July 15th, 2011 by Glenn Laffel, M.D., Ph.D. in Health Policy, Opinion
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In the 12 years since our government acknowledged we had a problem with racial disparities in health care, we’ve made significant progress in reducing them. Steep declines in the prevalence of cigarette smoking among African Americans have narrowed the gap in lung cancer death rates between them and whites, for example. Inner city kids have better food choices at school. The 3-decade rise in obesity rates, steepest among minorities, has leveled off.
Still, racial disparities persist across the widest possible range of health services and disease states in our country. The racial gap in colorectal cancer mortality has widened since the 1980s. Overall cancer death rates are 24% higher among African Americans. Sixteen percent of African American adults and 17% of Hispanic adults report their health to be fair or poor, whereas only 10% of white American adults say that. The number of African Americans and Hispanics who report having access to a primary care physician is 30-50% lower than white folks who have one.
How can EMRs Help? Read more »
*This blog post was originally published at Pizaazz*
July 15th, 2011 by RamonaBatesMD in Opinion, Research
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Stretch marks (striae distensae) are common. They represent linear dermal scars accompanied by epidermal atrophy. Stretch marks aren’t a significant medical problem, but can be a source of significant emotional distress.
There are many treatments available, ranging from therapy applied to the skin, laser therapy, and even more invasive surgical methods. Unfortunately, stretch marks remain a tricky problem to target, in which no established treatment exists.
A recent article in the May issue of the Aesthetic Surgery Journal (full reference below) discusses the use of fractional nonablative laser treatment for stretch marks.
Dr. Francesca de Angelis and colleagues conducted a clinical study involving 51 patients with striae, three male and 48 female, who were treated between May 2007 to May 2008. Several patients had striae on multiple areas of the body so a total of 79 striae locations were treated.
Patient ages ranged from 13 to 56 years (mean, 33 years). Fitzpatrick skin type ranged from II to IV. The duration of striae ranged from one to 40 years, with an average duration of 12 years. The striae formed as a result of pubertal growth (41%, n = 21), pregnancy (31%, n = 16), weight change (20%, n = 10), muscular atrophy (2%, n = one ), or unknown causes (6%, n = three).
Anatomical locations for treatment included the hips, breasts, abdomen, flanks, knees, buttocks, arms, thighs, and shoulders, with the majority of treatments occurring on the first three sites.
The stated objective of this study was to determine Read more »
*This blog post was originally published at Suture for a Living*
July 15th, 2011 by Linda Burke-Galloway, M.D. in Health Tips, Research
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A little knowledge is dangerous; especially when it relates to medicine. A recent article in the British newspaper, Daily Mirror discussed a medical study that attempted to prove there was a link between pregnant women’s sleeping positions and stillbirth. The author is of the opinion that the study was small and biased and therefore “there is a serious need for more research before we’re in a strong position to make ¬any recommendations.” Obviously this author has limited knowledge about the cardiovascular system of a pregnant woman.
Our organs and tissues require oxygen to function. Without it, they essentially die. Blood from the lower part of our body flows back to the heart where it receives oxygen, compliments of a large blood vessel called the Inferior Vena Cava (IVC). The inferior vena cava is a large, thin-walled blood vessel located near the spine. As the pregnant uterus becomes enlarged, it can press against the IVC and reduce the amount of its blood flow. Why is that not good? Because it reduces the circulating blood flow in the body that is commonly known as our cardiac output (CO). When the pregnant uterus squeezes the IVC and reduces cardiac output, a woman might feel dizzy and even faint. Her blood supply of oxygen is reduced and the unborn baby’s is as well. When a pregnant woman in her early or late third trimester feels faint after lying flat on her back, the syndrome is called Supine Hypotensive Disorder. Her blood pressure has dropped because her cardiac output has dropped. The heart can only pump out what comes into it, so less blood into the heart means less blood going out of the heart and the patient feels faint. How is this avoided? Read more »
*This blog post was originally published at Dr. Linda Burke-Galloway*
July 15th, 2011 by Jeffrey Benabio, M.D. in Health Tips
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I just flew back from Atlanta for the 4th of July weekend, and, boy, are my sweat glands killing me.
Atlanta has a way of making your sweat glands work overtime, and overworked sweat glands can lead to dreaded heat rash. Heat rash is a common, annoying problem in summertime that develops when sweat glands are blocked, thereby preventing sweat from escaping and irritating your skin.
Hot skin trapped under clothing is often affected, leading to red itchy or prickly bumps (hence it’s other name, prickly heat). Humid heat is worse than dry heat, and anything that blocks the sweat ducts such as lying on your back at night, wearing tight fitting clothing or even applying thick sunscreen is a sure way to bring the rash out.
Prickly heat is commonly seen in babies who aren’t able to tell us when they’re hot and sweaty from being overly bundled up. Hospital patients who are unable to move in bed are also commonly afflicted. Of course, healthy adults can get it too, especially Read more »
*This blog post was originally published at The Dermatology Blog*
July 14th, 2011 by Bryan Vartabedian, M.D. in Opinion
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It’s the age of medical disconnect.
The disconnect describes the emotional and intellectual detachment that physicians feel from their patients and patients from their doctors. This disconnect is the result of a confluence of factors, some from within the profession itself, others are more broadly social and economic.
To understand the disconnect you need look no further than your neighbor or your parents. Dissatisfaction is evolving as the norm. Patients feel increasingly marginalized in their experiences with physicians. Shrinking length of visits, indifferent attitudes, poorly coordinated evaluations, difficulty obtaining test results, an institutional feel to the patient experience, and the overall sense of not feeling at all important.
The truth is that many of us are really not aware of the disconnect. Most of us have been born into a system of dysfunctional provider relationships and we know nothing else. As physicians we’ve been trained to be detached. As patients we’ve been conditioned to live happily detached.
Of course there are plenty of physicians who Read more »
*This blog post was originally published at 33 Charts*
