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Strokes Are Quite Common In Pregnant Women: How Can They Be Prevented?

According to CDC, there has been a 54 percent increase in the number of pregnant women who’ve had strokes in 1995 to 1996 and in 2005 to 2006. While this may surprise some researchers, it certainly would not surprise clinicians who take care of pregnant women who have risk factors such as obesity, chronic hypertension or a lack of prenatal care. Ten percent of strokes occur in the first trimester, 40 percent during the second trimester and more than fifty percent occur during the post partum period and after the patient has been discharged home. Hypertension was the cause of one-third of stroke victims during pregnancy and fifty percent in the post partum period. Hypertension accounted for one-third of stroke cases during pregnancy and fifty percent in the post partum period. Many stroke cases might be prevented if blood pressure problems were treated appropriately during pregnancy.

Pregnant women who have high blood pressure during the first trimester are treated with medication and are classified as having chronic hypertension. The problem occurs when Read more »

*This blog post was originally published at Dr. Linda Burke-Galloway*

Can Pharmacogenomic Tests Help To Improve Public Health?

Adverse drug events are a serious public health problem. Consider the following facts:

  • an estimated 82% of American adults take at least one medication and 29% take five or more;
  • 700,000 emergency department visits and 120,000 hospitalizations are due to adverse drug events annually;
  • $3.5 billion is spent on extra medical costs of adverse drug events annually;
  • at least 40% of costs associated with adverse drug events occurring outside hospitals can be prevented.

How can genomics help? Pharmacogenomics is the study of genetic variation as a factor in drug response, affecting both safety and effectiveness. The intended applications of pharmacogenomics research include identifying responders and non-responders to medications, avoiding adverse events, optimizing drug dose and avoiding unnecessary healthcare costs.  The Food and Drug Administration has added pharmacogenomic information to the labeling for more than 70 drugs. Labels may include information on genetic determinants of clinical response or risk for adverse events.

In spite of current enthusiasm about pharmacogenomics in the research community, Read more »

*This blog post was originally published at Genomics and Health Impact Blog*

Why Doctors Should Participate In The Debt Ceiling Debate

Joe Scarborough reminds us that the divisions in American government are hardly new, paraphrasing Benjamin Franklin’s observation that “When you assemble a number of men, to have the advantage of their joint wisdom, you inevitably assemble . . . all their prejudices, their passions, their errors of opinion, their local interests, and their selfish views. From such an assembly can a perfect production be expected?” (This comes from a September 17, 1787 speech by Mr. Franklin to urge ratification of the U.S. Constitution, read on his behalf because he was too ill to deliver it in person. The Constitution was ratified the same day.)

I suppose we should be encouraged that Congress’s prejudices, passions, errors of opinion, local interests and selfish views are as American as apple pie, and the Republic has somehow survived nonetheless. Still, I find it deeply troubling that today’s politicians can’t find their way to agree on the debt ceiling.

No one should expect a “perfect production” to come out of this Congress and this administration, given how far apart they are on the need for tax increases and entitlement reforms. But they need to agree to something, and they need to do it soon.

I will leave it to others, who know a lot more about global economics than me, to explain what likely will happen to the economy if the debt ceiling isn’t increased by August 2. Let’s talk about the impact on health care, something I know quite a bit about—and why physicians especially should be concerned: Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

CDC Promotes Infection Prevention Guidance For Outpatient Settings

As healthcare professionals, we must recognize our responsibility to protect patients – care should not provide any avenue for the transmission of infections. By working together, we can ensure infection prevention practices are understood and followed by all, during every patient visit. Healthcare continues to transition to settings outside the hospital, and efforts to prevent infections must extend to all settings where patients receive care.

Today, CDC is pleased to present the Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care. a summary guide of infection prevention recommendations for outpatient settings. Although these recommendations are not new, this guide is a concise, one-stop resource where ambulatory care providers can quickly find evidence-based guidelines produced by the CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC).

Repeated outbreaks and notification events resulting from unsafe practices highlight the need for better infection prevention across our entire healthcare system, not just in our hospitals. Based primarily upon elements of Standard Precautions, including medical injection safety and reprocessing of reusable medical devices, this guide reminds healthcare providers of the basic infection prevention practices that must be followed to assure safe care.

I urge you to use this guidance document, and the accompanying Infection Prevention Checklist for Outpatient Settings to assess the practices in your facility to assure that patients are receiving the safe care that they expect and deserve.

I also invite you to view our CDC Expert Video Commentary on Medscape titled New Infection Prevention Guidance for Outpatient Settings to learn more about the guidance.

*This blog post was originally published at Safe Healthcare*

CDC Warns: Border Crossers May Expose US Population To Infectious Diseases Such As Tuberculosis

Picture overlooking El Paso border with microscopic picture of tuberculosis overlayed

Borders, Budgets, and the Rising Risk of Disease

Is there a perfect storm brewing along our nation’s southern border?  Let’s take a look at the numbers in El Paso, Texas where I recently visited:

  • There are 27 million crossings per year alone at the El Paso Point of Entry (POE)
  • Cuts to federal funding including a 50% reduction in the  Early Warning Infectious Disease Program as well as 12.5% cuts to critical preparedness and response funding;
  • Texas is second in the nation for number of tuberculosis cases, the majority of which are found near the border  and many of the cases involve tuberculosis strains that are drug resistant
  • The bordering country, Mexico, was the source of the last global influenza pandemic

So is this a bad situation getting worse or a ticking bomb? Read more »

*This blog post was originally published at Public Health Matters Blog*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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