Twitter and the dissemination of research evidence
Trip aggregates some wonderful content. The main route for people finding this evidence is via search or by registering with Trip and indicating what topic areas they're interested (in which case we email the user with the latest research that matches their interests).Towards Christmas I started to experiment with using Twitter as a dissemination route. Basically, I created two topic areas (Primary care and Cancer) and starting tweeting simply the title of the article and the URL of relevant articles that were recently added to Trip. The Trip techie (Phil) suggested I use some tracking to see if people ar...
Source: Liberating the literature - January 17, 2014 Category: Technology Consultants Source Type: blogs
Finding the Good in our Frazzled Lives
It was THAT day. You know the day.
The day began when I woke up precisely the moment after I had finally fallen asleep. I had only just fallen asleep because I had been very busy all night checking hot foreheads and cleaning up kids and administering ibuprofen and lying there worrying if maybe I shouldn’t have put the sleep sack on my daughter because I knew she was going to wake up with her fever raging and the sack might make her too hot.
I woke up and I knew I had to get up and check on the kids and then try to get them to eat something and then wash sheets and blankets and get to the store for more crackers and ibup...
Source: Conversations with Dr Greene - November 13, 2013 Category: Pediatricians Authors: Joelle Wisler Tags: Perspectives Parenting Source Type: blogs
Not all sore throats are self-limited – the role of antibiotics
This article is written in French, but the translate button allowed me to read the article clearly.
These ENTs note increasing numbers of peritonsillar abscess. They argue that sore patients deserve more than a rapid test. They argue for a history and physical done by a physician who looks for complications and explains red flags to the patient.
Long time readers know that I lament the term “just a sore throat”. While most sore throats are self-limited, we still should respect the possibilities for either suppurative or non-suppurative complications. I argue regularly that our sore throat treatment nihilism...
Source: DB's Medical Rants - October 22, 2013 Category: Health Medicine and Bioethics Commentators Authors: rcentor Tags: Medical Rants Source Type: blogs
nterventions for replacing missing teeth: antibiotics at dental implant placement to prevent complications.
CONCLUSIONS: Scientific evidence suggests that, in general, antibiotics are beneficial for reducing failure of dental implants placed in ordinary conditions. Specifically 2 g or 3 g of amoxicillin given orally, as a single administration, one hour preoperatively significantly reduces failure of dental implants. No significant adverse events were reported. It might be sensible to suggest the use of a single dose of 2 g prophylactic amoxicillin prior to dental implant placement. It is still unknown whether postoperative antibiotics are beneficial, and which antibiotic is the most effective. (Source: Dental Technology Blog)
Source: Dental Technology Blog - August 26, 2013 Category: Dentists Source Type: blogs
Healthcare Update Satellite — 07-09-2013
More updates available tomorrow on my other blog at DrWhitecoat.com
Why does an $11,596 emergency department visit cost $1,100? A spokesperson for the California Hospital Association says that it is because of government regulation. I want to know what doctor ever gets paid $4,242 for a Level 4 emergency department visit.
California attorneys are trying to raise the cap on damages under California’s Medical Injury Compensation Reform Act. Caps are currently $250,000 and haven’t been raised in more than 35 years.
The article says that many attorneys won’t take medical malpractice cases in California because they are t...
Source: WhiteCoat's Call Room - July 9, 2013 Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs
DOJ Probing International Pharmaceutical Manufacturing
Earlier this year, we noted that a new enforcement focus for the U.S. Department of Justice (DOJ) will be increased oversight to ensure compliance with the Food and Drug Administration's (FDA) current good manufacturing practices (cGMPs) regulations. Specifically, Maame Ewusi-Mensah Frimpong, Deputy Assistant Attorney General (DAAG) for DOJ's Consumer Protection Branch (CPB), noted her division has long worked closely with FDA to promote the safety of pharmaceutical products.
Several months later, it appears that DOJ is acting on this promise in two recent cases. As reported by the Washington Post, Reuters, and ...
Source: Policy and Medicine - July 5, 2013 Category: Health Medicine and Bioethics Commentators Authors: Thomas Sullivan Source Type: blogs
The Last Doctor is Always the Smartest
Twice recently, I’ve been privy to patient complaints about emergency department “misdiagnoses” when patients have gone to follow up appointments with their physicians.
One case involved a young girl who had a rash. The rash was preceded by a low grade fever in the days prior, began on the chest and spread outward, and had the classic appearance of a viral exanthem. The girl’s parents weren’t happy with that diagnosis. They believed that the girl was suffering from an allergic reaction and that she needed antihistamines and steroids. The doctor explained that the rash was not an allergic-type ...
Source: WhiteCoat's Call Room - June 17, 2013 Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: Patient Encounters Source Type: blogs
Please Poke My Paronychium!
THE BASICSWhat is more satisfying than draining a pus-filled paronychium? Seeing the look of relief on the face of your patient when his painful, pulsating digit is relieved of all that tension! This rather elementary procedure could be perceived as stale and uneventful for some of you. The more thorough and astute clinicians, however, realize these tiny infections around the nail root may open the door to a mixed bag of insidious and harmful bacterial infections including MRSA, chronic reoccurrences, cellulitis, subungual abscesses, osteomyelitis, herpetic whitlow, or even the dreaded felon.
Whatever your pleasure, thi...
Source: The Procedural Pause - May 1, 2013 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Follow-up: Z-pack is safe for young and middle aged folks
A new report out of Denmark has helped clarify the safety concerns with the antibiotic azithromycin (Zithromax/Zmax, Pfizer). Earlier this year, an analysis of Medicate patients showed an increase risk of death in patients that used Zithromax vs those that used none or amoxicillin. The current study has concluded that on its own, Zithromax does NOT raise the risk of cardiovascular death in patients aged 18-64 years. This was based on 12 years if data. Take home message: - Zithromax is safe to use in patients younger than 65 years of age- Zithromax does slightly raise the risk of CV death in patient...
Source: Dr Portnay - May 1, 2013 Category: Cardiology Authors: Dr Portnay Source Type: blogs
How safe is a Z-pak?
Text message:
“John, This cough and congestion is killing me. It’s turning thick and green. Can you write me a Z-pak? It always works for me.”
If you write a blog on medical decision-making and heart rhythm matters, it seems an incredible omission not to opine on the FDA warning concerning the commonly used antibiotic azithromycin (the drug in a Z-Pak). Quoting directly from the FDA warning:
[Azithromycin] can cause abnormal changes in the electrical activity of the heart that may lead to a potentially fatal irregular heart rhythm.
Should we say this more clearly: that simple antibiotic you are taking for a minor i...
Source: Dr John M - March 27, 2013 Category: Cardiology Authors: Dr John Source Type: blogs
Lyme Disease
Pathophysiology of Lyme Disease
Lyme disease is an
1) infection with Borrelia burgdorferi via tick bite
2) previous thinking held tick vector was Ixodes but transmission is now thought by some experts to be possible with additional tick species
3) occurs in stage I and stage II days to weeks after infection and in stage III months to years after infection (usually with preceding latency period
Signs and Symptoms
Stage I
1) characteristic expanding annular rash with central clearing (“bull’s eye or “target” rash) that occurs in only 40% of infections
Stage II
2) multiple secondary annular skin lesio...
Source: Inside Surgery - March 19, 2013 Category: Surgeons Authors: Editor Tags: Infectious Disease babesia bulls eye rash coinfections deer tick erythema migrans hyperbaric ixodes target rash Source Type: blogs
Peptic Ulcer Disease
Pathophysiology of Peptic Ulcer Disease
1) peptic ulcer disease is marked by a break in mucosal lining of stomach and duodenum
2) main causes are infection with Helicobacter pylori and use of NSAIDs
Signs and Symptoms
1) burning epigastric pain relieved by antacids and eating
2) epigastric pain causing patient to wake up in the middle of the night
3) chest pain mimicking angina
4) epigastric tenderness
5) gastrointestinal bleeding (15%) with coffee-ground emesis or vomiting bright red blood or lower gastrointestinal bleeding
6) perforation (8%) with peritonitis and rigid abdomen
7) duodenal obstruction (3%) with nausea and...
Source: Inside Surgery - February 24, 2013 Category: Surgeons Authors: Editor Tags: Gastroenterology Source Type: blogs
The influence of prophylactic antibiotic administration on post-operative morbidity in dental implant surgery. A prospective double blind randomized controlled clinical trial
ConclusionsThe use of for dental implant surgery may be justified, as it appears to improve implant survival in the short term and also results in less post-operative pain and interference with daily activities. From the results of this study, it appears that prophylactic antibiotics may also be beneficial both in terms of implant survival, especially when the surgical procedure is prolonged due to its difficulty, high number of implants placed or operator's inexperience. (Source: Dental Technology Blog)
Source: Dental Technology Blog - February 21, 2013 Category: Dentists Source Type: blogs
