Nonjudgmental listening is the first step in healing
Next in a series.
Years ago while in oncology training, I was on night duty when a patient of one of my colleagues was having severe penile pain. He had received a new investigational chemotherapy and it turned out to have an unexpected property of damaging the lining of the bladder and urethra. It gave him a strong uncontrollable urge to urinate yet each time the burning was excruciating. Oral pain killers were of no help and Pyridium, used for the burning of a typical urinary tract infection, was ineffective.
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Your patients are rating you online: How to respond. Manage your online reputation: A soci...
Source: Kevin, M.D. - Medical Weblog - June 16, 2014 Category: Journals (General) Authors: Stephen C. Schimpff, MD Tags: Physician Primary care Source Type: blogs
Overselling the microbiome award - many - for stories about placental vs. oral microbiomes
Conclusions: Microbial contact in utero is associated with changes in fetal intestinal innate immune gene expression profile. Fetal and placental immune physiology may be modulated by maternal dietary intervention using specific probiotics.This paper was not mentioned or cited as far as I can tell in the current study.UPDATE 4: This paper also seems relevantMicrobial contact during pregnancy, intestinal colonization and human disease. Abstract:Interaction with colonizing intestinal bacteria is essential for healthy intestinal and immunological development in infancy. Advances in understanding early host–microbe int...
Source: The Tree of Life - May 23, 2014 Category: Medical Scientists Authors: Jonathan Eisen Source Type: blogs
Can You Avoid Lumbar Puncture in Febrile Neonates?
I don’t have a problem with lumbar punctures in febrile neonates. In fact, my son ended up with three lumbar punctures before aging out of the febrile seizure protocols. I do have a problem, however, with doing unnecessary spinal taps. The emotional stress of a neonatal LP on parents is significant, and the physical stress of the procedure on the infant is also substantial.
The pain of the needle and the unique restraint required for the procedure are also potentially problematic. The pain of the needle can be minimized by EMLA cream (eutectic mixture of local anesthetics [lidocaine and prilocaine]) and local anes...
Source: M2E Too! Mellick's Multimedia EduBlog - May 1, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Can You Avoid Lumbar Puncture in Febrile Neonates?
I don’t have a problem with lumbar punctures in febrile neonates. In fact, my son ended up with three lumbar punctures before aging out of the febrile seizure protocols. I do have a problem, however, with doing unnecessary spinal taps. The emotional stress of a neonatal LP on parents is significant, and the physical stress of the procedure on the infant is also substantial.
The pain of the needle and the unique restraint required for the procedure are also potentially problematic. The pain of the needle can be minimized by EMLA cream (eutectic mixture of local anesthetics [lidocaine and prilocaine]) and local ...
Source: M2E Too! Mellick's Multimedia EduBlog - May 1, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Feline hyperthyroidism: our Puzzola.
Last year Stefano and I took our eldest cat, Puzzola, to the vet because she had peed all over my bathrobe, which indicated in no uncertain terms that she had a urinary tract infection (I wrote a post about this episode in February 2013, btw). The vet confirmed the infection and immediately put her on antibiotics. Then, while checking her out, the vet found a small nodule on Puzzola’s thyroid gland. A blood test confirmed what she suspected–Puzzola had hyperthyroidism. At that time, it was a very mild case…
Puzzola was supposed to go back for a checkup (=blood test) after a month or thereabouts, but all this unfortun...
Source: Margaret's Corner - March 24, 2014 Category: Cancer Authors: Margaret Tags: Blogroll Source Type: blogs
Inability to Sleep Well Could Trigger Alzheimer’s Disease
People who experience chronic sleep disturbance, either through their work, insomnia or for other reasons, could face an earlier onset of dementia and Alzheimer’s.Alzheimer's Reading Room“The big biological question that we tried to address in this study is whether sleep disturbance is a risk factor to develop Alzheimer’s or is it something that manifests with the disease,” said Domenico Praticò, professor of pharmacology and microbiology/immunology in Temple’s School of MedicineInitially, the researchers looked at longitudinal studies which indicated that people who reported chronic sleep disturbances often dev...
Source: Alzheimer's Reading Room, The - March 18, 2014 Category: Dementia Authors: Bob DeMarco Source Type: blogs
Those amazing little kidneys
Years ago I was a dialysis nurse and I could not believe what I learned about these little organs in your body and how they actually work. First let’s note that these are bean-shaped and about the size of a fist. The kidneys are located near the middle of the back, on each side of the spine. Kidneys, if healthy, are working 24 hours a day, 7 days a week; they are like a built-in water treatment plant! Their main job is to filter the blood – to maintain a balance of water and chemicals. Every day these amazing little organs filter out about 2 quarts of wastes and fluid in the form of urine.
Unfortunatel...
Source: Nursing Comments - March 13, 2014 Category: Nurses Authors: Stephanie Jewett, RN Tags: Advice/Education General Public Home/Articles Nursing/Nursing Students Patients/Specific Diseases acute blood loss AKI ARF chronic kidney disease diabetes dialysis end-stage renal disease high blood pressure Kidneys poison Source Type: blogs
Extend focus beyond hospitals to truly improve healthcare
by Thomas Dahlborg
The healthcare industry focuses on clinical quality outcomes at the hospital level, especially on preventable readmissions. Funders of healthcare implement both carrots and sticks (incentives and disincentives) to improve quality in this area; however, this sole approach is not enough.
Healthcare is a complex, adaptive system (as is each of our patients, practitioners and organizations), so a focus limited to hospital responsibility regarding care quality is not enough to truly make a difference.
For this discussion, let's expand our view to primary care as well.
Primary care physicians miss between ...
Source: hospital impact - March 7, 2014 Category: Health Managers Authors: Wendy Johnson Source Type: blogs
Some inconvenient observations regarding our "National Program for IT in the HHS"
(To astute readers, "National Program for IT in the HHS" is a not-very-thinly-veiled reference to the NPfIT, the National Programme for IT in the NHS, a £12.7bn project that went "pffft.")I have been very concerned over the years about EHR and other clinical IT risk, and with patient's rights (e.g., to a safe care environment, a legal obligation of healthcare facilities to maintain in the U.S).Looking at the medical malpractice data at my Feb. 28, 2014 post "Malpractice Claims Analysis Confirms Risks in EHRs" (http://hcrenewal.blogspot.com/2014/02/patient-safety-quality-healthcare.html) I make the following observat...
Source: Health Care Renewal - March 3, 2014 Category: Health Medicine and Bioethics Commentators Tags: CRICO Healthcare IT failure healthcare IT risk HIT regulation medical malpractice Source Type: blogs
UTI TOPICs Page
Urinary tract infections (UTI) are common in patients living with Alzheimer's and related dementias.UTIs can cause Alzheimer's and dementia patients to become dull, listless, discombobulated, mean, ornery, and confused.In is not unusual for Alzheimer's Care Partners to assume these changes in behavior are due to Alzheimer's disease when in fact these new found challenging behaviors are being caused by an infection - usually a urinary tract infection.You cannot assume that are person living with dementia will tell yo they are sick. In fact, they most likely won't when it comes to infection.This means you must be on guard at...
Source: Alzheimer's Reading Room, The - March 1, 2014 Category: Dementia Authors: Bob DeMarco Source Type: blogs
Neil Rens and Krzysztof Sitko of the Tricorder XPRIZE Team Aezon Talk With Medgadget
With the Qualifying Round of the Qualcomm Tricorder XPRIZE competition only a few months away, we had a chance to catch up with Aezon, a Johns Hopkins-based team vying for a position in the Final Round of the competition. One of the younger teams in the competition, Aezon has already spun out a start-up, Aegle, representing one component of their three-pronged approach. We had the chance to speak with Neil Rens and Krzysztof Sitko, two of the fifteen members on the team, about their project and how it’s going.
Michael Batista, Medgadget: I know many of our readers have been following the Qualcomm Tricorder XPRIZE ...
Source: Medgadget - February 28, 2014 Category: Technology Consultants Authors: Michael Batista Tags: Medgadget Exclusive Source Type: blogs
Article social networks, meaning and redundancy
This is very much a 'thinking aloud' post. In October last year I posted Structure in Trip an article that described the social networks of articles in Trip, based on clickstream data. The analysis allowed me to produce graphs like the one below (based on the clickstream data of people searching for UTI.The structure is clear and I've labelled a few, the most prominent being UTIs and cranberry (in the bottom left of the graph). I'm increasingly of the opinion that this can be used to speed up the review process and also improve the search experience (but search is for another day). In social network analysis there is...
Source: Liberating the literature - February 26, 2014 Category: Technology Consultants Source Type: blogs
Recent FDA Moves Suggests Agency Is Again Taking Its Role of "Protecting Public Health" Seriously
As a patient with type 1 diabetes, I have found myself at odds with the U.S. Food and Drug Administration (FDA) on a number of things the agency has done in recent years (actually since the 1980s), and perhaps even more so in recent years. In fact, I once joked (only halfheartedly) that the acronym "FDA" stood for Fatal Drug Administration. Indeed, for a number of years (under the leadership of chief Dr. Andrew von Eschenbach especially, he pushed for FDA to serve what he called its "clients", meaning the companies that the FDA regulates, rather than protecting public safety). Staff in areas for brand new...
Source: Scott's Web Log - January 28, 2014 Category: Diabetes Tags: 2014 Antibiotics Crisco FDA Trans Fats Source Type: blogs
Recent FDA Moves Suggests Agency Is Again Taking Its Role of " Protecting Public Health " Seriously
As a patient with type 1 diabetes, I have found myself at odds with the U.S. Food and Drug Administration (FDA) on a number of things the agency has done in recent years (actually since the 1980s), and perhaps even more so in recent years. & nbsp;In fact, I once joked (only halfheartedly) that the acronym " FDA " stood for Fatal Drug Administration. & nbsp;Indeed, for a number of years (under the leadership of chief Dr. Andrew von Eschenbach especially, he pushed for FDA to serve what he called its " clients " , meaning the companies that the FDA regulates, rather than protecting public safety). & nbsp;Staff in areas for ...
Source: Scott's Web Log - January 28, 2014 Category: Endocrinology Tags: 2014 Antibiotics Crisco FDA Trans Fats Source Type: blogs
Order Workflows
Except for emergent situations, no medical device is used without an order. And if not an order written to accomplish a certain clinical task for a specific patient, then “standing” orders captured in written policies and procedures to handle frequent, routine situations. Consequently, orders are one of the first workflow steps in medical device connectivity. Orders are pervasive, used in all health care delivery environments from acute care hospitals to patient’s homes.
Principal ways connectivity can add value to medical device are enhancing patient safety, improving clinical efficacy and productivity. ...
Source: Medical Connectivity Consulting - January 6, 2014 Category: Technology Consultants Authors: Tim Gee Tags: connectivity Patient Safety Source Type: blogs
