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The Morning Report provides a quick look at today’s medical news, research and features.  









Why Can’t Baby Wyatt Open His Mouth?
A 9-month-old baby is baffling doctors with his rare diagnosis – a condition that keeps him from opening his mouth.  A nurse first noticed something was wrong after Wyatt Scott was born on June 27, and she scooped him up to check his palate. ”She couldn’t get a finger in his mouth,” says Andrew Scott, Wyatt’s father. “I don’t really think it hit us at that point.”

Wyatt was diagnosed with congenital trismus, a condition that causes limited mouth movements. The best known form of trismus is lockjaw, muscle spasms in the jaw caused by a tetanus infection that make it almost impossible to open one’s mouth. But Wyatt does not have tetanus-caused trismus. In fact, doctors have no idea why Wyatt’s mouth doesn’t open.

“Congenital trismus is exceedingly rare,” says Dr. Wayne Ozaki, professor, chief of pediatric plastic surgery and director of craniofacial surgery at Mattel Children’s Hospital UCLA, who has not treated Wyatt. In his entire career, Ozaki has never seen a case of it.  ”The interesting thing with Wyatt is that we don’t know why. We have had other kids with trismus but with Wyatt we haven’t had a cause,” said Dr. J.P. Vaccani, a pediatric otolaryngologist at Children’s Hospital of Eastern Ontario, where Wyatt lives.

Wyatt is developing normally, though he has spent only six consecutive weeks at home before a scare sends him back to the hospital. Wyatt receives Botox injections, which relax the muscles in his jaw. Twice daily, his parents perform physiotherapy on his mouth, which works the muscles to help them slacken. After nine months of treatments, Wyatt can get one and a half fingers in his mouth – a huge improvement since birth. Even though the treatments seem to be making small improvements, doctors remain unable to offer a cure. (Today)

Which Docs Made The Most Money Last Year?
Medicine is undergoing significant changes — some for the better and others less so. Compensation has increased slightly in 19 specialties; the income gap between men and women is narrowing; ACOs are making their impact felt; self-employed physicians earn more than employed ones; and cash-only practices, while still a tiny percentage of all practices, are gaining some traction.

Those are some of the highlights of Medscape’s Physician Compensation Report: 2014 Results. The report is based on an extensive survey of more than 24,000 US physicians representing 25 specialties.

Orthopedics ($413,000), cardiology ($351,000), urology ($348,000), gastroenterology ($348,000), and radiology ($340,000) are the 5 top-earning specialties, as they were in last year’s survey. Compensation for both family physicians and internists is up 1% over last year. While physicians overall have been concerned about income declines due to healthcare reform, this was not the case in 2013 for 19 specialties which saw relatively modest increases.

Among physicians, men earn more than women, as they have in all past surveys. However, that picture appears to have improved. In 2010, male physicians earned 40% more than females, yet in 2013, males earned 30% more. In 2013, among internists, men earned 13% more than women ($195,000 vs $173,000); in family medicine, men earned 19% more ($187,000 vs $157,000).

Among physicians overall, self-employed doctors earned an average of $281,000 compared with employed physicians, who earned $228,000. In primary care, the difference was less pronounced; self-employed physicians earned $188,000 and employed physicians earned $180,000.

‘Pollen Vortex:’ Hard Winter Makes Allergy Season Stronger
This year’s long, brutal winter may mean the country’s headed for pollen eruption and a harsh allergy season in the spring, doctors say. The freezing temperatures of the prolonged winter may have delayed the blooming of trees, and now that it’s finally warming up, trees are expected to bloom at the same time as grasses, causing a dramatic rise in pollen, allergy experts said.

“People who may have both tree allergies and grass allergies are probably going be doubly impacted, because both of those things are going to be blooming at the same time,” said Dr. Lolita McDavid, a pediatrician at University Hospitals Rainbow Babies & Children’s Hospital in Cleveland, Ohio. ”The allergy seasons seem to be getting intense in the last few years. We are not quite sure why,” McDavid said. “We don’t know if it’s climate change. It may be.”

Some doctors also contend that people have more allergies today perhaps because they are less exposed to allergens, such as pollen, than they used to be, McDavid said. “We used to get exposed to all kinds of things. We didn’t have air conditioning, or air filtration systems.”

The severity of each year’s allergy season depends on the temperatures, precipitation and amount of flowering grasses in an area that year, studies have shown. This year, in addition to low temperatures, heavy precipitation in many areas of the country, especially in March, may have temporarily suppressed pollen release. But that same precipitation may have actually encouraged the growth of trees and grass, resulting in greater pollen release later in the season, experts said. (LiveScience)


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