May 31st, 2011 by RyanDuBosar in News, Research
Tags: ABI, Ankle-Brachial Index, Cardiovascular Risk, Easy Test, Internal Medicine, Internist, Not Used, PAD, Peripheral Arterial Disease, Screenings
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Despite poor awareness and a lack of training on handling peripheral artery disease, internists can and should be able to recognize the symptoms and manage 95% of such cases. Experts advise using the ankle-brachial index as a quick and effective diagnostic method.
But internists often don’t. As was reported in ACP Internist‘s previous cover story on the subject, the ankle-brachial index can be a major part of preventing peripheral artery disease, itself a major predictor of strokes and heart attacks, over and above the Framingham risk score.
The ankle-brachial index is the ratio of the ankle to the arm systolic pressure. A ratio of 0.90 or less indicates peripheral artery disease. Its sensitivity is 79% to 95%, and its specificity is 95% to 100%. It takes less than five minutes to perform in the office.
Yet, among the 85 respondents, 36 (42.35%) said “It’s a quick and easy test.” Another 27 (31.76%) thought, “It’s difficult to fit into the standard visit.” The final 22 (25.88%) said, “I don’t use the ABI to screen patients for PAD.” Read more »
*This blog post was originally published at ACP Internist*
May 29th, 2011 by DavedeBronkart in Research
Tags: Emory University, Emory’s Silke von Esenwein, Health IT, Low Income, Low Socioeconomic, Medical Records, My Health Record, Participatory Medicine, Patient Engagement, Personal Health Record, PHR, Safety Net, Technology, Usage
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The Society for Participatory Medicine was well represented last week at the 14th ICSI/IHI Colloquium. (ICSI is the Institute for Clinical Systems Improvement, a small midwestern think tank that’s way too poorly known.) SPM members who presented:
- Jane Sarasohn-Kahn of Health Populi gave the keynote for Day 2
- Jessie Gruman, four time cancer patient and founding co-editor of our journal, gave an important breakout session, about which I’ll be writing soon. (Jessie is founder and president of the excellent Center For Advancing Health.)
- Brian Ahier presented on the status of health IT, as Meaningful Use rolls out. (“You can’t measure the improvements that you gotta measure, unless you have computers keeping track of it.”)
- I gave a half-day pre-conference workshop titled “Participatory Health: Reshaping Patient Care.” I’m told the workshop had 40-50% higher registration than usual: interest in participatory medicine is strong.
An unexpected bonus was that right outside the workshop door, a poster presentation addressed some questions people often ask about patient participation and online health records:
- Will patients with problems actually use a PHR (personal health record)? (Many observers say PHRs are a non-starter, a pointless exercise.) Read more »
*This blog post was originally published at e-Patients.net*
May 29th, 2011 by Steven Roy Daviss, M.D. in Research
Tags: Bad days, Days of the Week, Depression, Emotions, HealthCentral, Mood, Mood Scores, Psychiatry, Psychology, Self Reports, Sunday, Tuesday, Worst day
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You know that 1979 Boomtown Rats song, “I Don’t Like Mondays.” (This Youtube music video features a very young-looking Bob Geldof.) The song is about the 1979 shooting spree on a Monday morning at a San Diego elementary school. The shooter’s only state reason for doing it was that she didn’t like Mondays.
The silicon chip inside her head
Gets switched to overload
And nobody’s gonna go to school today
She’s gonna make them stay at home
It turns out that — contrary to popular impression that Mondays are the worst day of the week — Tuesdays are the worst day of the week. According to a piece by Chris Hall (@hallicious) on HealthCentral, Tuesdays are the worst day of the week (moodwise) while Sundays are the best. This is based on mood rating scores from 500 users of the Mood 24/7 service, which HealthCentral licenses from Johns Hopkins University. After you sign up for the free service, the software sends you a text message at random times, and you text back your mood rating for that day.
So, you’d think that the latest date of the coming apocalypse, October 21, might be on a Tuesday. But it’s not — it’s on a Friday. Maybe it will get moved again.—–
*This blog post was originally published at Shrink Rap*
May 28th, 2011 by ChristopherChangMD in Health Tips, Research
Tags: Allergy, Anaphylaxis, Contrast, Contrast Agents, Contrast Dyes, CT, Iodine, Myth, Myth Buster, Radiology, Risk, Seafood
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It is a prevalent belief out in the medical (and lay public) community that patients with iodine or seafood allergy can not receive contrast when undergoing certain radiological tests like CT or MRI scans. The concern is that contrast contains minute amounts of free iodide and as such, IV administration of this material puts the patient at risk of a life-threatening anaphylactic reaction.
Contrast is often given in these tests as it traces out bloodflow enabling the physician to see organ and mass architecture much more clearly allowing for improved accuracy in seeing anything abnormal.
Well… rest assured that patients with iodine and seafood allergy CAN receive contrast without any significant increased risk of an allergic reaction as compared to other allergies.
In a large study encompassing 112,003 patients, Read more »
*This blog post was originally published at Fauquier ENT Blog*
May 28th, 2011 by RyanDuBosar in Research
Tags: Break Ups, Emotional Pain, Fibromyalgia, fMRI, Functional MRI, Love Hurts, Pain Management, Physical Pain, Psychiatry, Psychology, Radiology, Relationships
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Heart-ache can be a literal thing, as well as a metaphor for all those weepy, jilted-lover torch songs.
Consensus thinking in the peer-review literature is that the parts of one’s brain responsible for physical pain, the dorsal anterior cingulate and anterior insula, also underlie emotional pain.
Researchers at Columbia University in New York recruited 40 people who’d recently ended a romantic relationship, put them in a functional magnetic resonance imaging machine, and recorded their reactions to physical and then emotional pain.
Physical pain was created by heating the person’s left forearm, compared to having the arm merely warmed. Emotional pain was created by looking at pictures of the former partner and remembering the breakup, compared to when looking at a photo of a friend.
The fMRI scans showed physical and emotional pain overlapped in the dorsal anterior cingulate and anterior insula, with overlapping increases in thalamus and right parietal opercular/insular cortex in the right side of the brain (opposite to the left arm).
The theory is that Read more »
*This blog post was originally published at ACP Internist*
But internists often don’t. As was reported in ACP Internist‘s previous cover story on the subject, the ankle-brachial index can be a major part of preventing peripheral artery disease, itself a major predictor of strokes and heart attacks, over and above the Framingham risk score.
