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Showing posts from July, 2012

Amanda Trujillo - Nurse Interupted

I am just now hearing about the case of Arizona Nurse Amanda Trujillo and readers of EverythingHealth may also have missed this conflict between a Hospital, the Arizona Board of Nursing and a nurse advocating for her patient.  Nurses across the Country are blogging about it but I've seen very little from Physicians.  I think it is an important story and here is what happened:

Ms. Trujillo, a registered nurse of six years specializing in cardiology, geriatrics and end of life/palliative care,  was caring for a patient who was being evaluated for a liver transplant in the hospital.   According to Nurse Trujillo, the patient did not understand the complexity of what she would undergo,  nor did she know there were other options.  In the course of her assessment she reviewed the procedure and educated the patient with approved patient education materials.  After a full review of the materials the patient stated, “Had I known everything I would have to go through and the commitment I …

States Medicaid Expansion Saves Lives

Some experts have said that individual States and the decisions they make around health care reform will have more impact on people than the Federal Government and the Accountable Care Act (Obamacare).  Since States will be able to "opt out" of of the reform law's Medicaid expansion, where a person resides may have a huge impact on their health.

A new study published in the New England Journal of Medicine by researchers at the Harvard School of Public Health compared death rates in three states that expanded Medicaid in the past decade - Arizona, Maine and New York, with four neighboring states that did not - New Hampshire, New Mexico, Nevada and Pennsylvania.   They looked at data from adults age 20-64 for five years before and five years after the expansions.  They found that expanding Medicaid eligibility lowered mortality rates by 6.1% compared to States that did not expand.  They also found that death rates declined the most in minorities and residents in lower-inc…

Answer to Image Challenge

The answer to yesterday's image challenge is.....drumroll.....

#1  Congenital nevus.

The skin in this region of the boy's scalp was lightly pigmented, with dark hairs; the lesion had been more pigmented at birth.  A congenital nevomelanocytic nevus was diagnosed.  Such nevi are often present at birth but can develop later in life.  Biopsy or excision is often done since they can transform into melanoma.

These are often called "birthmarks" and can be found on all parts of the body.  Because this was on the scalp it affected the hair growth within the nevus.  Many of these birth nevi regress and shrink with age.

Thanks for playing.  I hope you learned something.

Let's Start With a Challenge

Re-entry after vacation can be hard so I'll start blogging by asking you to do the work with this New England Journal of Medicine challenge.  This patient was brought in by his parents for the odd discoloration on the top of his head.  What is the diagnosis?

1.  Congentital nevus
2.  Psoriasis
3.  Tuberous sclerosis
4.  Vitiligo
5.  Warrdenburg syndrome type II

Post your answer in the comments and I will post the answer tomorrow!

Blogging Break

EverythingHealth will be taking our own advice and relaxing and experiencing new ventures for 2 weeks.  Please scan the archives or the links on the right for great blog reading.  Enjoy the summer and check back in mid-July.