still quite accurate but may not apply to Madame Secretary Clinton..... Secretary of State,  Hillary Clinton has been hospitalized with a subdural hematoma after fainting, hitting her head and suffering a concussion less than a month ago.  Here is a repeat of a blog I did a few years ago about "a bump on the head".

Even a minor blow to the head can lead to serious trouble. A close relative of mine is an active, sharp guy in his 80's. He was hospitalized a few weeks ago with an infection and like many older folks, he wasn't aware of how weak he was and he tried to get out of the hospital bed and go to the bathroom and "whoops", he slipped and fell. Hospitals al…

Lactose Intolerance in the Genes

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National Public Radio (NPR) reported on a fascinating theory of Mark Thomas, an evolutionary geneticist at University College London.  He points out that we human beings all started out being unable to digest milk's dominant sugar, lactose, after childhood.  In fact, most adult mammals do not drink milk.  But 20,000 years ago,  people of Northern and Central European descent and certain African and Middle Eastern populations began developing lactose tolerance.  He theorizes that there was a strong natural selective pressure to allow those lactose tolerant genes to survive.  Drinking milk was an advantage to our species.

According to Thomas, milk was a "superfood" to early man.  It contains protein, calcium, fat and carbohydrates.  The ability to digest milk without developing diarrhea would give it's drinker an evolutionary edge.  The people who had the lactase mutation genes would survive the harsh winters, famines and even other illnesses that caused early death. …

Happy Healthy Holidays

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I Wish That I Could Wrap Up Christmas
I wish that I could wrap up all the love and Holiday cheer That comes along with Christmas and with New Year's every year, Pack it in a pretty box and put it on my shelf And pull it down again each year and give it to myself. I wish that I could tie up all my favorite carols with twine, Wind around some ribbon, too, and for twelve months call them mine Until the next Yuletide came when the sounds again could be unfurled And untie every single one then give them to the world.

Medical Fraud - Lock 'em Up

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When most Doctors and care-givers are trying to deliver "value" and keep costs down, it really chaps my hide to read about Medicare Fraud.  Here is the latest:

Dr. Michael Reinstein, psychiatrist in Chicago,  submitted at least 50,000 claims to Medicare and Medicaid, falsely stating that he provided "pharmacologic management" for patients at more than 30 area nursing homes and long-term facilities.  If that weren't enough, he also accepted kickbacks from Novartis, IVAX and Teva Pharmaceutical companies to medicate elderly patients with serious anti-psychotic medication.

The kickbacks go back as far as the 1990's and Dr. Reinstein had more than 1000 patients at a time on a rarely used medication called Clozaril.  Clozaril is typically used only as a last resort in treatment-resistant psychotic patients and is of particular risk to the elderly.  It is extremely rare to have a nursing home patient on Clozaril.   Reinstein was the largest prescriber of Clozari…

Health and Weapons

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There have been eight mass shootings in the United States this year and at least 61 since 1982.  The Connecticut community of Newtown is grieving for it's 20 slain children and 6 adults.  The towns of Columbine, Tucson, Aurora, Oak Creek, Minneapolis and Clackamas, to name a few, are still  grieving for their lost children and adults to gun violence.  Now is the time to stop this craziness.

As president Obama said, "Surely we can do better than this."  This cannot be a political, Blue vs. Red, North vs. South, Right vs. Left issue.  It is every one's issue now.  As a nation we are not doing enough to keep our children safe.

The rifle used by Adam Lanza, the mass murderer in Connecticut and by James Holmes, who killed 12 people in a movie theater in Colorado in July and by Jacob Roberts who killed two people in a shopping mall last week,  was an AR-15 semi-automatic weapon. This means it can rapidly fire multiple high-velocity rounds.  These rifles, along with glock…

RxTimer Cap

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EverythingHealth get's PR pitches on a daily basis...companies and PR agencies wanting me to cover their latest product, book, speaker or start-up.  You can't buy your way into my endorsement but I have found something that I tried and I want to share it with you.  It is a new smart cap that fits on a regular prescription pill bottle and it is called RxTimer Cap:

I know how hard it is for patients to keep track of their medications and it is the number one cause of preventable medical harm.  Medications are prescribed "once a day", "twice daily", "every 8 hours", "AM and PM with meals or any number of confusing regimens.  Many patients are taking 10 or more prescription medications A DAY!  Of course it is confusing.  I take just one prescription pill a day and even I forget if I already took it or not.  That's where Timer Caps come in.

They come in various sizes and just become the new cap on any pharmacy pill bottle.  Each cap has a buil…

Keratoderma

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The answer to yesterdays image challenge is #2 - Keratoderma.  This scaly condition affects hands and feet and can be congenital (passed on by genes)  or acquired.  There is a yellowish thickening and scaling of the skin and deep fissures can occur.   There are a number of different types of inherited conditions that have keratoderma and they are difficult to treat.  

Acquired keratodermas can be caused by eczema, lichen planus, psoriasis, Reiter's syndrome, drugs, internal malignancy and AIDS.   Besides treating the underlying disorder, the keratoderma is treated with topical solutions (salicylic acid 5%, lactic acid 10%, urea 10-40%) and topical retinoids.  Ulraviolet A (PUVA) may be needed in severe cases.

Be the Doctor and Make the Diagnosis

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The EverythingHealth ever popular image challenge from New England Journal of Medicine is good this week because the photo is so interesting (and challenging).  Be greatful your feet do not look like this.  Please make the diagnosis in the comment section and check back tomorrow for the answer.  Is the condition?

1.    Nephrogenic systemic sclerosis
2.    Keratoderma
3.    Poikiloderma
4.   Punctate psoriasis
5.   Verrucae

You be the diagnostician and have bragging rights at your next cocktail party.


Primary Care - Trying to Do Right

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Winter is officially here and  we are in the cold and flu season.  This is the time that patients get sick with viral illnesses and primary care doctors get even more frustrated as they try to do the right thing for patients.  What is the right thing?

 First of all we want to relieve suffering.  But we also want to do that without causing harm.  We  want to practice the best evidence-based medicine.  And evidence shows us that antibiotics and extra testing does not help the time course of a virus.  In fact, overuse of antibiotics drives drug resistance, increases the overall cost of health care and causes unintended side effects. 

I've seen comments on the internet that doctors are part of the "Business of Medicine" and they order tests and use "big pharma" drugs so they can "make money".  Well, folks, Primary Care Doctors make no money ordering tests or prescribing drugs.

 Zero!  In fact, it actually costs us money to do both.  Blood and imaging te…