Fluoroquinolones and Peripheral Neuropathy
Peripheral neuropathy, this is an often devastatingcondition in which people develop pain and numbness in their hands and feet. Basicallythey're told on the evening news that they should be taking this or that medication sothat they can get through life. That's treating the smoke and ignoring thefire. Those medicines that you're seeing advertised don't treat the neuropathy, they only treatthe symptoms. But what's causing peripheral neuropathy? Well we know that in America,one of the biggest causes of peripheral neuropathy is being diabetic, which is clearly relatedto the foods that you eat by and large. Becoming a type 2 diabetic dramatically increases yourrisk for having peripheral neuropathy and
in fact being devastated by it. This is adisease that effects 1 in 15 Americans. Let's take a look. So again this is 1 in 15 Americansâ€”thisis 20 million Americans afflicted by this disease, that aside from diabetes, we're toldthe cause is unknown. Well maybe that's not exactly true. Last month, in the journal Neurology,an incredible study was published describing a relationship between what are called fluoroquinolones,and the risk of developing a peripheral neuropathy. You may not know what fluoroquinolones are,but chances are you may have actually been exposed to fluoroquinolone. These are antibioticsused for treating things like upper respiratory
infections and even urinary tract infections.Things like Levaquin and Cipro are commonly used in walk in s. If you have a urinarytract infection, you may have received these mediations. Well, here's what the study showedus: So this is a study published in September2014 that looked at men between age 45 to 80 years of age followed for a 10 year periodand in this group there were over 6,000 cases of peripheral neuropathy. And they comparedthese individuals to about 25,000 aged match controls, and what they found was that riskfor developing this devastating condition called peripheral neuropathy was doubled inthose individuals exposed to this class of
antibiotics called fluoroquinolones. And whatthe researchers also told us is that, and I quote, quot;Fluoroquinolones have been shownto neurotoxic. Oral fluoroquinolones have also been associated with reported cases ofpsychosis and seizures, which similar to peripheral neuropathy have been shown to be acute eventsoccurring within days of fluoroquinolone use. In light of strong evidence of unnecessaryprescribing of oral fluoroquinolones in the United States, ians must weigh the riskof PN against the benefits of prescribing FQ when prescribing these drugs to their patients.quot; We've got to practice medicine under the dictumof quot;above all do no harm.quot; One of our most
well respected peer review journals is nowtelling us that the use of these medicationsâ€”these fluoroquinolone antibiotics is associatedwith doubling of the risk of peripheral neuropathy. A disease which often is not treatable. Sokeep that in mind the next time you think you need an antibiotic for this or that problem,discuss this study with your treating physician. I'm David Perlmutter.
ICD10 Coding and Diabetes
Welcome to CMS eHealth. By October 1, 2015, the new ICDcoding system will be in place for both diagnosesand inpatient procedures. Using ICD10, s willcapture much more information, meaning they can betterunderstand important details about a patient's healththan with ICD9. The new codes reflecthow health care has changed over the past 30 years with manyadvances in al practice.
You'll notice updates,including definition changes, terminology changes,and a lot more specifics. The most obvious change is thatthe code structure has expanded. While the old codes havethree to five characters, the new codes have up to seven, allowing for more detaileddescriptions. The first three charactersrepresent the category of disease or health condition,followed by a decimal point.
The fourth, fifth,and sixth characters represent al details,such as the cause of the disease, its severity,and its anatomical location. Let's look at how this all worksusing the example of diabetes. ICD9 has two major categoriesof diabetes codes, diabetes and secondary diabetes, but ICD10 separates Type 1diabetes from Type 2 diabetes. ICD10 also eliminates the broadcategory of secondary diabetes,
instead offeringsecondary options, such as underlyingconditions or causes. To capture more details,subcategories can be added to represent both complicationsand affected body systems. For example, the diabetessubcategories include ketoacidosis,kidney complications, ophthalmic complications,neurological complications, and circulatory complications.
Let's say a patient has diabetesdue to an underlying condition. That's code E08,followed by a decimal point. Next come the detailsin the form of subcategories, starting with the fourth digit. Ketoacidosis, for example,has a fourth digit of 1. To add even more detail,a fifth digit of zero is ketoacidosis without coma, and a fifth digit of oneis ketoacidosis with coma.
These subcategoriesstay the same, no matter what type of diabetesis being described. For example, diagnosis code .621 describes the complicationof foot ulcer. So E10.621 is type 1 diabeteswith foot ulcer, and E11.621 is type 2 diabeteswith foot ulcer. In this example,the provider has documented the category of diabetesand the complications.
A Journey Through A Stem Cell Transplant for Amyloidosis at Boston Medical Center
music music music music music Diane is such a great person the most selfless person I've even met in my entire life nurse talking
never complains never not once did she ever complain the words of quit fail and can't are not in her vocabulary well she is probably the strongest and one of the biggest fighters that I know in when we now when we found out it really um shook us all up because
Di isn't just my sister my best friend she's the family rock story begins with purple eyes my family are hockey players so most people most people just assumed I took a hockey puck in the eye but a biopsy showed i had a very rare noncurable disease hello and welcome to theMassachusetts School of Law educational forum produced by theMassachusetts School of Law At Andover I'm Diane Sullivan you're host for today's program Being Irish I have the curse of very fair skin so each year I visit my skin
finkel was concerned over my bruised eyelids but I explained to him they had been previously checked and a biopsy showed nothing abnormalthis is just how they are I said no diane said finkel, this is not normalthe biopsy showed nothing I responded again sometimes he said it depends on who reads ita few days later finkel was on the phone it was then I heardabout the disease amyloidosis the first time and I quickly learned
this was not good though the amyloidosis diseases are actually a set of diseasesthat can be blood or bone marrow disorders in themost common form but there are also genetic diseases and diseases that occursecondary to other conditions like chronic infections and chronicinflammatory diseases so they really span a broad spectrum of medical care and in fact we've developed a multidisciplinary program to take care ofpatients with amyloidosis but my interest is in what really is themost common type
amyloidosis in the United States withwhich is AL amyloidosis also known as primary amyloidosis and the same appliesto Sanchorawala so we are hematologists andbecause that particular form is a blood disorderover many decades research here and elsewherewe learn that these diseases can be treated with chemotherapy to affect cells in the bonemarrow and we consider the disease to be acousin of a more common