LITFL Review #209
Welcome to the 209th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM.
The Most Fair Dinkum Ripper Beauts of the Week
The St Emlyns podcast speak to Youri Yordanov in this moving account of managing the mass casualty situation in the recent and tragic events in Paris. There’s lots in here for us all to ponder and reflect on with regards to our setup and abilit...
Source: Life in the Fast Lane - December 6, 2015 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
How Many Patients Do You Have? Who cares!
How many patients do you have?
I’m not sure what you mean. How many patients do I see on average each day? About twelve.
No. How many patients do you have?
Let’s see: Last week I saw about sixty patients altogether. Five of them were new patients.
No, no. How many patients do you have on your panel?
My panel? I don’t know what you mean by that. I don’t work as an employer in a fully prepaid system where patients are specifically assigned to me. I’m down to only two capitated HMOs, insurance plans that pay me a certain amount (not much) each month for each patient on my list. Some people on the...
Source: Musings of a Dinosaur - November 22, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Know the signs of diverticulitis!
Diverticulosis is a condition that describes small pouches in the wall of the digestive tract that occur when the inner layer of the digestive tract bulges through weak spots in the outer layer. When these diverticula become inflamed, that is called diverticulitis. Diagnosis of diverticulosis/diverticulitis is made over several methods, including a physical exam which includes a digital rectal examination, blood tests, x-rays or CT scans of organs in the abdomen, a colonoscopy or a flexible sigmoidoscopy. Treatment for diverticulosis includes a diet high in fiber, fiber supplementation if needed, plenty of fluids and exerc...
Source: Nursing Comments - November 8, 2015 Category: Nursing Authors: Stephanie Jewett, RN Tags: Advice/Education Caregiving General Public Nursing/Nursing Students Patients/Specific Diseases abdominal pain bloating diverticulitis diverticulosis fever and chills gas nausea painfule urination rectal bleeding vomting Source Type: blogs
We need to provide health insurance for undocumented people. Here’s why.
The cost of medical service provision in the United States is one of the most palpable strains on the health care system, but we must not forget that cost is the sibling of quality and access — without considering the three as such, we will undoubtedly fail to navigate our country’s health care quandary. Low-quality care inevitably results in the need for more care in the form of readmissions, while lack of access to primary care leads to increases in the utilization of expensive, emergency services. Of particular concern in our country, a growing contributor to cost, and driven by low-quality care and even less ac...
Source: Kevin, M.D. - Medical Weblog - October 22, 2015 Category: Journals (General) Authors: Abraar Karan Tags: Policy Emergency Primary care Source Type: blogs
It Costs Nothing to Care: Why We Need to Provide Health Insurance for Undocumented US Residents
By ABRAAR KARAN, MD
The cost of medical service provision in the United States is one of the most palpable strains on the healthcare system, but we must not forget that cost is the sibling of quality and access—without considering the three as such, we will undoubtedly fail to navigate our country’s healthcare quandary. Low quality care inevitably results in the need for more care in the form of readmissions, while lack of access to primary care leads to increases in the utilization of expensive, emergency services. Of particular concern in our country, a growing contributor to cost, and driven by low quality care and...
Source: The Health Care Blog - September 30, 2015 Category: Consumer Health News Authors: Simon Nath Tags: THCB Uncategorized Source Type: blogs
Research and Reviews in the Fastlane 101
This article reviews the evidence and concludes that the harms of prophylactic antibiotics likely outweighs the benefits and that withholding antibiotics may be very reasonable.
Recommended by: Anand Swaminathan
Pediatrics
Cohen-Silver JH et al. Autism in the emergency department. Clin Pediatr 2014; 53(12): 1134-8. PMID: 25031320
Sometimes we need adjust our approach to a patient’s management in order to avoid exacerbating the problem. There are many clinical scenarios when this is true, but is especially important to consider when dealing with patients who have autism.
Recommended by: Sean Fox
Ultrasound and Im...
Source: Life in the Fast Lane - September 23, 2015 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Education Emergency Medicine Emergency Medicine Update General Surgery Infectious Disease Intensive Care Pediatrics R&R in the FASTLANE Radiology Urology critical care literature recommendations research and reviews Source Type: blogs
The top 5 reasons you still have cravings
Follow the Wheat Belly lifestyle and you should be freed of hunger and cravings except when physiologically appropriate, e.g., you haven’t eaten anything in 8 hours. Many of us eat breakfast, for instance, then have no desire for food until dinner. Or you have a healthy lunch at noon, then forget to eat dinner. In other words, the incessant, rolling, rumbling hunger that plagues modern people that can account for aggressive, even angry, food quests simply goes away and you are left with a soft reminder that it might be nice to eat sometime in the next few hours.
If you are following this lifestyle properly, you shoul...
Source: Wheat Belly Blog - August 12, 2015 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Success Stories cravings grains hunger opiates Weight Loss Source Type: blogs
Quit your pushing: A cutting-edge guide to constipation
Here’s an update to an earlier Wheat Belly Blog discussion about constipation.
I really don’t like talking about constipation, since it makes me wonder whether I’m starting down that inevitable decline towards the day when all I want to talk about is having a “good bowel movement.”
But the C word–constipation–continues to come up regularly when people go wheatless and grainless. “Won’t I lack fiber?” many ask. For example, in response to the Wheat Belly Blog post, The Wheat-free “Movement,” Janne posted this comment:
I am very happy on a no-wheat regi...
Source: Wheat Belly Blog - June 29, 2015 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle bowel habits constipation fiber magnesium microbiota prebiotics probiotics Source Type: blogs
Outsize Compensation for "Teflon-Coated" Executives - After Many Lawsuits and Negative News Stories, Norton Healthcare Executives Still Get Millions
In an earlier era of chemistry, politicians who continued to acquire votes while shedding doubts, criticisms, and allegations were called "Teflon-coated." Teflon may be outdated now, but there certainly seems to be some health care executives who have unique non-stick coatings.The Executives' Compensation Our latest example comes from the Louisville (KY) Courier-Journal, which just published an article about the compensation received by top executives of one of the region's major hospital systems. The essentials were:From 2011 to 2013, the three most recent years available, tax records show the chief executive...
Source: Health Care Renewal - February 5, 2015 Category: Health Management Tags: conflicts of interest cross fire executive compensation Medtronic Norton Healthcare public relations spine surgeons Source Type: blogs
This is, or at least may be, a BFD
I have discussed initiatives in the Affordable Care Act that encourage experimentation with new ways of reimbursing health care providers --Accountable Care Organizations being the most noteworthy. These are capitated (i.e. paid a lump sum per year per patient, with some adjustments) multi-specialty provider entities that get bonuses for patient satisfaction and good outcomes and get their pay docked for bad outcomes. But, these are just experiments that will only have a few takers.But now the Administration has announced a major change in Medicare. By then, 30% of payments will be under ACO-like alternative pay models. A ...
Source: Stayin' Alive - January 27, 2015 Category: American Health Source Type: blogs
Diverticulitis patients reveal psychological, physical symptoms long after acute attacks
UCLA researchers interviewed people with diverticulitis plus confirmed that many suffer psychological plus physical symptoms long after their acute illness has passed.
Related Posts:Scientists describe new form of ib syndromeIBS and bloating: When the gut microbiota gets out of…Most Severe Irritable Bowel Syndrome: Emotional DistressIRRITABLE BOWEL SYNDROME management through dietDoes High Stress Levels and Anxiety Cause IBS?The post Diverticulitis patients reveal psychological, physical symptoms long after acute attacks appeared first on My Irritable Bowel Syndrome Story. (Source: My Irritable Bowel Syndrome Story)
Source: My Irritable Bowel Syndrome Story - July 30, 2014 Category: Other Conditions Authors: Ken Tags: IBS News Source Type: blogs
Better care is mindfully listening to patients
“Dr. Liu, I don’t think he has diverticulitis.”
So said the second-year medical student. She had just completed her first year of anatomy, biochemistry, pathology, and introduction to doctoring at the local medical school. One of the sharpest medical students I’ve proctored.
Continue reading ...
Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - July 27, 2014 Category: Journals (General) Authors: Davis Liu, MD Tags: Physician Medical school Primary care Source Type: blogs
Research and Reviews in the Fastlane 040
In this study the role of a “1/2 dose” thrombolysis was evaluated for the reduction of pulmonary artery pressure in moderate PE. A total of 121 patients with moderate PE received either tissue plasminogen activator plus anticoagulation or anticoagulation alone with the primary end points of pulmonary hypertension and the composite end point of pulmonary hypertension and recurrent PE at 28 months. The results suggested that the ½ dose or “safe dose” thrombolysis was safe and effective in the treatment of moderate PE, with a significant immediate reduction in the pulmonary artery pressure that was ma...
Source: Life in the Fast Lane - July 21, 2014 Category: Emergency Medicine Authors: Soren Rudolph Tags: Anaesthetics Emergency Medicine Evidence Based Medicine Featured Gastroenterology Haematology Health Infectious Disease Intensive Care Neurology Pre-hospital / Retrieval Respiratory critical care literature R&R in the FASTLANE Source Type: blogs
Research and Reviews in the Fastlane 038
This study, however, has major flaws and biases that question the validity of their conclusions. Only 19% of centers that were contacted agreed to contribute data to the Consortium. Additionally, the researchers do not assess the quality of the studies included in their meta-analysis. Regardless, observational data should not be used to trump the RCT data included in the recent, Cochrane review. Finally, Roche pharmaceuticals was a major sponsor of this research team. The accompanying editorial is a must-read.
Recommended by: Anand Swaminathan
Infection Control, Hand hygiene
D’Egidio G et al. A study of the ...
Source: Life in the Fast Lane - July 10, 2014 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Anaesthetics Cardiology Emergency Medicine Featured Infectious Disease Intensive Care Neurology Palliative care R&R in the FASTLANE Radiology Resuscitation Trauma critical care literature recommendations research and reviews Source Type: blogs
Dr. Grumpy's gift guide
You're a medical student on a gastroenterology rotation, watching a colonoscopy. As the camera snakes up some guy's nether regions, the attending suddenly points to the monitor, turns to you, and says "does that look normal?"Of course, you have no f.ing clue (neither did I, but there are reasons I'm a neurologist). So what do you do? Well, now you can just quickly check your iPhone!These attractive iPhone cases come in a wide variety of pathology (normal is above) including inflammation, diverticulitis, malignant, pre-malignant, Crohn's disease, and many more! With this helpful guide, your biggest issue will be finding a w...
Source: Doctor Grumpy in the House - December 14, 2013 Category: Neurologists Authors: Grumpy, M.D. Source Type: blogs
