Sunday, February 20, 2011

Cigarette Smoke Ups Mucus in Lungs - in Pulmonology, Smoking & Tobacco from MedPage Toda

Cigarette smoke suppresses a protein whose normal function is to prevent an overpopulation of mucus-producing cells in the lungs, researchers reported.

Suppression of the so-called Bik protein leads to hyperplasia of airway epithelial cells and mucous cell metaplasia, according to Yohannes Tesfaigzi, PhD, of the Lovelace Respiratory Research Institute in Albuquerque, N.M., and colleagues.

The finding could lead to treatments for chronic bronchitis, Tesfaigzi and colleagues reported online in the American Journal of Respiratory and Critical Care Medicine.

Over-secretion of mucus is a characteristic of chronic bronchitis, which affects many cigarette smokers and is associated with chronic obstructive pulmonary disease, Tesfaigzi and colleagues noted.

Normally, mucus secretion increases in the airway epithelium in response to bacteria or viral infectious agents and environmental pollutants. An inflammatory response kickstarts the proliferation of epithelial cells that produce the protective substance.

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The care was futile, and the patient's wishes, KevinMD.com

by Jim deMaine, MD

“We have a patient on a ventilator here who is stable enough to transfer to your ICU, if that’s OK with you.”

This call, coming from the transfer coordinator, is emblematic of an insurance generated “medical care” coverage issue. I am salaried under the patient’s insurance carrier so the insurer wants this patient back under its wing as soon as possible.

The community hospital has been keeping Stella Norris (not her real name), an 89 year old woman, as long as possible. She is incapacitated from a massive stroke suffered five years ago. There is a feeding tube inserted through the stomach wall and she has needed total body care. 911 was called when she stopped breathing and she was taken to the closest hospital.

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Medical News: Operation Targets $225M in Healthcare Fraud - in Public Health & Policy, Medicare from MedPage Today

By Joyce Frieden, News Editor, MedPage Today
Published: February 18, 2011

WASHINGTON -- The largest healthcare fraud operation in U.S. history has nabbed suspects accused of collectively defrauding Medicare of more than $225 million, according to officials from the Department of Health and Human Services (HHS) and the Department of Justice (DOJ).

The Medicare Fraud Strike Force charged 111 defendants in nine cities for their alleged participation in Medicare fraud schemes, officials announced on Thursday. Defendants included doctors, nurses, and healthcare company owners and executives, among others.

"With this takedown, we have identified and shut down large-scale fraud schemes operating throughout the country. We have safeguarded precious taxpayer dollars. And we have helped to protect our nation's most essential healthcare programs, Medicare and Medicaid," said Attorney General Eric Holder in a statement. "As [these] arrests prove, we are waging an aggressive fight against healthcare fraud."

More than 700 law enforcement agents from the FBI, the HHS Office of Inspector General, multiple Medicaid Fraud Control Units, and other state and local law enforcement agencies participated in the operation.

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Medical News: Southerners Move as Slowly as They Speak - in Primary Care, Exercise & Fitness from MedPage Today

By Kristina Fiore, Staff Writer, MedPage Today
Published: February 20, 2011
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Southerners and folks from Appalachia appear to be the biggest couch potatoes in the U.S., according to a CDC report.

In the majority of counties in those regions, more than 29% of adults reported getting no exercise other than physical activity performed for their regular job. When compared with existing maps of other CDC data, counties with the lowest levels of physical activity also had the greatest prevalence of obesity and diabetes.

The new exercise data come from the CDC's Behavioral Risk Factor Surveillance System (BRFSS) from 2004-2008, which used self-reported data from state-based adult telephone surveys and 2007 census information. The BRFSS survey asks participants if they do any physical activity or exercise outside the workplace.

However, the agency wanted to paint a larger picture of physical activity in the U.S., and synthesized the survey response numbers with stats and maps showing patterns of obesity and diabetes -- which can be found on a special page on the CDC's website.

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Why Men Can't Win, Battle of The Sexes, Jokes & Humor

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If you work too hard, there is never any time for her. If you don't work enough, you're a good-for-nothing bum.

If she has a boring repetitive job with low pay, it's exploitation. If you have a boring repetitive job with low pay, you should get off your ass and find something better.

If you get a promotion ahead of her, it's favoritism. If she gets a job ahead of you, it's equal opportunity.

If you mention how nice she looks, it's sexual harassment. If you keep quiet, it's male indifference.

If you cry, you're a wimp. If you don't, you're insensitive.

If you make a decision without consulting her, you're a chauvinist pig, you bastard. If she makes a decision without consulting you, she's a liberated woman.

If you ask her to do something she doesn't enjoy, that's domination. If she asks you, it's a favor.

If you try to keep yourself in shape, you're vain. If you don't, you're a slob.

If you buy her flowers, you're after something. If you don't, you're not thoughtful.

If you're proud of your achievements, you're an egotist. If you're not, you're not ambitious.

If she has a headache, she's tired. If you have a headache, you don't love her anymore, and you must be sleeping around.

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Antiseptic baths 'reduce infection risk' | News | Nursing Times

Using 2% chlorhexidine gluconate cloths for the daily bathing of inpatients, instead of soap and water, reduces the risk of hospital-acquired infections, according to US researchers.

The study found a 64% decrease in the risk of acquiring either MRSA or Vancomycin-resistant Enterococcus. A group of 7,699 general medical patients were bathed daily by healthcare assistants with CHG antiseptic cloths for the duration of their admission, while a control group of 7,102 patients were bathed with soap and water.

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Saturday, February 19, 2011

Cardiovascular Disease [NCCAM Health Information], National Institutes of Health

Cardiovascular Disease

Cardiovascular disease (also called heart disease) comes in many forms and is the number one cause of death in the United States. The most common cause of heart disease is coronary artery disease (the narrowing or blockage of the coronary arteries, the blood vessels that supply blood to the heart).

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For Health Professionals

Clinical Practice Guidelines

Scientific Literature

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Teenage patients are answering medical questions on Yahoo! Answers

by Lorelei Armstrong

Doctors debate whether patients Googling symptoms is a good thing or a bad thing. I bet you haven’t thought about something that might be worse:  your teenage patients are answering one another’s medical questions on Yahoo! Answers.

They’re not always clear on anatomy and terminology:  “How can I tell if I’m circumcised?” and “What’s the best way to shave my vagina?” and “Where is the female prostate located?”

They are sexually active and not well informed: “If my boyfriend and I put the condom on after we start, can I still get an STD?” and “I had the HPV shot, am I protected from other STDs and AIDS?” and “I’m 12, should I take Viagra for my penis?”

They are worried that they are too tall, too short, too heavy, too thin, that their parts are the wrong shape or size. They believe every fad diet in the world. “Is anorexia a good diet?” and “Is it healthy to drink 16.9 fluid ounces of water per day?”

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LegalNursingConsultant.com, Medical Legal Resources, Nursing Entrepreneurs

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Welcome.

This website is intended to be a resource for Legal Nurse Consultants, Attorneys looking to use their services, and nurses looking to enter the field of Legal Nurse Consulting. On our site you'll find a directory of LNCs by state and specialty.

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Legal Eagles: Put nursing, law and business together and what do you get? The exciting field of legal nurse consulting! By Barbara Marquand, Minoritynurse.com:"Gloria Blackmon, RNC, BSN, LNC, LNHA, never met the young man who lost his legs, but after reading over his medical records, the compassion she felt for him was as strong as if he had been her own patient. The young man had been living in an intermediate care facility for developmentally disabled adults when circulation problems in his legs became so severe that both limbs had to be amputated. His parents sued the facility and it was Blackmon’s job, as a legal nurse consultant for their attorney, to review the records and determine if they had a valid case."
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Combine Nursing and the Law through Legal Nurse Consulting, Meghan Persichino, RN, BSN, LNC, Nursingspectrum.com:"Nursing and the law: While some nurses think only of the possibility of being sued, others understand the power of this partnership in improving health. These forward-thinking nurses are blazing a trail as legal nurse consultants (LNCs). An Emerging Role Nurses have been working alongside attorneys for almost 25 years, if not more. These nurses went by titles such as "nurse paralegal," "medical litigation consultant," and other monikers. In some instances, they combined the duties of both the paralegal and nursing professions; there was no uniform role definition."
http://nsweb.nursingspectrum.com/cfforms/GuestLecture/nursingandlaw.cfm

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Switching Gears Becoming a Legal Nurse Consultant Diane Barnet, RN, BA, Nursingspectrum.com:"It sounded so easy. On the strength of a guest opinion piece I wrote about the nursing shortage for The Dallas Morning News, an attorney contacted me in the spring of 2002. I was suspicious. What would a lawyer want from me? “I’d like to send you a case,” he offered. “But I don’t have any legal background,” I protested. “That doesn’t matter,” he replied. “You can write.”"
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Legal Nurse Consultant by Sara Courson, BSN, Career Development, PA State Nurses Association:"Legal Nurse Job Search Quick Links: What is a Legal Nurse Consultant Educational Requirements Specialty Certification Salary Ranges Entry Advice Associations Publications Schools References About the Author."
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Legal Consulting by Nurses, By Joy Collins, RN, BSBA, CLNC, LNCC, Wild Iris Medical Education, Inc.:"Nurses have been assisting attorneys with their medically related cases for far longer than is generally realized. It is only lately that the sub-specialty of legal nurse consulting has become a recognized field of nursing that the media has thrust into the mainstream. As far back as the 1980s (and probably earlier), nurses and other medical professionals were assisting the legal world to arrive at a fair settlement by moving through the quagmire of medical records and jargon that we nurses take for granted."
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Medical Information, The Internet, and You By Janabeth Fleming Evans R.N., R.N.C., Doereport.com:" As a medical-legal consultant and Internet researcher I am asked every day to find authoritative medical literature references for a broad spectrum of topics. The information I am looking for may be used to support a claim, to debunk an expert theory, or to educate the attorney during the course of a case evaluation. Changes in the way medical information is stored, accessed, and retrieved have created a wealth of health care information. The Internet provides free access to a great deal of the medical literature, either in full text or citation/abstract format. Because anyone with access to the Web can establish a Web page, many medical sites contain little useful information, even though they may be visually appealing. For this reason, the quality of information available varies from very good to poor, and some sites even intend to mislead. It is important to search for peer reviewed information, from an authoritative source.
1275 Shiloh Road Suite 3130 Kennesaw, Georgia 30144
Phone: 770.805.0460 800.338.5954 Fax: 770.805.0430
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Our health is worsening at a time when medicine has never been better, KevinMD.com

by David Gratzer, MD

With little notice, UnitedHealth released a major paper recently considering diabetes in America.

First the bad news: a large portion of our population either has the disease or is pre-diabetic.

Now, the really bad news: diabetes and pre-diabetes rates are going to soar in the coming decade, according to the analysis, in part driven by the obesity crisis.

I’ll return back to the study in a moment, but it underscores a paradox: medicine has never been better; our overall health, however, is worsening.

Indeed, after seventy years of staggering medical progress — whereby medicine has evolved from passive care to miraculous cure — we seem to have entered into a new age, one in which personal decision will increasingly influence our health and the cost of our health care.

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