June 26th, 2011 by DrWes in Opinion, Research
Tags: American Journal of Infection Control, Bacteria, Bacterial Colonization, Cell Phone, Health Care Worker, Hospital Visitor, Infection, Medicine, Mobile Phone, Pathogens, Patient, Phone
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Alright doctors, time to give up the cell phones. (Never mind that there has not been a study linking cell phones and hospital acquired infections).
From the American Journal of Infection Control:
A cross-sectional study was conducted to determine bacterial colonization on the mobile phones (MPs) used by patients, patients’ companions, visitors, and health care workers (HCWs). Significantly higher rates of pathogens (39.6% vs 20.6%, respectively; P = .02) were found in MPs of patients’ (n = 48) versus the HCWs’ (n = 12). There were also more multidrug pathogens in the patents’ MPs including methicillin-resistant Staphylococcus aureus, extended-spectrum β-lactamase-producing Escherichia coli, and Klebsiella spp, high-level aminoglycoside-resistant Enterococcus spp, and carabepenem-resistant Acinetobacter baumanii. Our findings suggest that mobile phones of patients, patients’ companions, and visitors represent higher risk for nosocomial pathogen colonization than those of HCWs. Specific infection control measures may be required for this threat.
What specific measures might they consider?
They better be careful what they wish for or they might also have to take away all those dirty EMR computer keyboards, too.
*This blog post was originally published at Dr. Wes*
June 25th, 2011 by AnnMacDonald in Health Tips, Research
Tags: Alternative Medicine, American Psychiatric Association, APA, CAM, Complementary And Alternative Medicine, Depression, FDA, FDA-Approved Drugs, Harvard, Maca Root, Massachusetts General Hospital, Mental Health, MGH, Natural Remedy, Omega-3 Fats, Psychiatry, Psychology, Side Effects, St. John's Wort, Valerian
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On Saturday, while thousands of Boston Bruins fans gathered at Government Center to celebrate the team’s recent Stanley Cup victory, a hundred or so true die-hards met a few blocks away at a Massachusetts General Hospital conference to talk about complementary and alternative medicine for psychiatric disorders. While I hated to miss the Bruins parade, I’m glad I attended the MGH conference.
I’ve always been a bit of a skeptic about so-called natural therapies for one simple reason: they don’t have to go through the same rigorous testing in clinical trials that medications do. At the same time, I realize that FDA-approved drugs don’t work for everyone. One in three adults with major depression, for example, can’t completely improve their mood and other symptoms even after trying multiple antidepressants.
Clearly, we need better options for treating mental health disorders. The MGH conference convinced me that some types of complementary and alternative medicine—or CAM, for short—might be worth trying. The presenters, all psychiatrists who treat patients at MGH, backed up their recommendations with scientific evidence. Several of them also contributed to the American Psychiatric Association’s recent report on CAM therapies.
We’ll be doing a story on CAM therapies for psychiatric disorders in an upcoming issue of the Harvard Mental Health Letter. For now, here are some things I learned on Saturday: Read more »
*This blog post was originally published at Harvard Health Blog*
June 25th, 2011 by RyanDuBosar in Health Policy, Research
Tags: Compensation, Health Care Reform, Hospital Employment, Hospitalist, Income, Internist, Medical Group Management Association, Medical Students, Merritt Hawkins, MGMA, Money, Patient Protection and Affordable Care Act, Physician Compensation, Primary Care, Recruitment, Relative Value Units, Review of Physician Recruiting Incentives, RVU, Salary, Specialty
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Primary care physicians are getting paid more, two surveys agree, while hospital employment is rising.
Internists earned $205,379 in median compensation in 2010, an increase of 4.21% over the previous year, reported the Medical Group Management Association’s (MGMA’s) Physician Compensation and Production Survey: 2011 Report Based on 2010 Data. Family practitioners (without obstetrics) reported median compensation of $189,402. Pediatric/adolescent medicine physicians earned $192,148 in median compensation, an increase of 0.39% since 2009.
Among specialists, anesthesiologists reported decreased compensation, as did gastroenterologists and radiologists. Psychiatrists, dermatologists, neurologists and general surgeons reported an increase in median compensation since 2009.
Regional data reveals primary and specialty physicians in the South reported the highest earnings at $216,170 and $404,000 respectively. Primary and specialty-care physicians in the Eastern section reported the lowest median compensation at $194,409 and $305,575. This year’s report provides data on nearly 60,000 providers.
Recruiting firm Merritt Hawkins reported that general internal medicine was one of its top two most requested searches for the sixth consecutive year. Family physicians were the firm’s most requested type of doctor, followed by internists, hospitalists, psychiatrists, and orthopedic surgeons.
Average compensation for internists Read more »
*This blog post was originally published at ACP Hospitalist*
June 24th, 2011 by Linda Burke-Galloway, M.D. in Research, Video
Tags: Abnormal Chromosomes, Abnormal Genes, Delivery Complications, Dr. Linda Burke-Galloway, Genetic Disorders, Growth Restrictions, Ihibin A, Infections, Maternal Disease, OB/GYN, Obstetrics And Gynecology, Pregnant Women, Research, Risk Factors, screening test, Stillbirth, Umbilical Cord Complications, Unexplained Fetal Loss
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One of the most dreaded complications in obstetrics is a stillbirth that is defined as the absence of life upon delivery of the baby. There are approximately 3million stillbirths that occur each year globally and one-half million in the U.S. In developing countries, the most common reasons of stillbirths were prolonged labor, pre-eclampsia and infections whereas in the U.S., the most common causes are abnormal genes, abnormal growth (aka growth restriction) and maternal diseases. According to medical studies, unexplained fetal loss is the most common reason for stillbirths that occur after 28 weeks. Risk factors for stillbirth include women who have infections, abnormal chromosomes, genetic disorders and umbilical cord complications. Race and socioeconomics also play a role. Black women have twice the risk of having a stillbirth as Caucasian women. Smoking and advanced maternal age also poses an increased risk.
Until recently, there are no screening tests available to see if a woman was carrying a baby at risk for stillbirth. However, a medical study presented at a conference reported that stillbirths can now be predicted using Read more »
*This blog post was originally published at Dr. Linda Burke-Galloway*
June 21st, 2011 by Harriet Hall, M.D. in Health Tips, Research
Tags: Autism, B12, B6, COMT genotype, Folic Acid, Genetics, Genotype, In Utero, Iron, Multivitamins, Nutrition, Prenatal, Prenatal Vitamins, Vaccines, Vitamins
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Science has found no evidence that vaccines cause autism; but the true cause(s) of autism have not yet been determined. So far the available evidence has pointed towards a largely genetic cause with possible interaction with environmental factors. A new study supports that interpretation. It also supports previous evidence that autism is triggered prior to birth, rather than at the time of vaccinations.
Schmidt et al. published a study in Epidemiology on May 23, 2011, entitled “Prenatal Vitamins, One-carbon Metabolism Gene Variants, and Risk for Autism.” It was a population-based case control study of 566 subjects comparing a group of autistic children to a matched control group of children with normal development. They looked at maternal intake of prenatal vitamins in the 3 months before conception and the first month of pregnancy, and they looked for genotypes associated with autism. They found that mothers who didn’t take prenatal vitamins were at greater risk of having an autistic child, and certain genetic markers markedly increased the risk. There was a dose/response relationship: the more prenatal vitamins a woman took, the less likely she would have an autistic child. There was no association with other types of multivitamins, and no association with prenatal vitamin intake during months 2-9 of pregnancy.
They had a large sample size, and they tried to eliminate confounders. They looked for these potential confounders of the association between prenatal vitamin intake and autism: child’s sex, birth year, parent-reported race/ethnicity, family history of mental health conditions, paternal age at child’s birth, maternal age at child’s birth, education, prepregnancy body mass index (BMI) category, cereal intake from 3 months before through the first month of pregnancy, cigarette smoking, alcohol consumption, and residence with a smoker during the period 3 months before pregnancy to delivery. Only maternal education and the child’s year of birth proved to be confounders. They adjusted for these two factors in their analyses. A weakness of their study is that it depends on patient recall long after the fact. Also, it did not attempt to gather any diet information.
Mothers of children with autism were less likely to report taking prenatal vitamins (odds ratio 0.62). Having certain genotypes increased the odds that a vitamin-omitting woman would have an autistic child. Children with the COMT 472 AA gene were at increased risk of autism. If their mothers took prenatal vitamins, the odds ratio for the risk of autism was 1.8; if their mothers didn’t, the odds ratio jumped to 7.2. This suggests that the maternal-fetal environment can magnify the effects of a child susceptibility gene. There was an association with certain maternal genes as well: those odds ratios went as high as 4.5.
The association was robust. The authors think Read more »
*This blog post was originally published at Science-Based Medicine*
