For Patients With Severe Chronic Obstructive Pulmonary Disease, Low Dose Steroid Tablets May Be Better Than Large Doses Of Injections.
Low-dose steroid pills seem to opus as well as exorbitant doses of injected steroids for patients hospitalized with unembroidered long-lived obstructive pulmonary disease (COPD), researchers report. Yet, some 90 percent of these COPD patients are given the higher doses, which is inimical to current prescribing guidelines, claims the swot appearing in the June 16 issue of the Journal of the American Medical Association. "We honestly think that doctors should be following hospital guidelines and treating patients with oral steroids, at least for those who are able to misappropriate oral steroids," said Dr Richard Mularski, author of an accompanying leader and a pulmonologist with Kaiser Permanente Center for Health Research.
Mularski added that he was surprised that this many patients were receiving IV steroids. Patients in disaster with COPD are routinely treated with corticosteroids, bronchodilators and antibiotics. Although it's unentangled that steroids are effective in treating COPD exacerbations, it's less clarion which dose is preferable, stated the study authors.
The Massachusetts-based researchers looked at records on almost 80000 patients admitted with dreadful symptoms of COPD to 414 US hospitals in 2006 and 2007. All had been given steroids within the opening two days of their stay. The study did not count individuals who needed care in the intensive care unit. "These are patients that were sick enough to go into the hospital, but not indisposed enough to go into the ICU," said Dr Norman Edelman, chief medical officer of the American Lung Association.
Showing posts with label doctors. Show all posts
Showing posts with label doctors. Show all posts
Friday, 19 April 2019
Tuesday, 17 July 2018
Using Non-Recommended Drugs For The Treatment Of Diabetes
Using Non-Recommended Drugs For The Treatment Of Diabetes.
Using the moot diabetes medicate Avandia as an example, new research finds that doctors' prescribing patterns shift across the country in response to warnings about medications from the US Food and Drug Administration. The denouement is that patients may be exposed to different levels of risk depending on where they live, the researchers said. "We were looking at the striking black-box warnings for drugs have at a national level, and, more specifically, at a geographical level, and how these warnings are incorporated into practice," said library skipper researcher Nilay D Shah, an assistant professor of health services research at the Mayo Clinic in Rochester, Minn.
In 2007, the FDA required that Avandia come with a "black-box warning" - the strongest sign workable - alerting consumers that the drug was associated with an increased danger of heart attack. Before the warning, Avandia was widely prescribed throughout the United States, although regional differences existed. "There was about a two-fold contradistinction in use before the warning - around 15,5 percent use in Oklahoma versus about 8 percent in North Dakota".
Right after the warning, the use of Avandia dropped dramatically, from a nationwide spaced out of 1,3 million monthly prescriptions in January 2007 to primitively 317000 monthly prescriptions in June 2009. "There was a colossal decrease in use across the country. But there was perfectly a bit of residual use".
After the FDA warning, the researchers still found as much as a three-fold difference in use across the nation. In Oklahoma, Avandia use dropped to about 5,6 percent, but in North Dakota it tumbled to 1,9 percent. The reasons for the differences aren't clear. Some factors might contain how doctors are made knowledgeable of FDA warnings and how they react.
Another circumstance could be the policy of state health warranty plans, including Medicaid, in terms of covering drugs. Also, prominent doctors in given areas can move the choice of drugs other doctors make. And drug-company marketing may play a role. "At this guts we don't have good insight into these differences".
Using the moot diabetes medicate Avandia as an example, new research finds that doctors' prescribing patterns shift across the country in response to warnings about medications from the US Food and Drug Administration. The denouement is that patients may be exposed to different levels of risk depending on where they live, the researchers said. "We were looking at the striking black-box warnings for drugs have at a national level, and, more specifically, at a geographical level, and how these warnings are incorporated into practice," said library skipper researcher Nilay D Shah, an assistant professor of health services research at the Mayo Clinic in Rochester, Minn.
In 2007, the FDA required that Avandia come with a "black-box warning" - the strongest sign workable - alerting consumers that the drug was associated with an increased danger of heart attack. Before the warning, Avandia was widely prescribed throughout the United States, although regional differences existed. "There was about a two-fold contradistinction in use before the warning - around 15,5 percent use in Oklahoma versus about 8 percent in North Dakota".
Right after the warning, the use of Avandia dropped dramatically, from a nationwide spaced out of 1,3 million monthly prescriptions in January 2007 to primitively 317000 monthly prescriptions in June 2009. "There was a colossal decrease in use across the country. But there was perfectly a bit of residual use".
After the FDA warning, the researchers still found as much as a three-fold difference in use across the nation. In Oklahoma, Avandia use dropped to about 5,6 percent, but in North Dakota it tumbled to 1,9 percent. The reasons for the differences aren't clear. Some factors might contain how doctors are made knowledgeable of FDA warnings and how they react.
Another circumstance could be the policy of state health warranty plans, including Medicaid, in terms of covering drugs. Also, prominent doctors in given areas can move the choice of drugs other doctors make. And drug-company marketing may play a role. "At this guts we don't have good insight into these differences".
Tuesday, 3 October 2017
How Many Doctors Will Tell About The Incompetence Of Colleagues
How Many Doctors Will Tell About The Incompetence Of Colleagues.
A philanthropic inquiry of American doctors has found that more than one-third would hesitate to turn in a ally they thought was incompetent or compromised by substance abuse or mental health problems. However, most physicians agreed in proposition that those in charge should be told about "bad" physicians. As it stands, said Catherine M DesRoches, auxiliary professor at the Mongan Institute for Health Policy at Massachusetts General Hospital and Harvard Medical School in Boston, "self-regulation is our best alternative, but these findings suggest that we honestly demand to strengthen that. We don't have a good alternative system".
DesRoches is lead author of the study, which appears in the July 14 come of the Journal of the American Medical Association. The American Medical Association (AMA) and other veteran medical organizations hold that "physicians have an ethical obligation to report" impaired colleagues. Several states also have essential reporting laws, according to background information in the article.
To assess how the widely known system of self-regulation is doing, these researchers surveyed almost 1900 anesthesiologists, cardiologists, pediatricians, psychiatrists and forebears medicine, general surgery and internal medicine doctors. Physicians were asked if, within the recent three years, they had had "direct, personal knowledge of a physician who was impaired or inexpert to practice medicine" and if they had reported that colleague.
Of 17 percent of doctors who had direct awareness of an incompetent colleague, only two-thirds actually reported the problem, the survey found. This without considering the fact that 64 percent of all respondents agreed that physicians should report impaired colleagues. Almost 70 percent of physicians felt they were "prepared" to account such a problem, the study authors noted.
A philanthropic inquiry of American doctors has found that more than one-third would hesitate to turn in a ally they thought was incompetent or compromised by substance abuse or mental health problems. However, most physicians agreed in proposition that those in charge should be told about "bad" physicians. As it stands, said Catherine M DesRoches, auxiliary professor at the Mongan Institute for Health Policy at Massachusetts General Hospital and Harvard Medical School in Boston, "self-regulation is our best alternative, but these findings suggest that we honestly demand to strengthen that. We don't have a good alternative system".
DesRoches is lead author of the study, which appears in the July 14 come of the Journal of the American Medical Association. The American Medical Association (AMA) and other veteran medical organizations hold that "physicians have an ethical obligation to report" impaired colleagues. Several states also have essential reporting laws, according to background information in the article.
To assess how the widely known system of self-regulation is doing, these researchers surveyed almost 1900 anesthesiologists, cardiologists, pediatricians, psychiatrists and forebears medicine, general surgery and internal medicine doctors. Physicians were asked if, within the recent three years, they had had "direct, personal knowledge of a physician who was impaired or inexpert to practice medicine" and if they had reported that colleague.
Of 17 percent of doctors who had direct awareness of an incompetent colleague, only two-thirds actually reported the problem, the survey found. This without considering the fact that 64 percent of all respondents agreed that physicians should report impaired colleagues. Almost 70 percent of physicians felt they were "prepared" to account such a problem, the study authors noted.
Tuesday, 19 September 2017
Painkillers Are One Of The Causes Of Death
Painkillers Are One Of The Causes Of Death.
Abuse of stupefactive painkillers and other drug drugs is a growing problem in the United States, and a leading doctors' guild is urging members to exercise tighter control on the medications. The American College of Physicians (ACP) says its recommended changes will set up it tougher for prescription drugs - painkillers such as Oxycontin and Vicodin, as well as drugs occupied for sleep problems and weight loss - to be maltreated or diverted for sale on the street. Prescription drug abuse may now be a prime cause of accidental demise in the United States, according to a recent tally of preliminary data from the US Centers for Disease Control and Prevention.
One 2010 survey, funded by the National Institute on Drug Abuse, found that 16 million Americans age-old 12 and older had old a prescription painkiller, sedative, tranquilizer or spur for purposes other than their medical care at least once in the prior year. One of the ACP's 10 recommendations highlighted the demand to educate doctors, patients and the public about the dangers of prescription drug abuse. The guidelines also suggested that doctors examine the full range of available treatments before prescribing painkillers. Among the other recommendations.
Evidence-based, nonbinding guidelines should be developed to balm guide doctors' care decisions. A national prescription-drug-monitoring program should be created, so doctors and pharmacists can check alike programs in their own and neighboring states before writing and filling prescriptions for substances with high malign potential. Two experts said the ACP recommendations are welcome, but more must be done.
Abuse of stupefactive painkillers and other drug drugs is a growing problem in the United States, and a leading doctors' guild is urging members to exercise tighter control on the medications. The American College of Physicians (ACP) says its recommended changes will set up it tougher for prescription drugs - painkillers such as Oxycontin and Vicodin, as well as drugs occupied for sleep problems and weight loss - to be maltreated or diverted for sale on the street. Prescription drug abuse may now be a prime cause of accidental demise in the United States, according to a recent tally of preliminary data from the US Centers for Disease Control and Prevention.
One 2010 survey, funded by the National Institute on Drug Abuse, found that 16 million Americans age-old 12 and older had old a prescription painkiller, sedative, tranquilizer or spur for purposes other than their medical care at least once in the prior year. One of the ACP's 10 recommendations highlighted the demand to educate doctors, patients and the public about the dangers of prescription drug abuse. The guidelines also suggested that doctors examine the full range of available treatments before prescribing painkillers. Among the other recommendations.
Evidence-based, nonbinding guidelines should be developed to balm guide doctors' care decisions. A national prescription-drug-monitoring program should be created, so doctors and pharmacists can check alike programs in their own and neighboring states before writing and filling prescriptions for substances with high malign potential. Two experts said the ACP recommendations are welcome, but more must be done.
Monday, 7 December 2015
Family Doctors Will Keep Electronic Medical Records
Family Doctors Will Keep Electronic Medical Records.
More than two-thirds of classification doctors now use electronic salubriousness records, and the percentage doing so doubled between 2005 and 2011, a original study finds. If the trend continues, 80 percent of family doctors - the largest assemblage of primary care physicians - will be using electronic records by 2013, the researchers predicted. The findings require "some encouragement that we have passed a critical threshold," said review author Dr Andrew Bazemore, director of the Robert Graham Center for Policy Studies in Primary Care, in Washington, DC "The significant seniority of primary care practitioners appear to be using digital medical records in some bod or fashion".
The promises of electronic record-keeping include improved medical regard and long-term savings. However, many doctors were slow to adopt these records because of the squiffy cost and the complexity of converting paper files. There were also privacy concerns. "We are not there yet. More accomplish is needed, including better information from all of the states".
The Obama administration has offered incentives to doctors who accept electronic health records, and penalties to those who do not. For the study, researchers mined two nationalist data sets to see how many family doctors were using electronic vigour records, how this number changed over time, and how it compared to use by specialists. Their findings appear in the January-February broadcasting of the Annals of Family Medicine.
Nationally, 68 percent of family doctors were using electronic health records in 2011, they found. Rates heterogeneous by state, with a low of about 47 percent in North Dakota and a consequential of nearly 95 percent in Utah. Dr Michael Oppenheim, vice president and ringleader medical information officer for North Shore Long Island Jewish Health System in Great Neck, NY, said electronic record-keeping streamlines medical care.
More than two-thirds of classification doctors now use electronic salubriousness records, and the percentage doing so doubled between 2005 and 2011, a original study finds. If the trend continues, 80 percent of family doctors - the largest assemblage of primary care physicians - will be using electronic records by 2013, the researchers predicted. The findings require "some encouragement that we have passed a critical threshold," said review author Dr Andrew Bazemore, director of the Robert Graham Center for Policy Studies in Primary Care, in Washington, DC "The significant seniority of primary care practitioners appear to be using digital medical records in some bod or fashion".
The promises of electronic record-keeping include improved medical regard and long-term savings. However, many doctors were slow to adopt these records because of the squiffy cost and the complexity of converting paper files. There were also privacy concerns. "We are not there yet. More accomplish is needed, including better information from all of the states".
The Obama administration has offered incentives to doctors who accept electronic health records, and penalties to those who do not. For the study, researchers mined two nationalist data sets to see how many family doctors were using electronic vigour records, how this number changed over time, and how it compared to use by specialists. Their findings appear in the January-February broadcasting of the Annals of Family Medicine.
Nationally, 68 percent of family doctors were using electronic health records in 2011, they found. Rates heterogeneous by state, with a low of about 47 percent in North Dakota and a consequential of nearly 95 percent in Utah. Dr Michael Oppenheim, vice president and ringleader medical information officer for North Shore Long Island Jewish Health System in Great Neck, NY, said electronic record-keeping streamlines medical care.
Tuesday, 3 November 2015
Teens Need Regularly Make Medical Examination
Teens Need Regularly Make Medical Examination.
Doctors often disdain to have a conference with their teen patients about sexuality issues during their annual physical, a new study reveals. This results in missed opportunities to enlighten and counsel young people about ways to help frustrate sexually transmitted diseases and unwanted teen pregnancies, the researchers suggested. The study, published Dec 30, 2013 in JAMA Pediatrics, complex 253 teens and 49 doctors from 11 clinics from the Raleigh/Durham, North Carolina area.
One-third of these teens did not expect questions about intimacy or discuss their sexual activity, sexuality, dating or sexual identity during their yearly check-ups, the muse about found. The researchers, led by Stewart Alexander of the Duke University Medical Center, recorded conversations between the teens and their doctor, and analyzed how much span was spent talking about sex. They also considered the involvement of teens in these discussions.
Doctors often disdain to have a conference with their teen patients about sexuality issues during their annual physical, a new study reveals. This results in missed opportunities to enlighten and counsel young people about ways to help frustrate sexually transmitted diseases and unwanted teen pregnancies, the researchers suggested. The study, published Dec 30, 2013 in JAMA Pediatrics, complex 253 teens and 49 doctors from 11 clinics from the Raleigh/Durham, North Carolina area.
One-third of these teens did not expect questions about intimacy or discuss their sexual activity, sexuality, dating or sexual identity during their yearly check-ups, the muse about found. The researchers, led by Stewart Alexander of the Duke University Medical Center, recorded conversations between the teens and their doctor, and analyzed how much span was spent talking about sex. They also considered the involvement of teens in these discussions.
Sunday, 20 April 2014
Choice Of Place Of Death From Cancer
Choice Of Place Of Death From Cancer.
Doctors who would decide hospice be concerned for themselves if they were dying from cancer are more likely to discuss such care with patients in that situation, a brand-new study finds in Dec 2013. And while the majority of doctors in the study said they would aspire hospice care if they were dying from cancer, less than one-third of those said they would discuss hospice care with terminally ruin cancer patients at an early stage of care. Researchers surveyed nearly 4400 doctors who keeping for cancer patients, including primary care physicians, surgeons, oncologists, emanation oncologists and other specialists. They were asked if they would want hospice care if they were terminally ill with cancer.
They were also asked when they would talk over hospice care with a patient with terminal cancer who had four to six months to alight but had no symptoms: immediately; when symptoms first appear; when there are no more cancer treatment options; when the patient is admitted to hospital; or when the stoical or family asks about hospice care. In terms of seeking hospice heedfulness themselves, 65 percent of doctors were strongly in favor and 21 percent were a bit in favor.
Doctors who would decide hospice be concerned for themselves if they were dying from cancer are more likely to discuss such care with patients in that situation, a brand-new study finds in Dec 2013. And while the majority of doctors in the study said they would aspire hospice care if they were dying from cancer, less than one-third of those said they would discuss hospice care with terminally ruin cancer patients at an early stage of care. Researchers surveyed nearly 4400 doctors who keeping for cancer patients, including primary care physicians, surgeons, oncologists, emanation oncologists and other specialists. They were asked if they would want hospice care if they were terminally ill with cancer.
They were also asked when they would talk over hospice care with a patient with terminal cancer who had four to six months to alight but had no symptoms: immediately; when symptoms first appear; when there are no more cancer treatment options; when the patient is admitted to hospital; or when the stoical or family asks about hospice care. In terms of seeking hospice heedfulness themselves, 65 percent of doctors were strongly in favor and 21 percent were a bit in favor.
Subscribe to:
Posts (Atom)