This February 21, 2017 JAMA Internal Medicine article concludes that testosterone improves bone density and bone strength in men with low testosterone. Although they couldnt determine if there was lower fracture risk, the investigators found that the treatment of older men with low testosterone increased volumetric trabecular bone mineral density of the lumbar spine. They… Read More
The California Department of Managed Health Care found ninety person ( 36 out of 40) healthplan/insurance company department compliance reports for 2015 contained data inaccuracies significant enough to render them essentially usable and certainly not consumer friendly. This story originally appeared in California Healthfax and then reported on in HealthLeaders. From HealthLeaders . A state… Read More
This January 1, 2014 JAMA article studies Mechanical Chest Compressions and Simultaneous Defibrillation vs Conventional Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest There are clearly many factors that affect the chances of survival after a cardiac arrest, including early recognition of arrest, effective cardiopulmonary resuscitation (CPR), timely defibrillation, and postresuscitation care. One important link is thought… Read More
A July 2016 Health Affairs article looked at the adequacy of provider networks for plans sold through insurance Marketplaces established under the Affordable Care Act by conducting a “secret shopper” survey of 743 primary care providers from five of California’s nineteen insurance Marketplace pricing regions in the Summer of 2015. They found less than 30%… Read More
A study in the the February 2017 issue of Epidemiology discusses one of the untoward side effects of gluten free diet. The downside is increased blood levels of heavy metal toxicity primarily arsenic and mercury. An initial thought was increased intake of fish but the the hypothesized cause is thought to be increased rice which tends… Read More
This March 2014 CDC report shows a high incidence of tick borne pathogens causing including the usual Borrelia burgdorferi, the spirochete that causes Lyme disease and also a relatively new B. miyamotoi, which causes a similar syndrome and relapsing fever. B. miyamotoi has also been found in the Midwest and East Coast U.S. This CDC… Read More
Most Americans support requiring the measles, mumps and rubella vaccine for public school children in order to protect public health. They see high preventive health benefits of such vaccines, and low risk of side effects, and they consider the benefits of the vaccine to outweigh the risks.Yet, public concerns about childhood vaccines linger in the… Read More
This article from the January 30, 2017 issue of Canadian Medical Association Journal looks at which patients with chest pain can be safely discontinued from telemetry/cardiac monitoring after an initial evaluation. Although this article may not persuade me from discontinuing patients when we have enough monitors in the Emergency Department, but this study in conjunction… Read More
This ACEP Clinical Policy published in Annals of Emergency Medicine looked at the management of patients with suspected Carbon monoxide poisoning. The policy reviewed the literature to answer several questions. 1. In ED patients with suspected acute CO poisoning, can noninvasive COHb measurement be used to accurately diagnose CO toxicity? Level B recommendations: Do not… Read More
