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Internal Medicine Funnies

Here’s the first of many posts from Internal Medicine 2010 in lovely Toronto, Canada.

As you’d expect during a cardiology lecture, Steve Kopecky, FACP, reviewed lots of studies known by cool acronyms. He also explained why picking an inspiring name like “COURAGE” is important for your trial, based on his attempt to recruit a patient for the “BARI” trial:

“Oh no, doc, you ain’t gonna bury me,” the patient replied.

Because that joke was funny, I’ll forgive Dr. Kopecky the implied insult with which he began his lecture:

“The Wall Street Journal’s become one of the best medical journals you can read.” (Harumph.)

*This blog post was originally published at ACP Internist*

Steroid Use, BMI, And Risk Of Death

You might already be aware of this week’s finding if you’ve watched baseball in the past decade or so and noticed that Mark McGwire’s arms are about the circumference of the average ballplayer’s waist in the 70s. But just to be sure, researchers recently compared the BMIs of professional baseball players from 1876 to 2007 to find that, like serving sizes and master bathrooms, they’ve gotten bigger.

Clear, right? But in taking the next step, drawing conclusions from this study, this article from HealthDay gets about as confused as a science article can be. The study authors are concerned because they correlated the ballplayers’ “increased BMIs with an increased risk of death.” (We’re assuming that’s a risk of premature death, since it seems pretty certain that the 1876 team would be dead regardless of their % body fat.)

But a critic of the study argued first that ballplayers’ increasing size is not a health risk, and then that the players might be dying early because they’re using steroids. Um, we’re not scientists, but mightn’t there be a relationship (even a causal one, perhaps?) between steroid use and increased BMI?

*This blog post was originally published at ACP Internist*

AHRQ Says It Will Take 20 Years To Close Healthcare Quality Chasm

As one would expect from such a diverse group, comparisons were a common topic at the co-located National Medical Home Summit, National Retail Clinic Summit, and Population Health and Disease Management Colloquium this week.

During an opening session, Carolyn Clancy, head of the AHRQ, updated us on some of the comparison work her agency has been doing. Last year’s stimulus bill dedicated a lot of funds ($300 mill directly, more through the Secretary of HHS) to the agency’s work on comparative effectiveness. Read more »

*This blog post was originally published at ACP Internist*

Health Affairs’ Susan Dentzer On The Prospect Of Healthcare Reform

This week I’m attending the co-located National Medical Home Summit, National Retail Clinic Summit, and Population Health and Disease Management Colloquium here in Philly. (If only they had invited the transitions of care folks, they could have covered every hot-button issue in medical practice.)

The opening lecture, by Health Affairs editor Susan Dentzer, was meant to be an overview of health system change, but not surprisingly, the focus was on one obvious potential source of change–pending health care reform legislation. She saw the major accomplishment of last week’s summit as convincing the “three or four people who might have believed in a bipartisan solution” that it wasn’t going to happen. Read more »

*This blog post was originally published at ACP Internist*

A New Way To Wash Your Hands?

Forget the debate over soap and water vs. alcohol sanitizers. Soon you may be cleaning your hands with plasma. The New York Times is reporting on research into plasma as a method of hand cleaning. Basically, you’ll stick your hand in a little box for a few seconds and then the plasma will zap all the germs, including MRSA. The technology is not ready for action yet, but sounds pretty cool. Except for one thing–if you look at the photos that accompany the article, you’ll notice that a normal-looking human hand is inserted in the box, but the hand that comes out the other side (in the next photo) looks creepy and synthetic. What else is that plasma doing?

*This blog post was originally published at ACP Hospitalist*

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