Cases: "Am I really going to have to live like this?": The Role of Octreotide in Patients with Persistent Nausea and Vomiting after Venting Gastrostomy
Discussion:Malignant bowel obstruction can occur with any cancer but is most commonly associated with advanced ovarian cancer, where it occurs in up to 50% of patients. It generally indicates a poor prognosis and carries a heavy symptom burden predominated by nausea, vomiting and abdominal pain. Patients with carcinomatosis, like Ms BB, are generally not candidates for surgical correction of the obstruction or endoscopic stenting. Fortunately, medical management can be very effective. Abdominal pain is treated with opioids and nausea is treated with metoclopramide in partial obstructions and haloperidol in complete obstruc...
Source: Pallimed: A Hospice and Palliative Medicine Blog - April 10, 2014 Category: Palliative Carer Workers Authors: Christian Sinclair Source Type: blogs
Feel the Burn, Heal the Burn: Wound Care Management
The Approach: How to Help HealWe promised you some information about soft tissue injuries, and you’ve got to hand it to us: we delivered! Last month, we discussed incision and drainage of large burns to the hand. Review it here before reading further: http://bit.ly/RobertsBurn. This month, we want to take an in-depth look at wound care management for burns and highlight other pearls needed for top-notch healing.
You should try to follow a few simple rules when it comes to treating burn patients. Soft tissue skin injuries heal in stages and are dependent on direct and correct treatment of the area, nutrition, and hydra...
Source: The Procedural Pause - April 2, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
NK cell testing – yet another way to exploit the vulnerable infertile patient!
This is a guest post from our expert patient, Manju.I get mails from patients saying that their NK cell number or NK cell activity is high and hence their doctor has asked them to undergo immunotherapy , using either IVIG infusion ; or intralipid therapy; Lymphocyte Immunotherapy (LIT) ; or tumour necrosis factor alpha blocking agents and steroids , or a combination of these, in order to 'treat' this abnormality. They are advised that, by doing this, they can improve their chance of having a baby. Is this claim justified ? What are NK cells ? What are their functions in human body ? How are they connected...
Source: The Patient's Doctor - March 24, 2014 Category: Obstetricians and Gynecologists Tags: Asia Biology Biotechnology Blood Cell Biology Embryo immune therapy ivf NK cells NK testing Pregnancy Stem Cells Source Type: blogs
The LITFL Review 127
The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the best and brightest from the blogosphere, the podcast video/audiosphere and the rest of the Web 2.0 social media jungle to find the most fantastic EM/CC FOAM (Free Open Access Meducation) around.
Welcome to the 127th edition, brought to you by:
Kane Guthrie [KG] from LITFL
Tessa Davis [TRD] from LITFL and Don’t Forget The Bubbles
Brent Thoma [BT] from BoringEM, and ALiEM
Chris Ni...
Source: Life in the Fast Lane - February 25, 2014 Category: Emergency Medicine Doctors Authors: Chris Nickson Tags: Education eLearning Emergency Medicine Featured Health Intensive Care Source Type: blogs
The Real Tragedy of Philip Seymour Hoffman’s Heroin Overdose
Yesterday I took my four and a half-year-old daughter to see her first movie, “Frozen.” I couldn’t take my eyes off her throughout the movie, my eyes welling up just watching her in amazement as she watched a movie on the big screen for the very first time. I don’t get many firsts—my wife gets the majority of those.
This morning I took my son out of the house alone and without my wife for the first time. I know that sounds ridiculous—my son is nine months old. But most of my time has been spent with my daughter, mainly because the baby needs mommy for milk and since he’s always either feeding or slee...
Source: Cliffside Malibu - February 3, 2014 Category: Addiction Authors: Richard Taite Tags: Richard Taite Source Type: blogs
Choosing Wisely – Critical Care Societies Collaborative
Healthcare professionals tend, like everyone else, to make some choices based on habit or training. The web site Choosing Wisely encourages physicians and patients to question some of those routine choices.
Choosing Wisely® aims to promote conversations between physicians and patients by helping patients choose care that is:
Supported by evidence
Not duplicative of other tests or procedures already received
Free from harm
Truly necessary
One of the lists on the site is from the Critical Care Societies Collaborative; five things physicians and patients should question:
1. Don’t order diagnostic tests at regular...
Source: MSSPNexus Blog - January 31, 2014 Category: Health Managers Authors: rkschwab Tags: Blood Management Patient Safety choosing wisely Source Type: blogs
This Study Reveals Children are Being Vaccinated With Toxic Levels of Aluminium Causing Neurological Damage and Autism
Conclusion
Aluminum, as these papers have demonstrated, is extremely toxic, especially when children are repeatedly vaccinated with vaccines containing aluminum over the recommended limits. The FDA and ASPEN recommend 25 mcg to be a safe limit and yet, as Dr. Sears has shown in his article, many of the childhood vaccinations contain aluminum far in excess of this amount.
The papers that I have studied make it abundantly clear that the more vaccines that children receive containing aluminum, the greater chance they have of developing autism, autoimmune diseases, Alzheimer’s disease and neurological deficits in the future....
Source: vactruth.com - January 28, 2014 Category: Health Medicine and Bioethics Commentators Authors: Christina England Tags: Christina England Top Stories Aluminum Adjuvant autism Dr. Sears Dr. Tomljenovic truth about vaccines vaccine ingredients Source Type: blogs
Critical Care Compendium update
LITFL’s Critical Care Compendium is a comprehensive collection of pages concisely covering the core topics and controversies of critical care.
Currently there are almost 1,500 entries with more in the works… Some pages are more developed than others, and all the pages are being constantly revised and improved. Links to new references and online resources are added daily, with an emphasis on those that are free and open access (FOAM!).
These pages originated from the FCICM exam study notes created by Dr Jeremy Fernando in 2011, and have been updated, modified and added to since. As such will be particularly us...
Source: Life in the Fast Lane - November 17, 2013 Category: Emergency Medicine Doctors Authors: Chris Nickson Tags: Critical Care Compendium Education eLearning Emergency Medicine Featured CCC LITFL collection Source Type: blogs
Introducing The Palliative Care ICU
Conclusion
Conversely, if Tom had a limited infection like a UTI, he may have responded quickly to antibiotics and recovered uneventfully in the nursing home. Either way, he was given high quality, judicious care that allowed nature to declare itself.
The future of healthcare is here.
We have to learn to drop our preconceived labels and adapt more hybridized models.
With this intention,
I introduce the Palliative Care ICU. (Source: In My Humble Opinion)
Source: In My Humble Opinion - November 7, 2013 Category: Family Physicians Authors: Jordan Grumet Source Type: blogs
Lessons from Haiti: Don’t Take Hot Showers and Drinkable Water for Granted
By Scott Kurpiel, MD
Practicing medicine in Port-au-Prince, Haiti, was an amazing experience that gave me a tremendous amount of perspective on health care and life. I was fortunate as the trip leader to recruit a well-rounded team of health care professionals, including 10 nurses, six doctors, two EMTs, and one sports rehabilitation therapist. We worked in a gated hospital that was secured by armed guards. The complex contained Haiti’s only full-body CT scanner, which was only available from 9 a.m. to 5 p.m. Most patients were seen urgently, and were dispositioned from a two- to four-person triage tent.
Arriving a...
Source: Going Global - August 7, 2013 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Lessons from Haiti: Don’t Take Hot Showers and Drinkable Water for Granted
By Scott Kurpiel, MD
Practicing medicine in Port-au-Prince, Haiti, was an amazing experience that gave me a tremendous amount of perspective on health care and life. I was fortunate as the trip leader to recruit a well-rounded team of health care professionals, including 10 nurses, six doctors, two EMTs, and one sports rehabilitation therapist. We worked in a gated hospital that was secured by armed guards. The complex contained Haiti’s only full-body CT scanner, which was only available from 9 a.m. to 5 p.m. Most patients were seen urgently, and were dispositioned from a two- to four-person triage tent.
Arriving at th...
Source: Going Global - August 7, 2013 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Drug Shortages Remain in 2013
While Congress and federal health agencies have been constantly busy enacting new healthcare and drug legislation and implementing various regulations, one key issue has remained at the forefront—drug shortages. For example, the University of Utah Drug Information Service counted 300 "active" -- or ongoing -- drug shortages at the end of April, just about the same as it did at the end of December 2012 (299 shortages) and September 2012 (282 shortages), as reported by Medpage Today.
On the brighter side, the number of new shortages is well off its pace from years past, with 54 so far this year, Erin Fox, PharmD, dir...
Source: Policy and Medicine - June 28, 2013 Category: Health Medicine and Bioethics Commentators Authors: Thomas Sullivan Source Type: blogs
Acupuncture Improves Diabetic Gastroparesis
By Diane Fennell
"Needleless" acupuncture can provide relief for people dealing with diabetic gastroparesis, according to new research recently presented at the 2013 Digestive Disease Week meeting in Orlando, Florida. As many as 50% of people with diabetes will develop gastroparesis.
Gastroparesis, most commonly caused by damage to the nerve fibers that control the movements of the stomach, is a condition in which the stomach's ability to move food into the small intestine is reduced. This slow stomach emptying results in a variety of symptoms, including nausea, vomiting, feelings of fullness after eating, a lack of app...
Source: Diabetes Self-Management - May 31, 2013 Category: Diabetes Authors: Diane Fennell Source Type: blogs
Here A Particle, There A Particle: FDA, Shortages And Troubled Manufacturers
How is this for bad timing? Yesterday, the FDA released a statement saying that there is a critical shortage of injectable drugs for total parenteral nutrition, a widely used intravenous solution for treating premature infants who are unable to eat or drink by mouth or experiencing other deficiencies.
Why? A key supplier, American Regent, had temporarily shut down at the end of last year because of quality control problems, such as particulates found in injectable drugs. To compensate, the FDA is turning to imports from Fresenius Kabi USA, which will import the ingredients from Norway (see the FDA statement).
Within the sa...
Source: Pharmalot - May 30, 2013 Category: Pharma Commentators Authors: esilverman Source Type: blogs
Emita's gift to her children
In honor of the yarzheit (anniversity) of my mother's death, I am reprinting a post from March 14, 2007. The message remains important for all families, and I think she would have liked me to remind you.In the story below, there is an important sentence: We discussed possible actions with Dr. X and decided to halt all invasive treatments, a course that my family has long agreed to.I know from personal experience what this simple bit of family planning can mean for the terminally ill patient and for his or her relatives. My Mom's living will had this directive, among others:That no extraordinary measures be used...
Source: Running a hospital - May 23, 2013 Category: Health Managers Source Type: blogs
