December 4th, 2010 by Shadowfax in Better Health Network, Opinion, True Stories
No Comments »
I’ve discovered over the years that I really like economics. I never took an econ class in my entire life, since I was pretty focused on the life sciences, but I’ve picked up a fair amount informally over the years. Fortunately I have a strong background in statistics and math, and I’ve done a lot of reading on economics. I wouldn’t say that I have any special level of understanding or credibility on the topic. Perhaps it should be noted that my wife took away the checkbook for good reason. But I enjoy it as a topic, as something to read about and a powerful tool for understanding how the world works.
One consequence of being an ER doc is that you are pretty close to “the street,” and I don’t mean Wall Street. I mean the folks living and scrounging on the streets. As a matter of functioning in the job, you learn the street jargon, you learn what drugs people are using and why, and what the effects of those drugs look like.
The other day I saw a middle-aged guy brought in for acting really weird. Though everything in his social history argued against it, he just looked like he was on meth. I checked a tox, and sure enough, it came back positive. He strenuously denied any drugs, but eventually gave in and admitted the meth use.
I remember in residency walking through downtown Baltimore with a fellow resident and our spouses, and we amazed them by serially identifying the likely drug of choice of the various street people we passed, based on casual observation of their behavior. It’s just what we do. Baltimore was a heroin town. Read more »
*This blog post was originally published at Movin' Meat*
December 4th, 2010 by Glenn Laffel, M.D., Ph.D. in Better Health Network, Health Tips, News, Research
No Comments »
Scientists have discovered a new, highly-transmissible gene that could, quite easily in fact, open a frightening new front in the ongoing global war against superbugs.
The antibiotic-resistant gene, NDM-1, was first identified in 2008 a Swedish patient that had received hospital care in New Delhi. NDM-1 produces an enzyme that allows bacteria to destroy most antibiotics. It exists on plasmids, which are pieces of genetic material that are easily shared between bacteria including E coli and other species that can cause pneumonia, urinary tract infections, and blood stream infections.
NDM-1 probably evolved in parts of India where poor sanitation and overutilization of antibiotics provide a perfect environment for the creation of antibiotic-resistant bacteria.
The gene has been identified in three U.S. patients. All had received medical treatment in India, and all recovered from their infections. It has been found sporadically in Britain, Australia and nearly a dozen other countries as well. Most affected patients were “medical tourists” — that is, people seeking less expensive medical care in India.
“We need to be vigilant about this,” said Arjun Srinivasan, an epidemiologist at the CDC told the Washington Post. “This should not be a call to panic, but it should be a call to action. There are effective strategies we can take that will prevent the spread of these organisms.” Read more »
*This blog post was originally published at Pizaazz*
December 3rd, 2010 by BobDoherty in Better Health Network, Health Policy, News, Opinion
No Comments »
In assessing the “best and worst” of the recommendations from the National Commission on Fiscal Responsibility, Washington Post blogger Ezra Klein accuses the Commission of “cowardice” in addressing healthcare spending:
“The plan’s healthcare savings largely consist of hoping the cost controls . . . and various demonstration projects in the new healthcare law work and expanding their power and reach. . . In the event that more savings are needed, they throw out a grab bag of liberal and conservative policies . . . but don’t really put their weight behind any. . .[their] decision to hide from the big questions here is quite disappointing . . . ”
Pretty harsh words, considering that in other respects Klein gives the Commission high marks. But I think there is a lot more to the Commission’s recommendations on healthcare spending than meet’s (Klein’s) eyes, even though I have my own doubts about the advisability and political acceptability of many of them. Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
December 3rd, 2010 by Bryan Vartabedian, M.D. in Better Health Network, Opinion, True Stories
No Comments »
I just can’t imagine life today as a medical student. Every medical publication in the palm of your hand. The capacity to create an audience and publish at your own will. Real-time dialog between students, faculty, anyone. Global reach from your phone. It’s mind-boggling really.
This is in stark contrast to my experience. My world was centered on index cards, textbooks and pens with different colors. We communicated via Post-it notes on the door of the student lounge. There were no apps and our only game was foozball. As a first year I scheduled time to compose H&Ps on the library’s only Macintosh II computer. This was plugged into the new Apple LaserWriter with WYSIWYG. Hi tech we were. We thought.
Being distractible and restless, I’m going to guess that if I had access to the communication platforms and tools available to today’s students, I might not have made it through. The inputs must be staggering and I imagine that discipline with personal bandwidth has become a critical key to survival. Read more »
*This blog post was originally published at 33 Charts*
December 3rd, 2010 by Medgadget in Better Health Network, News, Research
No Comments »
Cambridge Consultants and India’s Sun Pharma Advanced Research Company (SPARC) have developed a new dry powder inhaler. According to the companies, the device delivers an even, consistent drug dose deep into the lungs regardless of how strong the inhalation is performed by the patient.
From the press release:
The device employs a novel de-agglomeration engine to separate the drug from the lactose ‘carrier’ particles. Based on a highly efficient airway design, the patented drug separation mechanism has successfully completed clinical trials and demonstrated that it is capable of delivering significantly more of the drug to the deep lung than traditional inhalers. In practice, this will minimise side effects from drug build-up in the back of the throat, reduce non-systemic load and wastage, and means almost 50% less active drug needs pre-loading into the device in comparison to a standard inhaler. Read more »
*This blog post was originally published at Medgadget*
