Managing Managed Care

Our inequitable, inefficient, oftentimes uncaring health care "system," revealed. -- Jeffrey G. Kaplan, M.D., M.S.

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Illness Care

Cancer and Nutrition

 It's often difficult to maintain a good appetitie and nutritional status when fighting cancer. Here are some tips from cancer experts and dietitians that may help: Fresh ginger (not ginger flavoring), taken about 1/2 hour before eating can lessen or even eliminate nausea, but  common in many sodas. Eat more protein and less fat and/or fiber; eat smaller meals more frequently throughout the day--maybe 5-6 Drink more between meals than during... Read more Tags: nutritional supplements, nutrition, cancer, Naturopaths, CAM Read more articles about: growths, cancers, neoplasms

Headache Fix

 Headaches/Colic: Blame irritation to blood vessels and nervesInfantile colic (intense crying, often blammed on gas pains lasting more than 3 hours a day and continuing for more than 3 weeks) is a common "diagnosis" use to explain inconsolable crying occurring during the first four or so months of life, when there are no organic or other physiologic findings. Colic has been thought to be a hypersensitivity state, in this case manifest as ... Read more Tags: nerve, blood vessels, irritation, headache, headaches from fasting, religious fast fasting, colic, intestine, gastrointestinal Read more articles about: pain

Asthma Control

 In poorly controlled asthmatic children, what works best? Ans: Long-acting beta agonists (the ones with the warning*) are more effective than either monteleukast (Singulair) or doubled dosing inhaled corticosteroids. To put things into perspective, about 7 million U.S. children have asthma; the prevalence is more than doubling over the past 2 decades; this  group suffers 500,000 hospitalizations, 10.5 million physician-office visits, 3,500... Read more Tags: asthma, reactive airway disease, long-acting beta agonists, works best, Singulair, montelukast, inhaled corticosteroids, systemic corticosteroids, steroids, asthma-free days, poorly controlled asthmatic children Read more articles about: airway / breathing

Autism and Age

 Key Factors for Autism: A 40-year-old woman’s risk of having a child later diagnosed with autism is 50% greater than a woman between 25 and 29. Advanced paternal age was also associated with an elevated risk for autism even when the mother was younger.         For example, children fathered by a man older than 40 years were twice as likely to develop autism as those children with fathers between the ages of 25 and 29, among births to mothers... Read more Tags: autism, age, the risk of autism, autism risk, age and the risk of autism, autistic, autism spectrum disorder Read more articles about: neurological conditions

Strept Dx

 Strept Cultures and Rapid Strept Tests Objective. The American Academy of Pediatrics recommends that all negative rapid diagnostic tests for Streptococcus pyogenes pharyngitis be backed up by culture, which creates a dilemma for clinicians who must make treatment decisions without complete diagnostic information at the time of visit. The use of a follow-up serial rapid antigen test instead of a follow-up culture would provide a more timely... Read more Tags: pharyngitis, strep throat, rapid diagnostic tests, Streptococcus pyogenes, strep culture, Throat culture Read more articles about: ear, nose and throat conditions

Singulair v. Steroids

 Observation: children with mild to moderate acute asthma had been stabilized in the ER; upon discharge they received montelukast (Singulair] or oral prednisolone; those receiving the latter, the oral corticosteroids after discharge did better. Study Abstract Objective  To examine whether outpatient post-stabilization therapy with montelukast produces more treatment failures than prednisolone. Study design  In this randomized, double-blind,... Read more Tags: asthma, reactive airway disease, Singulair, montelukast, inhaled corticosteroids, systemic corticosteroids, steroids, asthma-free days Read more articles about: airway / breathing

Specialist Surfeit; Primary Care Paucity

 It's schadenfreude: enjoyment obtained from the troubles of others.  That's where I find myself as I observe the surfeit of specialists juxtaposed to a dearth of primary care docs. As Dr. Pauline W. Chen said in "Where Have All the Doctors Gone?"—"I [don’t] envy Mr. Obama.... Any attempt to make health care more accessible will be doomed to failure without an adequate number of primary care physicians and a strong primary care system."... Read more Tags: specialist, primary care, medical school debt, training costs Read more articles about: primary care

Deer-tick Bites—Do You Need Medicine to Prevent Lyme Disease?

 Prophylactic antimicrobial treatment is not routinely indicated Abstract Background Borrelia burgdorferi, which causes Lyme disease, is transmitted by deer ticks (lxodes dammini) in the northeastern and midwestern United States. Although deer-tick bites are common in areas in which the disease is endemic, there is uncertainty about how to manage the care of persons who are bitten. Method To assess the risk of infection with B. burgdorferi and... Read more Tags: Lyme disease, tick bite, prophylaxis Read more articles about: Infectious diseases/conditions

Tic Therapy

 Tic disorders may respond to intense behavioral therapy--E.G., comprehensive behavioral therapy for tics (CBIT). Dr. Piacentini said It "is not to eliminate tics, but [rather] to teach kids how to manage the urge to tic so they don't have to tic as often or intensely." CBIT is based primarily on habit reversal training. The child is taught to be aware of the urge to tic and to use a competing response; for vocal tics, for example, they might... Read more Tags: tic therapy, how to manage, behavioral therapy Read more articles about: Illness Care

Tics, Shakes & Tremors

 For patients wuth abnormal (hyperkinetic) movements, tics, or tremors:.... The initial "Clinical and Compasionate Approach to Managing Tics and Twitches" In my office was (yesterday) was a 5 year old and her Mommy who who rather insightful; here's how she dealt with her child's tics including the eyes sqinching, shoulders moving, head bobbing ans so forth--by purposefully ignoring all of it. She says, despite it hurting her, the parent, this is... Read more Tags: tic, twitch, hyperkinetic movement disorder, tremor, drug-related, adverse Read more articles about: neurological conditions

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