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Latest Posts

Video Game Provides Framework For Solving Genomic Sequence Alignment Problems

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gene-puzzle-game

Over the past year our genetic understanding of diseases such as Alzheimer’s, diabetes and cancer has been accelerated by thousands of video gamers thanks to an online flash game called Phylo. Phylo is a video game created by Dr. Jérôme Waldispuhl of the McGill Centre for BioInformatics and collaborator Mathieu Blanchette. The game itself is a framework for solving the common problem of multiple sequence alignments in comparative genomics and leverages the visual problem solving skills of online gamers.

The Phylo website explains the background to game: Read more »

*This blog post was originally published at Medgadget*

CDC Works To Eradicate Polio Around The World By The End Of 2012

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Men painting billboard for polio vaccination campaign

Polio is a crippling and potentially fatal infectious disease that is completely preventable. Since 1988, members of the Global Polio Eradication Initiative (GPEI), including CDC, the World Health Organization (WHO), Bill and Melinda Gates Foundation, Rotary, and UNICEF, have teamed up to eradicate polio world-wide through large scale vaccination efforts. Global polio cases are down more than 99% since GPEI began. We were able to completely eradicate the disease in the Americas by 1994 and protect our children. By 2006, polio was endemic in only four countries: Read more »

*This blog post was originally published at Public Health Matters Blog*

It’s Not Too Late for You AND Your Patients to Get a Flu Vaccine

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Getting a flu vaccine is on many “to do” lists in the fall, but for those who still haven’t checked it off their list, it’s not too late to get vaccinated. Many people don’t realize that flu activity usually peaks in the United States in January or February, and flu viruses can circulate as late as May. As long as there’s flu around, it isn’t too late to get vaccinated.

Getting a yearly flu vaccine is the first and most important step in protecting against the flu, and CDC recommends influenza vaccination for everyone age 6 months and older. We urge you and all health care professionals to get vaccinated yourselves and offer flu vaccine at every opportunity to every patient—except infants younger than 6 months and the very few people for whom flu vaccination is contraindicated.

Studies show that your recommendation makes the difference in your patients’ decision to get a flu vaccine. You should continue to emphasize the importance of flu vaccination for your patients. And, if you don’t already do so, consider offering flu vaccines to patients in your own practice, even if yours is a sub-specialty practice and you don’t see yourself as a vaccine provider. Even if you don’t offer flu vaccines, you can still recommend and emphasize the importance of flu vaccination as a way to keep your patients—and their families—protected throughout the season.

As promising as it is sounds that flu vaccination rates are increasing among children and healthcare personnel, Read more »

*This blog post was originally published at Safe Healthcare*

Product Used For Poison Ivy Skin Reaction Undergoes Price Increases

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I recently received a note mailed to health care providers from Steve Sisler, Vice President of Sales Development for Zanfel Laboratories, Inc. Zanfel is a product used to decrease the skin reaction attributable to poison ivy and similar plants (e.g., poison oak and sumac). Here is an edited part of the note that I received:

While attending the recent American Academy of Family Physicians trade show, numerous health care professionals stopped by the Zanfel Laboratories booth to ask questions and gain additional knowledge regarding the Zanfel product and the overall disease state of urushiol-induced allergic contact dermatitis. Additionally, a great many prescribers voiced concern over the recent price increases of Zanfel Poison Ivy Wash. The conversations were very specific in that the retail price for Zanfel had increased to $42.99, $44.99 and even as high as $48.99 plus tax. These prescribers are aware of the retail price increases because their patients are calling them back after visiting CVS and Walgreens pharmacies. Their patients are aware that Zanfel had previously been sold for approximately $39.99 plus tax. These patients are upset because they believe that Zanfel Laboratories has initiated a retail price increase.

Zanfel Poison Ivy Wash has not had a cost increase in over Read more »

This post, Product Used For Poison Ivy Skin Reaction Undergoes Price Increases, was originally published on Healthine.com by Paul Auerbach, M.D..

Share Your Story: Has Social Media Improved Your Health Or Work In Medicine?

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There is a new social campaign being launched right now on Webicina.com that curates the medical resources of social media in 80 topics in 18 languages:

We receive hundreds of suggestions from empowered patients and medical professionals every week about which social media resources should be included in our selections, and we thought we must find a way to let them know how much we appreciate their help.

So now we kindly ask you to tell us your story about how social media helped you improve your health management or helped you get better in your specialty in order to win grand prizes.

As we curate resources in basically all the social media platforms, you can tell your story in any platforms from Twitter and Facebook to blogs and Youtube. Your submissions will be Read more »

*This blog post was originally published at ScienceRoll*

Latest Interviews

How To Make Inpatient Medical Practice Fun Again: Try Locum Tenens Work

It s no secret that most physicians are unhappy with the way things are going in healthcare. Surveys report high levels of job dissatisfaction burn out and even suicide. In fact some believe that up to a third of the US physician work force is planning to leave the profession…

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Caring For Winter Olympians In Sochi: An Interview With Team USA’s Chief Medical Officer Dr. Gloria Beim

I am a huge fan of the winter Olympics partly because I grew up in Canada where most kids can ski and skate before they can run and partly because I used to participate in Downhill ski racing. Now that I m a rehab physician with a reconstructed knee I…

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Latest Cartoon

Richmond, VA – In an effort to simplify inpatient medical billing, one area hospitalist group has determined that “altered mental status” (ICD-9 780.97) is the most efficient code for use in any patient work up.

“When you enter a hospital, you’re bound to have some kind of mental status change,” said Dr. Fishbinder, co-partner of Area Hospitalists, PLLC. “Whether it’s confusion about where your room is located in relationship to the visitor’s parking structure, frustration with being woken up every hour or two to check your vital signs, or just plain old fatigue from being sick, you are not thinking as clearly as before you were admitted. And that’s all the justification we need to order anything from drug and toxin screens, to blood cultures, brain MRIs, tagged red blood cell nuclear scans, or cardiac Holter monitoring. There really is no limit to what we can pursue with our tests.”

Common causes of mental status changes in the elderly include medicine-induced cognitive side effects, disorientation due to disruption in daily routines, age-related memory impairment, and urinary tract infections.

“The urinalysis is not a very exciting medical test,” stated Dr. Fishbinder. “It doesn’t matter that it’s cheap, fast, and most likely to provide an explanation for strange behavior in hospitalized patients. It’s really not as elegant as the testing involved in a chronic anemia or metabolic encephalopathy work up. I keep it in my back pocket in case all other tests are negative, including brain MRIs and PET scans.”

Nursing staff at Richmond Medical Hospital report that efforts to inform hospitalists about foul smelling urine have generally fallen on deaf ears. “I have tried to tell the hospitalists about cloudy or bloody urine that I see in patients who are undergoing extensive work ups for mental status changes,” reports nurse Sandy Anderson. “But they insist that ‘all urine smells bad’ and it’s really more of a red herring.”

Another nurse reports that delay in diagnosing urinary tract infections (while patients are scheduled for brain MRIs, nuclear scans, and biopsies) can lead to worsening symptoms which accelerate and expand testing. “Some of my patients are transferred to the ICU during the altered mental status work up,” states nurse Anita Misra. “The doctors seem to be very excited about the additional technology available to them in the intensive care setting. Between the central line placement, arterial blood gasses, and vast array of IV fluid and medication options, urosepsis is really an excellent entré into a whole new level of care.”

“As far as medicine-induced mental status changes are concerned,” added Dr. Fishbinder, “We’ve never seen a single case in the past 10 years. Today’s patients are incredibly resilient and can tolerate mixes of opioids, anti-depressants, anti-histamines, and benzodiazepines without any difficulty. We know this because most patients have been prescribed these cocktails and have been taking them for years.”

Patient family members have expressed gratitude for Dr. Fishbinder’s diagnostic process, and report that they are very pleased that he is doing everything in his power to “get to the bottom” of why their loved one isn’t as sharp as they used to be.

“I thought my mom was acting strange ever since she started taking stronger pain medicine for her arthritis,” says Nelly Hurtong, the daughter of one of Dr. Fishbinder’s inpatients. “But now I see that there are deeper reasons for her ‘altered mental status’ thanks to the brain MRI that showed some mild generalized atrophy.”

Hospital administrators praise Dr. Fishbinder as one of their top physicians. “He will do whatever it takes to figure out the true cause of patients’ cognitive impairments.” Says CEO, Daniel Griffiths. “And not only is that good medicine, it is great for our Press Ganey scores and our bottom line.”

As for the nursing staff, Griffiths offered a less glowing review. “It’s unfortunate that our nurses seem preoccupied with urine testing and medication reconciliation. I think it might be time for us to mandate further training to help them appreciate more of the medical nuances inherent in quality patient care.”

Dr. Fishbinder is in the process of creating a half-day seminar on ‘altered mental status in the inpatient setting,’ offering CME credits to physicians who enroll. Richmond Medical Hospital intends to sponsor Dr. Fishbinder’s course, and franchise it to other hospitals in the state, and ultimately nationally.

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Click here for a musical take on over-testing.

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Latest Book Reviews

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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Unaccountable: A Book About The Underbelly Of Hospital Care

I met Dr. Marty Makary over lunch at Founding Farmers restaurant in DC about three years ago. We had an animated conversation about hospital safety the potential contribution of checklists to reducing medical errors and his upcoming book about the need for more transparency in the healthcare system. Marty was…

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