Archive for November, 2008

from Medscape

WASHINGTON (Reuters) Nov 18 – Primary care doctors in the United States feel overworked, and nearly half plan to either cut back on how many patients they see or quit medicine entirely, according to a survey released on Tuesday.

More than half — 60% — of 12,000 general practice physicians would not recommend medicine as a career.

“The whole thing has spun out of control. I plan to retire early even though I still love seeing patients. The process has just become too burdensome,” the Physicians’ Foundation, which conducted the survey, quoted one of the doctors as saying.

The survey adds to building evidence that not enough internal medicine or family practice doctors are trained or practicing in the United States, although there are plenty of specialist physicians.

Health care reform is near the top of the list of priorities for both Congress and president-elect Barack Obama, and doctor’s groups are lobbying for action to reduce their workload and hold the line on payments for treating Medicare, Medicaid and other patients with federal or state health insurance.

The Physicians’ Foundation, founded in 2003 as part of a settlement in an anti-racketeering lawsuit among physicians, medical societies, and insurer Aetna, Inc., mailed surveys to 270,000 primary care doctors and 50,000 practicing specialists.

The 12,000 answers are considered representative of doctors as a whole, the group said, with a margin of error of about 1%. It found that 78% of those who answered believe there is a shortage of primary care doctors.

More than 90% said the time they devote to nonclinical paperwork has increased in the last 3 years and 63% said this has caused them to spend less time with each patient.

Eleven percent said they plan to retire soon and 13% said they plan to seek a job that removes them from active patient care. Twenty percent said they will cut back on the number of patients they see and 10% plan to move to part-time work.

Seventy-six percent of physicians said they are working at “full capacity” or “overextended and overworked.”

Many of the health plans proposed by members of Congress, insurers and employers’ groups, as well as Obama’s, suggest that electronic medical records would go a long way to saving time and reducing costs.



by Arianna Huffington
excerpted from The Huffington Post

Even if your candidate didn’t win tonight, you have reason to celebrate. We all do.

Ten months ago, when Obama won in Iowa, we had a glimpse of what was possible and what became real tonight. What I wrote then about one state is now true for the whole country:

Barack Obama’s impressive victory says a lot about America, and also about the current mindset of the American voter.

Because tonight voters decided that they didn’t want to look back. They wanted to step into the future — as if a country exhausted by the last seven-plus years wanted to recapture its youth.

And they turned out in unprecedented numbers today to make sure that no amount of scrubbed rolls, malfunctioning machines, endless lines, or polling places running out of ballots would block the way.

The history of America is studded with great breakthroughs — propelled by leaders such as Lincoln, Teddy Roosevelt, FDR, and Martin Luther King – followed by decades of consolidation and occasional regression.

The Bush years have clearly been in a period of regression. The repudiation of those years is now almost universal. Even conservatives are admitting it; over the course of today, I’ve received numerous emails from conservatives ending with some variation on “Go Obama!”

In America’s journey toward a more just and truly democratic society, tonight is another milestone. And not just because the son of a Kenyan father and a mother from Kansas is now President-Elect. But also because tonight’s outcome is a declaration that we are once again a nation more driven by hope and promise than a nation driven by fear.

Bush’s re-election in 2004 was a monument to the power of fear. And McCain, his staff stocked with Karl Rove disciples, followed the Bush blueprint and played the fear card again and again.

Be afraid of Obama, the GOP warned us. Be afraid of something new, something different. He would meet with our enemies. His middle name is Hussein. He “pals around with terrorists,” consorts with the radicals at Acorn (which is “destroying the fabric of democracy”), and doesn’t see America “like you and I see America.” A vote for Obama would be “dangerous” and “too risky for America.”

The people of America listened, but chose to take the risk. So even if you voted for John McCain; even if you love Sarah Palin, who is still in search of the “pro-American areas of this great nation”; even if are Joe the Plumber – or, hell, even if you are Michele Bachmann – tonight is a night to be proud of America.

Obama’s victory holds up a mirror, reflecting the country we are. And it turns out to be the kind of country we’ve always imagined ourselves being — even if in the last seven-plus years we fell horribly short: a young country, an optimistic country, a forward-looking country, a country not afraid to take risks or to dream big.

Of course, it will take more than big dreams to help America dig out from the many crises we face. From the global economic crisis to the wars in Iraq and Afghanistan, the day of reckoning is upon us.

But these challenging times also will provide the new president with the opportunity to really transform America. As Gary Hart points out, “Great presidents do not emerge form quiet times; they arise in times of chaos and crisis.”

This is an idea that has animated Obama’s candidacy from the beginning. As he put it on the stump many times last week:

We began this journey in the depths of winter nearly two years ago, on the steps of the Old State Capitol in Springfield, Illinois. Back then, we didn’t have much money or many endorsements. We weren’t given much of a chance by the polls or the pundits, and we knew how steep our climb would be. But I also knew this. I knew that the size of our challenges had outgrown the smallness of our politics.

Since that time, the size of our challenges has grown even bigger — and the smallness of our politics has even downsized McCain from a noble hero to a hack fearmonger.

But over the course of this long and arduous campaign, Obama has repeatedly demonstrated the ability to inspire us to tap into the better angels of our nature — to stir the American people to expect more of themselves than they otherwise would.

It’s a theme Michelle Obama touched on many times on the campaign trail. “Barack Obama will require that you work,” she said at a rally on the eve of Super Tuesday. “He is going to demand that you shed your cynicism; that you put down your divisions; that you come out of your isolation; that you move out of your comfort zones; that you push yourself to be better; and that you engage.”

This call echoed something that historian and presidential biographer David McCullough had once said about JFK. “The great thing about Kennedy,” he told me, “is that he didn’t say I’m going to make it easier for you. He said it’s going to be harder. And he wasn’t pandering to the less noble side of human nature. He was calling on us to give our best.”

See the rest of this article on The Huffington Post

Passed Gas Good for Your Blood Pressure

Posted: November 3, 2008 by Doc in Medical
Tags: ,

Flatulence’s stink may be linked to lower blood pressure
Friday, October 24, 2008 | 12:44 PM ET
from CBC News
The gas responsible for the foul odour of flatulence and rotten eggs may play an important role in regulating blood pressure, Canadian researchers say in a study released Friday.

Hydrogen sulphide — a toxic gas that, among other things, is made by bacteria living in the human intestinal tract — relaxes blood vessels and allows for easier blood flow, according to the study in Friday’s edition of the journal Science.

It is hard “not to overestimate the biological importance of hydrogen sulphide or its implications in hypertension,” writes Rui Wang, a physiologist at Lakehead University in Thunder Bay, Ont. Wang co-authored the study with Lingyun Wu, a pharmacologist of the University of Saskatchewan and other researchers from the Johns Hopkins medical school in Baltimore.

The five-year mouse study found that an enzyme called CSE produced the gas in cells lining the walls of blood vessels throughout the body.

That finding confirmed earlier research that suggested a link between the enzyme and the gas.

In the study, researchers bred mice with lower-than-average levels of CSE and found that the engineered animals had significantly depleted levels of hydrogen sulphide compared to a group with normal levels of the enzyme.

The researchers also found that the mice with CSE deficiencies had blood pressure levels that were 20 per cent higher than the normal mice.

However, when the mice bred for lower CSE levels were given methacholine, a drug given to relax blood vessels, their blood pressure levels were not significantly different than those with normal levels of the enzyme. The researchers said this suggests the gas is responsible for the change in blood pressure.

The findings could lead to new treatments for high blood pressure in humans, said the study authors.

“Now that we know hydrogen sulphide’s role in regulating blood pressure, it may be possible to design drug therapies that enhance its formation as an alternative to the current methods of treatment for hypertension,” study co-author Dr. Solomon H. Snyder, a neuroscientist at Johns Hopkins University, said in a Johns Hopkins news release.