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181. Extracorporeal Photopheresis for Sezary Syndrome or Mycosis Fungoides: Clinical and Cost-Effectiveness

photopheresis for the management of Sezary Syndrome or Mycosis fungoides. Tags blood, cancer, granulomatous slack skin, mycosis fungoides, photopheresis, sezary syndrome, Cutaneous T Cell Lymphoma, ECP, granuloma fungoides, photophereses Files Rapid Response Summary of Abstracts Published : September 30, 2015 Follow us: © 2019 Canadian Agency for Drugs and Technologies in Health Get our newsletter:

2015 Canadian Agency for Drugs and Technologies in Health - Rapid Review

182. Newborn Nursing Care Pathway

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Skin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Neuromuscular . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Genitalia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Elimination Urine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Stool . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Vital signs (...) through breastfeeding or skin-to-skin contact Referring to a Primary Health Care Provider (PHCP) Prior to referring to a Primary Health Care Provider (PHCP) a specific or newborn global assessment 4 (physical and feeding) including history of the pregnancy and labour and birth, will be performed by the nurse. Whenever possible, the woman/her family (supports) are present at the assessment and included in the planning, and implementation of the newborn’s care. In the intervention sections

2015 British Columbia Perinatal Health Program

183. Acromegaly

sizes) ? Soft tissue change (e.g., skin tags) ? Hyperhidrosis ? Glucose intolerance ? Neuropathy ? Arthritis ? Sleep apnea BACKGROUND Acromegaly is a chronic debilitating condition that is usually the result of a growth hormone secreting pituitary adenoma. Epidemiologic studies have suggested an incidence of three to four per million with a prevalence of 68 to 80 cases per million. 1,2 Serum IGF-1 detects nearly all cases of acromegaly and correlates with the clinical activity of the disease. 3-5

2014 Toward Optimized Practice

185. A patient gives the gift of poop

A patient gives the gift of poop A patient gives the gift of poop A patient gives the gift of poop | | February 15, 2019 10 Shares In broken English, against the backdrop of the emergency department’s chaos and clatter, Mr. Simon relayed his story: unintentional weight loss, gradually yellowing skin, weeks of constipation. He punctuated his list of devastating symptoms with laughter — exaggerated but genuine guffaws. Over the next few days, as the medical student responsible for his care, I (...) . This piece was originally published in . Image credit: … … 10 Shares Tagged as: , Subscribe to KevinMD and never miss a story! Get free updates delivered free to your inbox. Subscribe Hire KevinMD to keynote your next event "Kevin's keynote presentation was perfect. Extremely rich in content, and a delivery that is world class." Related Posts More in Conditions < Previous post Next post > Find jobs at Careers by KevinMD.com Search thousands of physician, PA, NP, and CRNA jobs now. × Leave a Comment

2019 KevinMD blog

186. Patient Dignity (Formerly: Patient Modesty): Volume 95

that night to my husband. Reviewing several drugs sites, I found that these of some of the side effects fentanyl can have: decreased awareness/responsiveness difficult or labored breathing slow breathing rate chills chest pain tightness of chest irregular heartbeat fast/slow heartbeat unusual tiredness/weakness lethargy confusion nausea pale skin seeing, hearing, feeling things that are not there severe sleepiness thinking abnormalities trembling trouble concentrating lack/loss of strength hypotension

2019 Bioethics Discussion Blog

187. Are penicillin allergies fake news?

parents who can’t recall which of their children has the amoxicillin allergy; we end up testing all of them because somehow it was listed in all of their charts. We can let families know that rashes may not be due to amoxicillin and that they should have allergy evaluation as soon as possible. Prepping for when they visit the allergist, and letting the families know what to expect, may help overcome initial hesitation to visit another doctor. The child (or adult) may not need skin testing (in the past (...) this was always done with painful intradermal injections – essentially multiple PPDs). Our guidelines around who needs skin testing are in flux, and more physicians are skipping this and going directly to oral challenges. We can start to change our societal narrative around drug allergies. Counseling the family that drug allergies are not “inherited” will go a long way. Grandma’s drug allergy should not affect a toddler’s prescription for amoxicillin. Allergists will continue to clear the allergies and keep

2019 KevinMD blog

188. “The Wait” after a mammogram changes lives

sometimes bald. There are women with coiffed hair and manicured fingers bright with diamonds and women whose gravelly voices erupt around decayed teeth set into a fold of prematurely wrinkled skin. Everyone is equal in “The Wait.” As you flip mindlessly through the magazines awaiting your turn at the massive machine that minimizes what some might consider their “best asset” into flat pancakes of flesh you can’t help but turn to wonder: Does the young woman across from you have cancer? How awful. Would (...) and distracts you from your worry. That creaky worry that sits in your subconscious all year long and comes to visit today. They say they will email your results, but that’s not really true. Several days pass — a week. You’re still looking for that email. Then the voice on your answering machine after a long day at work says, “Please call our office to discuss your test results.” Face it. No one makes time to call you for good news. is a family physician. Image credit: … … 72 Shares Tagged as: Subscribe

2019 KevinMD blog

189. In medicine, what’s in a name?

that the excess water deep within her skin oozed onto the surface when prodded. Our job had been to slowly coax her kidneys to release the excess fluid. What I found most intimidating, however, was not the complexity of her disease. It was using my newly titled name with her. On my first day as her doctor, I avoided it altogether. I introduced myself as Megan Baker, the doctor taking care of you in this admission. Using the title felt particularly hollow and counterfeit when it was directed toward this young (...) time to say goodbye. As I turned to walk out of her room, she caught a glimpse of my name tag, stopped me and asked, “Wait, what name do you like to go by again?” I laughed. “You can call me Maggie.” Suddenly, I felt more like a doctor than I had felt the whole month. is an internal medicine resident. Image credit: … … 213 Shares Tagged as: , Subscribe to KevinMD and never miss a story! Get free updates delivered free to your inbox. Subscribe Hire KevinMD to keynote your next event "Kevin's keynote

2019 KevinMD blog

190. Patients are an integral part of medical student education

Patients are an integral part of medical student education Patients are an integral part of medical student education Patients are an integral part of medical student education | | January 25, 2019 13 Shares A face feels nothing like a frozen pig’s foot, I thought, as I guided a curved needle into the woman’s cheek, drawing the absorbable thread across her still-bleeding wound. Two wraps around the needle driver and I pulled the nearly invisible thread through, bringing the edges of her skin (...) back together, securing my first knot. “Hey, have you ever sutured?” the ER doctor had asked, just minutes before. “Only in class,” I replied, thinking back to the stitches we learned on thawing pig’s feet. I had also practiced that morning on a little plastic pad that had clean cuts of fake, rubbery skin. “You can close up that woman’s laceration,” she hollered, already walking away to gather supplies. “Great! Thank you! Oh,” I paused, “but isn’t the cut on her face?” The doctor stopped in her

2019 KevinMD blog

191. Evaluating the Accuracy of Hemorrhoids: Comparison Among Specialties and Symptoms. (PubMed)

48%. The hemorrhoid diagnostic accuracy was 65% (n = 311). Among patients with incorrect hemorrhoid diagnoses (35%; n = 169), actual diagnosis was anal fissure (34%), skin tag (27%), and hypertrophied papilla (6%). One rectal and 2 anal carcinomas were found (0.63%). Compared with general practitioners, gastroenterologists had 86% higher odds of correct diagnosis (OR = 1.86 (95% CI, 1.10-3.10); p = 0.02), whereas the gynecologists had 68% lower odds of correct diagnosis at the time of referral

2019 Diseases of the Colon & Rectum

192. Why is Medicaid reimbursement below sustainability?

Why is Medicaid reimbursement below sustainability? Why is Medicaid reimbursement below sustainability? Why is Medicaid reimbursement below sustainability? | | January 15, 2019 54 Shares Recently, a child was on a waitlist for five months to get into my practice. For this article, I will call him Tiny Tim. Tiny Tim, now five years old, has a skin condition known as eczema or atopic dermatitis. When we first met, virtuously every area of his body was covered with wounds from constant scratching (...) . Skin that breaks easily and heals poorly can give bacteria access to other parts of the body. After our first visit, his mother complied with all the necessary care, and his condition was slowly improving. But on a weekend day in December Tim was rushed to an urgent care center, with a fever and pain in his ankle. He had no history of injury and the blood work, at first glance, indicated only mild infection. He was diagnosed with a virus and sent home. Two days later his fever spiked to 103 degrees

2019 KevinMD blog

193. Horrific decisions that no parent should ever have to make

of chromosome 18 instead of the usual two. There is no cure. Most babies with trisomy 18 . The majority of those who make it to term , usually due to severe heart and lung defects. The few who live past one year have serious health problems, such as a toddler lacking abdominal wall muscles, revealing the slithering movement of intestines beneath his skin, or a 1-year-old who cannot defecate on her own, requiring anal sphincter dilation multiple times each day. In rare cases, babies with trisomy 18 (...) are able to make. Allison Chang is a medical student. This article originally appeared in . Image credit: … … 53 Shares Tagged as: , Subscribe to KevinMD and never miss a story! Get free updates delivered free to your inbox. Subscribe Hire KevinMD to keynote your next event "Kevin's keynote presentation was perfect. Extremely rich in content, and a delivery that is world class." Related Posts More in Conditions < Previous post Next post > Find jobs at Careers by KevinMD.com Search thousands

2019 KevinMD blog

194. A change in a patient changed us all

, and she’s wearing a long, heavy wool cape. She looks like she’s nine months pregnant with triplets. There’s a man with her, but he’s not saying anything.” Gingerly, I entered the exam room. Maraby, a tall woman, sat staring at the floor. Her partner, Darren, stood to one side. When I glanced his way, he anxiously averted his eyes. Maraby’s skin was a goldenrod hue. I felt my own skin tingling. She was in her early 40s but looked much older. Her hair was scanty, her teeth were short nubs, and her body (...) published in . Image credit: … … 15 Shares Tagged as: , Subscribe to KevinMD and never miss a story! Get free updates delivered free to your inbox. Subscribe Hire KevinMD to keynote your next event "Kevin's keynote presentation was perfect. Extremely rich in content, and a delivery that is world class." Related Posts More in Conditions < Previous post Next post > Find jobs at Careers by KevinMD.com Search thousands of physician, PA, NP, and CRNA jobs now. × A change in a patient changed us all 1

2019 KevinMD blog

195. Patients and physicians need to talk more and tweet less

that even if the doctors were outstanding, an argument with a receptionist, a canceled appointment, or insurance glitch were responsible for a miserable experience. The reviewer warns patients to go elsewhere. Wouldn’t it be more effective to let the practice know to directly to address the issues? Destructive. Over nearly four decades of practice have I ever misdiagnosed a skin cancer? Prescribed a drug that did not work or yielded an adverse reaction? Have I ever not acquiesced to every patient (...) patient outcomes. The late President George H.W. Bush, asked for a “kinder, gentler” nation. I hope the same for medical practice. Communication is the key. Patients and physicians need to talk more and tweet less. is a dermatologist and can be reached at . Image credit: … … 50 Shares Tagged as: , Subscribe to KevinMD and never miss a story! Get free updates delivered free to your inbox. Subscribe Hire KevinMD to keynote your next event "Kevin's keynote presentation was perfect. Extremely rich

2019 KevinMD blog

196. Sun exposure makes people both more and less likely to die of melanoma. How can that be?

? The answer is pale-faced Paula. Surprised? Let me unpack this mystery and explain why sun exposure simultaneously kills people, while making the cancers they are diagnosed with appear to be less life-threatening. I will start with what you probably know already. Melanoma is a potentially life-threatening skin cancer. It occurs usually as a , including fair complexion and sun exposure. (I lost my beloved redheaded aunt to melanoma when she was tragically young.) All else equal, people who , or in tanning (...) dermatologists, for treatment of all the sun damage on their skin. While at those appointments, the dermatologists find melanomas that otherwise might have gone undetected. More importantly, some of those melanomas might be relatively mild, and if undetected might have never become life-threatening. My wife, for example, is a redhead, whose family is chock full of people who have been diagnosed with melanoma. So she has been diligent about seeing dermatologists regularly. One of those doctors removed a bad

2019 KevinMD blog

197. Not all pathologists are created equal

the area must be examined under a microscope. Those cells can be obtained with an open biopsy or an FNA biopsy. An open biopsy, as you might expect, is a surgical procedure. It may take weeks to set up the appointment. You need a general or local anesthetic. These procedures are usually done in an outpatient surgery center or hospital. The surgeon makes an incision, or cut, in the skin and removes the questionable tissue. There is a certain amount of tissue trauma and bleeding, which means it takes (...) are created equal, so make sure you do your research and find the best option for your health. is a pathologist and can be reached at her self-titled site, . Image credit: … … 7 Shares Tagged as: Subscribe to KevinMD and never miss a story! Get free updates delivered free to your inbox. Subscribe Hire KevinMD to keynote your next event "Kevin's keynote presentation was perfect. Extremely rich in content, and a delivery that is world class." Related Posts More in Conditions < Previous post Next post > Find

2019 KevinMD blog

198. Responding to Emergencies One Behavior at a Time

in traditions During the behavior change was critical to prevent people from getting sick and ultimately stop a disease threat. In the wake of the outbreak, communities in West Africa were encouraged to give up or change their traditional burial practices. Some of these longstanding rituals, like washing the body, proved dangerous because the virus can live on the skin of a victim after death. Communicators developed public health messaging to help change social norms and customs for burials (...) that seem counterintuitive or wrong to them. Careful application of behavioral science is critical to any mission that seeks to improve public health and safety, here and around the world. The Communication Research and Evaluation blog series highlights innovative research and evaluation methods used at CDC to improve behavior change campaigns. Posted on February 26, 2018 by Dr. Stephen Redd, Director, Office of Public Health Preparedness and Response Categories , , , , Tags , , , , , , , 9 comments

2018 CDC Public Health Matters

199. Funtabulously Frivolous Friday Five 224

of the Simulium black fly. It is the world’s second-leading infectious cause of blindness. Bizarrely, it is actually an endosymbiont of the nematode, Wolbachia pipientis, that causes the severe inflammatory response typical of the disease when the nematodes die in various parts of the body. This manifests as keratitis, optic neuritis, onchodermatitis (including a ‘lizard skin’ appearance), edema and lymphadenopathy. The parasite is transmitted to humans through the bite of a black fly of the genus Simulium (...) . Mazzotti reactions can be life-threatening, and are characterized by fever, urticaria, swollen and tender lymph nodes, tachycardia, hypotension, arthralgias, oedema, and abdominal pain that occur within seven days of treatment of onchocerciasis. Today, treatment focuses on the use of ivermectin to kill the nematodes, as well as antibiotics such as doxycycline to kill the Wohlbachia species. [ ] Share this: Filed Under: Tagged With: , , , , , , , , About Neil Long Emergency Physician working

2018 Life in the Fast Lane Blog

200. How “they” view “us”: Colton Berrett edition

). Even so, we cannot allow the potential emotional reaction of such families silence us. The stakes are too high. We can, however, try our best to be empathetic and respectful while keeping the focus on the target, in this case, antivaccine misinformation and pseudoscience of the type being spread by Polly Tommey. Share this: Related Categories , , , , , , Tags , , , , , , , Previous January 18, 2018 Next January 22, 2018 121 Comments Nail, head, you hit it. Anti-vaxxers think nothing of exploiting (...) for skin testing and for allergen-specific IgE assays. Now more than 10 unique proteins are recognized as major latex allergens. Although much has been learned about latex allergy, important unanswered questions remain, including the sources of latex exposure that led to sensitization, why latex allergy increased dramatically during the 1980s, and the prevalence of latex allergy in diverse populations. This review concentrates on the history of latex use in medicine and the dramatic emergence

2018 Respectful Insolence

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