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Study Shows That Knowledge Of Imminent Death Is Beneficial For Cancer Patients

Providing information of imminent death to cancer patients does not increase pain or anxiety, but is associated with improved care and to increase the likelihood of fulfilling the principles of a good death, a Swedish study found.

Informed patients significantly more often had parenteral drugs prescribed as needed, died in his or her preferred place, and had an informed family who were offered bereavement support. There was no difference between informed and uninformed patients in control of pain, anxiety, nausea, and respiratory tract secretions, although there was a difference in management of confusion. Results appeared in the Journal of Clinical Oncology.

Since 2000, there has been an increasing focus on palliative care in Sweden, the study authors wrote. In 2001, the Swedish Government identified breakpoints for Read more »

*This blog post was originally published at ACP Hospitalist*

First Successful Implantation Of A Synthetic Trachea

Clinicians at Karolinska University Hospital in Sweden are reporting that they successfully performed the world’s first implantation of a synthetic trachea.  The organ was created from a biocompatible scaffold that was seeded with the 36 year old patient’s own stem cells inside a Harvard Bioscience bioreactor.

The patient had been suffering from late stage tracheal cancer. Despite maximum treatment with radiation therapy, the tumor had reached approximately 6 cm in length and was extending to the main bronchus. It was progressing and almost completely blocked the trachea. Since no suitable donor windpipe was available, Read more »

*This blog post was originally published at Medgadget*

Is Looking At “Long Term” Impossible In Our Healthcare System?

I spent last week in Gothenburg, Sweden covering the European Committee for the Treatment of Multiple Sclerosis (ECTRIMS) meeting. Lots of good science, lots of excitement over the new oral and targeted therapies coming on the market to treat this awful disease. But what I want to write about isn’t the science, but about how it will play out in the brave new world of healthcare in which we all live in today.

For instance, consider the first oral therapy to hit the market: Gilenya (fingolimod), which the FDA approved in September. Last month Novartis announced the price: $48,000 a year.

This is not a rant against the high cost of drugs, however. It is a rant against the inability of our healthcare system to take the long view of the impact of such drugs, a view that is particularly important with a chronic disease like MS that strikes healthy young adults in their early 20s and 30s. Read more »

*This blog post was originally published at A Medical Writer's Musings on Medicine, Health Care, and the Writing Life*

Magnet-Guided Medicine Hits The Spot

Researchers at Lund University in Sweden successfully used magnets to guide clot-dissolving drugs (fibrinolytics) directly to the site of a thrombus stuck within a coronary stent. They did this by attaching the drugs to magnetic nanoparticles and using external magnets to move them to the right spot.

From the press release:

Guiding drug-loaded magnetic particles using a magnet outside the body is not a new idea. However, previous attempts have failed for various reasons: It has only been possible to reach the body’s superficial tissue, and the particles have often obstructed the smallest blood vessels.

The Lund researchers’ attempt has succeeded partly because nanotechnology has made the particles tiny enough to pass through the smallest arteries and partly because the target has been a metallic stent. When the stent is placed in a magnetic field, the magnetic force becomes sufficiently strong to attract the magnetic nanoparticles. For the method to work the patient therefore has to have an implant containing a magnetic metal.

Press release: Medicine reaches the target with the help of magnets…

Abstract in Biomaterials: The use of magnetite nanoparticles for implant-assisted magnetic drug targeting in thrombolytic therapy.

*This blog post was originally published at Medgadget*

The Epidemic Of Sedentary Behavior

“I never worry about action, but only about inaction.”  — Winston Churchill

Winston Churchill was right: Experts are saying sedentary behavior is an epidemic, with the resulting health effects potentially devastating.

Lack of muscular activity is associated with higher incidence of obesity, cardiovascular disease, diabetes and cancer, as well as a heightened risk of death. And this is regardless of one’s level of structured physical exercise, according to the authors of an article published [recently] in the British Journal of Sports Medicine.

The team from Stockholm, Sweden, says that sedentary behavior has become synonymous with lack of exercise, but that this is inaccurate and misleading. Rather, sedentary behavior should be defined as whole body muscular inactivity. Read more »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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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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