http://contranemesis.monroeblogs.com/ Exploring the Medical Nemesis, in philosophy, history and practice en-us rmaddox@contranemesis.com 2008-05-15T16:40:10-06:00 hourly 1 2000-01-01T12:00+00:00 http://contranemesis.monroeblogs.com/archives/003850.html Very good analysis of the consequences of the well-intentioned law, EMTALA. This law has had a significant effect on my practice since before its inception. I was in med school while it was being debated, and graduated about the time... 3850@http://contranemesis.monroeblogs.com/ 2008-05-15T16:40:10-06:00 http://contranemesis.monroeblogs.com/archives/003848.html I need to start a book review section, but short of figuring out what that means, I need to make a few comments about The Medical Profession and Social Reform, 1885-1945. It is great study of the transformation of medicine... 3848@http://contranemesis.monroeblogs.com/ 2008-05-14T10:50:54-06:00 http://contranemesis.monroeblogs.com/archives/003838.html American Family Physician (paid subscribers only) has a great analysis of the TORCH study. TORCH (Toward a Revolution in COPD Health) was a large, randomized, double-blind trial studying a treatment for COPD (emphysema). The particular treatment they were studying has... 3838@http://contranemesis.monroeblogs.com/ Clinical Iatrogenesis 2008-04-26T21:24:57-06:00 http://contranemesis.monroeblogs.com/archives/003803.html This editorial evaluates the differences in conclusions between ACCORD (which showed that the group with the lower risk of death from heart attacks was the group that had the less-intensive glycemic-lowering target) and ADVANCE [Action in Diabetes and Vascular Disease:... 3803@http://contranemesis.monroeblogs.com/ 2008-04-07T18:05:23-06:00 http://contranemesis.monroeblogs.com/archives/003802.html From the same issue, a graph of a 2007 survey of 3,501 adults asking, Who should pay for Americans' Health Insurance? Only 6% responded "mostly individuals." The rest responded that some combination of employers, government, and/or individuals should share costs.... 3802@http://contranemesis.monroeblogs.com/ 2008-04-07T16:56:58-06:00 http://contranemesis.monroeblogs.com/archives/003801.html After yet another long lapse, I post. As I am my primary audience, this does not bother me. I know how much reading and studying I do, how many patients are cared for in the intervening days and weeks. If... 3801@http://contranemesis.monroeblogs.com/ Clinical Iatrogenesis 2008-04-07T16:46:22-06:00 http://contranemesis.monroeblogs.com/archives/003771.html A new study released in Pediatrics compared a sucrose solution to water placebo as anesthesia two minutes prior to the routine 2 and 4 month immunizations. Responses were measured on a pain scale at 2, 5, 7, and 9 minutes.... 3771@http://contranemesis.monroeblogs.com/ Social iatrogenesis 2008-03-05T13:10:38-06:00 http://contranemesis.monroeblogs.com/archives/003750.html I have never followed the business news but this commentary from AAPS gives some hope. The business and even news people are beginning to understand the difference between relative and absolute risk reduction. The question still remains: is an absolute... 3750@http://contranemesis.monroeblogs.com/ 2008-02-21T14:03:13-06:00 http://contranemesis.monroeblogs.com/archives/003748.html Interesting article here by a Pharm D on ADRs, makes this statement: "Contrary to the public's common belief, all drugs are dangerous. Just because a drug is approved by the US Food and Drug Administration (FDA) does not mean that... 3748@http://contranemesis.monroeblogs.com/ Clinical Iatrogenesis 2008-02-21T10:48:41-06:00 http://contranemesis.monroeblogs.com/archives/003715.html I do not want to make a practice of evaluating every alternative therapy that is offered. However, I found this news interesting. This is one of Royal Rife's infamous claims. Rife additionally built a frequency generator to blast apart various... 3715@http://contranemesis.monroeblogs.com/ 2008-02-07T10:23:06-06:00 http://contranemesis.monroeblogs.com/archives/003701.html Perhaps in light of the last post, I should make a general comment again. I stopped posting for a long time for various unrelated reasons, but among them was the post VERITAS. Patients and doctors like think that medicine has... 3701@http://contranemesis.monroeblogs.com/ 2008-02-01T09:07:27-06:00 http://contranemesis.monroeblogs.com/archives/003700.html The AHRQ has reviewed therapies for osteoarthritis of the knee, including OTC glucosamine and chondroitin, injected hyaluronan, and various arthroscopy techniques. None has been proven to help. (Hyaluronan does improve pain scores and function scores temporarily but there is no... 3700@http://contranemesis.monroeblogs.com/ 2008-02-01T09:02:23-06:00 http://contranemesis.monroeblogs.com/archives/003689.html The battle is proceeding apace. The Baltimore Health Commissioner is pushing the issue of safety and efficacy of the OTC cough and cold preparations in children before the FDA. Doctors are elated on the one hand that they have found... 3689@http://contranemesis.monroeblogs.com/ Social iatrogenesis 2008-01-24T13:35:20-06:00 http://contranemesis.monroeblogs.com/archives/003688.html The NEJM published a study last month (or Nov. 29, 2007) which estimated that CT scans are responsible for 1.5% - 2% of all cancers. There are 62 million scans done in America each year. This was merely a calculation... 3688@http://contranemesis.monroeblogs.com/ Clinical Iatrogenesis 2008-01-24T13:18:41-06:00 http://contranemesis.monroeblogs.com/archives/003687.html This is the subtitle of a commentary in the latest JAMA. Written by an affiliate of the ABIM, it is a credible argument for improving the quality of care by assuring that doctors have the necessary knowledge base to make... 3687@http://contranemesis.monroeblogs.com/ 2008-01-24T12:54:24-06:00