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Emergency Medicine Treatment and Labor Act

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121. Andrew Weil, the Coors Foundation, and Americans for Prosperity, or: “Integrative medicine” isn’t just for hippy dippy lefties anymore

Foundation is well known for promoting integrative medicine. Mr. Jackson said as much himself in his email, and the touts its projects with the (run, of course, by Andrew Weil), the , and the . For instance, the : The health insurance industry, and its practice of not reimbursing doctors who prescribe CAM-type treatments, creates a massive bottleneck that prevents promising integrative treatments from entering the medical mainstream. The Adolph Coors Foundation has awarded a gift to the Center (...) of "integrating" alternative medicine quackery with real medicine. He's nationally and internationally regarded as a pioneering expert in "complementary and alternative medicine" (CAM). Indeed, arguably no human being has done more in his lifetime and career to seemingly legitimize the specialty of "integrative medicine." He's even started an integrative medicine residency and managed to spearhead a , although the latter does not use the usual accrediting organization used by most other established medical

2015 Respectful Insolence

122. Medical imaging

in pharmaceutical clinical trials [ ] Medical imaging has become a major tool in clinical trials since it enables rapid diagnosis with visualization and quantitative assessment. A typical goes through multiple phases and can take up to eight years. or outcomes are used to determine whether the therapy is safe and effective. Once a patient reaches the endpoint, he or she is generally excluded from further experimental interaction. Trials that rely solely on are very costly as they have long durations and tend (...) to expand, including studies, , , and assessing the effects of disruption agents on cancer tumors. Nuclear medicine [ ] Main article: Nuclear medicine encompasses both diagnostic imaging and treatment of disease, and may also be referred to as molecular medicine or molecular imaging & therapeutics. Nuclear medicine uses certain properties of isotopes and the energetic particles emitted from radioactive material to diagnose or treat various pathology. Different from the typical concept of anatomic

2012 Wikipedia

123. Medical transcription

care to ensure that the impositions on MT autonomy are not so onerous as to outweigh its benefits. Medical transcription is still the primary mechanism for a physician to clearly communicate with other healthcare providers who access the patient record, to advise them on the state of the patient's health and past/current treatment, and to assure continuity of care. More recently, following Federal and State Disability Act changes, a written report (IME) became a requirement for documentation (...) notes that were added in the patient's file for interpretation by the primary physician responsible for the treatment. Ultimately, this mess of handwritten notes and typed reports were consolidated into a single patient file and physically stored along with thousands of other patient records in a wall of filing cabinets in the medical records department. Whenever the need arose to review the records of a specific patient, the patient's file would be retrieved from the filing cabinet and delivered

2012 Wikipedia

124. Late Effects of Treatment for Childhood Cancer (PDQ®): Health Professional Version

and capacity for normal tissue repair. Hormonal milieu. Function of organs not affected by cancer treatment. Socioeconomic status. Health habits. Resources to Support Survivor Care Risk-based screening The need for long-term follow-up for childhood cancer survivors is supported by the American Society of Pediatric Hematology/Oncology, the International Society of Pediatric Oncology, the American Academy of Pediatrics, the Children’s Oncology Group (COG), and the Institute of Medicine. A risk-based medical (...) Late Effects of Treatment for Childhood Cancer (PDQ®): Health Professional Version Late Effects of Treatment for Childhood Cancer (PDQ®) - PDQ Cancer Information Summaries - NCBI Bookshelf Warning: The NCBI web site requires JavaScript to function. Search database Search term Search NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health. PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. PDQ Cancer Information

2016 PDQ - NCI's Comprehensive Cancer Database

125. EMTALA and Patients With Psychiatric Emergencies: A Review of Relevant Case Law. (Abstract)

EMTALA and Patients With Psychiatric Emergencies: A Review of Relevant Case Law. Emergency department (ED) care for patients with psychiatric complaints has become increasingly challenging given recent nationwide declines in available inpatient psychiatric beds. This creates pressure to manage psychiatric patients in the ED or as outpatients and may place providers and institutions at risk for liability under the Emergency Medical Treatment and Labor Act (EMTALA). We describe the patient (...) screening examination and did not detect an emergency medical condition that required stabilization.Lawsuits involving alleged EMTALA violations in the care of ED patients with psychiatric complaints are uncommon and rarely successful.Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

2014 Annals of Emergency Medicine

126. Pheochromocytoma and Paraganglioma Treatment (PDQ®): Health Professional Version

of cyclophosphamide, vincristine, and dacarbazine (the Averbuch protocol).[ ] Results of this regimen in 18 patients after 22 years of follow-up demonstrated a complete response rate of 11%, a partial response rate of 44%, a biochemical response rate of 72%, and a median survival of 3.3 years.[ ][ ] Several other chemotherapy regimens have been used in small numbers of patients, but the overall results were disappointing.[ , ] Targeted therapy Novel targeted therapies are emerging as potential treatment (...) disease. Surgery Treatment for recurrent disease involves appropriate medical management (i.e., alpha-adrenergic blockade) followed by complete surgical resection, when possible. Palliative Therapy Palliation of symptoms, including those related to catecholamine excess and local mass effect, is the primary focus of treatment for disease that is not resectable. The following are options for patients with local-regional or metastatic disease who are not considered candidates for surgical resection

2015 PDQ - NCI's Comprehensive Cancer Database

127. The “go to the ER” mentality of American medicine

doctors or secretaries. People who need to be admitted are sent in “just to get checked before they go upstairs.” Or sometimes, so the physician on duty can do the negotiation with the hospitalist, rather than having the primary care physician do so. Why is the ED the default? In 1986 Reagan championed and Congress passed EMTALA, the Emergency Medical Treatment and Active Labor Act, which says you can’t turn anyone away for reasons of non-payment. Another well-intentioned bit of government meddling (...) with more and more complex and multi-varied duties in the emergency departments of the 21st century. I’m not a medical economist. I do have some thoughts on the well-intentioned but deeply flawed Affordable Care Act. However, I won’t go there right now. What I do want to address is the “go directly to the ER” mentality of modern American medicine. Call your physician. If it’s after hours, the recording for any physician or practice of any sort in America will have a message: “If this is an emergency

2016 KevinMD blog

128. Mad Libs for medicine. Do you think you can use these?

these with the nurses, and give the shift a little levity. Pain medication. You see, doctor, my pain specialist is in (foreign city). Before he left, he gave me a (duration of time) supply of (narcotic), and said if I had any problems I should go to the (health care facility). It turns out that my cousin’s (type of pet) got into my pills and (bodily function) all over half of them and ate the rest. If I could just get a (unit of weight or volume) of (drug that begins with D), I’ll be fine until my doctor comes back (...) . This time he says the pain is (erotic but not profane word), and feels as if he may (normal bodily function). His (government official) has the same thing and was (spa treatment) last week and then hospitalized. This patient insists that only IV (insect) serum will reverse the symptoms. Also a dose of (pain med that starts with D). Satisfaction scores. Dear (medical provider title): A review of your patient satisfaction scores reveals that you need to spend more time doing (type of massage) on your

2015 KevinMD blog

129. Case studies at Denver Health: 'patient dumping' in the emergency department despite EMTALA, the law that banned it. Full Text available with Trip Pro

Case studies at Denver Health: 'patient dumping' in the emergency department despite EMTALA, the law that banned it. The Emergency Medical Treatment and Labor Act was enacted in 1986 to prevent hospitals from turning away patients with emergency medical conditions, often because they were uninsured--a practice commonly known as "patient dumping." Twenty-five years later, Denver Health--a large, urban, safety-net hospital--continues to experience instances in which people with emergency (...) conditions, many of whom are uninsured, end up in the safety-net setting after having been denied care or receiving incomplete care elsewhere. We present five case studies and discuss potential limitations in the oversight and enforcement of the 1986 law. We advocate for a more effective system for reporting and acting on potential violations, as well as clearer standards governing compliance with the law.

2012 Health affairs

130. Treatment and recommendations for homeless people with Chronic Non-Malignant Pain

with these patients to develop a plan of care. The practice adaptations recommended in this document are based on a comprehensive review of published reports and consensus opinion of clinicians with expertise in homeless health care, treatment of chronic pain, and addiction medicine. These recommendations are intended to be consistent with the standard clinical guidelines listed below. Their purpose is to facilitate adherence to these standards in the care of impoverished, displaced persons with multiple medical (...) indicated. FOLLOW-UP ? Determine frequency of follow-up based on stability of the patient and his/her living situation and risk of misuse. For patients with comorbid behavioral health issues who are receiving COT, more frequent visits with random urine drug tests may be necessary. In general, opioid prescriptions should be of shorter duration (1 month or less) to help reduce risk of diversion/ overdose/ loss of medications. ? At each visit, assess for behaviors outside the treatment plan, including

2011 National Health Care for the Homeless Council

131. Diagnosis and Treatment Malaria in Pregnancy

promptly while obtaining IV artesunate). The UK guidelines explain expert consultation is required before the artesunate will be issued. 1 Severe malaria in pregnancy provides an urgent and pressing reason for artesunate to be issued (although this is not in the current guidelines). 1 IV clindamycin is a very slow-acting antimalarial and it is unlikely to add any additional value to IV artesunate, which is the fastest acting of all antimalarial drugs. In endemic countries, the treatment course when (...) of the infant to malaria. P. falciparum causes greater morbidity (maternal and fetal, principally low birth weight and anaemia) and mortality than non-falciparum infections 5,7–10 but there is mounting evidence that P. vivax is not as benign as had been previously thought. 12–14 Response to antimalarial treatment is multifactorial but is associated with the degree of prior immunity acquired from repeated exposures in childhood and the background level of drug resistance. The higher the transmission

2010 Royal College of Obstetricians and Gynaecologists

132. Late Effects of Treatment for Childhood Cancer

, the Children’s Oncology Group (COG), and the Institute of Medicine. A risk-based medical follow-up is recommended, which includes a systematic plan for lifelong screening, surveillance, and prevention that incorporates risk estimates based on the following:[ ] Previous cancer. Cancer therapy. Genetic predisposition. Lifestyle behaviors. Comorbid conditions. Sex. Part of long-term follow-up is also focused on appropriate screening of educational and vocational progress. Specific treatments for childhood (...) for medical late effects, the impact of health behaviors on cancer-related health risks is also emphasized. Health-promoting behaviors are stressed for survivors of childhood cancer. Targeted educational efforts appear to be worthwhile in the following areas:[ ] Abstinence from smoking, excess alcohol use, and illicit drug use to reduce the risk of organ toxicity and, potentially, subsequent neoplasms. Healthy dietary practices and active lifestyle to reduce treatment-related metabolic and cardiovascular

2012 PDQ - NCI's Comprehensive Cancer Database

133. Drug rehabilitation Full Text available with Trip Pro

or family-based recovery support systems. Whatever the methodology, patient motivation is an important factor in treatment success. For individuals addicted to prescription drugs, treatments tend to be similar to those who are addicted to drugs affecting the same brain systems. Medication like and can be used to treat addiction to prescription opiates, and behavioral therapies can be used to treat addiction to prescription stimulants, benzodiazepines, and other drugs. Types of behavioral therapy include (...) their jobs, avoid crime and violence, and reduce their exposure to HIV and by stopping or reducing injection drug use and drug-related high risk . is a long-acting with few side effects. It is usually prescribed in medical conditions. Naltrexone blocks the euphoric effects of alcohol and opiates. Naltrexone cuts relapse risk during the first 3 months by about 36%. However, it is far less effective in helping patients maintain abstinence or retaining them in the drug-treatment system (retention rates

2012 Wikipedia

134. Drug abuse

-help organizations in which members support each other not to use alcohol. are significantly impaired in people suffering from due to the effects of alcohol on the brain, especially the area of the brain. It has been suggested that training adjunctive to inpatient treatment of alcohol dependence is probably efficacious, including managing the social environment. Medication [ ] A number of medications have been approved for the treatment of substance abuse. These include replacement therapies (...) such as and as well as antagonist medications like and in either short acting, or the newer long acting form. Several other medications, often ones originally used in other contexts, have also been shown to be effective including and . Methadone and are sometimes used to treat opiate addiction. These drugs are used as substitutes for other opioids and still cause withdrawal symptoms. Antipsychotic medications have not been found to be useful. Acamprostate is a glutamatergic NMDA antagonist, which helps

2012 Wikipedia

135. [Enzalutamide-a novel androgen receptor inhibitor that provides treatment options for patients with castration-resistant prostate cancer]. (Abstract)

[Enzalutamide-a novel androgen receptor inhibitor that provides treatment options for patients with castration-resistant prostate cancer]. The recent emergence of new hormonal or chemotherapeutic drugs has resulted in a paradigm shift in the treatment of castration-resistant prostate cancer(CRPC). Enzalutamide is a rationally designed, orally administered androgen receptor(AR)inhibitor. It inhibits multiple points in the androgen receptor signalling pathway, which is considered an important (...) free survival[rPFS], time to the first skeletal related event[SRE])as well as objective response outcomes(i.e. PSA, soft tissue, and quality of life[QOL]). On the basis of the AFFIRM results, Astellas and Medivation filed a new drug application with the United States Food and Drug Administration and the European Medicines Agency in 2012, and obtained their approval. Another phaseI/II enzalutamide trial was conducted in both chemotherapy-naïve patients and post-chemotherapy pa- tients

2014 Gan to kagaku ryoho. Cancer & chemotherapy

136. Corneal Abrasion (Treatment)

of ketorolac in the management of corneal abrasions. Acta Ophthalmol Scand . 2001 Apr. 79(2):177-9. . Salz JJ, Reader AL, Schwartz LJ, Van Le K. Treatment of corneal abrasions with soft contact lenses and topical diclofenac. J Refract Corneal Surg . 1994 Nov-Dec. 10(6):640-6. . Weaver CS, Terrell KM. Evidence-based emergency medicine. Update: do ophthalmic nonsteroidal anti-inflammatory drugs reduce the pain associated with simple corneal abrasion without delaying healing?. Ann Emerg Med . 2003 Jan. 41(1 (...) acquired organisms to these drugs. In addition, fluoroquinolones have proven efficacy in the treatment of bacterial corneal ulcers. Prolonged and low-frequency dosing should be avoided to discourage the emergence of resistant organisms due to subinhibitory antibiotic concentrations on the ocular surface. Ofloxacin has effectiveness similar to that of tobramycin for external ocular infection, fortified cefazolin and tobramycin for bacterial keratitis, and fortified gentamicin and cefuroxime

2014 eMedicine.com

137. Cor Pulmonale (Treatment)

therapy, diuretics, vasodilators, digitalis, theophylline, and anticoagulation therapy are all different modalities used in the long-term management of chronic cor pulmonale. Patient education Patient education regarding the importance of adherence to medical therapy is vital because appropriate treatment of both hypoxia and underlying medical illness can improve mortality and morbidity. Complications Complications of cor pulmonale include syncope, hypoxia, pedal edema, passive hepatic congestion (...) that mimics the function of nitric oxide as well as acts synergistically with it to promote vasodilation. Unlike other advanced therapies, riociguat has been FDA approved for the treatment of group I pulmonary hypertension as well as group 4 pulmonary hypertension (chronic thromboembolic pulmonary hypertension). It was shown to improve exercise tolerance as well as reduce symptoms. [ ] Cardiac glycoside agents The use of cardiac glycosides, such as digitalis, in patients with cor pulmonale has been

2014 eMedicine.com

138. Nephrolithiasis (Treatment)

== processing > Nephrolithiasis Treatment & Management Updated: Jun 21, 2018 Author: Chirag N Dave, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS Share Email Print Feedback Close Sections Sections Nephrolithiasis Treatment Approach Considerations Treatment of nephrolithiasis involves emergency management of renal (ureteral) colic, including surgical interventions where indicated, and medical therapy for stone disease. In emergency settings where concern exists about possible renal failure, the focus (...) , the presence of a ureteropelvic junction (UPJ) obstruction or a ureteral stricture could make passing even very small stones difficult or impossible. Most experienced emergency department (ED) physicians and urologists have observed very large stones passing and some very small stones that do not move. Aggressive medical therapy has shown promise in increasing the spontaneous stone passage rate and relieving discomfort while minimizing narcotic usage. Aggressive treatment of any proximal urinary infection

2014 eMedicine.com

139. Nephrolithiasis: Acute Renal Colic (Treatment)

=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNDM3MDk2LXRyZWF0bWVudA== processing > Nephrolithiasis Treatment & Management Updated: Jun 21, 2018 Author: Chirag N Dave, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS Share Email Print Feedback Close Sections Sections Nephrolithiasis Treatment Approach Considerations Treatment of nephrolithiasis involves emergency management of renal (ureteral) colic, including surgical interventions where indicated, and medical therapy for stone disease. In emergency settings where concern exists about possible renal failure (...) individual. For example, the presence of a ureteropelvic junction (UPJ) obstruction or a ureteral stricture could make passing even very small stones difficult or impossible. Most experienced emergency department (ED) physicians and urologists have observed very large stones passing and some very small stones that do not move. Aggressive medical therapy has shown promise in increasing the spontaneous stone passage rate and relieving discomfort while minimizing narcotic usage. Aggressive treatment of any

2014 eMedicine.com

140. Breech Presentation (Treatment)

subjects in the planned vaginal delivery group, 591 (56.7%) had vaginal deliveries. Indications for cesarean delivery included: fetopelvic disproportion or failure to progress in labor (226), nonreassuring fetal heart rate tracing (129), footling breech (69), request for cesarean delivery (61), obstetrical or medical indications (45), or cord prolapse (12). The composite measurement of either perinatal mortality or serious neonatal morbidity by 6 weeks of life was significantly lower in the planned (...) are attempted prior to 39 weeks, as long as there are no obstetrical or medical indications for induction, discharging the patient to await spontaneous labor would seem most prudent. In those with an unsuccessful ECV, the practitioner has the option of sending the patient home or proceeding with a cesarean delivery. Expectant management allows for the possibility of spontaneous version. Alternatively, cesarean delivery may be performed at the time of the failed ECV, especially if regional anesthesia is used

2014 eMedicine.com

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