The art of medicine is slowly being pushed out. Is that a good thing?
One late evening on pediatrics call, a frantic young couple brought in their few weeks old baby. She had spiked a fever which refused to go down and was fussier than normal. The cause of her symptoms could have been anything — at best, a mild respiratory infection, in which case we would simply watch her and manage her symptoms, but at worst, it could be meningitis, an infection attacking the membrane covering her spinal cord and brain. It’s a grave condition that would be fatal if left undiagnosed, but diagnosing it meant doing a lumbar puncture, an extremely invasive procedure for anyone, let alone a baby, involv...
Source: Kevin, M.D. - Medical Weblog - April 16, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/steven-zhang" rel="tag" > Steven Zhang < /a > Tags: Education Mobile health Primary Care Source Type: blogs

Intracranial Hypotension : MRI
Case Report:27 year old female without any previous co-morbidity and not on any medications was diagnosed with hydatidiform mole. Evacuation was done under spinal anesthesia. The next day following the procedure, she developed headache, which was only present on sitting on standing and was relieved on attaining supine position. After 2 days , she developed worsening of the headache which now became continuous and  she also developed right sided focal seizures in upper limb. Initial clinical diagnosis in the background of a hypercoagulable state (hydatiform mole), headache and seizures was cerebral venous thrombosis. H...
Source: Sumer's Radiology Site - April 8, 2018 Category: Radiology Authors: Sumer Sethi Source Type: blogs

Tropical Travel Trouble 007 Mega Malaria Extravaganza
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog aka Tropical Travel Trouble 007 When you think tropical medicine, malaria has to be near the top. It can be fairly complex and fortunately treatment has become a lot simpler. This post is designed to walk you through the basic principals with links to more in depth teaching if your niche is travel medicine, laboratory diagnostics or management of severe or cerebral malaria. If you stubbled on this post while drinking a cup of tea or sitting on the throne and want a few basi...
Source: Life in the Fast Lane - April 5, 2018 Category: Emergency Medicine Authors: Neil Long Tags: Clinical Cases Tropical Medicine malaria Plasmodium plasmodium falciparum plasmodium knowles plasmodium malariae plasmodium ovale plasmodium vivax Source Type: blogs

Medicine isn ’t a competition. It’s a team sport.
I love sports analogies. There is so much in competition and team play that mirrors the way departments work in many sectors of medicine. “There is no ‘I’ in ‘team,'” as the adage says. Michael Jordan, for example, did not win his championships in the NBA until he had fairly decent and dependable team of support around him. The stars in many sports cannot achieve the greatest height of success without the team dynamic. Medicine is no different. Physicians in the hierarchy of medicine are often considered the clinical “team leaders.” Yes, there has been an onslaught on physician autonomy. Y...
Source: Kevin, M.D. - Medical Weblog - March 25, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/n-bande-virgil" rel="tag" > N. Bande Virgil, MD < /a > Tags: Physician Hospital-Based Medicine Source Type: blogs

Answer to Case 484
Answer:Trypanosoma bruceiThis is most likelyT. brucei rhodesiensebased on:The patient ' s recent travel to Eastern Africa (Kenya),His participation in a game tracking excursion (classic history given that wild ungulates are the reservoir for this subspecies),His rapid onset of symptoms, andThe very high (!) parasitemiaBe sure to check out the video which show the characteristic ' auger ' like motility of the trypomastigotes (i.e. rotating along its long axis).Thanks to everyone who wrote in with the excellent comments. A lot of good points were raised by all. Ali Mokbel mentioned that we can ' t exclusively rule outT. b. g...
Source: Creepy Dreadful Wonderful Parasites - March 4, 2018 Category: Parasitology Source Type: blogs

Fight Aging! Newsletter, February 19th 2018
Fight Aging! provides a weekly digest of news and commentary for thousands of subscribers interested in the latest longevity science: progress towards the medical control of aging in order to prevent age-related frailty, suffering, and disease, as well as improvements in the present understanding of what works and what doesn't work when it comes to extending healthy life. Expect to see summaries of recent advances in medical research, news from the scientific community, advocacy and fundraising initiatives to help speed work on the repair and reversal of aging, links to online resources, and much more. This content is...
Source: Fight Aging! - February 18, 2018 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs

Evidence for Tau Accumulation and Failing Cerebrospinal Fluid Clearance to be the Starting Point for Alzheimer's Disease
Alzheimer's disease might be considered as the consequence of the related, interacting buildup of two primary forms of metabolic waste in the brain, tau and amyloid-β. Either, independently, can cause neurodegeneration, but they have a complicated relationship with one another in which the presence of both makes the pathology worse. Which comes first? There is evidence to suggest that amyloid aggregation leads to tau aggregation, and there is also evidence for things to be the other way around, such as that presented in the research materials here. Both of these options could be the case, in that either tau or amy...
Source: Fight Aging! - February 13, 2018 Category: Research Authors: Reason Tags: Daily News Source Type: blogs

To Err is Homicide in Britain – the case of Dr. Hadiza Bawa-Garba  
By, SAURABH JHA The good that doctors do is oft interred by a single error. The case of Dr. Hadiza Bawa-Garba, a trainee pediatrician in the NHS, convicted for homicide for the death of a child from sepsis, and hounded by the General Medical Council, is every junior doctor’s primal fear.   An atypical Friday Though far from usual, Friday February 18th, 2011 was not a typically unusual day in a British hospital. Dr. Bawa-Garba had just returned from a thirteen-month maternity break. She was the on-call pediatric registrar – the second in command for the care of sick children at Leicester Royal Infirmary. As a “r...
Source: The Health Care Blog - January 30, 2018 Category: Consumer Health News Authors: at RogueRad Tags: Patients Physicians The Business of Health Care Source Type: blogs

Huge ST Elevation in V2 and V3. What is it?
A 30-something presented with methamphetamine use and agitation. He was sedated, then had an ECG as part of his workup:He was stabilized and observed.He was still confused 8 hours later when I was now on duty, and he was found to have a heart rate of 140, so another ECG was recorded:There is one lead (V2) with massive ST elevation.Since there is very little STE in V1 or V3, there must be lead misplacement.I suspected some lead misplacement and ordered another with the leads corrected:Now there is massive STE in BOTH leads V2 and V3What do you think?What do you want to do?What do you think? This is what I thought:...
Source: Dr. Smith's ECG Blog - June 4, 2017 Category: Cardiology Authors: Steve Smith Source Type: blogs

Oh, the Things You ’ll See Over an MS Lifetime
I once wrote a toast for a dear couple who were to celebrate their 50th wedding anniversary at the same island hotel where they had honeymooned — well, where they’d spent a weekend after their wedding. As I researched their life together, I realized that some pretty amazing stuff had taken place during the time they’d spent as a couple. They’d seen the rise and fall of the Third Reich, the Iron Curtain, and the Berlin Wall. Their married life encompassed 11 presidents and five popes, and spanned from the age of propeller planes through to manned space travel and the sending of a man-made object beyond our solar s...
Source: Life with MS - April 13, 2017 Category: Neurology Authors: Trevis Gleason Tags: multiple sclerosis Everyday Health life with MS Living with MS MS and family MS doctors MS in the news trevis gleason Source Type: blogs

New Blood Test May Make ‘Off the Rack’ MS Treatments Closer to ‘Designer Drugs’
Since the mid-1990s, the diagnosing process for most people suspected of having multiple sclerosis (MS) has included a lumbar puncture (also called a spinal tap) to look for certain antibodies and proteins, and an MRI scan to look for lesions in the brain. Previous to that, immersion into a hot tub (to see if symptoms worsened with heat) and evoked response tests may have been used. In the future, it’s possible that a test for blood biomarkers could become a standard part of the diagnostic process for MS — and it could also help to determine the best form of treatment for those diagnosed. Chemical Identifiers of MS Pro...
Source: Life with MS - February 16, 2017 Category: Neurology Authors: Trevis Gleason Tags: multiple sclerosis clinical trials drug trial MS treatment research Source Type: blogs

Are you asking students questions or “pimping?”
One of the most respected and skilled clinician-educators — of course, he is an infectious diseases specialist — at our institute came into my office, sat down and immediately starting eating pretzels. “Let me know what you think about this,” he said between bites. He went on to recapitulate a recent interaction he had with the members of the internal medicine team (medical students, house staff and the attending physician) about a week ago. He described a presentation to our emergency department of a young woman with a headache, neck stiffness and fever, who was previously well and had young children at home who w...
Source: Kevin, M.D. - Medical Weblog - February 10, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/joseph-cooper" rel="tag" > Joseph Cooper, MD < /a > Tags: Education Medical school Residency Source Type: blogs

MKSAP: 45-year-old man with cough and right-sided chest discomfort
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 45-year-old man is evaluated for right-sided chest discomfort and cough of 2 weeks’ duration. His chest discomfort is described as a vague, painful sensation on the right. The cough occasionally produces a small amount of sputum; he reports no hemoptysis or shortness of breath. He has felt feverish with mild fatigue but has had no weight loss. He is a smoker with a 20-pack-year history. He takes no medications. On physical examination, temperature is 37.6 °C (99.7 °F), blood pressure is 130/70 mm Hg, p...
Source: Kevin, M.D. - Medical Weblog - February 4, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Infectious disease Source Type: blogs

Hemiplegic Migraine and Paraspinous Cervical Injections with Bupivacaine
​I recently treated a patient with hemiplegic migraines successfully with bupivacaine cervical injections, a novel therapeutic technique using paraspinous cervical injections. The technique employs deep intramuscular injections of 1.5 mL of 0.5% bupivacaine bilaterally into the paraspinous muscles of the lower neck. (Read more in my October 2012 blog and see it demonstrated in a video at http://bit.ly/2ewC5n1.)This headache and orofacial pain treatment was first described in 1996 by my twin brother, Gary Mellick, DO, a neurologist who did a pain fellowship. The exact mechanism is unknown, but the treatment appears to...
Source: M2E Too! Mellick's Multimedia EduBlog - December 1, 2016 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs