For those of you who haven’t seen it yet, here is video of St. Paul University Hospital being imploded on Sunday.
St. Paul University Hospital was built in 1963 and has been owned by UT Southwestern since 2005. Among other firsts, St. Paul was the site of the first heart transplant in Dallas in 1985. The grounds of the former St. Paul will serve as the physical site of the West Campus Master Plan. This comprises 1.1 million square feet of new space; a high-tech Simulation Center for training students, residents, fellows, and faculty; and expansion of outpatient facilities. It also includes construction of a new thermal energy plant and more than 5,000 new parking spaces.
Two sisters of St. Paul’s Daughters of Charity order, along with a man, observe progress on the steel frame of St. Paul Hospital on Harry Hines Blvd. The Daughters of Charity wore the distinctive “cornette” headpieces until September 20, 1964. Photo circa 1962
Video courtesy of Dallas Morning News.
Photo taken from UT Southwestern Archives Collection.
The Pulitzer-prize winning investigative journalism site, ProPublica, recently published an analysis of Medicare data regarding over 17,000 surgeons and their complication rates. Doctors can go to the site to compare themselves to their peers and patients can use the same information to select a surgeon. The analysis found that a small percentage of surgeons account for a disproportionate percentage of the complications. The study focused on elective surgeries and reportedly accounted for age and health.
Although the data is reported on individual surgeons and their complication rates within a particular hospital system, it begs the question of whether these rates are reflective of the individual or if there are significant healthcare systems issues at play.
At morning report, discussions surrounding our own patient management issues arose: How do I score on managing diabetes compared to my peers? What is my going complication rate for heart failure patients?
Read the full article here
Find out how your surgeon scored
The Centers for Medicare and Medicaid Services (CMS) announced yesterday a proposal to reimburse physicians for counseling Medicare patients on end-of-life planning. This proposal follows the recommendations of multiple large physician and healthcare organizations including the AMA, ACP and AARP. The proposal is still pending and the final rule change is due November 1 with payments starting January 1.
Reimbursement for end-of-life planning was initially included in the early stages of the Affordable Care Act but was removed after strong political opposition from groups who argued that it would lead to the creation of “death panels”. Sarah Palin famously said during her 2008 presidential run “Government needs to stay the hell out of our end-of-life discussions”.
While many physicians already engage in end-of-life planning discussions with their patients, the establishment of a formal reimbursement structure would undoubtedly lead to increased utilization.
Read more at Medscape, WSJ and the NYTimes
What are your thoughts? Would Medicare reimbursements change your willingness to engage in advanced care planning with your patients?
Check out the recent Nature publication by Dr. Hesham Sadek‘s group in which they identify and characterize cycling cardiomyocytes in a novel transgenic mouse model. Their work was recently highlighted on KERA and highlights the role of hypoxia signalling and HIF1-alpha in maintaining cardiomyocyte proliferative capacity. This research suggests that adult mammals are capable of cardiac regeneration following ischemic injury and is an important step toward the ultimate goal: cellular therapies for human coronary ischemia!
Figure reprinted with permission by Nature Publishing Group
Our own Dr. Christian Mayorga was interviewed on KERA yesterday about the recent spike in cases of cyclosporiasis in Texas. Following outbreaks in 2013 (133 cases) and 2014 (270 cases), the Texas Department of Health State Services has already received reports of 113 cases as of July 3 with the majority of these occurring in the past two weeks. Remember to ask your patients about fresh produce consumption and sick contacts!
- single-celled organism (Cyclospora cayetanensis)
- typically found in imported fresh produce
- dominant symptom is watery diarrhea
- Diagnosis: acid-fast stool stain
- Treatment: typically supportive but persistent diarrhea treated with bactrim
Figure courtesy of DPDx
This week the FDA Endocrinologic and Metabolic Drugs Advisory Committee will discuss the safety and efficacy of two PCSK9 inhibitor drugs (Praluent and Repatha) and may recommend approval of these drugs to lower cholesterol. Recently published research in NEJM showed reduced cardiovascular outcomes with these inhibitors and has sparked guarded optimism from the medical community. UT Southwestern cardiologist, Dr. Amit Khera, was recently quoted in Medscape regarding these powerful cholesterol lowering medications, “If you’re a cardiologist, you must not have a pulse if you’re not excited.” Click on the link below to read more from The Washington Post!
Could these New Cholesterol Drugs Save Many Americans from Heart Attacks?
The FDA panel today recommended approval of the cholesterol drug, alirocumab, in a 13-3 vote. Click on the link below to read a summary from today’s developments from The New York Times.
Federal Panel Recommends Approving New Cholesterol Drug
Recently, South Korean authorities have increased the number of people quarantined and have temporarily closed many schools due to fears of the Middle Eastern Respiratory Syndrome (MERS) spreading. As of June 4, 35 South Koreans had tested positive for the virus including 2 deaths. Click on the link below to read about this from The New York Times.
Middle Eastern Respiratory Syndrome – Coronavirus
- Coronavirus first isolated in 2012
- Camels and bats established as a reservoir
- Range of disease includes “common cold” type symptoms/signs to severe pulmonary illness
- Majority of cases identified in regions near Arabian Peninsula: Saudi Arabia, United Arab Emirates, Qatar, Oman, Jordan, Kuwait
- Human-human spread likely requiring close-contact
- Symptoms: fever, cough, and dypsnea most common; also includes nausea, vomiting, and diarrhea
- Mortality: 50-65%
- Molecular diagnostics are the method of choice: PCR assays of respiratory, stool, blood specimens
- Cases should be reported immediately to the local and state health department
- No antiviral therapy identified
- Supportive care including mechanical ventilation
(Hopkins ABX Guide)
Fears of MERS Virus Prompt Broadening of Cautions in South Korea
Congratulations to Dr. Ishak Mansi from the division of General Internal Medicine at UT Southwestern for his recently published article, “Statins and New-Onset Diabetes Mellitus and Diabetic Complications: A Retrospective Cohort Study of US Healthy Adults” in the Journal of General Internal Medicine. Dr. Mansi’s findings were featured on the frontpage of Medscape this past week and has gained a lot of attention. According to Dr. Mansi and the authors, this is one of the first studies to show a connection between statin use and risk of diabetes in a generally healthy group. Click on the links below to read the summary of the article’s findings as well as the abstract!
Statins and New-Onset Diabetes Mellitus and Diabetic Complications: A Retrospective Cohort Study of US Healthy Adults
Statins Linked to Diabetes and Complications in Healthy Adults (Medscape)
Our previous post about food-borne botulism referred to a recent outbreak in Ohio. The source of that outbreak has been discovered – potato salad. For more on recent outbreaks – click the image below: