domingo, 6 de marzo de 2011

Salud_especial_NYT


“I had to train myself not to get too interested in their problems, and not to get sidetracked trying to be a semi-therapist.” DR. DONALD LEVIN, a psychiatrist whose practice no longer includes talk therapy.
Richard Perry/The New York Times
“I had to train myself not to get too interested in their problems, and not to get sidetracked trying to be a semi-therapist.” DR. DONALD LEVIN, a psychiatrist whose practice no longer includes talk therapy.
Many psychiatrists, in large part because of how much insurance will pay, no longer provide talk therapy.
18 AND UNDER

On the Left Hand, There Are No Easy Answers

Though the stigma has largely vanished, the riddle of why about 10 percent of people are born with this essentially human asymmetry remains.
Marcie Iseli and one of her children, Whitley.

West Virginia Hospital Overradiated Brain Scan Patients, Records Show

A hospital overdosed patients for over a year after federal officials alerted hospitals to be careful, records show.
Buddy Zaremba, vice president of RAM Printing in Manchester, N.H.

As Health Costs Soar, G.O.P. and Insurers Differ on Cause

Republicans are seizing on rising costs as evidence that the new health care law includes expensive features, but insurers say premiums are rising because of demand and cost of care.

Troubles of Chronic Fatigue Syndrome Start With Defining It

For an ailment with no known cause and subjective symptoms, definitions differ, and so do diagnoses.
PATIENT MONEY

Who Should Worry About Dust Mites (and Who Shouldn’t)

People who have allergies to dust mites should take some steps to protect themselves. But everyone else can skip the expensive bedding covers.
THE NEW OLD AGE BLOG

A Better Bank Account

The joint bank account is "everybody's default estate-planning tool," says one expert. But an alternative type of account, more useful to caregiving children and their parents, usually is available.
Judge Roger Vinson ordered an appeal filed in seven days.

Judge Stays Own Ruling Against Health Care Law

A federal judge in Florida who struck down the Obama health care law issued a stay while it is being appealed.
Dennis C. Galluzzo, an independent pharmacist, said he had to fight mail-order plans to fill patients' prescriptions at his store.

Pharmacists Fight the Rise of Mail Order

Drug chains and mom-and-pop pharmacies argue they are better able to manage a patient’s medications and contend that health plans should allow the option of buying medicine at their stores.
RECIPES FOR HEALTH

Steel-Cut Oatmeal and Blueberry Muffins

Andrew Scrivani for The New York Times
Use leftover oatmeal in these moist, nourishing muffins.
DOCTOR AND PATIENT

When Optimism Is Unrealistic

Janos Radler/Getty Images
Patients think experimental cancer drugs will work for them, even though fewer than 5 percent ever benefit from early-phase studies.

House Votes to Help Small Businesses Comply With Health Bill, but Relief Is Held Up

The vote to repeal tax-reporting requirements provides no immediate relief because the House and the Senate disagree on how to pay for the expected loss of revenue.
VITAL SIGNS

Aging: Hearing Loss Is Common but Often Ignored

A survey found that 63 percent of Americans 70 and older suffered from impaired hearing, but only a minority use hearing aids.
VITAL SIGNS

Hazards: Misuse of Drugs Crowds Emergency Rooms

Some 700,000 Americans are taken to the hospital each year after ingesting drugs, and the care costs nearly $1.4 billion in emergency room charges alone.
VITAL SIGNS

Regimens: Drugs’ Benefits Go Beyond Blood Pressure

Heart disease patients who took blood pressure medication cut their risk of stroke, heart attack and congestive heart failure, even if their blood pressure was normal to begin with.

The Billionaire Who Is Planning His 125th Birthday

How many blueberries a day does it take to keep the grim reaper away? An 87-year-old’s quest.
URBAN ATHLETE
Isaac Peña, left, and Marlo Fisken, back, attend a class taught by Jonathan Nosan, right.

Happy to Bend Over Backward

For even the most ardent practitioners of yoga, the bending and flexing required in Jonathan Nosan’s contortion class is extreme.
Views
CASES

18 Stethoscopes, 1 Heart Murmur and Many Missed Connections

A woman let her heart speak, and only some medical students talked back.

Geomedicine Shows Patterns in U.S. Breast and Prostate Cancer



Read More: Cancer , Health News

The emerging field of geomedicine can't get moving fast enough for many of us who fear the threat of cancer -- particularly of the breast or prostate. In a recently published study that used the geographic microscope, as I like to refer to the geographic analysis of disease, it was found that the incidence of these two cancers is not a random event. While the authors state that they don't know exactly the underlying factors that cause these "hot spots" -- the areas seen in red on the maps -- it does reveal the wide geographic variability in where people with these types of cancer live. The maps are compelling because they reveal distinct geographic patterns.
2011-02-02-Figure2clusterwithhighrates.JPG

The authors suggest, and you can see for yourself, that both breast cancer (map above) and prostate cancer (map below) cluster geographically, with a strong north-south distribution. You can learn more about this study here.
2011-02-02-huffposttestjpg.JPG
If I lived for more than a couple of years in any one of the red "hot spots," I would probably be more proactive in seeking more frequent screenings for prostate or breast cancer -- wouldn't you?
More alarming to me, however, was the finding that in counties with a high incidence of breast cancer, there was also a high incidence of prostate cancer. The authors suggest that this could be happening because these two cancers might share similar or common risk factors (i.e. environmental).
2011-02-03-Figure4GWRcancerrates.JPG.
These geographical areas might be places where prostate and breast cancer screening advocates could clearly collaborate. Perhaps health care providers could receive more favorable reimbursement from our health insurance programs to increase the frequency of our cancer screenings?
I believe that as the practice of public health and the science of medicine guide the direction of geomedicine, the geographic "microscope" will become an integral part of medical practice. We will begin to see our doctors receive greater value out of all the data that we, as patients, are prepared to give to them -- such as our individual geographic place histories as well as our genetic and lifestyle profiles. (You can check out how a personal place history might work by downloading a free app called My Place History available in the Apple app store for both iPhones and iPads.)
Think of geomedicine as your personal health surveillance system -- always turned on and always vigilant about sensing changes in your environments (communities, neighborhoods, households and worksites, both past and present) that might impact your health. Geomedicine has the capacity to become that platform -- a new medical informatics specialty devoted to bringing all the data together intelligently to actually do something to help you and your doctor keep you healthy. Only though informed informational partnerships with our personal physicians and our public health professionals will we be better served by what is revealed through the modern geographic microscope!

As always, I invite a second opinion!

Radiología digital en los servicios de radiodiagnóstico. Parámetros dosimétricos


Radiología digital en los servicios de radiodiagnóstico. Parámetros dosimétricos

A lo largo de los últimos 20 años se ha producido una revolución tecnológica en la radiología que ha implicado un cambio sustancial en la configuración y composición de los servicios de diagnóstico por la imagen. Hablamos de la aparición de la radiología digital, tanto directa como indirecta, que ha ido desplazando completamente la tradicional radiología analógica basada en la combinación pantalla-película.
Imagen Diagn.2010; 01 :70-2
Palabras clave: Radiología digital; Parámetros dosimétricos; Diagnóstico por imagen

Asistencia inicial al traumatismo pediátrico y reanimación cardiopulmonar

Asistencia inicial al traumatismo pediátrico y reanimación cardiopulmonar

http://www.elsevier.es/watermark/ctl_servlet?_f=10&pident_articulo=13095853&pident_usuario=0&pcontactid&pident_revista=37&ty=160&accion=L&origen=elsevier&web=www.elsevier.es&lan=es&fichero=37v65n06a13095853pdf001.pdf

Los accidentes son la causa más frecuente de muerte en niños por encima del año de edad. Las causas más importantes de muerte por accidente son los accidentes de tráfico, el ahogamiento, las lesiones intencionadas, las quemaduras y las caídas. La reanimación cardiopulmonar es una parte más del conjunto de acciones de estabilización inicial en un niño con traumatismo. La parada cardiorrespiratoria en los primeros minutos después del accidente, ocurre generalmente por obstrucción de la vía aérea o mala ventilación, pérdida masiva de sangre o lesión cerebral grave, y tiene muy mal pronóstico. La parada en las horas siguientes al traumatismo está generalmente producida por hipoxia, hipovolemia, hipotermia, hipertensión intracraneal o alteraciones hidroelectrolíticas. La primera respuesta ante el traumatismo, tiene tres componentes: proteger (valoración del escenario y establecimiento de medidas de seguridad), alarmar (activación del sistema de emergencias) y socorrer (atención inicial al traumatismo). La atención inicial al traumatismo se divide en reconocimiento primario y secundario. El reconocimiento primario incluye los siguientes pasos secuenciales: A. control cervical, alerta y vía aérea; B: respiración; C: circulación y control de la hemorragia; D: disfunción neurológica, y E: exposición. El reconocimiento secundario consiste en la evaluación del accidentado mediante la anamnesis, exploración física ordenada desde la cabeza a las extremidades y práctica de exámenes complementarios. Durante la atención al traumatismo se pueden precisar algunas maniobras específicas que no suelen ser necesarias en otras situaciones de emergencia como son maniobras de extracción y movilización, control cervical mediante inmovilización cervical bimanual y colocación del collarín cervical y retirada del casco. Si durante la asistencia inicial al traumatismo ocurre una parada cardiorrespiratoria las maniobras de reanimación cardiopulmonar se realizarán de forma inmediata adaptándose a las características específicas del niño traumatizado.

An Pediatr (Barc). 2006;65:586-606.

Palabras clave: Politraumatismo. Asistencia inicial al traumatismo. Collarín cervical. Shock. Hemorragia. Reconocimiento primario en traumatismo. Reconocimiento secundario en traumatismo.

Validez de los criterios de aviso a los helicópteros de los servicios médicos de emergencia en los casos de lesiones traumáticas: una revisión sistemática

Validez de los criterios de aviso a los helicópteros de los servicios médicos de emergencia en los casos de lesiones traumáticas: una revisión sistemática

http://www.elsevier.es/watermark/ctl_servlet?_f=10&pident_articulo=13146062&pident_usuario=0&pcontactid&pident_revista=44&ty=95&accion=L&origen=elsevier&web=www.elsevier.es&lan=es&fichero=44v02n04a13146062pdf001.pdf

Manejo general y extrahospitalario del paciente con infarto de miocardio

Valor predictivo de la herramienta de detección prehospitalaria del accidente cerebrovascular de Ontario (Ontario Prehospital Stroke Screening Tool) para la identificación de los pacientes con accidente cerebrovascular agudo

Valor predictivo de la herramienta de detección prehospitalaria del accidente cerebrovascular de Ontario (Ontario Prehospital Stroke Screening Tool) para la identificación de los pacientes con accidente cerebrovascular agudo



http://www.elsevier.es/watermark/ctl_servlet?_f=10&pident_articulo=13142215&pident_usuario=0&pcontactid&pident_revista=44&ty=10&accion=L&origen=elsevier&web=www.elsevier.es&lan=es&fichero=44v02n03a13142215pdf001.pdf

Prehospital Emergency Care (Edición Española) Manual de triage prehospitalario