August 27th, 2011 by RyanDuBosar in Research
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Heart attack patients are now being treated on average 32 minutes faster than they were five years ago, and medical societies are touting it as evidence of the success of national campaigns to treat heart attacks more quickly.
The study, “Improvements in Door-to-Balloon Time in the United States: 2005-2010,” found that the average time from hospital arrival to treatment declined from 96 minutes in 2005 to just 64 minutes in 2010. In addition, more than 90% of heart attack patients who required emergency angioplasty in 2010 received treatment within the recommended 90 minutes, up from 44% in 2005.
Also, the study reported that Read more »
*This blog post was originally published at ACP Hospitalist*
August 20th, 2011 by DeborahSchwarzRPA in News
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As of May 2011, performance of MitraClip, a minimally invasive procedure to correct mitral regurgitation, has been voluntarily suspended due to a problem with its catheter delivery system.
Since 2008, about 3000 patients with severe mitral valve regurgitation (leaky mitral valve) have been treated with MitraClip rather than open surgery. In this minimally invasive procedure a small clip is delivered via catheter to the heart, where it is carefully placed over the center of the mitral valve. This non-surgical option has been an important alternative for patients who may be unable to withstand open surgery. MitraClip has been advanced and investigated at NewYork-Presbyterian/Columbia since the first EVEREST trial in 2004, and is currently available throughout the U.S. as part of the EVEREST II trial. Read more »
*This blog post was originally published at Columbia University Department of Surgery Blog*
August 19th, 2011 by John Mandrola, M.D. in Health Tips
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The “normal” number of heartbeats per minute is very much a frequently asked question. People, especially medical people, like well-defined lows and highs. Parameters which can be assigned an ‘L’ or ‘H’ makes life easier.
2009 National Championship Masters (45-49) Road Race
As a modern-day competitive cyclist, I am immersed in a sea of information. In our quest for weekend glory, minutia like speed, wattage outputs, RPMs, torque, elevation gain and of course, heart rates (highs, lows, and averages) get recorded, downloaded, and then studied intensively.
As a heart rhythm specialist, it is a frequent occurrence to see patients referred for low or high heart rates. More often than not, heart doctors are called upon to adjudicate patients who fall outside the “normal” values.
The old school teaching holds that the normal resting heart rate is greater than 55 and less than 100 beats per minute (bpm). Maximal heart rates are estimated by the Read more »
*This blog post was originally published at Dr John M*
August 7th, 2011 by Glenn Laffel, M.D., Ph.D. in Research, True Stories
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The Case
In 2009, administrators at St. Joseph Medical Center in Maryland wrote letters to patients of Mark Midei, informing them that its staff cardiologist may have subjected them to a coronary artery stenting procedure inappropriately. That communication prompted an article in a local newspaper, which triggered an investigation by the Senate Finance Committee.
The Committee subsequently released a report which asserted that Midei performed nearly 600 stenting procedures unnecessarily, and charged Medicare nearly $4m for these procedures. According to the report, all the procedures involved stents made by Abbott Labs. Abbott, in turn, had paid Midei $31,000, added him to its roster of top stent volume cardiologists, and feted him with a pig roast at his home to celebrate a prodigious day in which he implanted 30 stents (apparently a company record). Then, after St. Joseph’s dropped Midei from its roster, Abbott hired him to provide services in Japan and China. In the subsequent year, the number of patients who received stents at the hospital fell to 116 from 350 in the previous year.
Most recently, the Maryland Board of Physicians revoked Midei’s license to practice medicine after concluding that he did implant stents into the coronary arteries of 4 patients inappropriately. The Board also determined that he exaggerated the severity of coronary blockages, and claimed incorrectly that they had unstable angina. Midei has denied the allegations and sued St. Joseph for damaging his career.
The Context Read more »
*This blog post was originally published at Pizaazz*
August 2nd, 2011 by DrWes in Opinion
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It’s the hardest thing in the world for a doctor to do.
After all, doctors are do-ers. That is how they have managed to achieve their degrees: hard work, discipline, perseverence. Who else would be willing to memorize all those organic chemistry equations long enough to vomit them back on paper? Who else would tolerate long nights and weekends on a constant basis? But they do it because it’s the right thing to do. They do it because someone has to. People don’t get sick nine to five. They get sick at 2 am. And so, by it’s very nature over the years, medical education becomes a sort of natural selection: only the strong survive.
Historically, doctors endure the system because they know that there are rewards for this hard work personally, professionally, socially, and financially. So throughout their training, doctors learn to perfect the art of doing. That’s what people come to expect. Oh my God, doctor, he’s choking: do something! He’s turning blue: do something! But he fainted, doctor! Do something!
One of the best parts of medical school is learning the answers to these mysteries of medicine and how to fix them. In the past, this gave doctors an aura of deity: they could be trusted to fix just about any ailment that befell man. It was awesome. With time, a sense of invincibility and omnipotence set in.
And like flies to a flame, we bought it. Lock. Stock. Barrel.
In fact, Read more »
*This blog post was originally published at Dr. Wes*