August 9th, 2011 by RyanDuBosar in Research
Tags: Diet, Exercise, Genes, Heredity, Journal of the American Geriatrics Society, Lifestyle, Longevity, National Health and Nutrition Examination Survey, NHANES, Obesity, Research, smoking cessation
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People with exceptional longevity have the same bad lifestyle habits as the rest of us, suggesting that their genes may interact with environmental factors differently than others. There’s not much you can do if you’re not one of the lucky ones born with superior genes. For the rest of us, a healthy lifestyle is still the best option to live longer.
To assess lifestyle factors including physical activity, smoking, alcohol consumption, and diet in men and women with exceptional longevity, researchers conducted a retrospective cohort study of community dwelling Ashkenazi Jews with exceptional longevity defined living independently at age 95 and older. The Ashkenazi population descended from tens of thousands of Jews originating in the 15th Century who eventually moved to or were born in the U.S. before World War II.
The researchers compared Read more »
*This blog post was originally published at ACP Internist*
August 9th, 2011 by Elaine Schattner, M.D. in Opinion, Research
Tags: B. Hillner, Bending the Cost Curve in Cancer Care, Cancer Treatment, End Of Life, Honesty, Hospice, NEJM, New England Journal of Medicine, Oncology, Palliative Care, Realistic Discussions, Research, T. Smith
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We’ve reached the second half of our discussion on Bending the Cost Curve in Cancer Care. The authors of the NEJM paper, Drs. T. Smith and B. Hillner, go on to consider how doctors’ behavior influences costs in Changing Attitudes and Practice. Today’s point on the list: “Oncologists need to recognize that the costs of care are driven by what we do and what we do not do.”
In other words (theirs): “The first step is a frank acknowledgment that changes are needed.” A bit AA-ish, but fair enough –
The authors talk about needed, frank discussions between doctors and patients. They emphasize that oncologists/docs drive up costs and provide poorer care by failing to talk with patients about the possibility of death, end-of-life care, and transitions in the focus of care from curative intent to palliation.
They review published findings on the topic: Read more »
*This blog post was originally published at Medical Lessons*
August 8th, 2011 by GarySchwitzer in Opinion, Research
Tags: Abdominal Surgery, Colorectal Surgery, Conventional Surgery, Esophageal Reflux Disease, Evidence Based Medicine, Gynecologic Surgery, Laparoscopic Cholecystectomy, Laparoscopic Prostatectomy, Medical Devices, Prostate Cancer, RALF, Research, Robot-Assisted Laparoscopic Fundoplication, Robotic Surgery, Robotics, Skeptical Scalpel, Surgeon
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The surgeon who blogs as Skeptical Scalpel writes that he (she?) is unable to contain him(her)self any longer and then lunges into a review of evidence (or lack thereof) for robotic surgery.
You may disagree with Skeptical Scalpel’s decision to be anonymous, but he/she explains:
“I’ve been a surgeon for almost 40 years and a surgical department chairman for over 23 of those years. During much of that time, conforming to the norms, rules and regulations of government agencies, accrediting bodies, hospitals, societies, and social convention was necessary for survival. I was always somewhat outspoken but in a controlled way most of the time. I now have a purely clinical surgery practice with no meetings, site visits or administrative hassles. I am free to speak my mind about medicine or anything else.”
On robotics, Skeptical Scalpel writes: Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
August 7th, 2011 by David H. Gorski, M.D., Ph.D. in Opinion, Research
Tags: Acupuncture, Allergies, Alternative Medicine, Alternative Therapies, Back and Neck Pain, CAM, Chiropractic, Cold and Flu, Complementary And Alternative Medicine, Consumer Reports, Integrative Medicine, Massage Therapy, Prescription Drugs, Science And The Media, Science Based Medicine, Yoga
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Ever since I was a teenager, I’ve intermittently read Consumer Reports, relying on it for guidance in all manner of purchase decisions. CR has been known for rigorous testing of all manner of consumer products and the rating of various services, arriving at its rankings through a systematic testing method that, while not necessarily bulletproof, has been far more organized and consistent than most other ranking systems. True, I haven’t always agreed with CR’s rankings of products and services about which I know a lot, but at the very least CR has often made me think about how much of my assessments are based on objective measures and how much on subjective measures.
Until now.
I just saw something yesterday on the CR website that has made me wonder just how scientific CR’s testing methods are, as CR has apparently decided to promote alternative medicine modalities by “assessing” them in an utterly scientifically ignorant manner. Maybe I just haven’t been following CR regularly for a while, but if there’s an article that demonstrates exactly why consumer product testing organizations should not be testing medical treatments; they are ill-equipped to do so and lack the expertise and knowledge. The first red flag was the title, namely Hands-on, mind-body therapies beat supplements. The second red flag was the introduction to the article: Read more »
*This blog post was originally published at Science-Based Medicine*
August 7th, 2011 by Happy Hospitalist in Opinion, Research
Tags: Acute Coronary Syndrome, American Journal of Cardiology, Health Insurance, Heart Attack, Lipitor, Medicare, Patient Consults, Plavix, Prevent Heart Attacks, Quit Smoking, smoking, smoking cessation, Smoking Lecture, Smoking Relapse
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I’ve been telling my smoking patients for years that nothing I do for them is going to make an ounce of difference until they quit smoking for good. And the Italians are out to prove me right. The American Journal of Cardiology reported July 11th, 2011 on the Effect of Smoking Relapse On Outcome After Acute Coronary Syndrome.
In a study of just under 1,300 patients, Reuters reports that just over 1/2 the patients started smoking within 20 days of hospital discharge, despite in-hospital smoking cessation consultation for all patients. Researchers also found that resuming smoking increased death 3-fold compared with those that did not relapse and quitting smoking had a similar lifesaving effect as taking cholesterol and blood pressure medications. And I’m sure these folks all landed themselves back into the hospitals for a very expensive dying process.
That’s why billing the patient or their insurance for smoking cessation (CPT® 99406 and 99407) is so important. And that’s why I give many of my smoking patients my smoking lecture. You know how much Medicare pays for a ten minute consultation to help cardiac patients quit smoking right now? Read more »
*This blog post was originally published at The Happy Hospitalist*
