Top stories in health and medicine, December 4, 2014
From MedPage Today:
Men on ADT Skipping Out on Bisphosphonates. Few men in Canada receiving androgen deprivation therapy (ADT) for prostate cancer have simultaneous bisphosphonate treatment to prevent fractures.
What Every ED Should Have. The emergency department (ED) is one of the highest risk areas of any institution. Both the fast-paced environment and high patient volume and acuity contribute to this phenomenon. In addition, minimal information regarding the medical history of patients is known at the time of presentation.
Even Without Concussion Football Players May Have Brain Changes. High school football players s...
Source: Kevin, M.D. - Medical Weblog - December 4, 2014 Category: Journals (General) Authors: MedPage Today Tags: News Endocrinology Neurology Source Type: blogs
Vienna conference return to play recommendations
1. Remove from game if any signs of concussion- any items missed on sideline exam2. No return to play in current game3. Medical evaluation after injury a. rule out serious focal injury b. neuropsychologic evaluation4. Stepwise return to play a. rest till asymptomatic b. light aerobic c. sport specific training d. noncontact practice e. full contact practice f. return to play1 var gaJsHos...
Source: neurologyminutiae - October 9, 2014 Category: Neurologists Source Type: blogs
Teaching Kids How To Deal With Injuries
Recently our 1st grader had a really bad fall. The fall was so bad she looked like an MMA fighter. In many ways I wish she were fighting because the story would be a lot more interesting. But alas this was your typical young child meets concrete experience where the score was concrete 100, child 0. I’m not certain what happened but as I turned to face her shrill scream I saw her face was scraped from top to bottom, permanent tooth chipped and pride destroyed. My heart sank when I saw her, I thought “anything else”. We’d already dump more than $1000 into her mouth from accidents with baby teeth...
Source: Disruptive Women in Health Care - October 9, 2014 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Children Source Type: blogs
Research and Reviews in the Fastlane 052
This study looked at compliance with discharge instructions. Surprisingly (or maybe not so), 39% of pediatric patients returned to play (RTP) on the day of the injury. RTP is widely recognized as a risk for recurrent and more severe concussions as well as significant morbidity. It is the duty of the Emergency Physician to stress the importance of discharge instructions as well as the importance of appropriate follow up.
Recommended by: Anand Swaminathan
PediatricsSingleton T et al. Emergency department care for patients with hemophilia and von Willebrand disease. J Emerg Med. 2010; 39(2): 158-65. PMID: 18757163
Bleeding...
Source: Life in the Fast Lane - October 9, 2014 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Administration Anaesthetics Cardiology Clinical Research Education Emergency Medicine Haematology Infectious Disease Intensive Care International Emergency Medicine Microbiology Neurosurgery Obstetrics / Gynecology Ophthalmology Source Type: blogs
A Soldier’s War on Pain - NYTimes.com
Four years and a lifetime ago, a new war began for Sgt. Shane Savage.On Sept. 3, 2010, the armored truck he was commanding near Kandahar, Afghanistan, was blown apart by a roadside bomb. His head hit the ceiling so hard that his helmet cracked. His left foot was pinned against the dashboard, crushing 24 bones.Sergeant Savage came home eight days later, at age 27, with the signature injuries of the conflicts in Iraq and Afghanistan: severe concussion, post-traumatic stress and chronic pain. Doctors at Fort Hood in Killeen, Tex., did what doctors across the nation do for millions of ordinary Americans: They prescribed p...
Source: Psychology of Pain - May 11, 2014 Category: Psychiatrists and Psychologists Source Type: blogs
Top stories in health and medicine, March 17, 2014
From MedPage Today:
SGR Repeal Passes House; Patch Still Expected. A full repeal of Medicare’s sustainable growth rate (SGR) payment formula hit a snag Friday, but political insiders say another temporary stay from drastic cuts in Medicare reimbursement is likely on its way.
Pap Test Down but Far From Out. To take license with Samuel Clemens’ words, reports of the Pap test’s demise have been exaggerated, authorities agree in the aftermath of an FDA decision about HPV testing.
House and Senate Bills Call for Zohydro Ban. Members of Congress have introduced bills to ban Zohydro and prevent future formulat...
Source: Kevin, M.D. - Medical Weblog - March 17, 2014 Category: Family Physicians Tags: News Neurology OB/GYN Pain management Source Type: blogs
ICD deactivation in the NY Times — with a quote from a blogger
The news came via a direct message on Twitter. “You got a plug in the NY times. Congrats.” (Thanks Dr. Jay Schloss.)
Paula Span, author of the NY Times’ The New Old Age Blog, reported today on the issue of cardiac device deactivation in patients who are approaching end of life.
The role I had in the piece stems from the editorial I co-authored with University of Colorado Professor Dr. Dan Matlock in the Journal of the American Medical Association-Internal Medicine.
I think this is my first mention in the Times. It’s especially nifty because end-of-life care is such an important topic.
Yes, car...
Source: Dr John M - January 30, 2014 Category: Cardiology Authors: Dr John Source Type: blogs
Son of the absent-minded professor
I’m standing in the kitchen, but I haven’t a clue why I’m there. Again. I mean, I got up out of bed and came in here for some reason, obviously. I scratch my head distractedly and dislodge a few scabs. Crap! I’m supposed to leave those alone. I try a mental checklist. Am I hungry? No. Am I thirsty? No. Did I need a cup of coffee? A glass of wine? No and no. Defeated, I wander back to bed, clueless about the mission I set out on less than a minute before. This is my new reality. As my body heals, my mind dissolves. Probably, I’ve been out of my mind for a bit, but was just too sick to notice it. Now I’m well eno...
Source: LifeAfterDx--The Guardian Chronicles - January 20, 2014 Category: Diabetes Authors: Wil Source Type: blogs
Are Concussions Related to Alzheimer’s Disease?
A new study from the Mayo Clinic indicates that concussions are a risk factor for developing Alzheimer's decades; although, not everyone with head trauma will lose their memory.+Alzheimer's Reading Room A new study suggests that a history of concussion involving at least a momentary loss of consciousness may be related to the buildup of Alzheimer’s plaques in the brain.The research is published in the online issue of Neurology®, the medical journal of the American Academy of Neurology. Subscribe to the Alzheimer's Reading RoomEmail: The Gist“Interestingly, in people with a history of concussion, a difference in the ...
Source: Alzheimer's Reading Room, The - December 26, 2013 Category: Dementia Authors: Bob DeMarco Source Type: blogs
Understanding the impact of concussions on the brain
What a concussion looks like inside your brain (PBS):
“But what happens to the brain right after a concussion? Researchers at the National Institute of Health peered into the brains of mice and watched how a traumatic brain injury progresses over a day. Their findings, published in the journal Nature this week, showed that a single concussion can cause cell death in the brain in a matter of hours…This damage was the result of a single injury, similar to what LaTour had observed in patients coming to the emergency room after car accidents or falling 6 feet from a ladder. The injury isn’t fatal, but the concussion lea...
Source: SharpBrains - December 12, 2013 Category: Neurologists Authors: SharpBrains Tags: Cognitive Neuroscience Health & Wellness concussion neurological function Traumatic-Brain-Injury Source Type: blogs
The Solution to the Football Concussion Dilemma: Hold All Games at High Altitude
A new study shows that high school athletes playing at higher altitudes suffer fewer concussions than those closer to sea-level, a phenomenon attributed to physiological changes in the brain causing it to fit more tightly in the skull. "This is the first time any research has linked altitude to sports-related concussion," said Dawn Comstock, PhD, associate professor of epidemiology at the Colorado School of Public Health and co-author of the study. "It appears that when you are at altitude there may be a little less free space in the skull so the brain can't move around as much." The study, first-authored by Davi...
Source: neuropathology blog - December 10, 2013 Category: Pathologists Tags: trauma Source Type: blogs
Sensible thoughts on concussions
Given our inability to accurately measure the neurological damage from concussions, this seems like a prudent step. From ScienceDaily:Any athlete with concussion symptoms should not be allowed to return to play on the same day, according to the latest consensus statement on sports-related concussion. The updated guidelines are summarized in Neurosurgery, official journal of the Congress of Neurological Surgeons.The fourth consensus report from the Concussion in Sport Group (CISG 4) represents the latest recommendations from an expert panel, sponsored by five international sports governing bodies. "The statement ...
Source: Running a hospital - December 7, 2013 Category: Health Managers Source Type: blogs
Evidence Based Medical Decision Making Notes and Templates
by miamidoc13 (Posted Wed Dec 04, 2013 11:48 pm)Examples:Pediatric Head Trauma@AGE@ @SEX@ presenting with head trauma. Patient's neurological exam was non-focal and unremarkable. Canadian Head CT Rule was applied and patient did not have any of the following; GCS score < 15 at 2 hours after injury, suspected open or depressed skull fracture, any sign of basilar skull fracture, 2 or more episodes of vomiting, age ≥ 65 years old, amnesia for ≥ 30 minutes of events before impact, dangerous mechanism. 100% sensitivity (95% CI 92-100%) for predicting neurological intervention (Lancet 2001 May 5;357(9266):1391). I discus...
Source: Med Student Guide - December 5, 2013 Category: Medical Students Source Type: forums
Evidence Based Medical Decision Making Notes and Templates
by miamidoc13 (Posted Wed Dec 04, 2013 11:47 pm)Examples:Pediatric Head Trauma@AGE@ @SEX@ presenting with head trauma. Patient's neurological exam was non-focal and unremarkable. Canadian Head CT Rule was applied and patient did not have any of the following; GCS score < 15 at 2 hours after injury, suspected open or depressed skull fracture, any sign of basilar skull fracture, 2 or more episodes of vomiting, age ≥ 65 years old, amnesia for ≥ 30 minutes of events before impact, dangerous mechanism. 100% sensitivity (95% CI 92-100%) for predicting neurological intervention (Lancet 2001 May 5;357(9266):1391). I discus...
Source: Med Student Guide - December 5, 2013 Category: Medical Students Source Type: forums
Depressed? You May Not Be Able to Enter the U.S.
Could you imagine being discriminated against because you had a broken arm? Or a diagnosis of cancer? Or suffered from a concussion (like hundreds of pro sports players do every year) and were denied rights everyone else enjoys?
What if you suffered from clinical depression and have been, at past times in your life, severely depressed? Should the government be allowed to discriminate against you because of a mental health diagnosis?
The U.S. Department of Homeland Security’s agency of Customs and Border Protection apparently thinks that maybe sometimes the answer should be “yes.”
You’d think I was ...
Source: World of Psychology - December 3, 2013 Category: Psychiatrists and Psychologists Authors: John M. Grohol, Psy.D. Tags: Depression Disorders General Mental Health and Wellness Policy and Advocacy America Depressed Ellen Richardson Homeland Security Jenny Burke Medical History Mental Disorder official Toronto U.S. Immigration United States Va Source Type: blogs
