Kathleen Miller

It’s Sepsis Awareness Month! Are you looking for peer inspiration to get started on improving Sepsis practices? Check out our 2023 Sepsis Honor Roll hospital journey posterboards, compiled in this Excellence in Practice Hospital Journey virtual booklet. https://hubs.ly/Q02MWxGn0 #SepsisAwarenessMonth

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Full read review of the benefits & impact of hydroxychloroquine in #SLE. Benefits on: - T cells, cytokines, TLR signaling - VTE prevention - Decr CV risks - Glucose & lipid benefits - Pregnancy

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There's a lot to unpack in this 2023 snapshot of obesity rates in the US. Further monitoring and investigation is needed to fully understand the causal impact of GLP-1s, the effects on cardiovascular risk and long-term health, the extent of rebound weight gain after discontinuation, and a wider range of appropriate use cases across cardiometabolic health. #obesity #glp1 #healthcareonlinkedin

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📢 Check out the latest issue of the Journal of Diabetology! (Apr-Jun'24, Volume 15, Issue 2) Highlights include: • Review articles delve into diabetes mind-body interactions, cardiovascular benefits of newer combinations, neuromuscular taping and Clinical and Biochemical Features for diabetes classification. • Original articles cover diverse topics such as non-pharmacological diabetes management, Insulin Degludec impact on COVID-19 patients, and new-onset diabetes in Long COVID-19. • Case reports spotlight persistent hypoglycemia and a prolonged honeymoon phase in type 1 diabetes. • A letter to the editor discusses the potential of AI in gestational diabetes management Read more: https://lnkd.in/gFvprUmM #Diabetes #Research #Healthcare #Innovation #JournalOfDiabetology

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Novel Efficacy Index Compares Long-Term Therapy Outcomes in AD Treatments. To assess long-term treatment outcomes for atopic dermatitis (AD), researchers have introduced a novel efficacy index that accounts for both on-drug and off-drug responses. https://lnkd.in/d2PGB4s3

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With the FLEXdose Delivery Program, physicians can admit, map and treat patients on the same day. Nima Kokabi, MD FRCPC, Ripal Gandhi, M.D., FSVM, FSIR and Alex Villalobos, MD expand on the benefits and case examples of this #Y90 approach in a 20-minute video on Endovascular Today: https://lnkd.in/egndVp4S

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Combining treat-to-target principles and shared decision-making: International expert consensus-based recommendations with a novel concept for minimal disease activity criteria in atopic dermatitis. https://lnkd.in/diEmrs9b

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5 yr outcomes of 150 difficult-to-treat RA (D2T RA) pts - D2T RA resolved in 45%, persisted in 50%, & 5% died. Resolved D2T RA was signif younger, had more Rx changes, & more IL-6i use. Mortality predicted by comorbidity index, steroid escalation (OR 3.50; & 32) https://buff.ly/4bG7aRQ

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"How to Live Longer" - reflecting on a fascinating discussion about the future of healthcare at the #newyorkerfest between Dr. Atul Gawande and Dr. Dhruv Khullar: A few key insights worth sharing: 💡 The future of medicine isn't just about living longer—it's about living better. We're finally recognizing that healthcare should align with patients' life priorities and values, not just survival metrics. 🔍 While maximum lifespan remains stubborn (~120 years), we're getting better at helping more people reach their 80s and 90s with quality of life. Countries like Japan and Korea are leading the way with 85-year average life expectancies. 📊 The power of accessible healthcare is striking: Thailand reduced deaths before age 50 from 60% to just 35% in 20 years by building strong primary care infrastructure and deploying community health volunteers. That's the difference good healthcare systems can make. 🌡️ Climate change is emerging as a major health crisis. From heat-related illnesses to changing disease patterns, our healthcare systems need to adapt quickly. ⚖️ The biggest challenge ahead? Healthcare equity. When our top 1% live to 89 while others barely reach 72, we have work to do. Countries succeeding in this space prioritize accessible primary care and community health workers. One measure Dr. Gawande uses in his work at USAID is % of people dying under the age of 50. This is what this measure looks like in different parts of the world: - Japan 2% - Europe -5%  - USA - 10%  - Africa - 65% #Healthcare #FutureOfMedicine #PublicHealth #HealthEquity #ClimateHealth

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The Sequence for the week of 4/29-5/5 talks about a previously unreported repeat expansion founder mutation causing Spinocerebellar ataxia type 4 (SCA4). SCA4 is a rare subtype of SCA characterized by ataxia and nerve pain and numbness that has never before been associated with repeat expansions. This could mean an entirely new way to utilize testing and treatments for SCA4! #genetics, #publicpolicy, #geneticcounseling, #precisionmedicine, #translationalmedicine, #genetictesting, #geneticresearch, #genomesequencing, #spinocerebellarataxia, #SCA, #SCA4

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Alcohol and Cancer: A Wake-Up Call from the US Surgeon General A recent report by US Surgeon General Dr. Vivek Murthy highlighted an alarming truth that even small amounts of alcohol consumption can increase the risk of cancer. This revelation serves as a crucial reminder that alcohol is not as harmless as it’s often perceived. It’s time to rethink our habits and raise awareness about the risks with evidence mounting about the carcinogenic effects of alcohol, The Surgeon General’s report draws attention to the link between alcohol and several types of cancer, including cancers of the mouth, throat, esophagus, liver, colon, rectum, and breast. Alcohol’s cancer-causing effects stem from its breakdown in the body into acetaldehyde, a toxic chemical that damages DNA and prevents it from being repaired. Dr. Murthy emphasizes that even low levels of drinking, such as a glass of wine or beer occasionally can elevate cancer risk. Contrary to popular belief in India that 2 pegs of alcohol are good of health but there is no completely safe level of alcohol consumption when it comes to cancer. The World Health Organization (WHO) has also revealed that “there is no safe limit for alcohol consumption that does not affect your health adversely”, destroying a long-held belief that imbibing alcohol in small amounts is good for health. Like most of the tobacco products, alcoholic beverages should also come with clear warning labels that will inform consumers of the potential health risks. These labels will help to increase awareness as many people remain unaware of alcohol’s cancer risks. With proper warning, individuals may reconsider their drinking habits along with encouraging public health advocacy by labeling alcohol as a carcinogen could lead to stronger prevention strategies and policies. Let's inform the world by sharing the US Surgeon General’s findings to help raise awareness and to support initiatives to mandate warning labels on alcohol bottles. This new report serves as a wake-up call for individuals, policymakers, and public health advocates to not just avoid excessive drinking but also to understand that even moderate alcohol use carries cancer risks. Alcohol’s widespread cultural acceptance should not overshadow its serious health consequences. If tobacco products carry warnings about cancer risks, why shouldn’t alcohol? Your Health Matters. Let’s Take a Stand. #cancer #alcohol #prevention #breastcancer #colorectalcancer #livercancer #mouthcancer #throatcancer #esophagealcancer AIIMS (All India Institute of Medical Sciences, New Delhi), @American Society of Clinical Oncology (ASCO), Asian Pacific Organization for Cancer Prevention (APOCP), ESMO - European Society for Medical Oncology, IARC - International Agency for Research on Cancer / World Health Organization, Indian Council of Medical Research (ICMR) https://lnkd.in/gUhKfzmN

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Case Record of the Massachusetts General Hospital: One hundred years ago, a 24-year-old man was admitted to this hospital because of fever, cough, and shortness of breath. The patient had been well until 3 days before this admission, when malaise, generalized weakness, headache, and back pain developed. During the next 2 days, his symptoms persisted, and he remained at home and slept in bed for most of the day. On the day before this admission, he began to have fever, dry cough, and chills that caused him to shake considerably and “hunched him up in a knot.” He was unable to get out of bed. He took aspirin at a dose of 10 grains (648 mg) every 4 hours, which led to decreased severity of the headache and back pain. On the day of this admission, the patient awoke with difficulty breathing and chest pain just below the xiphoid process. The pain increased with deep breathing and coughing. He sought evaluation at this hospital. Source: The New England Journal of Medicine Answer: https://nej.md/3MzwCOI Disclaimer:  https://pdf.ac/4cIFXB #DiagnosticRadiology #Teleradiology #RadiologyWorkflow #RadiologyServices #UKRadiologists #RadiologySupport #RadiologySolutions #RadiologyEfficiency #XRayDocumentation #CTScanWorkflow #MRIDocumentation #UltrasoundReports #HealthcareDocumentation #RadiologyTech #MedicalImaging #RadiologistSupport #HealthcareEfficiency

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I always say “When #nurses #innovate they save #patients #lives”. There is no truer an example than in my friend Kelly Ayala, DNP, APRN, RN and Shannon Hattenhauer who invented #StreamLineFlow to solve the problem they witnessed as #NPs working in a pulmonary clinic and witnessing many #lungcancer patients get lost in the system… This is an excerpt from the Johnson & Johnson article linked below: “Patients were being evaluated for lung cancer, but then dropping from the continuum of care after being referred for follow up screenings. For example, a patient might be referred to a clinic for a CT scan, but the scheduler may reach out only once or twice. If the patient doesn’t schedule, the referral may be closed, and it’s possible that the patient isn’t contacted again. The challenge, as Ayala shared, is that some aggressive types of lung cancer progress very quickly, with a ‘doubling time’ of just a few weeks. In other words, it can take less than a month for a tumor to double in size, which drastically affects the patient’s treatment options. Ayala and Hattenhauer developed a solution that establishes guardrails for patients who miss an appointment or don’t follow up on a referral.” This is the #innovation that is going to save millions of lives! Bravo! It’s been years in the making - but these 2 nurses show what fortitude is - working full time jobs, raising families and building on the side - they never faulted in their passion to solve this problem. You can meet them at #HLTH24 at the #NursesPavillion with NurseApproved :). #NursesOnLinkedIn #HealthcareOnLinkedin #NurseInnovation https://lnkd.in/emWCsytH

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The Lancet publishes an Editorial on Direct-to-consumer medical testing: an industry built on fear. Let's take a deeper look... The direct-to-consumer medical testing industry is booming, with the global market predicted to reach more than US$9 billion by 2033. Genetic tests are increasingly available—with ten new ones entering the market every day—as well as biochemical tests for markers associated with health or disease, devices for monitoring parameters such as blood glucose, and even so-called wellness tests, all of which can be performed without a health professional involved. Many screening tests sold to the public would not be conducted within a formal health system. Some have no medical purpose. Weak regulation has enabled the direct-to-consumer medical testing industry to flourish, but its growth is fuelled by the exploitation of consumers’ fears and commercial interests that do not have our health at heart. Some consumers informed of their APOE4 homozygosity, and therefore increased risk for Alzheimer’s disease, report feeling overcome with anxiety, are left without post-test support, and turn to unapproved drugs in the hope of preventing dementia. The industry washes its hands of consumers once the result is delivered. The direct-to-consumer testing industry is disruptive to the classic model of health care, and changing attitudes towards conventional health care might be one factor underlying the industry’s success. The relationship between patients and health-care providers is an increasingly fractious one, as patients struggle to obtain appointments or fear that their concerns are not taken seriously. Self-testing provides not only convenience but also empowerment and autonomy. The industry promises to give consumers control over their health. However, empowerment can only come through access to accurate tests that give actionable results, as well as reliable health information and linkage to care. Tighter regulation of the industry is urgently needed, but so is an honest conversation within the public sphere about the benefits, risks, and value for money of asymptomatic screening tests. Direct-to-consumer testing is no substitute for formal health-care evaluation. Data must be collected systematically on individual consumer harms arising from direct-to-consumer testing, as well as its wider effects on health systems. Those working within the industry must ask themselves whether they are promoting products that are in their consumers’ best interests. https://lnkd.in/eRk27Hf9

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Cancer screening costs increased...up to $43B (in 2021). This headline can easily cause alarm. News outlets are missing the main point as the authors explain that this cost is "less than the reported annual cost of cancer treatment in the United States in the first 12 months after diagnosis." The estimated financial burden of cancer in the US over the next 25 years is $5.3T...trillion...with a "T" (Chen, et al., 2023, JAMA Oncol). For perspective, $5.3T is 123 times larger than $43B. If you spent $1 million per *hour*, it would take a little less than 5 years to spend $43B but 605 years to spend $5.3T (OpenAI, 2024). Cancer screening makes physical *and* financial health sense. Not sure if you need cancer screening based on your risk or age? Here are the guidelines to help: https://lnkd.in/eaHERyQS https://lnkd.in/eSD8-9FQ #CancerScreening #CostOfCare #FinancialHealth #Economy

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JAMA Cardiology reports an estimated 136 million adults eligible for GLP-1 therapy; that’s more than half of all U.S. adults. The data was based upon a survey of 25,000 individuals, and across the population studied, mean age was 50.7 years, 49.1% were female, 26.8 million insured by Medicare, 13.8 million by Medicaid, and 61.1 million by private insurance. The drugs were indicated for 35.0 million adults for diabetes management, 129.2 million adults for weight management, and 8.9 million adults for secondary prevention of CVD. In contrast, statin therapy is the most prescribed pharmaceutical in the U.S., currently eligible for 82 million adults. Whilst the clear focus will be on affordability of the drugs at current prices, the impact on populations to reduce chronic disease burden is massive, and almost unfathomable, in a good way. https://lnkd.in/evNZ2Taf

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My attention is drawn to a recent interesting observation published in JAMA Network Open (Sept 5, 2024), titled "Upper Gastrointestinal Mucosal Damage and Subsequent Risk of Parkinson Disease." This research explores the potential link between gut health and Parkinson disease (PD), a neurodegenerative disorder affecting 8.5 million people globally. Parkinson Disease (PD): PD is marked by the degeneration of dopaminergic neurons in the brain's substantia nigra, leading to motor symptoms like tremors, rigidity, and bradykinesia, along with nonmotor symptoms such as constipation. The „Braak hypothesis” suggests a gut-first pathway for PD in some individuals, with pathology traveling from the gut to the brain via the vagus nerve - backed by recent animal studies showing this connection. Key Findings: This cohort study of 9350 patients with no prior history of PD found that upper gastrointestinal mucosal damage (MD), such as erosions, ulcers, and esophagitis, is associated with a 76% increased risk of developing PD. This finding supports the "gut-first" hypothesis for some PD cases. What's New? - The study is among the first to examine upper gastrointestinal damage (beyond H. pylori infection) and its link to PD, addressing an important gap in existing research. - While H. pylori has been linked to PD in prior studies, this research expands the focus to broader mucosal damage, including peptic ulcers and erosions, potentially caused by NSAID and proton pump inhibitor (PPI) use. Study Limitations: - Confounding factors such as NSAID use (known to cause GI damage) may play a role, as NSAIDs have a mixed relationship with PD risk, possibly offering neuroprotective effects in some cases. - The study’s retrospective design limits the ability to establish causality. - Generalizability is limited to the specific patient cohort from the Boston area. This research opens avenues to better understand the gut-brain connection in PD, offering opportunities for early intervention and treatment strategies. Congratulations to Jocelyn J. Chang, Subhash Kulkarni, PhD, and Trisha S. Pasricha, MD, MPH, for this important contribution to the field! Read the full study here:: JAMA Netw Open. 2024;7(9):e2431949]: https://lnkd.in/d7T7rwcN

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