October 2022: A Case of Ankle Annihilation
“Has your ankle been a problem for a long time?"I felt a sense of déjà vu looking at my patient's foot. I had seen this before: Someone with diabetes who had worsening, long-standing ankle pain, and had seen various doctors over the years.As before, my patient's foot was swollen, without ulcerations or signs of cellulitis or acute trauma. Perhaps we would do better this time. We could optimize our resource utilization, have him spend less time in the emergency department, and offer better care.Still, we began with an x-ray, and predicted that this symptom was one that some people with diabetes develop chronica...
Source: Lions and Tigers and Bears - October 6, 2022 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

The Candy in My Pocket with John Robert Wiltgen
I had a chance to catch up with John Robert Wiltgen, the fascinating international award-winning JRW Design founder. I’m enjoying his recent blog posts and stories and want to spread the word in case you might enjoy them too. John was diagnosed with diabetes at 8 years old. He’s lived with diabetes for more than 53 years now and has faced many challenges. I enjoy his positive attitude and how he continues to charge forth and do what he loves. Over the course of his life, he built an incredible design business. He’s won more than 40 major design awards, and his work has brought him from Chicago̵...
Source: Scott's Diabetes Blog - February 23, 2021 Category: Endocrinology Authors: Scott K. Johnson Tags: Blog Posts Source Type: blogs

Sacral Tuberculosis
Here is a case of 35 year Indian origin male with backache with MRI revealed marrow edema in the sacral vertebral bodies along with presacral abscess noted on sagittal fat suppressed images. Interestingly before the MRI Xray didnot show much changes. In patients with osteomyelitis, MRI will pick up the changes earlier than plain xray.MRI SHOWING SARCAL EDEMA& PRESACRAL ABSCESS                              XRAY LS SPINE LATERAL VIEW Famous Radiology Blog http://www.sumerdo...
Source: Sumer's Radiology Site - August 2, 2020 Category: Radiology Authors: Sumer Sethi Source Type: blogs

The Echoes of Patient Safety Events: Errors in Third Year
Conclusion/Takeaways These stories are constantly shaping us; when we notice, think, and share them, how can it not be for the better? None of these stories has an end, because we remember them; they echo. There is multifaceted value in their retelling and reworking, clinically and personally. The curriculum provides students with a platform (the structured assignment), mentorship (the physician reader), and dialogue within a community of peers (the class debrief). It provides faculty with new eyes: the emotion and introspection that can blur with long practice. Together the pieces of the curriculum remind us how much st...
Source: Academic Medicine Blog - October 8, 2019 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Guest Perspective medical errors medical students patient safety Source Type: blogs

Pressure Injuries Expanded by CMS as Indicators of Hospital Harm
CMS has implemented a new quality measure for hospitals that expands the array of pressure injuries considered as adversely impacting quality care.  The new measure, developed in a program to provide electronic clinical quality measures (eCQMs), widens the scope of pressure injury stages that directly infer quality deficit.  The new measure however, bears no consideration for unavoidability of some pressure injuries even when recommended clinical practice guidelines for prevention have been followed.  According to CMS, the benefit of eCQMs is to assess the outcomes of treatment, reduce the burden of manual abstraction a...
Source: Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers - September 28, 2019 Category: Geriatrics Authors: Jeffrey Levine Tags: Featured Medical Articles Geriatric Medicine Pressure Injuries & Wound Care Risk Management bedsores decubiti decubitus ulcer end-of-life care geriatrics Healthcare Quality hospital quality Improving Medical Care Jeff Levine MD J Source Type: blogs

Xray features Chronic Osteomyelitis :DAMS eQ Series
Sharing brief video about visual multiple choice question on chronic osteomyelitis in DAMS eQ series.Famous Radiology Blog http://www.sumerdoc.blogspot.com TeleRad Providers at www.teleradproviders.com Mail us at sales@teleradproviders.com (Source: Sumer's Radiology Site)
Source: Sumer's Radiology Site - November 26, 2018 Category: Radiology Authors: Sumer Sethi Source Type: blogs

The “untouchables” of mental health care
When I was first reading up on JM (identifying information changed), I thought the case would go smoothly, well, as smoothly as any inpatient psychiatry case can go. All I had known about her is that she was an elderly woman who was recently released from jail. When the staff came to escort JM to her freedom, instead of being overjoyed as most likely would be, she was agitated and said she would not speak with them and would not leave until she was ready. She was also speaking to someone else in the cell that the staff could not see or hear. The staff came to find out that she was speaking to Jesus Christ regarding an ongo...
Source: Kevin, M.D. - Medical Weblog - October 19, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/jake-pemberton" rel="tag" > Jake Pemberton < /a > Tags: Education Psychiatry Source Type: blogs

More equitable health care starts with you
I am a hospitalist at a safety-net hospital. Through my work, I have come to understand how our daily decisions — filtered through our own biases — influence how health care is implemented, and I had a personal teacher in my first year as an attending. Soon after starting my job, I met Mr. K. He was in his 40s, well-kempt, soft-spoken and had the good habit of looking people in the eyes when talking to them. Originally from New York, he had been living comfortably as a middle manager in restaurant supply sales until an unexpected mixture of midlife crisis and wanderlust struck. He traveled the country looking for a new...
Source: Kevin, M.D. - Medical Weblog - June 14, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/rehaan-shaffie" rel="tag" > Rehaan Shaffie, MD < /a > Tags: Policy Hospitalist Public Health & Washington Watch Source Type: blogs

Nailed It!
​What do you do for a nail from a nail gun in the hand? This procedure is simple, but you have to worry about the aftermath. Complicated issues may arise post-procedure in the days to weeks after extraction, including retained foreign bodies, infection, fractures, disability, pain, nerve damage, tendon rupture, and cosmetic concerns.​Removing the nail is only half the battle. Proper removal, treatment, and follow-up should be considered with all foreign bodies in the skin, especially the hand. Being prepared for the possible aftershocks will help your patient have a successful recovery.A 23-year-old man with a nail fro...
Source: The Procedural Pause - June 1, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Tropical Travel Trouble 004 Bloody Diarrhoea
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 004 A medical student who has just returned from their elective in Nepal presents with 1 week of bloody diarrhoea. He has been in the lowlands and stayed with a family in the local village he was helping at. It started three days before he left and he decided to get home on the plane in the hope it would settle. He is now opening his bowels 10x a day with associated cramps, fevers and has started feeling dizzy. Questions: Q1. What is dysentery ...
Source: Life in the Fast Lane - March 12, 2018 Category: Emergency Medicine Authors: Neil Long Tags: Clinical Cases Tropical Medicine amoebic dysentery bacillary dysentery e.histolytica entamoeba histolytica shigellosis Source Type: blogs

Precision Medicine and the Reinvention of Human Disease (Book Index)
In January, 2018, Academic Press published my bookPrecision Medicine and the Reinvention of Human Disease. This book has an excellent " look inside " at itsGoogle book site, which includes the Table of Contents. In addition, I thought it might be helpful to see the topics listed in the Book ' s index. Note that page numbers followed by f indicate figures, t indicate tables, and ge indicate glossary terms.AAbandonware, 270, 310geAb initio, 34, 48ge, 108geABL (abelson leukemia) gene, 28, 58ge, 95 –97Absidia corymbifera, 218Acanthameoba, 213Acanthosis nigricans, 144geAchondroplasia, 74, 143ge, 354geAcne, 54ge, 198, 220geAcq...
Source: Specified Life - January 23, 2018 Category: Information Technology Tags: index jules berman jules j berman precision medicine Source Type: blogs

What it ’s like to be a doctor in the heroin capitol of the U.S.
I am a practicing hospitalist physician in Dayton, Ohio. Dayton has emerged in the last year as the city with the highest per capita death rate from opioid overdoses. When we measure the number of deaths here we talk about how many there are per day, not per week or month. We have been inundated with heroin and other products laced with fentanyl or carfentanil. Every other drug, including marijuana, is laced with an opiate in this city. Dealers stand on street corners and throw baggies of heroin into passing cars who have the windows open — free of charge — to get new customers hooked. A routine dose of Narcan ...
Source: Kevin, M.D. - Medical Weblog - July 19, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/jenny-hartsock" rel="tag" > Jenny Hartsock, MD < /a > Tags: Physician Medications Source Type: blogs

Back-to-Basics for Strains and Sprains: ACE Wraps, Aircast, and Velcro
​Simple ankle and wrist sprains and strains still need ACE wraps, Aircasts, Velcro wrist splints, or hard splints. Patients without fractures may still need assistive devices to help control their pain and place their injured extremity in a comfortable position while they heal. Hard splints (like Ortho-Glass) may be unnecessary. Appropriate splinting or hard casting, however, should be used to prevent further injury and decrease pain until follow-up. Strain, sprains, and even contusions do not need hard casting unless there is a high level of suspicion for missed injury, such as a Jones fracture, complicated avulsion inj...
Source: The Procedural Pause - July 3, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Back-to-Basics for Strains and Sprains: ACE Wraps, Aircast, and Velcro
​Simple ankle and wrist sprains and strains still need ACE wraps, Aircasts, Velcro wrist splints, or hard splints. Patients without fractures may still need assistive devices to help control their pain and place their injured extremity in a comfortable position while they heal. Hard splints (like Ortho-Glass) may be unnecessary. Appropriate splinting or hard casting, however, should be used to prevent further injury and decrease pain until follow-up. Strain, sprains, and even contusions do not need hard casting unless there is a high level of suspicion for missed injury, such as a Jones fracture, complicated avulsion inj...
Source: The Procedural Pause - July 3, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

No, I ’m not settling for family medicine
During a recent internal medicine rotation, a senior resident expressed disappointment that I’ve chosen a career in family medicine. He was concerned that my talents would be wasted, because — in his words — I wouldn’t get to care for the “more complex patients” he sees in internal medicine. Although I appreciated his confidence in my abilities, I felt my heart sink, as it does each time I am faced with misinformed perceptions about family medicine. I thought back to my last family medicine rotation, and the following patients came to mind: A young woman with a previous diagnosis of idi...
Source: Kevin, M.D. - Medical Weblog - May 16, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/lauren-abdul-majeed" rel="tag" > Lauren Abdul-Majeed < /a > Tags: Physician Primary care Source Type: blogs