The story behind the new sore throat article
Today, our latest sore throat article appears in the Annals of Internal Medicine. The story behind the article starts with this blog!
This post documents the story as of 2009 when I wrote about Expanding the Pharyngitis Paradigm
To recap, I first posted an article about the Lemierre Syndrome in 2002. Because of my long standing interest in adult sore throats, I immediately wondered if the rise in the Lemierre Syndrome should influence pharyngitis management.
Since my thought experiment publication in 2009, working with some great colleagues, we developed a PCR for Fusobacterium necrophorum. We did some pilot work and pr...
Source: DB's Medical Rants - February 16, 2015 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
A Tale of Two Sore Throats: On Retail Clinics and Urgent Care
By LESLIE KERNISAN, MD Six years ago, just after arriving in Baltimore for a winter conference, I fell sick with fever and a bad sore throat. After a night of feeling awful, I went looking for help. I found it at a Minute Clinic in a CVS near the hotel. I was seen right away […] (Source: The Health Care Blog)
Source: The Health Care Blog - January 29, 2015 Category: Consumer Health News Tags: THCB Leslie Kernisan Longform Practice Models Retail Clinics Strep throat urgent care Source Type: blogs
The Lemierre Syndrome – 2014 survey data
Recently, 79 members of Facebook’s Lemierre’s Syndrome Survivor group (which has 813 members) answered a hastily written survey. I wrote this survey to get a rough idea of their experiences. Over the years I have probably talked with at least 10 patients or families about their disease. Two of the discussions occurred after the teenager had died. As I talk with patients or families I have learned much about the devastation that this syndrome causes. This informal survey did not have IRB approval, as it really represents some pilot data and information to inform the struggle to prevent this horrible disease...
Source: DB's Medical Rants - January 20, 2015 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
Hospitalized Woman with New Complaint Everyday Diagnosed with Broken Furnace Syndrome.
Fargo, ND - Bertha Jensen was hospitalized two weeks ago for chest pain rule out, but a new complaint every day has prevented doctors from sending her home during the cold winter months. That is, until a breakthrough in discharge planning was discovered by her current Hospitalist. Consider Broken Furnace Syndrome for difficult winter discharges."When I was a resident in Minneapolis, I took care of at least a dozen cases of Broken Furnace Syndrome every winter," said Hospitalist Dr. David Penter, who is known for his uncanny ability to spot patients with ulterior motives from a mile away.Broken Furnace Syndrome is any...
Source: The Happy Hospitalist - January 7, 2015 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs
What Doctors are Thinking
Ever wonder what your doctor is thinking while taking your history? If we’re doing it right, we’re looking at you instead of a computer. We’re making appropriate eye contact while displaying welcoming body language. And we’re letting you tell your story with as few interruptions as possible. Clearly we are listening intently, but did you ever wonder what’s going through our minds while you’re speaking?
I’ve been thinking about this lately in the context of teaching medical students about history-taking. They’re being taught all the right questions to ask and how to ask them (...
Source: Musings of a Dinosaur - December 31, 2014 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Top 7 Otolaryngology EMR Software Features to Guide Your Investment
EMRs don’t exist in a vacuum: their usefulness is dependent upon optimal integration within the medical practice. Because each organization and specialty has its own unique demands which exist outside the parameters of basic EMRs, the ability to customize continues to be one of the most important features. This is particularly applicable in the field of otolaryngology where the right kind of workflow can vastly enhance productivity and profitability while the wrong kind can be a significant impediment to quality of care. There are many available EMR choices today, and identifying the one that will best meet the needs of ...
Source: EMR EHR Blog for Physicians - December 23, 2014 Category: Technology Consultants Authors: Alok Prasad Tags: Patient Engagement Otolaryngology EMR Source Type: blogs
Ten things to expect after AF ablation
Here is a list of ten things to say about the experience of having an AF ablation.
(Note: This list concerns standard radio frequency catheter ablation for AF.)
1. AF ablation is a big deal:
The first thing to say about AF ablation is that it is a big procedure. I tell patients to expect AF ablation to be hard on them. How could it be easy to undergo hours of general anesthesia, insertion of big tubes in the leg veins, 50-75 burns in the atrium and hours of bed rest? Although a minority sail through the recovery without complaints, most patients tell me they were surprised at how hard it was on them. I recommend taking a ...
Source: Dr John M - December 16, 2014 Category: Cardiology Authors: Dr John Source Type: blogs
Did President Obama receive high value care for his sore throat?
Two days ago we all noticed that President Obama had direct laryngoscopy and then a CT scan for a persistent sore throat. As a physician who has studied acute pharyngitis for 35 years, I had to carefully think about his complaint and the decisions that his physicians made.
First, his “sore throat” was not acute pharyngitis. Guidelines and expert recommendations on acute pharyngitis diagnosis and management only apply to patients who have a brief (5 day or less) acute illness characterized primarily by a sore throat. Thus, we should not expect that the standard approach to pharyngitis would apply.
Second, we ...
Source: DB's Medical Rants - December 9, 2014 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
Physicians are treating the well, and nurses are treating the sick
A rash could be leukemia or idiopathic thrombocytopenic purpura. A sore throat could be glossopharyngeal neuralgia or a retropharyngeal abscess. A blocked ear could be Ramsay-Hunt syndrome, a self-limited serous otitis or sudden sensorineural hearing loss with an abysmal prognosis if not treated immediately with high doses of steroids. A headache or sinus pain could be cancer, and a cough could be a pulmonary embolus or heart failure.
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 - December 3, 2014 Category: Journals (General) Authors: A Country Doctor, MD Tags: Physician Primary care Source Type: blogs
Why Should Doctors Treat the Well and Nurses the Sick?
By HANS DUVEFELT, MD A rash could be leukemia or idiopathic thrombocytopenic purpura. A sore throat could be glossopharyngeal neuralgia or a retropharyngeal abscess. A blocked ear could be Ramsay-Hunt syndrome, a self-limited serous otitis or sudden sensorineural hearing loss with an abysmal prognosis if not treated immediately with high doses of steroids. A headache […] (Source: The Health Care Blog)
Source: The Health Care Blog - November 18, 2014 Category: Consumer Health News Tags: THCB Source Type: blogs
The Nurse Practitioner … Er, We Mean Doctor Is In
By HANS DUVEFELT, MD A rash could be leukemia or idiopathic thrombocytopenic purpura. A sore throat could be glossopharyngeal neuralgia or a retropharyngeal abscess. A blocked ear could be Ramsay-Hunt syndrome, a self-limited serous otitis or sudden sensorineural hearing loss with an abysmal prognosis if not treated immediately with high doses of steroids. A headache […] (Source: The Health Care Blog)
Source: The Health Care Blog - November 18, 2014 Category: Consumer Health News Tags: Tech THCB Nurse Practitioners Physician practice practice management Workflow Source Type: blogs
Fright Week: The Waking Nightmare of Lord Voldemort
Nightmares can seem very real at times, but then we wake up and realize it was all a bad dream. Now imagine having a vivid nightmare with all the reality of waking life and then... it turns out you're actually awake through it all!This happened to an 11 year old Italian boy who reported frightening auditory and visual hallucinations of Voldemort, the archenemy of Harry Potter, for three straight days. These hallucinations began after a bout of sore throat and fever (38°C). As Vita et al. (2008) report:The day after the resolution of fever, he began to present hallucinations. Hallucinations occurred in the aft...
Source: The Neurocritic - October 25, 2014 Category: Psychiatrists and Psychologists Authors: The Neurocritic Source Type: blogs
Still worrying about Lemierre syndrome #continuedfrustration
Periodically something happens that reminds me that I must continue working to increase our knowledge of Lemierre syndrome. Today I received a comment on a post from 2008 – Championing an orphan disease – Lemierre syndrome. The latest comment makes 15 comments over the years. If you doubt the personal impact this disease has on adolescents and their families, please read the comments.
Here is the problem. Lemierre syndrome is infrequent but very dangerous. It can kill and can disable. It occurs more frequently in the US than does rheumatic fever. The most common organism causing Lemierre syndrome is Fu...
Source: DB's Medical Rants - October 21, 2014 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
Research and Reviews in the Fastlane 051
Welcome to the 51st edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature.
This edition contains 10 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Anand Swaminathan and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R project or check out...
Source: Life in the Fast Lane - October 6, 2014 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Anaesthetics Cardiology Education Emergency Medicine Gastroenterology Infectious Disease Intensive Care Pre-hospital / Retrieval Respiratory Resuscitation critical care literature R&R in the FASTLANE recommendations Research an Source Type: blogs
MKSAP: 32-year-old man with cough and nasal congestion
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 32-year-old man is evaluated for a 3-day history of productive cough, sore throat, coryza, rhinorrhea, nasal congestion, generalized myalgia, and fatigue. His sputum is slightly yellow. His two children (ages 3 years and 1 year) had similar symptoms 1 week ago. He is a nonsmoker and has no history of asthma.
On physical examination, temperature is 37.5 °C (99.4 °F), blood pressure is 128/76 mm Hg, pulse rate is 92/min, and respiration rate is 14/min. There is bilateral conjunctival injection. The nasal mucos...
Source: Kevin, M.D. - Medical Weblog - September 14, 2014 Category: Journals (General) Authors: mksap Tags: Conditions Primary care Source Type: blogs
