Why I oppose home strep testing
Yesterday I read this tweet:
home strep test likely to reduce inconvenience, cost, strep complications, unneeded antibiotic and antibiotic resistance #medx
I disagree, but the reasons are fairly complex.
In order to understand this problem, we have to define the possible test, its use, the likely misuse and both the intended and unintended consequences of such a test.
What makes a good home test? Users should have no difficulty collecting the test sample. The test performance must be straightforward and simple. The test should answer a question that has a dichotomous implication.
Clearly, even health care profession...
Source: DB's Medical Rants - September 20, 2016 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
On taking an excellent history
The art of eliciting the medical history requires medical knowledge, cultural knowledge, and many “people skills”. History taking is not science, but rather art, because it requires interpretation and clarification. Patients with the same symptoms express them differently. A major feature of the art of medicine involves learning how to interpret different descriptions of the same phenomenon.
A few examples might clarify these concepts.
The patient tells you that they have chest pain. At this point you really know very little. What are they really describing? How might they characterize the pain?
A p...
Source: DB's Medical Rants - June 22, 2016 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs
Why patients shouldn’t always get what they want
“Customer service” is the new buzzword in health care. (Yes, I know it’s two words. Stay with me here.) Health care has become a service industry, like a restaurant or a company that comes to your home to replace a broken windshield. The shrimp is too salty, or the tech left footprints on your floor mat? You complain, and you send the shrimp back, and the tech apologizes and says “yes sir” and vacuums out your car. The customer, as we know, is always right.
Except in health care. Administrators and patients don’t want to hear this, but in health care, the “customer” is not always right. And pretending that ...
Source: Kevin, M.D. - Medical Weblog - June 17, 2016 Category: Journals (General) Authors: Roy Benaroch, MD Tags: Physician Primary care Source Type: blogs
The tears flow after chemotherapy
One weekend about nine-and-a-half years ago, I flew from Minneapolis, where I live, to Atlanta for a publishing conference. A colleague and I were to make a presentation to the vice-president of one of our major customers.
For a couple of weeks, I’d been plagued by a sore throat, but I’d written it off as allergies or a virus. When I tried to begin the presentation, though, all that came out was a squeak. The VP was very sympathetic, and fortunately, my colleague was able to handle the meeting.
I flew home that afternoon. The next morning, I saw my primary care physician, who referred me to a radiologist for a ...
Source: Kevin, M.D. - Medical Weblog - June 15, 2016 Category: Journals (General) Authors: Rick Monteith Tags: Patient Cancer Source Type: blogs
Will The Medical Tricorder From Star Trek Become Real?
Analyzing disease instantly: the medical tricorder has been one of the most exciting futuristic technologies in medicine since Star Trek. But will it ever get to the black bag of General Practitioners?
As a movie fan, I love talking about how the science fiction movies of the last 100 years have shaped our ideas about medical technology. When university students doing film studies asked me to give a talk on how sci-fi influenced medical technology, I dedicated a whole section to technology inspired by Star Trek. The long list includes telepresence, the hypospray for painless injections, voice–activated communicators, the...
Source: The Medical Futurist - May 25, 2016 Category: Information Technology Authors: berci.mesko Tags: Portable Diagnostics GC1 Source Type: blogs
Here are the limitations of virtual doctor visits
Virtual visits are increasingly the rage amongst forward-thinking healthcare providers that want to jump on the telehealth band wagon. Extending the office visit across distance, using the same technology we use to keep in touch with loved ones (videoconferencing such as Skype and FaceTime), is a safe and logical way for providers to venture into a new tech-enabled world that may still be scary for some.
One way to think of this trend is to consider virtual visits an extension of the brick and mortar care model made famous a decade ago by companies like MinuteClinic. Offer convenient access to a care provider for a lim...
Source: Kevin, M.D. - Medical Weblog - May 21, 2016 Category: Journals (General) Authors: Joseph Kvedar, MD Tags: Tech Mobile health Source Type: blogs
The Quality of Virtual Visits
By JOE KVEDAR, MD
Virtual visits are increasingly the rage amongst forward-thinking healthcare providers that want to jump on the telehealth band wagon. Extending the office visit across distance, using the same technology we use to keep in touch with loved ones (videoconferencing such as Skype and FaceTime), is a safe and logical way for providers to venture into a new tech-enabled world that may still be scary for some.
One way to think of this trend is to consider virtual visits an extension of the brick and mortar care model made famous a decade ago by companies like Minute Clinic. Offer convenient access to a care...
Source: The Health Care Blog - May 17, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Kvedar Quality measurement Virtual Visits Source Type: blogs
LITFL Review – Best of 2015
Welcome to the Best of 2015 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 Year
SMACC Podcast: Crack the Chest Get Crucified (John Hinds)
John’s talk from the opening plenary at SMACC Chicago had a furious battle with David Newman’s talk for the number one spot. Both were clear front runners given the shear numb...
Source: Life in the Fast Lane - January 8, 2016 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Education LITFL review Source Type: blogs
Conjunctivitis
Pinkeye is another name for conjunctivitis and is a condition that causes inflammation and redness of the membranes inside the eyes. It causes the whites of your eyes to appear reddish or pink. The disease can be caused by a bacterial or viral infection in addition to an allergic reaction. Pinkeye caused by infection is highly contagious. Many children will develop pink eye at a daycare and spread it to others. For this reason, early diagnosis and treatment is extremely important. Pinkeye can affect one or both eyes. Many times it will start in one eye and then spread to the other. The most common symptoms of pink eye are ...
Source: Nursing Comments - January 2, 2016 Category: Nursing Authors: Stephanie Jewett, RN Tags: Advice/Education Caregiving General Public Nursing/Nursing Students Patients/Specific Diseases allergy bacterial burning conjunctivitis eye discharge eye disease eye drops gritty eyes infection itching matted eyes in morning Source Type: blogs
Research and Reviews in the Fastlane 114
This article reviews techniques, indications, contraindications and complications of VV and VA ECMO. A literature review of ECMO in poisoned patients is also included.
Recommended by: Meghan Spyres
Critical CareMadhuri S. Kurdi et al. Ketamine: Current applications in anesthesia, pain, and critical care. Anesth Essays Res 2014; 8(3): 283–290. PMID: 25886322
A nice review article on the use of ketamine in the field of anesthesia, pain, palliative care, intensive care and procedural sedation. Based on at quite extensive literature search this paper highlights Ketamine’s current evidence based use as well as ...
Source: Life in the Fast Lane - December 23, 2015 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Education Neurosurgery Respiratory Resuscitation Trauma Emergency Medicine Intensive Care R&R in the FASTLANE critical care examination LITFL R/V research and reviews recommendations Source Type: blogs
the latest developments in the brain of Laurie K
I have been planning for ages to return to writing in this space and feeling a bit guilty about it. I've just been really busy with other writing, volunteering, having fun and getting healthy.Ironically, what brings me back is a return of the cancer in my brain. The letter below is an edited version of one I sent out via email earlier this week. I am happy to have this blog. I just wish I had different news to share at this time.Dear friends and family,My last MRI revealed two new tumours in my brain. Both are the same area as before - the cerebellum. One is in my inner auditory canal and the other is in the cerebellu...
Source: Not just about cancer - November 27, 2015 Category: Cancer & Oncology Tags: brain metastasis breast cancer cancer blog chemotherapy chronic illness community conversations cyber knife metastatic my friends my kids my love news pissed off remission Source Type: blogs
Don't Be Blue
A 21-year-old woman presented with a sore throat, low-grade fever, body aches, swollen glands, and generalized malaise for three days. The patient said her symptoms had worsened over the past day. She denied any difficulty breathing but endorsed pain and difficulty swallowing.
Her initial vital signs were blood pressure 132/84 mm Hg, heart rate 113 bpm, respiratory rate 22 bpm, temperature 100.4°F, and pulse oximetry 100% on room air. She was diagnosed with a peritonsillar abscess, and the EP applied a topical anesthetic to the area prior to draining it. During the procedure, the patient’s pulse oximetry dropped to...
Source: The Tox Cave - November 2, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Don't Be Blue
A 21-year-old woman presented with a sore throat, low-grade fever, body aches, swollen glands, and generalized malaise for three days. The patient said her symptoms had worsened over the past day. She denied any difficulty breathing but endorsed pain and difficulty swallowing.
Her initial vital signs were blood pressure 132/84 mm Hg, heart rate 113 bpm, respiratory rate 22 bpm, temperature 100.4°F, and pulse oximetry 100% on room air. She was diagnosed with a peritonsillar abscess, and the EP applied a topical anesthetic to the area prior to draining it. During the procedure, the patient’s pulse oximetry dropped to 8...
Source: The Tox Cave - November 2, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
TRIAL BY ERROR: The Troubling Case of the PACE Chronic Fatigue Syndrome Study
By David Tuller, DrPH
David Tuller is academic coordinator of the concurrent masters degree program in public health and journalism at the University of California, Berkeley.
A few years ago, Dr. Racaniello let me hijack this space for a long piece about the CDC’s persistent incompetence in its efforts to address the devastating illness the agency itself had misnamed “chronic fatigue syndrome.” Now I’m back with an even longer piece about the U.K’s controversial and highly influential PACE trial. The $8 million study, funded by British government agencies, purportedly proved that patients could “recover” fr...
Source: virology blog - October 21, 2015 Category: Virology Authors: Vincent Racaniello Tags: Information adaptive pacing therapy CFS chronic fatigue syndrome clinical trial cognitive behavior therapy Dave Tuller exercise graded exercise therapy mecfs myalgic encephalomyelitis outcome PACE trial recovery Source Type: blogs
5 Year Old New Jersey Girl Died from the MMR Vaccine, Holly’s Law Created
Conclusion
We leave you with words from Robin:
“My family and I hope that Holly’s story will make a difference and help you realize that you must be aware of the risks of vaccinations, just as you make yourself aware of the risks of any medical procedure.
We hope to make change, and one very important improvement must be that the pediatricians acknowledge that there are vaccine reactions, that moderate to serious and even fatal vaccine reactions do exist and occur at least 100 times more than is reported to the Vaccine Adverse Event Reporting System (VAERS).
We are still very disappointed and disgusted with the actio...
Source: vactruth.com - September 24, 2015 Category: Allergy & Immunology Authors: Augustina Ursino Tags: Augustina Ursino Human Top Stories adverse reactions Holly Marie Stavola Holly's Law MMR vaccine National Vaccine Injury Compensation Program (NVICP) Robin Stavola truth about vaccines Vaccine Death VAERS Source Type: blogs
