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Saturday, October 21, 2017

Professor with leukemia teaches Texas A&M class from his hospital bed

Purpose in life-that’s wonderful medicine, the kind you can’t find in a pill or potion. Wishing professor Bryant a speedy recovery.
from Rajesh Harrykissoon, MD

Friday, October 20, 2017

Study: Nearly 50% of US medical care occurs in EDs

Variables: -Convenience: Consumers rarely “pre-shop” for healthcare so when a need arrives we use proximity and time conveniences as the deciding factor. -Urgent versus emergent: we don’t tend to differentiate. Although 85% of all ER contacts are due to a non-emergency issues, that awareness has not changed consumer preference. -Alternative resource availability: limited. Even outpatient medical offices with extended hours may have non-24 hour availability and may not have the resources to address a pressing concern resulting in the patient being redirected to an ER. -Price: although ER bills are pricey, this has not dissuaded 50% of Americans from seeking care in ERs. Conclusion: consumers are declaring what they want-convenience of medical care. Solution: give consumers what they want-redefine how and when care is delivered. Some ERs are already charging a flat “entry fee“ for non-urgent issues ($250).
from Rajesh Harrykissoon, MD

Monday, October 9, 2017

In COPD, Stem Cells May Offset Damage Done by Smoking to Lungs, Early Study Says

If you have the proper scaffolding which allows cell-to-cell contact, then healing (naturally or by regenerative medicine) is likely to occur. The issue is having the proper scaffolding in place to which circulating cells may attach. The "pores" between the scaffolding support has to be on the order of a few microns or less. This would better allow the cells to have a 3-dimensional conformation with the cell surface in contact with support structure on all sides. If you have the proper scaffold, the body very well may heal itself as we naturally have endogenous stem cells and growth hormones. Without the proper cellular scaffolding infusing exogenous stem cells and growth hormones fail. The analogy would be akin to building a house without having the framing. You may have all the bricks (stem cells) and all the workers (growth hormones) at the work site, but without having done proper framing for the house you may end up with a lump of brick and mortar which resembles nothing like the home you envisioned and within which you cannot live/function. Simply bringing more bricks and workers to the site (akin to infusing more stem cells and growth hormones, respectively) does not give you a better outcome without the framing. If we really want to make headway in regenerative pulmonary medicine, we have to work on the proper tissue scaffolding.
from Rajesh Harrykissoon, MD

Saturday, October 7, 2017

8 things to know about online symptom checker applications

I checked out a few of these and at best they generate a "differential diagnosis." The differential diagnosis is the short list of diagnostic considerations your doctor develops after taking your history and performing a physical exam. The differential diagnosis is rank ordered from most likely to least. The list may be further refined or rank ordered based on testing results, clinical course or response to offered therapy. These programs were pretty good at generating a differential diagnosis (list) but had shortcomings with rank ordering. One even advised going to the ER for symptom of "out of breath" without requesting associated symptoms (which your doctor would do). Perhaps I was out of breath because I was exercising or I had swelling of my legs from chronic heart failure or perhaps I had been out of breath for years due to chronic emphysema, but the symptom checker didn't ask--it simply said to go to the ER.
from Rajesh Harrykissoon, MD