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Wagon Wheel – Cottonwood Creek (Old Crow Medicine Show cover) Live on Great Day KMPH Fox 26 – Video

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Wagon Wheel - Cottonwood Creek (Old Crow Medicine Show cover) Live on Great Day KMPH Fox 26
Cottonwood Creek performing "Wagon Wheel" by Old Crow Medicine Show live on Great Day KMPH Fox 26 on 10/10/14.

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Wagon Wheel - Cottonwood Creek (Old Crow Medicine Show cover) Live on Great Day KMPH Fox 26 - Video

Alien: Isolation Funny Moments – (Being Hunted & Finding Medicine For Taylor!) – Video

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Alien: Isolation Funny Moments - (Being Hunted Finding Medicine For Taylor!)
If you enjoyed the video, why not leave a like? Thanks for the support! Follow me on Twitter: https://twitter.com/AlordsGAMING My profile picture and cover art was produced by TR1CKZ GAMING,...

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Alien: Isolation Funny Moments - (Being Hunted & Finding Medicine For Taylor!) - Video

This Mans Simple System Could Transform American Medicine

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Katherine Carpenter couldnt sleep. For more than a week shed been coughing herself awake every night and then hacking until she retched. Finally, she decided to see a doctor.

The physician suspected bronchitis and wrote Carpenter a prescription for heavy-duty cough medicine. She also suggested antibiotics. Thats pretty standard: Up to 80 percent of people who go to a physician for acute bronchitis are prescribed antibiotics. But Carpenter, an import entry agent for UPS, didnt want antibiotics. She thought theyd stop working if you take them too often, and she suspected her symptoms were caused by a virus, which antibiotics dont affect anyway.

She didnt know it, but her hesitation had science on its side: A meta-analysis in the Cochrane Database of Systematic Reviews looked at 17 trials on antibiotics for people with acute bronchitis, and concluded that they only slightly shorten the duration of the illnessif they have any benefit at all. (And of course theres the issue of antibiotic resistance to consider.) In the end, Carpenter refused the prescription, and her bronchitis eventually cleared up. But the experience left her with the distinct impression that she was just one more patient on the medical assembly line. I felt like a number, she says.

Instead of being a number, Carpenter might have preferred to see a number, one that can help us weigh the benefits (or lack thereof) of a treatment. That number exists, and its called the number needed to treat. Developed by a trio of epidemiologists back in the 80s, the NNT describes how many people would need to take a drug for one person to benefit. (The NNT for antibiotics in a case of acute bronchitis is effectively infinity, because the medicine is no better at curing the illness than a placebo.)

Consider a couple other examples: If your kid is throwing up and you take her to the hospital, she might get a drug called Zofran. The NNT for that is 5, meaning that only five kids need to take Zofran for one of them to stop throwing up. And if you look at Zofrans number needed to harm (the number of people who would need to take a drug for one to have a bad side effect) the answer is well, there really isnt oneno one has a significant side effect.

Now, say youre pushing 50. Youre healthy, but your doctor suggests you start taking a baby aspirin. Just in case, you know? That NNT is 2,000. Thats how many people have to take a daily aspirin for one (nonfatal) heart attack to be prevented. Statistically speaking: Not especially helpful.

Its unfortunate, then, that the NNT is not a statistic thats routinely conveyed to either doctors or patients. But you can look it up on a site that youve probably never heard of: TheNNT.com. Started by David Newman, a director of clinical research at Icahn School of Medicine at Mount Sinai hospital, the sites dozens of contributors analyze the available studies, crunch the numbers on benefits and harms, and then post the results. While a low NNT is generally good and a high NNT is bad, you also have to consider the severity of both the illness and the drugs side effects. Which is why the team added a color-coding system: Green for when a treatment makes sense, yellow for when more study is needed, red for when the harms and the benefits cancel each other out, and black when the harms outweigh the benefits.

Newmans goal for the site is nothing short of a revolution in medical practice. He wants doctors to base their treatments on good scientific evidence, not tradition, hunch, and the fear that patients will see them as doing nothing. And he wants patients to start demanding such care. Thats the big picture, anyway. For now, hed be happy if he could just get people looking at medicine in a different way. People tend to think that if its a medical intervention, theres science behind it, he says. Unfortunately, thats often not the case. It is a lie to tell patients to do something without telling them, You should know weve done lots of research on this and we cant find any benefit to it.

Its a bright, cold morning outside Mount Sinai Hospital in New York City. Central Park is across the street, and runners huff along the paths, baby joggers in front, dogs in tow. Newman has just arrived at work in the emergency department where hes an attending physician, and hes giving his residents the Three Networks spiel.

ABC, always be closing. You want to be moving patients back home or into the hospital for treatment. At the ER, the front door is always open, but if the back door is closed, and you have people mounting up, things get missed, heart attacks occur, sepsis gets worse, and people die. Always be closing. Then comes NBC, never be consultingdont call specialists if you can avoid it. Then CBS, close before signoff. Theres good evidence that medical errors are more likely to occur with handoffs. Discharge your cases before the end of your shift to avoid these errors, he tells his charges.

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This Mans Simple System Could Transform American Medicine

The Future of Genomic Medicine – Anne Wojcicki, Richard Lifton and Eric Green – Video

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The Future of Genomic Medicine - Anne Wojcicki, Richard Lifton and Eric Green
September 30, 2014 - Genomics and Our Health: What does the future hold? A closing symposium for the exhibition - Genome: Unlocking Life #39;s Code - that explores the potential of genomics to...

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The Future of Genomic Medicine - Anne Wojcicki, Richard Lifton and Eric Green - Video

"How To Get A Mouse To Take His/Her Medicine" – Martin Javors, PhD – Video

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"How To Get A Mouse To Take His/Her Medicine" - Martin Javors, PhD
"How to Get a Mouse to Take His/Her Medicine" By: Martin Javors, Ph.D., Professor UT Health Science Center at San Antonio Barshop Institute Seminar Series for Wednesday October 8, 2014.

By: UTHSCSA Barshop

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"How To Get A Mouse To Take His/Her Medicine" - Martin Javors, PhD - Video

Personalized Medicine Versus Obamacare

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Personalized medicine recognizes that each of us may be different from every other individual. Where those differences are discovered, it seeks unique therapies. What I call cookbook medicine urges doctors to treat all patients with similar symptoms the same way. It implicitly assumes we are all alike.

Right now science is headed in the direction of personalized medicine. ObamaCare is pushing us in the opposite direction. Your life could hang in the balance.

Take the case of Dr. Lukas Wartman, a St Louis physician who developed a rare form of leukemia that is usually rapidly fatal and for which there is no effective treatment. He and his colleagues at Washington University refused to accept defeat. They worked round-the-clock for many days using the universitys 26 sequencing machines and a supercomputer. As descried by Gina Kolata in The New York Times:

[T]hey discovered a single gene mutation in his cancer cells that was producing a protein that appeared to be stimulating the cancers growth. It turned out that a new drug existed that was targeted specifically at shutting down the offending protein, a drug that to that point had been used only for kidney cancer. When they administered the drug to Dr. Wartman, his cancer went into complete remission.

In contrast to this case, consider what happens in a typical clinical drug trial, under the FDAs traditional guidelines. An experimental group receives the drug and a control group receives a placebo. Then the drug is approved if the experimental group significantly improves relative to the control group, on the average. If there is no significant difference, the drug is rejected as not effective.

But wait a minute. Usually when a drug is found to be ineffective, there are a few experimental patients who react positively to it. Why are we ignoring them? The answer: randomized controlled trials implicitly assume that all the patients are alike. So if one or two patients get better, thats assumed to be an anomaly. If the drug were responsible, it would have worked for all the other patients as well. Interestingly, almost all the best research on cancer care these days is rejecting the FDA approach. If some patients respond favorably to a drug even when most do not researchers want to know if genetic differences explain the results.

Gina Kolata reports:

One study at Memorial Sloan-Kettering Cancer Center tested a drug called Everolimus that is approved for kidney and breast cancer. Researchers asked if it could treat bladder cancer. Forty-five patients received the drug. Two responded.

Under ordinary protocols, researchers would have decided the drug doesnt work. But in this case, they tried to find out why two patients got better. In the case of one patient:

The investigators found out why. Her cancer had a mutation in a gene that made it dependent on a protein, mTOR, for growth. Everolimus squelches the activity of mTOR. The woman is still taking Everolimus, and her cancer has not recurred.

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Personalized Medicine Versus Obamacare

Tip sheet from Annals of Internal Medicine Oct. 14, 2014

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PUBLIC RELEASE DATE:

13-Oct-2014

Contact: Megan Hanks mhanks@acponline.org 215-351-2656 American College of Physicians @ACPinternists

1. Experts urge cautious use of experimental Ebola drugs

While a World Health Organization (WHO) advisory panel says it is ethical to use experimental medications and vaccines on Ebola patients, experts caution that these drugs are not without risks, and physicians must carefully triage patients or risk serious adverse events, according to a commentary being published in Annals of Internal Medicine. The WHO's epidemic-specific conclusion mandates that health care professionals employ particular ethical standards (fairness of dissemination, patient consent, physician nonmaleficence) when using unapproved Ebola drugs. Therein lies the problem, according to the authors. Because the drugs are experimental, physicians will not be able to discern which patients are likely to benefit from treatment. Drug misuse may lead to poorer outcomes for the 'treated' severely ill, missed opportunities for realistically treatable patients, and a possible induction of drug resistance. The authors also suggest that meaningful informed consent may not be possible during this current epidemic. They urge physicians to employ careful triage strategies to maintain principled experimentation. Data and safety monitoring and experimentation protocols with plans for adequate drug supply to allow sufficient research will be required to ensure a better future standard.

Note: Note: The URL for this story will be live at 5:00 p.m. on October 13 and can be used in news stories. For a PDF, please contact Megan Hanks. To interview the lead author, please contact John Easton at john.easton@uchospitals.edu or 773-795-5225.

2. Health economists find major flaw in FDA's tobacco label regulation cost-benefit analysis

The FDA's cost-benefit analysis of its proposed cigarette labeling regulation has a major flaw, according to an Ideas & Opinions piece being published in Annals of Internal Medicine. Federal agencies proposing any significant regulatory action are required to evaluate the regulation's costs and benefits. In this case, the FDA evaluated its proposed rule requiring cigarette packs to bear large graphic warning labels to deter consumers from smoking. Among other components (costs of implementation, FDA administrative and enforcement costs), the FDA included the cost to consumers, or "consumer surplus." The consumer surplus is the pleasure smokers derive from smoking over and above the price they pay for cigarettes. A group of prominent health economists say that including "lost pleasure" from tobacco use as an element of economic impact is flawed thinking because most tobacco users derive little consumer surplus from smoking. Rather they struggle with trying to break an addiction, regret having ever started smoking, and face psychological costs from being addicted and unable to quit. The authors urge the FDA to consider this reality in future economic evaluations of proposed tobacco regulations.

Note: The URL for this story will be live at 5:00 p.m. on October 13 and can be used in news stories. For a PDF or an interview with the lead author, please contact Abby Abazorius at abbya@mit.edu or 617-253-2709.

3. National study is first to report on medical resident knowledge of High Value Care via exam vignettes

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Tip sheet from Annals of Internal Medicine Oct. 14, 2014

Concierge Medicine: How At-Home Doctor Visits Yield Savings

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Oct 13, 2014 5:03pm

Its been a while since any member of the Basile family missed school or work for a visit to the doctor.

We had perfect attendance two years in a row, said mother Meredith Basile. No lates. No sick days.

Instead of waiting in a doctors office, she and husband Joe found family physician Dr. Brian Thornburg, who treats them and their two children at their home in Naples, Florida.

ABC News

Related: Save money and time by bringing doctor to you with telemedicine.

Thornburg is one of an estimated 10,000 concierge doctors in the US.

For a fee, these doctors offer personalized care and around-the-clock access, often treating their patients at home for everything from a routine checkup to the occasional stitch or two.

On top of their regular health insurance, patients pay Thornburg a $100 monthly fee for whatever home care they might need.

Although critics say the service is only for the rich and famous, ABC News consumer health advocate Michelle Katz disagrees. She said there could be hidden savings in concierge medicine.

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Concierge Medicine: How At-Home Doctor Visits Yield Savings


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