Medical

“Something bad has happened. I’ve got eyelash extensions,” singer and actress Kristin Chenoweth confessed on the “Late Show with David Letterman” last year while wearing large dark sunglasses, and visibly drowsy on Benadryl. “Here’s the problem: The glue has formaldehyde in it, and I’m allergic,” Chenoweth said. “I swelled up and I’m sneezing. . . . It looks like I have lips on my eyelids.” The Broadway star is far from alone in her quest for longer, thicker eyelashes. Women have been enhancing their lashes since before the days of Cleopatra. Mascara, marketed since 1917, is a multibillion-dollar industry. False eyelashes went mainstream in the 1960s (thanks in part to Twiggy). The market has benefited from promotion by celebrity trendsetters including Nicki Minaj and Rihanna. The Kardashian sisters recently announced their line of false eyelashes and tweeted, “Faking fuller lashes are a thing of the past. For 2013 faux lashes are being worn BIG and without apology.” Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.

We live in a strange world. What would happen if tomorrow a common sedative was found to cause 21,000 cancer deaths every year? What if it resulted in breast cancer, mouth cancer, hepatoma and esophageal malignancies, and if the average patient lost 19 years of life?  What if the drug also killed by cirrhosis, massive upper GI bleeding, accelerated dementia, and for good measure slaughtered thousands innocent children in car accidents. Do you think this caustic concoction would last in the pharmacies for a month … a week … a moment?  Of course not.   Let us raise a drink to that. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.

The American Association of Clinical Endocrinologists (AACE) proudly showcased their new “comprehensive algorithm” for diabetes treatment at their 22nd Annual Conference in Phoenix, AZ, at the beginning of May, replacing their previous algorithm that’s been in place since 2009. Wait,…The post AACE’s New Diabetes Treatment “Algorithm” Leaves Us Cold appeared first on DiabetesMine: the all things diabetes blog.

Brought to you by MedPage Today. 1. Hospitalists Work Longer, Patients Stay Longer. Long work hours for hospitalists led to longer patient stays and unnecessary orders. 2. Automated BP Device Not Cutting It. An automated BP cuff billed as an in-office substitute for ambulatory monitoring may substantially underestimate pressures. 3. No Hike in Mass. Hospital Use Post Health Reform. Healthcare reform in Massachusetts did not increase overall use of inpatient resources, but other states may not be so lucky. Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.

I find WPI’s Kwik-Cast handy for some things around the lab. When we were modest users, the price didn’t bother me too much. However, when we started going through so much of it, I wondered if there was a way to buy it that fit our consumption level a bit better. Both of those pots together were about $50. (Body Double Fast Set – Trial Size, Reynolds Advanced Materials) These are the double-barreled syringes and mixing tips I bought. They’re from this company. 2mm x 8 Element, Needle Tip qty. 1-99 – $0.91 each (WPI charges about $2.90 per tip, about 318% more) qty. 100+ – $0.637 each (Buy 100 for $63.70. From WPI, 30 tips cost $87.00, 455% more) 4B19 Double barreled syringe qty. 1-99 – $1.953 each qty. 100+ – $1.367 each Here, you can see below that the WPI Kwik-Cast kit uses the same syringes and mixing tips, at least as far as I can tell. From WPI, each of these syringes (with contents) is $85. So you can buy the DIY stuff above ($50), 50 tips ($9.10 * 5 = $45.50), and 10 syringes ($19.53) for a grand total of $115.03. This would cost $850 + ($29 * 5 = $145) = $995.00 from WPI. Plus, with the DIY way, you’ll still have the vast majority of your silicone elastomer left over from the $50 kit. I’m not sure I’ll ever run out. The drawback of the DIY way is that you have to fill your own syringes, or have an undergrad do it for you. I used a couple of 5 mL syringes, and it took maybe a minute or two to do one syringe.

I had been debating whether to blog about Angelina Jolie’s announcement last week in a New York Times editorial entitled My Medical Choice that she had undergone bilateral prophylactic mastectomy because she had been discovered to have a mutation in the BRCA1 gene that is associated with a very high risk of breast cancer. On the one hand, it is my area of expertise and was a big news story. On the other hand, it’s been nearly a week since she announced her decision, and the news story is no longer as topical as it was. Also, I’ve already written about it a couple of times on my not-so-super-secret other blog, making the division of blogging…problematic. So, if some of this is a bit repetitive to those who are also fans of my more—shall we say?—insolent persona, I apologize, but try to be patient. I will be doing more than just rehashing a couple of posts from last week (although there will unavoidably be at least a little of that), because there have been even more examples of reactions to Jolie’s announcement that provide what I like to consider “teachable moments.” I will start by asserting quite bluntly that in my medical opinion, from the information I have available, Angelina Jolie made a rational, science-based decision. How she went about the actual mechanics might have had some less than scientific glitches along the way (more about that later), but the basic decision to remove both of her breasts to prevent breast cancer associated with a BRCA1 mutation that she carried was quite reasonable and very defensible from a scientific standpoint. One advantage of waiting nearly a week to write about this story is that it provided me with the opportunity to sit back and observe the reactions that Jolie’s decision provoked. One thing that I really didn’t expect (although in retrospect maybe I should have) is the pure denialism on display that genes have any effect whatsoever on cancer. I say “in retrospect I should have” because I’ve written at least a couple of times before about how quacks use and abuse the term “epigenetics” in the same way that they abuse the word “quantum” and how they seem to believe that wishing makes it so (through epigenetics, of course!) to the point where they believe that genetics is irrelevant to cancer. Indeed, they go far beyond that, asserting that, in essence, environment is all. From what I’ve been reading thus far, the second strongest strain of reaction to Jolie’s announcement (after revulsion at the “mutilation” of women that it represented to certain quacks) is pure denial that mutations in BRCA1 and BRCA2 genes portend such a high risk of ultimately developing breast cancer. This denial is often accompanied by conspiracy mongering about BRCA1 and BRCA2 mutations being a “conspiracy” on the part of the “cancer industry” and Myriad Genetics & Laboratories, the company that holds the patents on BRCA1 and BRCA2, to increase genetic testing and preventative mastectomies. Myriad happens to have a complete monopoly on BRCA1 and BRCA2 testing because of this patent and has been criticized for its high prices and stifling of competition. There is currently a case before the U.S. Supreme Court regarding whether human genes are patentable under the law. I’m not a big fan of Myriad, and I’ll tell you why later. (Not that it matters; I’m stuck with them for now.) My personal distaste for Myriad Genetics aside, this sort of conspiracy mongering is part and parcel of the quack approach to denying the significance of BRCA1 mutations. This denial is usually coupled with confident blather that Angelina Jolie didn’t need to undergo “disfiguring” surgery to prevent BRCA1-associated breast cancer but instead could have achieved the same—or even better!—risk reduction if only she had used this magic herb or that miracle supplem

Every year, a Gallup survey asks Americans to rank the professionals they trust the most. With the single exception of 2001, nurses have always been in first place. According to the Gallup poll, Americans view nurses as honest people with high ethical standards. There seems to be no doubt that the more than three million nurses in the United States are a highly-valued, integral part of prevention illness, providing health education, assessing and intervening when disease strikes, and collaborating with a wider healthcare system. As Anna Reisman, MD wrote in her article, “Nurse practitioners should be released from their arbitrary bondage,”  the most trusted profession is facing a disabling distrust. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.

Much has already been written about the Oregon Medicaid study that came out in the New England Journal of Medicine. Unfortunately, the vast majority is reflex, rather than reflection.  The study seems to serve as a Rorschach test of sorts, confirming people’s biases about whether Medicaid is “good” or “bad”.  The proponents of Medicaid point to all the ways in which Medicaid seems to help those who were enrolled – and the critics point to all the ways in which it didn’t.  But, if we take a step back to read the study carefully and think about what it teaches us, there is a lot to learn. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.

Video from the UK Department of Health "Digital Challenge" project:

Too often patients feel like they’re in the passenger seat when entering the hospital. Even in the best of circumstances — such as planned admissions — patients often don’t feel in control of their own care. One of the most unnecessary issues facing patients when they enter the hospital is untreated (or undertreated) pain. Often the focus of the medical team is to treat a condition, and controlling a patient’s pain comes second. Fortunately, this doesn’t need to be the situation. Here are a few tips for patients to ensure that their pain does not go overlooked: Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.