Why physicians won’t unite to “rescue” medicine

by jmiller on September 16, 2014

This Medscape article deals with many of the problems that physicians have in regard to getting organized.  An oft-heard comments is, “We let them do this to us, we gave away our power.  If we want to change medicine in … learn more

American Geriatrics Society Feeding Tubes in Advanced Dementia Position Statement

by jmiller on September 16, 2014

The American Geriatrics Society Position Statement statement:  1.  Feeding tubes are not recommended for older adults with advanced dementia.  Careful hand feeding should be offered; for persons with advanced dementia, hand feeding is at least as good as tube feeding … learn more

Delirium in elderly people

by jmiller on September 11, 2014

This updated review (Lancet, March) summarizes the epidemiology, causes, pathophysiology, diagnosis, assessment and workup, non-pharmacological prevention and treatment, pharmacological prevention and treatment, controversies and future directions with recommendations.  “Delirium is an acute disorder of attention and cognition in elderly peiople … learn more

“Use of mortality after bilateral mastectomy compared with other surgical treatments for breast Cancer” and accompanying editorial, “Contralateral prophylactic mastectomy: Is it a reasonable option?”

by jmiller on September 11, 2014

This article concludes that the “use of bilateral mastectomy increased significantly through California from 1998 to 2011 and was not associated with lower mortaligy than that achieved with breast-conserving surgery plus radiation.  Unilateral mastectomy was associated with higher mortality than … learn more

Barrett’s Esophagus

by jmiller on September 11, 2014

This review article (NEJM, Aug 28) updates the pathogenesis, diagnosis, screening and surveillance, management, endoscopic eradication of dysplasia, management of low-grade dysplasia,  and radiofrequency ablation of nondysplastic metaplasia.  Click here to read full-text… learn more

Characteristics associated with postdischarge medication errors

by jmiller on August 20, 2014

This article (Mayo Clin Proc, Aug) concludes, “Medication errors are present in approximately half of patients after hospital discharge and are more common among patients with lower numeracy or health literacy.  Click here to read full-text.… learn more

Is hospital admission for heart failure really necessary? The role of the ED and observation unit in preventing hospitalization and rehospitalization

by jmiller on August 20, 2014

“Evidence-based therapies have resulted in improvements in the outpatient mangement of HF.  Despite an increasingly complex population of patients, the overall length of hospital stay has decreased.  However, post-discharge event rates remain disturbingly high and it is not clear that … learn more

Leisure-time running reduces all-cause and cardiovascular mortality risk

by jmiller on July 30, 2014

“Running, even 5 to 10 min/day and at slow speeds <6 mi. hr, is associated with markedly reduced risks of death from all causes and cardiovascular disease.  This study may motivate health but sendentary individuals to begin and continue running … learn more

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