Comments for Hospital Medicine Quick Hits

Comment on US Healthcare spending slowing down by RESP Canada

RESP Canada — Sun, 16 Jan 2011 22:25:27 +0000

RESP Canada…

Thank you for information on Hospital Medicine Quick Hits ” Blog Archive ” US Healthcare … . As I have read other online views on the same I think the details are well reflected on this.It was a good way of spending evening on Sunday . I’ll visit …

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Comment on COPD disease management very effective by Bone Marrow

Bone Marrow — Sat, 13 Nov 2010 15:15:06 +0000

In March 2010, researchers at Columbia University noted that they created a tissue-designed jaw bone using mesenchymal stem cells (MSCs) derived from bone marrow. MSCs naturally give rise to connective tissue such as bone and cartilage, making bone regeneration one of the most canvassed therapeutic areas for MSCs today.

Comment on Lung cancer after pneumonia diagnosis by Cristi Alsbury

Cristi Alsbury — Sat, 13 Nov 2010 04:20:08 +0000

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Comment on Carrying MRSA home by Marva Cay

Marva Cay — Fri, 12 Nov 2010 17:03:19 +0000

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Comment on Famotidine to prevent ASA-associated ulcers by Daniel Capurro

Daniel Capurro — Mon, 27 Jul 2009 17:05:45 +0000

Considering that patients were endoscopically screened at the end of the study, looking for the presence of esophageal, gastric and duodenal mucosa alterations, there is a considerable possibility that the investigators diagnosed clinically non-significant complications. This study looks very well designed but it shouldn’t be used yet to guide clinical decisions. Clinicians should wait for a study powered to detect clinically significant complications.

Daniel Capurro, MD.

Comment on Adoption of electronic health records (EHR) in US hospitals by Jairy Hunter, MD, MBA, FHM

Jairy Hunter, MD, MBA, FHM — Thu, 23 Apr 2009 01:24:38 +0000

I heard a news story today that suggested while most of the public believes that EHRs will most definitely enhance communication, reduce duplication of tests, and enhance efficiency/expedite care, they don’t believe it will reduce cost. In fact, most believe it will increase the cost of healthcare.

I know in a prior practice, the promise that we would make back the cost of the electronic system by “eliminating” FTEs in the front office was countered by the need for those FTEs to scan existing records into digitized form (took about a year). We never truly eliminated the positions.

Comment on Bicarbonate or saline to prevent contrast-induced nephropathy? by Titilola Britto

Titilola Britto — Sat, 31 Jan 2009 19:24:39 +0000

Standard saline protocols require 4 hours of infusion prior to test, while bicarbonate protocols only need one hour. In an ED, an urgent cardiac cath or an outpatient who does not want to spend nine+ hours at the facility. the bicarbonate protocol is effective and much more convenient.
The other important point is that Clinicians assessment of and correction of volume depletion is still one of the most important preventive strategies in avoiding CIN (contrast induced nephropathy). acetylcysteine is probably voodoo and volume expabnsion in CKD patients at risk is still the most effective preventive strategy

Comment on Anti-psychotics and sudden cardiac death by Tara Scheufler, D.O.

Tara Scheufler, D.O. — Tue, 27 Jan 2009 23:46:45 +0000

We must be very careful not to assume direct (or indirect) causality only from association.

Remember that patients who are getting the higher dose of antipsychotics have more severe, and therefore more end-stage, dementia. The further advanced dementia is, the greater the risk of death in any given year. Dementia itself is a terminal, progressive condition.

I don’t think we should autmoatically draw the conclusion that antipsychotics CAUSE a higher risk of death, but there is an ASSOCIATION. What causes that association is simply not known. Studies should try to elicit the this before we jump to such major conclusions about a medical treatment that, in many patients, is no longer an option.