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ACC has pulled together a toolkit to help treat patients with atrial fibrillation (AFib) based on the most recent evidence and best practices. Developed by experts and field-tested, the AFib Toolkit is a valuable and free reference or point-of-care resource you can use on your own time.
There is a very useful patient education section at the bottom which paitents will find valuable
C-reactive protein (CRP) is a marker of systemic inflammation and cardiovascular disease. CRP has been recommended as an adjunct screening tool to stratify cardiovascular risk in the general population. Evidence regarding within-person variability of CRP in the general population is limited. Short-term variability in CRP has important implications for its use & interpretation in clinical practice and research studies. This study found significant short-term (approximately 2.5 weeks) within-person variability in CRP levels, particularly at high values. Approximately one-third of persons with elevated CRP levels were reclassified as having normal CRP levels after repeated testing. Our results are consistent with those of previous studies conducted in small selected populations (eg, patients with ischemic heart disease) or in which measurements were months or years apart.
My comment: Gross!! We find out about concerning, unethical, unsafe manufacturing practices from Chinese manufacturers of prescription drugs (in this case the common antibiotics of the cephalosporin class) We previously had similar issues with heparin leading to US deaths. Beyond this (and pertinent to my concerns about Vitamins and "natural therapies" (see my scoop and YouTube) is that non-prescription therapies are not even regulated for purity like prescription drugs so the hazard may be even greater and harder to detect.
Chinese authorities are investigating allegations that several antibiotic makers in China used so-called gutter oil, repurposed oil salvaged from restaurant waste and drains, in their products instead of more expensive soybean oil.
Pentucket Medical cardiologists Seth Bilazarian and Sunny Srivastava discuss vitamins and dietary supplements as alternative, complimentary and natural therapies.
Patients often think doctors are "against" the use of vitamin or herbal therapies. I try to explain on our community program "Matters of the Heart" the doctors viewpoint on Vitamin supplements - cautions and recommendations. I speak about Vitamin D deficiency and its treatment.
Because its a VItamin or because it says its natural doesn't mean its good.
My comment: This is apt and timely. There isn't a physician who would not want to take more time with paitents since that is the fufilling part of our profession. Systemic finanacing structures prevent it. Its not physicians unwillingness.
Boston internist Suzanne Koven's 21-day experiment in “slow medicine” . She says, "that longer visits made me a more empathic, more cost-effective, and happier,physician. During those three weeks, I felt more relaxed and — was it my imagination?"
During those slowed-down three weeks, I felt more relaxed and — was it my imagination? — my patients seemed more relaxed, too. I spent less time scribbling notes (if I typed in front of patients, a practice I’ve resisted, I suspect I would have done less of that as well) and more time looking at my patients and listening to them.
But even these innovations, even a radical change in how we finance health care, won’t soon undo the subtle and often subconscious expectations of doctors and patients that medicine — like everything else in our culture — is supposed to work fast.
Ammonia, sugars, cocoa and more. Once-secret documents reveal some surprising ingredients.
Global consumption of cigarettes has now reached six trillion sticks a year, which turns out to be more than 300 million miles of cigarettes—enough to make a continuous chain from the Earth to the sun and back, with enough left over for a couple of side trips to Mars. On that long journey, smokers deserve to know exactly what's in their cigarettes, and why.
As we mark an important birthday of the first statin (lovastatin), it's good to celebrate the success of this class of drugs and ponder what the next big thing in prevention of cardiovascular disease will be. Statins are the mopst important achievement in cardiovascular medicine in the last 25 years and demonstrates the best of industry and clinician collaboration. Stains moved from feared unknown drugs to standard of care.
Coffee Consumption and Cardiovascular Risk: Over the past three decades, many epidemiologic
My comment: Useful information for patients undergoing cardiac testing. The 10 questions are excessive. Patients should be sure they understand the answers to questions 1,2 4 & 9.
Recent public concern regarding radiation exposure in a cardiac test provides an important opportunity for all patients to discuss with their doctors the benefits and risk of testing. Within the medical community, there is controversy regarding the projected cancer risk resulting from radiation exposure during cardiac testing, such as a nuclear scan or catheterization. Research experts studying the projected cancer risk agree that there is a very low risk of cancer following radiation exposure during medical testing for certain procedures including a nuclear scan or catheterization.
Political counterpoint to the Big Medicine piece of Dr Atul Gawande in the New Yorker., (See my scoop).
The highlighted aspects are the corporatization of medical practices and the Payment advisory Board.
'The "most important institutional change" after ObamaCare passed in 2010: the Independent Payment Advisory Board composed of 15 philosopher kings who will rule over U.S. health care."
The unknown aspects of who, what and why and perceived hazards of this decision making process are discussed.
"The longer-run danger is ... cost board starts to decide what types of care "work" for society at large and thus what individual patients are allowed to receive. '
"The Cheesecake Factory is a great place to eat but you probably wouldn't want to be operated on there—especially if it's run by the government."
I'm doing this the old-fashioned way by eating healthy and exercising. Plain and simple. I know these comments come from a place of love -- the people I've heard these from mean well. It just comes out wrong and winds up bugging me. So without further ado, here are the things I "nevah evah nevah" want to hear again about my loss of 45+ pounds:
i became nauseous
maybe this is a heart attack
i took some bayer aspirin
i did not call 911
by some miracle i was not one of them
my LAD was 99% blocked
Infographic has harsh data on use of information technology, making healthcare safer & more transparent and collaborative between providers and patients.
Summary from NY Times: The health care system squanders $750 billion a year, 30 cents of every medical dollar, through unneeded care, byzantine paperwork, fraud and other waste. Controlling health care costs is one of the keys to reducing the deficit. The report came from an 18-member panel of experts, including doctors, business people and public officials.
A morsel of good news about Medicare drug coverage for the coming year: 2013 premiums will remain basically level for the fourth year in a row.
As it has since 2010, the average monthly premium is projected to hover around $30, the federal Department of Health and Human Services has announced. Last year, the actual amount came in a few cents lower, at $29.67. And the dread doughnut hole, which this year suspends coverage once spending hits $2,930, will kick in a few dollars later, at $2,970.
My comment: Do you want your drug approvals too fast or too slow? As a practioner I would like access to new therapies for my patients so we can make best decisions based on our assessment of the risks & benefts from the avaialble data. Making drugs available does not require them to be used. Not approving drugs absolutely prevents us from using them.
An FDA effort to speed approval of new medicines allowed drugs onto the market without proper safety analysis, according to two drug-safety experts.
" the FDA could strike a better balance of safety versus innovation by insisting that companies produce more safety and effectiveness data soon after the drug is approved—and by insisting on automatic withdrawal of a drug if the data don't materialize. "Once a drug is approved, it is often very difficult to put the genie back in the bottle,"
Two major clinical trials are testing for the first time whether treating inflammation can reduce the risk of a heart attack or stroke, potentially opening up a new line of attack in the battle against cardiovascular disease.
Research over two decades has shown that people with chronic inflammation—detectable at low levels, for instance, with a high-sensitivity test for a marker called C-reactive protein—are at significantly higher risk of heart attack and stroke compared with those with evidence of little or no such inflammation.
These are especially high-risk patients for whom current optimal treatment often fails. "We've kind of run out of our tool kit for these individuals and yet they're still having events," said Gary Gibbons, director of the NIH's National Heart, Lung and Blood Institute, which officially funded the study.
The CANTOS trial sponsored by Novartis is testing the company's anti-inflammatory antibody called canakinumab, has already enrolled 3,000 patients of a planned 17,000 patients with stable cardiovascular disease and elevated levels of inflammation. (Ilaris is marketed for inflammatory disease called Muckle-Wells Syndrome.) In proof-of-concept studies, it yielded "provocative" evidence of benefit in coronary arteries.
PMA is participating in the CANTOS trial. For more information see http://www.pmaonline.com/PDF/CACZ885M2301_trial.pdf
Pills for anything from the common cold to diabetes or cancer can be embedded with tiny ingestible chips that keep track of whether a patient is taking their medicine on time.
The digital feedback technology, in the form of the Proteus Pill, devised by Redwood City, California-based Proteus Digital Health Inc, can also prompt patients to take their medicine and even ask them to take a walk if they have been inactive for too long.
Will [patients embrace this strategy to improve adherence to medication use and the feedback aspects to their physician caregivers?
Decades of messages that regular physical activity is necessary for health have cast exercise as a pill to be swallowed.
What would it take to persuade you to exercise?
A desire to lose weight or improve your figure? To keep heart disease, cancer or diabetes at bay? To lower your blood pressure or cholesterol? To protect your bones? To live to a healthy old age?
Many, if not most, people start exercising because they want to lose weight. But very often they abandon exercise when the expected pounds fail to fall off. Study after study has found that, without major changes in eating habits, increasing physical activity is only somewhat effective for losing weight, though it helps people maintain weight loss and shedding even a few pounds, especially around one’s middle, can improve health.
It’s how these activities make me feel: more energized, less stressed, more productive, more engaged and, yes, happier — better able to smell the roses and cope with the inevitable frustrations of daily life.
President Barack Obama and GOP vice presidential nominee Paul Ryan are pushing the same target rate for controlling Medicare spending, but their approaches to curbing costs are very different, as will...
"There is a consensus, an agreement that Medicare is unsustainable," That's where the agreement is, and it's where the agreement ends."
There is no other industry where the price for the exact same thing varies so widely. which compiles medical price data. For a patient paying out of pocket, a colonoscopy can cost from just under $1,000 to about $3,500, depending on the facility. If you add in the fact that each insurance company maintains dozens of different plans, the system is opaque to doctors as well as patients. "The lack of transparency about prices within the medical system is staggering," "There is a cloud of secrecy over the whole system, and the patients who can least afford it often get the highest bills." Levy said that if an uninsured or underinsured patient asks him what a medical bill would be, it's a question he does not know how to answer. "We are totally insulated from price, what medical care actually costs the patient". "I can't tell when a test I order becomes a bill or if and when my patient gets charged by it, and that's absurd."
Severe heart attacks may not be as deadly as they used to be, according to new research. A new French study demonstrated that patients hospitalized for severe heart attacks – technically known as ST-elevation myocardial infarctions – the chances of dying within 30 days dropped from 13.7% in 1995 to 4.4% in 2010, an improvement of 68%.
My comment - I am hearing with increasing frequency from doctors older AND younger that the system's current burdens (electronic records, documentation, coding, reimbursement declines) are reaching a breaking point. Unfortunately the burdens are likely to accelerate in the coming years.
Analyzing questionnaires sent to more than 7,000 doctors, researchers found that almost half complained of being emotionally exhausted, feeling detached from their patients and work or suffering from a low sense of accomplishment. The researchers then compared the doctors’ responses with those of nearly 3,500 people working in other fields and found that even after adjusting for variables like gender, age, number of hours worked and amount of education, the doctors were still more likely to suffer from burnout.
My comment: now that Lance Armstrong and I have an equal number of Tour de France victories under our belt - I wanted to learn more about Livestrong
IT'S NOT ABOUT THE LAB RATS
Michael J. Fox Foundation had about the same revenue as Livestrong in 2008—$40 million—and gave away $33 million of that in grants for Parkinson’s research. The Susan G. Komen foundation also does a huge amount of pink-ribbon “awareness” work, but it still dished out $145 million in breast-cancer research grants over the past two years. Livestrong’s resources pay for a very large amount of marketing and PR. During those years, the foundation raised $84 million and spent just over $60 million. (The rest went into a reserve of cash and assets that now tops $100 million.)