What would you give for a little more time? Take a vital task that you do every day, every week, or every month, and do it about three times faster—with no effect on the quality of the outcome. No, this is not another comfort-food recipe from Rachael Ray’s best-selling series of “30-Minute Meals” cookbooks. This is the story of how a growing number of histocompatibility laboratories are optimizing a test that can detect low concentrations of donor-specific human leukocyte antigen antibodies and help avoid post-transplant organ graft failure.
My latest in CAP TODAY. Read the whole shebang.
A child born recently at Broward Health Medical Center was definitively diagnosed, without testing, as having a significant genetic abnormality. A medical resident eager to put his education into practice ordered genetic testing for the newborn, two normal siblings, and the child’s parents.
The tests would have cost the hospital up to $10,000—each.
My first bylined story in CAP TODAY. Read the whole shebang.
The dramatic increase in overdose deaths and emergency department visits related to the class of narcotic painkillers known as opioids has drawn national attention to the rise in abuse of the drugs as well as inappropriate prescribing by physicians.
But the problem, dubbed an “epidemic” by the Centers for Disease Control and Prevention Director Dr. Tom Frieden, is not limited to teens looking for a cheap high by raiding their parents’ medicine cabinets. Rather, it is being felt in a big way by employers. Companies are seeing their workers compensation costs rise by $1.4 billion annually as a result of injured workers taking prescription opioids such as OxyContin and subsequently experiencing a pronounced delay in return to work.
Experts say that a coordinated effort among all the stakeholders—politicians, regulators, medical authorities and the general public—is needed to comprehensively address the opioid epidemic. But they note that there are some steps that employers and their insurers can take to discourage improper prescribing, help injured workers return to work more quickly and help rein in workers compensation costs.
My latest appears in the January issue of Rough Notes, a final holdover from my freelancing interregnum. Read the whole shebang.
In a July 2 editorial, the Tribune’s editorial board spoke out against Indiana’s more liberal fireworks laws, calling them a “farce.” I find it extremely ironic that when the 4th of July comes around, adults in Illinois aren’t allowed to freely celebrate what little liberty they have left.
So began my 1999 letter to the Chicago Tribune, which it recently occurred to me to dig up. Read the whole shebang.
Today marks the one-month birthday of our son, Lucas. Elizabeth is doing a marvelous job ensuring that he is properly nourished, and he is growing quite beautifully. Lucas has so many looks. Here he is being pensive.
A 36-year-old woman recently presented with flu-like symptoms at Shonan Kamakura General Hospital in Kamakura, Japan. Just a week earlier, her son had been diagnosed with influenza, leading her doctors to think that might be the cause of her fever, fatigue, sore throat and dry cough.
But she tested negative for flu, so she was diagnosed with an upper respiratory infection, prescribed 1,200 mg of acetaminophen daily and sent home. The woman returned the next day, reporting symptoms of vertigo. Testing showed she had suddenly become anemic. Within days she was dead, felled by acute promyelocytic leukemia, which has a 5-year survival rate surpassing 70% when correctly diagnosed and treated.
The tragic case of delayed diagnosis, presented at the Diagnostic Error in Medicine 6th International Conference in Chicago in September, was one of those extremely rare “white zebras” that every physician dreads, expert diagnosticians said.
“These are tough cases at every level,” said David E. Newman-Toker, MD, PhD, associate professor of neurology and otolaryngology at Johns Hopkins University School of Medicine in Baltimore.
But new research shows that it’s not just the one-in-a-million diagnoses that get missed, Dr. Newman-Toker noted. Diagnostic errors are responsible for more patient deaths, disabilities and medical liability costs than any other kind of medical mishap.
My latest is in the December issue of ACP Hospitalist, a holdover from when I was still freelancing. Read the whole shebang.
The Stris lights the menorah on Thanksgivukkah.
Here are a few more pictures from the evening.
Valentin Torres is the kind of resident Illinois officials know they need to reach if their effort to vastly expand health insurance coverage under the Affordable Care Act is going to succeed.
Torres, a truck driver and the sole provider for his wife and three children under 18, said his family has gone uninsured since 2005 when he lost the coverage he had through an employer.
At a state-organized outreach event he heard about on Spanish-language radio, Torres learned the family would be eligible for Medicaid under the health law’s expanded income rules. He planned to complete his application from home through abe.illinois.gov, a site for Medicaid applicants separate from the troubled federal website where private insurance plans are sold.
“I came here to get health coverage for me and my family,” said Torres, 44, who is bilingual but spoke to a counselor in Spanish. “Without insurance, you can’t afford to get sick.”
Federal health officials estimate that Latinos make up nearly a quarter of Illinois’ uninsured population, inspiring a special effort by state officials to spread the word about options available under the health law. To help raise awareness, Illinois is partnering with nearly 50 community-based organizations with close ties to immigrant populations.
My latest is in the Chicago Tribune. Read the whole shebang.
… at the College of American Pathologists, where I started a position Monday as senior editor for a monthly magazine the college publishes, CAP TODAY. The publication focuses principally on clinical issues in pathology, laboratory medicine and laboratory management. So, I have a lot to learn. The job is out in the suburb of Northfield, so I had to buy a car to make the daily commute. It’s interesting work so far and, hey, free coffee! I will, as I’ve done with all my previous jobs, post links to my articles. Given the audience at which the publication is aimed, however, these stories may be less accessible to the general reader than most of my previous work.
After more than a year of research, public hearings, and consideration of nearly 3,000 comments filed by physician organizations, patients, and others, the U.S. Food and Drug Administration in September altered the labeling of extended-release and long-acting opioid analgesics to place a greater emphasis on the medications’ safety risks. The action falls far short of the strict limits on the dosage and duration of opioid therapy for patients’ noncancer pain that were proposed by advocacy groups last year.
My latest, published in the American Academy of Pain Medicine’s Pain Medicine Network newsletter. Read the whole shebang.
At least for now. This one can seemingly do everything. It’s the Cross Tech 3+.
Simply twist the barrel to switch from black ink, to red ink, to mechanical pencil. Blue ink also is available.
And there’s the plus part, which is that the bottom end includes a nib that smoothly glides across the touch screen on any smartphone or tablet computer.
Which can be unscrewed to reveal an eraser for when the pencil is used. Of course!
Update: Another thing this pen can do, apparently, is become useless fairly quickly. The coating on the stylus nub that made it glide smoothly across the screen started peeling off within a week or two of use. Soon enough, the nub started getting stuck when dragging across my phone’s screen, making it difficult to use.
In addition, I had trouble getting the mechanical pencil to remain functional. Every other time I tried to use it, normal writing would push the lead back up into the barrel and I’d have to replace it. Alas, the search for my pen continues.
Elizabeth and I took a trip up to Wisconsin a few weeks ago, leaving the morning after my last day on the job at American Medical News. What better way to celebrate unemployment? Here are a few photos from the trip. See more.
As schools around the country wrap up their first month back in session, parents soon may start receiving the first reports on how their children are shaping up — literally.
Public schools in 19 states now track students’ body mass index numbers and report the fat metrics back to parents. There may, indeed, be more schools tracking students’ BMI than there are schools teaching kids the arithmetic needed to do such calculations on their own. To some, this would seem like the prudent step to take given that childhood obesity has nearly tripled since 1990. The Centers for Disease Control and Prevention says about one in five American children is obese, and one in three is overweight or obese.
There are only a couple of problems with this increasingly popular nanny-state tactic: There’s not much evidence that BMI-tracking reduces obesity, and it may harm the very children it’s meant to help.
My latest, for the R Street Institute. Read the whole shebang.