Here is an excerpt from a recent review article in the official AFP journal American Family Physician:
Acute low back pain is one of the most common reasons for adults to see a physician. Most patients recover quickly with minimal treatment.
"Red flags"
Serious "red flags" include:
- significant trauma related to age (i.e., injury related to a fall from a height or motor vehicle crash in a young patient, or from a minor fall or heavy lifting in a patient with osteoporosis or possible osteoporosis) - major or progressive motor or sensory deficit - new-onset bowel or bladder incontinence or urinary retention - loss of anal sphincter tone - saddle anesthesia - history of cancer metastatic to bone - suspected spinal infection
Diagnosis
Without signs of serious pathology, imaging and laboratory testing often are not required.
Treatment
Patient education, nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and muscle relaxants are beneficial.
Bed rest should be avoided, if possible.
Exercises directed by a physical therapist, such as the McKenzie method and spine stabilization exercises, may decrease recurrent pain.
Spinal manipulation and chiropractic techniques are no more effective than established medical treatments.
Here are my suggestions for some of the top articles in medicine in June 2012:
Risky Music-Listening Behavior Associated with Health-Risk Behavior: alcohol, drugs and unsafe sex (study) http://goo.gl/eoUfL
Study: Couples get health benefits simply from sleeping in the same bed - WSJ http://goo.gl/PBlPJ
Love's initial romantic phase lasts anywhere from 18 months to 3 years, experts say, then it ends - WSJ http://goo.gl/2x1mS
5 Minute Medicine Video Series by Internal Medicine at McMaster University http://bit.ly/KidaPU
Aspiring to Make MDR-TB Nevermore: Delamanid for Multi-drug Resistant Pulmonary Tuberculosis - NEJM http://goo.gl/b7rQ8
The risks and benefits of social media for cardiologists - theheart dot org interview with @doctorwes http://goo.gl/TUfxj
Radiation from 2-3 head CTs in children triple the risk for brain tumors (5-10 CTs triple risk for leukemia) http://goo.gl/xs2ZH - Source: Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study - The Lancet http://goo.gl/teqnX
Inhibiting Hedgehog Pathway in Basal-Cell Cancer: Vismodegib is effective but 50% stop treatment due to adverse events http://goo.gl/966X5
Small-molecule inhibitor of the hedgehog pathway Vismodegib showed 58% response rate in advanced basal-cell cancer http://goo.gl/sJfm1
Another therapeutic option for Multidrug-Resistant TB: Delamanid nitro-dihydro-imidazooxazole inhibits mycolic acid http://goo.gl/zUhYY
Hospital mortality is complex and should be used cautiously in evaluating quality of care. Last 10 years marked by diminishing returns, with growth in costs far outpacing reductions in inpatient mortality http://goo.gl/T16W3
Churchill had a doctor's approval for "medicating with a minimum 250 cc alcohol at meal times" - “This is to certify,” the doctor writes — this in the midst of Prohibition — “that the postaccident convalescence of the Hon. Winston S. Churchill necessitates the use of alcoholic spirits especially at meal times.” The quantity, the doctor continues, is “naturally indefinite,” but the “minimum requirements would be 250 cubic centimeters,” or just over 8 ounces. Archives in NYT http://goo.gl/Yc9cr
The articles were selected from my Twitter and Google Reader streams. Please feel free to send suggestions for articles to clinicalcases@gmail.com and you will receive acknowledgement in the next edition of this publication.
The articles were selected from my Twitter and Google Reader streams. Please feel free to send suggestions for articles to clinicalcases@gmail.com and you will receive an acknowledgement in the next edition of this publication.
From Mayo Clinic YouTube channel: Imagine what life would be like if you lost your hearing. No music, no sounds of nature, no listening to the voices of your loved ones. But some people with profound hearing loss do have options. Cochlear implants, in the right patients, offer the chance to hear again.
The “Best of Medical Blogs - weekly review and blog carnival” is a weekly summary of the best posts from medical blogs. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best of Medical Blogs (BMB) is published every Tuesday, just like the old Grand Rounds.
New mnemonic for CXR Interpretation: DRS ABCDE (Doctors ABCDE)
Life in the Fast Lane: Many people would be familiar with the ABC method to interpreting CXRs: Airways, Breathing & Bones, Circulation.The mnemonic DRSABCDE can used as a simple, yet comprehensive, approach to CXR interpretation http://goo.gl/fGDmS:
D – Details R – RIPE (Assessing The Image Quality): Rotation, Inspiration, Picture, Exposure (Penetration) S – Soft Tissues And Bones A – Airway & Mediastinum B – Breathing C – Circulation D – Diaphragm E – Extras: ETT, CVP line, NG tube, ECG electrodes, PICC line, chest tube
Routine physical exam and screening tests rarely yield valuable information
From Dr. Centor’s blog: Doing a routine exam rarely yields valuable information in the absence of symptoms. Doing routine screening tests rarely yields value information. http://goo.gl/xobBm
Tips for wearing flip-flops from Cleveland Clinic
From the Health Hub blog from Cleveland Clinic, Dr. Brian Donley talks about avoiding flip-flop related injuries this summer http://goo.gl/gJltj:
- Don’t wear flip-flops if you’re going on a long walk. - Don’t buy flip-flops with soles that freely bend or twist.
With expectations set high, "it’s hard, perhaps impossibly hard, to be a good doctor", says the former BMJ Editor-in-Chief Richard Smith http://goo.gl/CTJc6
Skeptical Scalpel: The report of "10 Shocking Medical Mistakes" by CNN has a few mistakes of its own: http://goo.gl/oglRX
How to harvest the medical research with "snowballing" and "pearl growing" search strategies http://goo.gl/gEsdQ
A Brief Social Media Guide for Authors of Medical Resources http://goo.gl/6n17e
Here are 3 infographic templates for Google Drive by Google:
Infographics Toolbox By Google - Illustrate your data with your own custom graphs, charts, maps and more. Draw your own pie charts and bar charts with this template. Edit the colors of the map of the United States. Create an infographic of male and female symbols to use for counting data (including one-half male and female symbols). http://goo.gl/R0Cjh
United States Data Map By Google - This map of the United States is shaded based on state-by-state data. Just click on each state and set a custom color based on the information that you want to display. Then adjust the key at the bottom of the drawing to describe your custom data. The default data displayed is the population density from the year 2000 census. Notes: - States with multiple unconnected parts have been created as grouped shapes (eg. Hawaii, Michigan). - Washington DC starts as a grouped shape with Maryland. - Map can be changed to be displayed at any size. Using the same border for all states (eg. 1px white) is recommended. http://goo.gl/KjM3H
Map of the United States (Multi-colored) By Google - This map of the United States is colored with 5 standard colors to distinguish each state outline. Each set of same-colored states is a grouped shape, just click a state and change the color to choose custom map colors for all those states. A gray shadow of the states outlines adds a lightweight 3D effect. http://goo.gl/p58VS
Related reading:
How to Get Started With Infographics | PCWorld Business Center http://goo.gl/ViWk2
How To Create Your Own Infographics: Step By Step Guide and Tips - TechTheBest.com http://goo.gl/pT2mH
The Meibomian glands (or tarsal glands) are sebaceous glands at the rim of the eyelids, responsible for the supply of meibum, an oily substance that prevents evaporation of the eye's tear film. They prevent tear spillage onto the cheek, trapping tears between the oiled edge and eyeball, and make the closed lids airtight. There are approximately 50 glands on the upper eyelids and 25 glands on the lower eyelids. The glands are named after Heinrich Meibom (1638–1700), a German physician (source: Wikipedia).
The LipiFlow Thermal Pulsation System uses heat and pressure to open blockages of the eyelid (Meibomian) glands. The treatment was approved by the FDA in 2011. Here is more information: http://lipiflow.com
Here are my suggestions for some of the top articles in medicine in June 2012:
Cancer rates worldwide are expected to increase by 75% by 2030 http://goo.gl/Wu8i9
Zinc could be useful adjunct treatment in infants with probable serious bacterial infection - The Lancet http://goo.gl/Hgqs7
To screen or not to screen for prostate cancer? Fewer than 2% of Johns Hopkins doctors plan to follow the recommendations and stop ordering PSA screening - Lancet http://goo.gl/5Nkha
Dark chocolate could work as prevention therapy of cardiovascular disease - BMJ's exercise in wishful thinking: http://goo.gl/Om6kq
UV protection and sunscreens: What to tell patients - CCJM http://goo.gl/yhRH4 -- Related reading: How to avoid damaging ultraviolet light - CCJM launches "Patient Page" similar to JAMA http://bit.ly/MkL6Ae
NYTimes asks experts what they want from the future: "permanent sunblock that embeds in skin ~ Lasik eye surgery" ?! http://goo.gl/TnHZa -- Related: 32 Innovations Will Change Your Tomorrow - underwear with sensors tells how hard you’re working your quadriceps muscles http://goo.gl/EWRuX
Psoriasis: Evolving treatment for a complex disease - CCJM 2012 review, free full text http://goo.gl/Sc9Uy
Acute community-acquired bacterial meningitis in adults: CCJM 2012 review, free full text http://goo.gl/XKYQR
"Walmart clinics go live in the cloud": retail giant pushes healthcare providers to make diagnoses over the internet http://goo.gl/P51NW
A Single Inhalation of Laninamivir Works in Children With Influenza (study) http://goo.gl/BxgRs
Inhaled Hypertonic Saline (3%) mixed with albuterol reduces length of stay and admission rate for wheezing children http://goo.gl/g9cFH
College freshman at age 9, medical degree at 21 - Dr. Yano is the youngest student to get an M.D. from UChicago http://goo.gl/qkqNh -- Disclaimer: I am an assistant professor of medicine and pediatrics at UChicago and have met Dr. Yano in our clinic.
The articles were selected from my Twitter and Google Reader streams. Please feel free to send suggestions for articles to clinicalcases@gmail.com and you will receive acknowledgement in the next edition of this publication.
Who knows, maybe they’ll come out with a new drug that makes legs bend easier, Joints hurt less, drives go further, memory come roaring back, And all fears about falling off fishing rocks go away.
Remember the old song: I’ll be there ready when you are. Well I’ll be there ready when you are There’s so much excitement ahead, so many grandkids to watch grow. If you need me I’m here."
By the way, the 88-year-old former president said he was not done skydiving. His goal: to jump again when he is 90.
'If you need me I'll be there': George HW Bush moved to tears during interview with granddaughter Jenna about his family and growing old | Daily Mail Online http://goo.gl/noCt0
The “Best of Medical Blogs - weekly review and blog carnival” is a weekly summary of the best posts from medical blogs. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best of Medical Blogs (BMB) is published every Tuesday, just like the old Grand Rounds.
The DSM-Tw: Handbook of Twitter Personality Types
Dr. Wes: In an effort to assist the American Psychiatric Association with the publication of the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) expected in May, 2013 it seemed only appropriate that a DSM-Tw (Twitter) supplement be provided to help classify newly emerging personality types on Twitter.
Example: 292.891 Caffeine-induced disorder: Newscycling Disorder - chronic obsession with Tweeting main stream media news stories. For instance, all topics that have an association with medicine are cited: even acne studies. Diagnostic finding: first to tweet the story so that others will "retweet" their tweet, as if it was their own. Gaining followers is the name of the game, so they occasionally venture off on tangents, like American Idol, or Justin Bieber. http://goo.gl/f7w6U
Who paid for that study?
From Dr. Jay Parkinson's blog: "When I read that something is good or bad for you, the first question I ask myself is “Who would pay for that study?” Here are a few examples: Is coffee good or bad for you? Is kale a better food for you than sprouts? Does Acai really prevent cancer? Read more here: http://goo.gl/gqS3T
Do you avoid using your iPhone’s medical apps in the hospital for social reasons?
An overcautious doctor: “Even though I have an iPhone, I don’t like to pull it out in the Hospital because I’m worried my patients or staff will think I’m playing games or using it for social reasons. When I have a book or manual in my hand, at least people can see what I’m doing”. http://goo.gl/O05pG
100% Patient Satisfaction Scores
Fauquier ENT Blog: Whether good or bad, patient satisfaction scores can be VERY misleading if not completely wrong... http://goo.gl/sOjvm
How significant is the lack of a reversal agents with the new blood thinners?
From the blog of the electrophysiologist Dr. John M: Dabigatran and rivaroxaban have no reversal agents; but their effects dissipate quickly. More than 50,000 AF patients have been enrolled in trials comparing novel blood thinners to warfarin, and in all three studies, a trend towards lower mortality was seen with the new blood thinners. This fact strongly suggests the lack of reversal agents may not be clinically significant. http://goo.gl/Q2Rui
"Hello Doctor. I Wouldn't Hesitate To Sue You"
From Freelance MD Blog: If you Google “how to sue a doctor,” an abundance of information follows. There’s an “ehow” on the subject, and even CNN offers an opinion. Any doctor has a 75% chance, give or take, that he or she will be named in at least one claim during their career. http://goo.gl/W64JZ
Medical School Life in Cambridge and Debrecen - @Berci compares the promotional videos http://goo.gl/BZm2w:
Medicine at Cambridge:
University of Debrecen Medical and Health Science Center:
Comments from Twitter:
Dr. Ellis @DrAnneEllis: Cute read, I'm sure we could come up with even more: The DSM-Tw: Handbook of Twitter Personality Types buff.ly/MC1338 via @DrVes
Here are my suggestions for some of the top articles related to healthcare social media (#HCSM) in the past 2 weeks:
Ed Bennett shares three things he's learned about Healthcare Social Media: Our patients are ahead of us, Real change start at the top, Social media is more than the sum of its parts http://goo.gl/fD2Sj
Research Bloggers show a preference for papers from high-impact journals - just like everyone else on earth http://goo.gl/Ny7EA
Traffic to Hospital Web Sites - Cleveland Clinic surges, overtaking Mayo and Johns Hopkins http://goo.gl/O5Msp
The articles were selected from my Twitter and Google Reader streams. Please feel free to send suggestions for articles to clinicalcases@gmail.com and you will receive acknowledgement in the next edition of this publication.
The articles were selected from my Twitter and Google Reader streams. Please feel free to send suggestions for articles to clinicalcases@gmail.com and you will receive acknowledgement in the next edition of this publication.
From Swedish hospital YouTube channel: Dr. James Porter, medical director of robotic surgery at Swedish folds a small paper airplane with the da Vinci robot to demonstrate how this device gives surgeons greater surgical precision and dexterity over existing approaches.
With over 600,000 views, this video undoubtedly brings good publicity to the hospital.
However, the robot costs on average $1.3 million, in addition to several hundred thousand dollars of annual maintenance fees. Surgical procedures performed with the robot take longer than traditional ones. Critics say that hospitals have a hard time recovering the cost and that most clinical data does not support the claim of improved patient outcomes.
The manufacturer Intuitive Surgical has sold more than 1,000 units worldwide.
Westby Fisher, MD @doctorwes: Surgeon Folds and Throws Paper Airplane Using da Vinci Robot (video) bit.ly/KG2EG6 - Manual faster, no?
PDara MD, FACP @JediPD: da Vinci good for that
Skeptical Scalpel @Skepticscalpel: Finally a use. Maybe the airplanes could have the hospital's logo on them. Folding a paper airplane. Amazing feat by a surgical robot? I think not. My blog. is.gd/6tBcZp -- Folding a paper airplane. Amazing feat by the surgical robot? http://goo.gl/cz7lC
Ravi Pamnani @ravrav0: Surgical robots: Folding tiny paper airplanes - CHECK. Actually improving clinical outcomes - TBD. bit.ly/LEp3jg #medtech
Jenaro Fdez-Valencia @JenaroFV_MD: after all ... it doesn't fly! If he did a boat instead, it would work. Can he try?
The “Best of Medical Blogs - weekly review and blog carnival” is a weekly summary of the best posts from medical blogs. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best of Medical Blogs (BMB) is published every Tuesday, just like the old Grand Rounds.
Maybe the young doctors are onto something
From the blog of the electrophysiologist, Dr. John M.: As is often the case when doctors of my generation talk about younger doctors, the issue of attitudes on work and life came to the fore. We are perplexed that young doctors focus so strongly on finding balance in life. Maybe they are onto something? Maybe they have figured out that even doctors get only one crack at life? http://goo.gl/FzEDU
Sunglasses for Kids: What Parents Need to Know
The effect of the sun’s damage is cumulative; it adds up over time. Eye damage beginning during childhood can lead to the development of cataracts, skin cancer around the eyes, photokeratitis (“eye sunburn”), and damage to the retina itself. They’ve gotta wear shades! Here are some tips from Dr. Natasha Burgert http://goo.gl/SStt9:
Doctors specializing in Emergency Medicine are the most active bloggers - by far
Here is Dr. Mike Cadogan @sandnsurf, the co-founder of the blog Life in the Fast Lane (LiTFL): Updated the EM bloggers list... WOW - they certainly like to write! bit.ly/aPWZXe
New allergy medications and drug affordability advice. The allergist Dr. Neil Kao does not blog every day but when he does his posts are very well-researched: http://goo.gl/ogZmT
How can I treat toenail fungus? Ask Doctor K from Harvard Medical School http://goo.gl/9pdj9
Dr Nick Tullo's ECG Academy - LiTFL calls it "asynchronous learning at its best" http://goo.gl/dokV6
Comments from Twitter:
John Mandrola, MD @drjohnm: Thank you!
Mike Cadogan @sandnsurf: Reading: Best of Medical Blogs - weekly review and blog carnival - another rollercoaster from @DrVes
Social Media ROI Reform - Measuring the effectiveness of your hospital SoMe efforts http://goo.gl/3YPQH
As Facebook grows, millions say, 'no, thanks' - AP story http://goo.gl/QdfkB
Create free infographics online with Drag and Drop pre-designed themes: easel.ly http://goo.gl/uXXmi
How Amazon Killed The Book Reviewer Star - aggregate rating of Amazon reviewers as good as professional book critics http://goo.gl/ISc15
Research Sidebar in Google Docs - find more information about words in a document, add web content http://goo.gl/IqdQb
How blogging has helped me academically: Because I write most days, my writing has improved dramatically http://goo.gl/GLNsL
Social Media and Relationship Stress: There can be consequences when "Like" turns to love online http://goo.gl/V5itM
Medical School Life in Cambridge and Debrecen - @Berci compares the promotional videos http://goo.gl/BZm2w
The articles were selected from my Twitter and Google Reader streams. Please feel free to send suggestions for articles to clinicalcases@gmail.com and you will receive acknowledgement in the next edition of this publication.
Comments from Twitter:
Neelesh Bhandari MD @edrneelesh: @DrVes That's an excellent selection of #hcsm posts
The newly launched "Mayo Clinic News Network" is billed as the journalists' multimedia source for health, science and research information: http://newsnetwork.mayoclinic.org
The no cost, password-protected site for journalists offers the latest breaking medical news, videos, graphics, links for background, animation, experts and patient interviews. Journalists from TV, radio, newspaper, blogs, and mobile platforms are invited to visit our site http://newsnetwork.mayoclinic.org and register. Pending approval, you will have access to this rich source of multimedia content.
I feature high-quality videos from Mayo Clinic on CasesBlog 2-3 times per month, and after some brief consideration I registered and applied for access. I will let you know if a medical blog with 7 million page views qualifies for access to the Mayo Clinic News Network or not (update: the application was approved).
The flagship journal of ACP, Annals of Internal Medicine, already includes medical bloggers in their embargoed news release before each new issue.
The ACP Internist website took a step further and includes guest posts from hand-picked medical bloggers (disclaimer: I am one of the selected authors). Many of the posts are quite interesting and cover a wide variety of topics. You can see for yourself here: http://blog.acpinternist.org
Here is an excerpt from a recent review article in the official AFP journal American Family Physician:
