Subaqua Sternal Rubs

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Plastic surgeons disapprove of face transplant - “Surgeons in the United States and Europe are planning to perform the world’s first face transplant in the not-too-distant future. About 200 plastic surgeons who attended a debate on the topic were asked that question Sunday. In a show of hands, they expressed their disapproval by at least a 2-to-1 margin. 1 Comment

Maybe we should post the results of this study on the ED door to reduce the number of patients that 1) don’t need to be in an ED, and 2) demand antibiotics when they won’t help anyways: Bronchitis Sufferers Can Skip Antibiotics - “A study found that bronchitis sufferers who are otherwise healthy do not get better any faster by taking antibiotics. “Antibiotics for the vast majority of people don’t seem to make much difference,” said Dr. Paul Little, author of the five-year study of patients in England. Moreover, many bronchitis cases are caused by viruses, which antibiotics do not fight. Little said that otherwise healthy patients can skip the drugs to treat the chest infections, even though they will feel crummy for a couple of weeks. But patients with conditions such as chronic lung and heart disease that can cause bronchitis to develop into pneumonia should see their doctors, he said.” Post a Comment

The 10 Commandments of Medication Usage: From Rangel, MD, this is something that all patients should read. Post a Comment

Access to Trauma Centers in the United States: “An estimated 69.2% and 84.1% of all US residents had access to a level I or II trauma center within 45 and 60 minutes, respectively. The 46.7 million Americans who had no access within an hour lived mostly in rural areas.” What about the 100,000 Grenadians with no access to trauma care, as evidenced by recent events? Post a Comment

“New York Proposes Measures to Slow the Spread of AIDS - A commission appointed by the city’s health department has proposed a set of measures to increase condom distribution vastly in prisons, schools and nightclubs, expand needle exchange for intravenous drug users and make H.I.V. testing a routine part of every emergency room visit“. 1 Comment

Think twice before back pain surgery, experts say (Reuters) - “Surgery to relieve chronic lower back pain is no better than intensive rehabilitation and nearly twice as expensive, researchers said Monday.” Post a Comment

“The evolutionary path that separated humans from chimps 5 million years ago may have made human sperm survive better but paradoxically may have made humans prone to cancer.” More: Reuters Post a Comment

Life at the Top in America Isn’t Just Better, It’s Longer

Monday, May 16th, 2005 Print Email

An interesting article in the New York Times explores the effect of class on health outcomes:

Jean G. Miele's heart attack happened on a sidewalk in Midtown Manhattan last May. He was walking back to work along Third Avenue with two colleagues after a several-hundred-dollar sushi lunch. There was the distant rumble of heartburn, the ominous tingle of perspiration. Then Mr. Miele, an architect, collapsed onto a concrete planter in a cold sweat.

Will L. Wilson's heart attack came four days earlier in the bedroom of his brownstone in Bedford-Stuyvesant in Brooklyn. He had been regaling his fiancée with the details of an all-you-can-eat dinner he was beginning to regret. Mr. Wilson, a Consolidated Edison office worker, was feeling a little bloated. He flopped onto the bed. Then came a searing sensation, like a hot iron deep inside his chest.

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Two-Year-Old Dies in ED Waiting Room

Saturday, April 30th, 2005 Print Email

In a sad story coming out of Canada, a 2-year-old child died while waiting to be seen in an Emergency Department:

The Ontario coroner's office is investigating the death of a two-year-old child in a hospital emergency room waiting area this week.

The boy died in his father's arms while waiting to see a doctor at Toronto East General hospital early Monday morning.

The Toronto Sun reported yesterday that the child was brought to the hospital by his parents around 5:30 Monday morning. He had reportedly vomited and had diarrhea the day before, and when his condition did not improve his parents tried to have him seen by an emergency room doctor.

They told the Sun that they waited for an hour without being seen by a doctor. Then, their son stopped breathing.

Source/Read more at: The Globe and Mail

While I feel tremendous sympathy for the family, and the loss of their child must be extremely difficult, I don't think it could have been avoided, based on the limited information in the article. With the current state of overtaxed emergency departments, waiting an hour to see a physician would be quick by most standards, especially for something as seemingly-innocuous as an episode of vomiting/diarrhea the day before. Unfortunately, triage guidelines do not rate vomiting/diarrhea high on the list of what qualifies as an emergency, unless signs/symptoms of severe dehydration/electrolyte imbalances (i.e. lethargy) were present. I wasn't there, so I can't comment on that. Since death by acute diarrhea is virtually unheard of in developed countries (Mortality rate: 0.0002 Source), there must have been some other undiagnosed underlying disease processes at play. It would be interesting to see what the coroner's report turns up, which hopefully can improve triage guidelines so this doesn't happen again.

Hat Tip: Kevin, MD

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The first successful transplant of insulin-producing cells from a live donor — a mother to her daughter — is being reported today by Japanese scientists, raising hopes for a cure for severe diabetes. Read more at USA Today Post a Comment

A Third-Year Medical Student who wishes he was Scuba Diving