January 3rd, 2012 by Lucy Hornstein, M.D. in Opinion
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Why is it easier to talk about quality of life with patients who are dying? Why don’t we factor these considerations into the decision-making for patients with conditions that aren’t fatal?
The presence of a terminal illness serves to focus everyone’s attentions. Widespread cancer metastases? Concerns about tight blood glucose control fade away. End-stage liver disease? Blood pressure control doesn’t matter so much any more. Bony pain from prostate cancer? Narcotic and sleeping pill addiction doesn’t even occur to anyone. I find it far more problematic to deal with patients with debilitating but non-fatal conditions when treatment options are perceived as limited because of co-existing diseases that produce so-called contraindications to certain medications.
I have a patient in his mid-70s with severe pain from osteoarthritis. Several fractures and a couple of unsuccessful joint replacement surgeries haven’t helped matters. Several years ago he found that a little drug called Vioxx worked extremely well for him, reducing his pain considerably and allowing him to do pretty much watever he wanted. As we all know, however, that drug was pulled from the market because of an unacceptable increased risk of heart attacks and other untoward cardiovascular events. Interestingly, Read more »
*This blog post was originally published at Musings of a Dinosaur*
December 22nd, 2011 by RyanDuBosar in Health Tips, Research
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Health care facilities should take five steps to ensure staff aren’t becoming sleep fatigued, according to a Sentinel Event Alert from The Joint Commission.
Shift length and work schedules impact job performance, and in health care, that means patient safety, the alert stated. A study of 393 nurses over more than 5,300 shifts showed that nurses who work shifts of 12.5 hours or longer are three times more likely to make an error in patient care.
Furthermore, residents who work traditional schedules with recurrent 24-hour shifts:
–make 36 percent more serious preventable adverse events than individuals who work fewer than 16 consecutive hours,
–make five times as many serious diagnostic errors,
–have twice as many Read more »
*This blog post was originally published at ACP Hospitalist*
December 21st, 2011 by DeborahSchwarzRPA in News, Opinion
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This year’s Pancreatic Cancer Awareness Day was the largest and most successful yet, says event organizer Christine Rein. One hundred fifty participants attended the event, which was held Saturday, November 12, 2011 at NewYork-Presbyterian/Columbia.
The program provided information about the pancreas and its function, genetics, risk stratification and screening, cancer-therapy breakthroughs, surgical options, cysts, pre-cancerous tumors and more.
Lecture topics included: Read more »
*This blog post was originally published at Columbia University Department of Surgery Blog*
December 18th, 2011 by GarySchwitzer in News
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I’m choosing to blog about a HealthDay story headlined, “British Study Suggests Mammograms Do More Harm Than Good,” rather than do one of our criteria-driven systematic story reviews because our criteria don’t address the bigger picture.
And that bigger picture is this:
In a criteria-driven, systematic story review of another HealthDay story about a Dutch study this week headlined, “Mammograms Cut Risk of Breast Cancer Death by Half, Study Finds,” our review team commented: Read more »
*This blog post was originally published at Health News Review*
December 13th, 2011 by Peggy Polaneczky, M.D. in News
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After cautiously clearing Yaz for continued use Thursday, an FDA Advisory Panel Friday addressed post-marketing data showing similarly increased blood clot risks among users of the contraceptive patch. The committee, after having been clearly quite extensively briefed, heard testimony from Ortho Evra’s manufacturer and experts in epidemiology, gynecology and hematology. They also heard moving testimony about a young woman who died from a massive pulmonary embolism while using the Nuvaring, whose parents argued that not only the Patch, but most of the newer methods carry an increased clot risk that no woman should be allowed to take without being adequately informed.
The committee ruled that despite limitations of the data, the patch most likely carried a 1.5 times relative risk of blood clots compared to 2nd generation levonogestrel pills, but not necessarily higher than that of newer pills containing 3rd and 4th generation progestins and drosperinone. With a few dissenters, the committee voted to allow the Patch to stay on the market, but asked for Read more »
*This blog post was originally published at The Blog That Ate Manhattan*
