Department of Medicine

Case Western Reserve University School of Medicine & UH Case Medical Center

A Move Towards Home Health Care

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Governor Kasich plans to save the state millions of dollars by cutting down on reimbursements for nursing homes, where care is more expensive than the national average. It will ease budget pressure and, he says, keep mom and dad at home.

How would that work?

On the sound of ideas, we’ll explore alternatives to nursing home care, including expansion of the state’s passport program for Medicaid-eligible elderly people.

WCPN Ideastream interivew, Dr. Peter DeGolia, Geriatrician, University Hospitals and Case Western Reserve University School of Medicine.

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Study Finds Vitamin D Decreases Swine Flu Death Risk

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Vitamin D, which plays a key role in healthy bone development, may also decrease the risk of dying from H1N1 swine flu, a study finds.

The vitamin appeared to especially benefit people in high risk groups, including people who are obese. Obesity increases the risk of dying from viral diseases. Last year’s H1N1 pandemic was especially deadly for pregnant women and people who were obese, according to health officials.

But a report, which will be published in the February 1 issue of Clinical Infectious Diseases found that vitamin D can help cut mortality rates.

The study, conducted by Janice Louie of the California Department of Public Health in Richmond, Calif., looked at 500 obese patients with a body mass index of 40 or more. It was found that these patients were three times more likely to die from viruses, like the flu, than people with a healthy BMI.

Dr. Rebecca S. Boxer, a geriatrician at University Hospitals Case Medical Center, says that vitamin D is important to the health of the immune system on a cellular level.

“Vitamin D also has a relationship to inflammation and obese patients may already have a degree of inflammation,” she told AOL Health. “One way to understand this is that the volume of distribution of vitamin D might be greater for obese people. Vitamin D is fat-soluble. So the bigger you are, the more you need for it to show up at adequate levels in your blood. It spreads throughout the fat tissue and less of it is in your blood. So it can be difficult to find obese patients with enough vitamin D because it’s sinking into their fat tissue.”

Boxer says that there has been a lot of interest in vitamin D in relation to general health and well-being but that studies have not yet shown a direct cause and effect when it comes to the swine flu. “People are getting bigger, which can contribute to lower vitamin D levels. Also people do not get enough sun exposure,” she said.

Eating foods high in vitamin D, such as fatty fish, including wild salmon, is a good way to maintain healthy levels of this vitamin, Boxer said.

“Everyone should be getting their levels checked,” said. “If anything, we know that it can help keep bones healthy. We can’t say that it will prevent the swine flu, but it’s important to make sure you’re getting enough.”

Richard Walsh, MD, Chair
discusses 2010 achievements

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University Hospitals Case Medical Center Remains Among the Elite in U.S. News & World Report Annual Survey

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University Hospitals Case Medical Center (UHCMC) has again ranked among the elite in the latest U.S. News & World Report hospital rankings.  In this year’s survey, UHCMC ranked seven clinical specialties in the top 50 for hospitals and health systems nationwide.

Top among clinical departments at UHCMC, the Department of Medicine again contributed four of the specialties – Gastroenterology (28), Geriatrics (28), Cancer (34), and Pulmonology (42). This contribution by the Department of Medicine figured significantly into UHCMC joining only 152 other hospitals, or the top 3% of the nation’s 5,000 eligible healthcare organizations.

“This consistent level of excellence in compassionate, cost-effective patient care is a testament to the quality and dedication of the full time faculty in the Department of Medicine and to the leadership of our organizations.”

Richard A. Walsh, MD, Chairman, Department of Medicine

Dr Sarah Augustine honoured with Clinical Gender Equity Award

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Dr. Sarah Augustine was honoured with the American Medical Women’s Association Clinical Gender Equity Award.

This award is supported by the Women Faculty of the School of Medicine but decided upon by the senior year medical student body to honour a faculty member who the students feel exemplify the principle of gender equality in their teaching and who promote a gender-fair environment for education and training of physicians.

Learn more at CWRUmedicine.org

Drug assistance programs keep seniors on track :: USATODAY.com

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Peter DeGolia, MD, Director of Geriatric Medicine at University Hospitals Case Medical Center, comments on medication management programs and the potential impact for seniors. Read the full article at USA Today.

Learn more about the Division of General Internal Medicine and Geriatrics.

International Journal of Clinical Practice Most Read Article 2009

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The Department of Medicine’s Dr. Clifford Packer’s editorial, “Cola-induced hypokalemia: a super-sized problem” was the most-read article in International Journal of Clinical Practice for the year 2009.

“Consider this curious case: a 44-year-old ostrich farmer from the Australian outback developed sudden onset of muscle weakness after returning home from an evening of kangaroo-shooting. He had difficulty in getting out of his bath and was unable to stand while waiting for help to arrive. His respiratory status deteriorated, and he required intubation and mechanical ventilation. He was found to be profoundly hypokalaemic with a serum potassium level of 1.4 mmol/l. He had been drinking 4 l of Coca-Cola per day over the past 3 years, and drank up to 10 l to slake his thirst when he went for kangaroo-shooting at night. He was advised to curtail his cola drinking, and his potassium level normalised, his weakness resolved, and he made a full recovery”

Full article

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