Or do I have to "go private"!?

Diego Rosselli writes:Some of the principles underlying evidence-based medicine (EBM) might have been around far longer than we tend to believe. Here is a fragment of one of the 8777 brief suttas (discourses) collected in the Anguttara-nikaya, or "Collection of the gradual sayings", one of the oldest Buddhist texts. The Buddha preaches to the Kalamas people:Yes, Kalamas, you may well doubt, you may well waver. In a doubtful matter wavering does arise. Now look you, Kalamas. Be ye no...

Mammogram screening for breast cancer continues to simmer in the news. The recent USPSTF guidelines, no longer recommending a routine mammogram for women between the ages of 40 and 49, continue to stir controversy between physicians and their patients. In a recent survey from the Annals of Internal Medicine, it looks like the debate between doctors and [...]Posted at KevinMD.com. Stay updated and subscribe, follow me on Twitter, or connect on Facebook.

You can’t stop it — the natural aging process that ages not only our bodies, but our brains too. Normal aging doesn’t significantly impact our thinking, however. Most people do not suffer from significant memory problems, deficits in problem-solving, or issues with thinking through activities that require analysis and reasoning. Still, things that may have come to us quickly when we were younger may take a little bit more time as we get older. And these slow-dow...

The patient comes to meSick with symptoms and uncertaintyIs it bad; is it fatal, can I be cured?She sits in front of me with that lookThat look asks me to tell her the answers“Sure” I think to myselfNo uncertainty on my part to myselfAnd I guess no uncertainty is on my faceI say to her “Tell me how you feel”Then comes the stream of symptoms and complaintsI try to keep the stream from flooding my understandingIn my mind the diagnoses start their own streamIt could be this, it could be...

Today's recommended reading addresses proposed efficacy measures for use in clinical trials related to traumatic brain injury (TBI):Bagiella E, Novack TA, Ansel B, Diaz-Arrastia R, Dikmen S, Hart T, & Temkin N. Measuring Outcome in Traumatic Brain Injury Treatment Trials: Recommendations From the Traumatic Brain Injury Clinical Trials Network. Journal of Head Trauma Rehabilitation. 2010.BACKGROUND: Traumatic brain injury (TBI) involves several aspects of a patient's condition, including p...

Long story short, from Christina Boyle's story in today's New York Daily News: An unknown person is covering tree branches [above and below] and lamp poles with little sweaters under cover of darkness. Here the article. ••••••••••••••••••••••••••• Jersey Shore town...

Scientists at Yale University believe they have discovered the signaling mechanism at work during artery formation, which may end up being used to control the growth of replacement arteries for people with coronary stenoses, etc. Until now, scientists have focused on growth factors as tools to control vessel formation, but the new research provides a direct signaling mechanism that's already proving to be more effective. Coronary arteries can become blocked with plaque, leading to a decrease...

The FDA has issued approval for Boston Scientific's Express LD Iliac Premounted Stent System, granting it an indication for the treatment of peripheral artery disease in iliac arteries. It is the same balloon expandable stent that has FDA indication for palliation of malignant neoplasms in the biliary tree, and already has the European CE Mark of approval for PAD in iliac procedures. From the product page: The Tandem Architecture™ design is comprised of both Micro™ and Mac...

At University College London, scientists are using an fMRI machine to identify the memories that people are bringing up. By first playing three different videos to human subjects and then asking them to recall them in turn while inside an fMRI, the researchers were able to use a computer algorithm to identify which video was being recalled. Professor Eleanor Maguire led this Wellcome Trust-funded study, an extension of work published last year which showed how spatial memories – in...

Dr Ramona Bates of Suture for a Living points us to a recent study in Archives of Dermatology that looked into correlating which laser wavelengths were best for removing different tattoo inks. The team of Spanish researchers blasted 21 tattoo inks with laser light ranging from 300 to 800 nm, and discovered that there's a benefit to matching the color of the laser to the specific ink that is being removed. Here's from the study abstract: Results Reflection spectroscopy facilitated selection of...

The following is part of a series of original guest columns by the American Medical Association. by J. James Rohack, MD Physicians in nearly every area of the country face a David and Goliath scenario when negotiating with entrenched health insurance companies. This is clearly illustrated by a new AMA study showing [...]Posted at KevinMD.com. Stay updated and subscribe, follow me on Twitter, or connect on Facebook.

Electronic Arts, the video game development company, has announced its next generation of fitness tools. Following up on its popular EA SPORTS Active product line, the release scheduled for this fall should include a heart rate monitor, arm and leg accelerometers, and an online program to track and share one's workouts. The name for the new system has yet to be finalized, so for now EA just tacked on a "2.0" to the end of the current name. The new EA SPORTS Active 2.0 innovative wir...

Cambridge Consultants, a product design and development firm, has created a new prefilled syringe that uses fewer resources to manufacture than many current models. Unsurprisingly, the green syringe was named Syreen, but its environmental credentials are only part of the features of the new device. Instead of glass, Syreen syringes are made with COP (cyclic olefin polymer) plastic, which has enabled Cambridge Consultants to shed the need for secondary packaging altogether, a first in this med...

Medtronic is making available in the US its VERTEX SELECT Reconstruction System, a package for performing cervical spinal stabilization procedures via the posterior approach. From the press release: When paired with the VERTEX SELECT? Occipitocervical Module this system comprises a comprehensive posterior cervical-upper thoracic spinal system that offers adjustability through multiple plate designs, rods, screws, and hooks that gives surgeons more options during surgery, enabling them to tail...

Scientists at John Innes Centre in Norwich, UK managed to create Cowpea mosaic virus particles that are missing their genetic material, turning them into drug ferrying containers that may prove useful against cancer and other localized diseases. Unlike other research teams that tried to remove genetic material from already existing virus particles, the current research involved assembling these particles out of precursor chemicals without ever having to implant them with any genes. From the a...

by Matthew Mintz, MD There are certain actions we take even though we know that ultimately we will not be successful. Sometimes we do this out of hope for a better tomorrow (like playing the lottery) or because we are taking a moral stand (like supporting a candidate that has no chance of winning). Supporting health care [...]Posted at KevinMD.com. Stay updated and subscribe, follow me on Twitter, or connect on Facebook.

Our friends over at the Association for Psychological Science made sure that a new study about video games would get out (because, you know, it’s about video games and kids, and that always seems to get people’s attention), so we took a look and published a news story earlier today about the study. This, however, is an example of a fairly silly study that provides little additional insight into the impact video games may have in a child’s world. The researchers c...

In a lucid, scathing piece appearing on the February 19, 2010 New York Times Op-Ed page, he explained (convincingly, at least to me) why EMI's locking up his group's videos so they can't be viewed anywhere other than on YouTube's...

"They snap onto any standard 12 oz. can, providing a stein-style handle that also eliminates the need for a coaster." "Plus, your can stays cold while your hand stays warm." Put me down for a set (of 6): $9.98.

Medgadget.com, the coolest medical technologies website in the world, is looking for an associate editor. The person that will join us will become an integral player in our editorial process. Together with our small group of MDs (and MD/PhDs), he or she will learn about the latest medical discoveries, technologies and medgadgets. Then there is more to learn about the blogging business, web production, future events, such as Medical Weblog Awards and Med SciFi competition, conferences, and pub...

Originally published in MedPage Today by Chris Emery, MedPage Today Contributing Writer The symptoms of autism tend to emerge in children after six months of age, with a loss of social and communications skills that is more common and more subtle than previously thought, according to a new study that questions previous assumptions about the progression of [...]Posted at KevinMD.com. Stay updated and subscribe, follow me on Twitter, or connect on Facebook.

<img src="http://feeds.feedburner.com/~r/PhysiciansFirstWatch/~4/11NjSFtAMLo" height="1" width="1"/>

It&rsquo;s an extremely frustrating problem I see every single day of my life. Whether we&rsquo;re talking about my exam room patients, puppy park players, a neighbor&rsquo;s pooch or my family members&rsquo; dogs, the problem is the same: Their pets are fat and they know it...but they&rsquo;re scared of offering them too little to eat.? OK so that&rsquo;s my personal interpretation of the psychology that underlies the problem. And I may be wrong. But I believe it&...

Men who were single in the 1960s were 64% more likely to suffer a fatal stroke over the next three decades than their married counterparts.The risk of fatal stroke was also 64% higher in men who reported dissatisfaction with their marriages than in men who rated their marriages as successful.That figure is comparable to the risk of fatal stroke faced by men with diabetes.References:Single Men Have Higher Risk of Stroke. WebMD.Image source: CT scan slice of the brain showing a right-hemispheri...

First, thanks to the great discussion.? Readers will learn as much from the discussion as they will from me.? To repeat the presentation: The patient is an 81 year old man found with altered mental status.? He has known diabetes mellitus, hypertension, COPD and CHF, but has not taken any medications for the past year. Electrolyte panel Na 142 Cl 96 BUN 99 K 5.5 HCO3 21 creat 2.3 Blood [...] Related posts:AMS &#8211; an acid-base problem II 17 days at the VA &#8211; day 12 A...

With health reform possibly passing within the next few months, attention now turns to the primary care doctor shortage. Regular readers of this blog know that there are not enough primary care doctors currently; it&#8217;s frightening to think what would happen if an additional 40+ million newly insured patients start looking for care. A recent piece from [...]Posted at KevinMD.com. Stay updated and subscribe, follow me on Twitter, or connect on Facebook.

Therapists are turning out in droves to the online landscape, making our marks with blogging, article writing, social networking and other creative efforts. In Psychotherapists Unmasked on the Internet last October , I examined how this landscape had changed with the increasing prevalence of therapist websites with photos (ethically taboo not so long ago), raising interesting conversation about how we are “supposed” to be presenting (or not presenting) ourselves. The wave of the “t...

A preliminary ruling by the Prescription Medicines Code of Practice Authority says AstraZeneca broke advertising rules by failing to accurately reflect the side-effects of its antipsychotic Seroquel.The policing arm of the Association of the British Pharmaceutical Industry has allegedly found the Anglo-Swiss drugmaker to be in breach of the Code on three counts, with claims made in an ad – published in the British Journal of Psychiatry in 2004 - that Seroquel (quetiapine) has a favourable w...

Documents from a lawsuit by the state of Louisiana accusing J&J of off-label marketing shed fresh light on the company's long-standing desire to broaden the market for Risperdal beyond the ailments listed initially on the label—psychotic disorders linked to schizophrenia. J&J disclosed the documents from the suit, filed in the Opelousas district court in September 2004, after Bloomberg News asked the court to unseal them. The case is scheduled to go to trial in September. As early...

Attorney General Martha Coakley’s office joined a federal lawsuit yesterday that contends that Johnson & Johnson paid tens of millions of dollars in kickbacks to get its drugs, especially the powerful antipsychotic Risperdal, prescribed in nursing homes. The action was taken as Coakley’s office disclosed that it is also scrutinizing companies that market antipsychotics to Massachusetts nursing homes. These drugs are widely used in some homes for residents suffer...

© yashimaHear ye ladies! What&#39;s recently published at the Archives of Internal Medicine requires toasting for cheers: Healthy-weight women who drink a light to moderate amount of alcohol - no more than two servings a day of red wine, white wine, beer or liquor - tend to gain less weight over time than non-drinkers. Warning: don&#39;t binge on alcohol just yet. The key words are healthy-weight women and light to moderate amount of alcohol. According to cardiologist Lu Wang...

Glomus tympanicum tumors are chemodectomas that arise from the glomus bodies that run with the tympanic branch of the glossopharyngeal nerve. They are are the most common primary neoplasms of the middle ear located along the jacobson nerve. Our case shows a small glomus tympanicum in the hypotympanum.Reported by Teleradiology Providers.From Sumer's Radiology Site http://www.sumerdoc.blogspot.com -The Top Radiology Magazine. Teleradiology Providers at www.teleradproviders.com Mail us at telera...

Found this illustration via The Examining Room of Dr. Charles. I'd say it captures the feel of most family doctors' offices just right except that the tape the woman sitting behind the doctor is tangled up in should be red instead of white. For other depictions of various medical specialties, go to this exhibition on the art of Jose Perez.

The internet is only coming through in fits and starts tonight, so I&#8217;m going to have to put off my annual best of/worst of comic book medicine until tomorrow. Here&#8217;s a scene from the first story in Moonstone&#8217;s Airfighters #1. The setting is the Normandy beaches on D-Day, and one American commander is running into [...]

Mr. Obama said the auditors would have an incentive to find improper payments because they would receive a small percentage of the savings. “It’s estimated that improper payments cost taxpayers almost $100 billion last year alone,” he said. “If we created a Department of Improper Payments, it would actually be one of the biggest departments in our government.” The auditors — whom some White House officials are already referring to as “bounty hunters” — would have high-tech...

A patient wants to know about symptoms she may have from a prescription drug she is taking. Consulting the label's "Adverse Reactions" section, she finds a wealth of data. Little does she realize that this information, largely collected during clinical trials, is based almost entirely on clinicians' impressions of patients' symptoms — not on patients' own firsthand reports of their experiences with the drug.via content.nejm.org Posted via web from Jack's posterous

http://www.hcsmeucamp.com/

Bisphosphonates are commonly prescribed to treat osteoporosis and are designed to build bone mass. Drugs in the class include Actonel, marketed by Sanofi Aventis SA and Procter & Gamble Co.; Boniva, marketed by Roche Holding AG and GlaxoSmithKline PLC; and Merck & Co.'s Fosamax.Posted via web from Jack's posterousvia online.wsj.comA bone expert once said to me: "what if these drugs make bones harder, but not necessarily stronger?"Two studies presented Wednesday at the Ameri...

"The jury of 12 believed Ms. Breeden and disbelieved the executives of Novartis in arriving at this verdict. She was committed to her job, but her employer questioned her commitment. No employee should have to choose between having a family or keeping their job, and this jury verdict will help teach that lesson to all employers covered by the FMLA."via healthnewsdigest.com Posted via web from Jack's posterous

via nj.com Posted via web from Jack's posterous

Fisher & Paykel out of Auckland, New Zealand has released a new line of CPAP machines that smudge the line between medical devices and consumer products. The ICON line features a built-in alarm clock and an mp3 player, along with all the company's latest CPAP technology. From the announcement: The product range spans three models; Auto, Premo and Novo. The Auto detects interruptions to normal breathing and provides the appropriate positive airway pressure to meet the breath-by-breath need...

Are we really training an army of superbugs? Yep. No doubt about it. Ever since we started killing microscopic organisms with drugs we call antimicrobials (of which antibiotics are the most famous subset), these &ldquo;bugs&rdquo; have been looking for ways to survive the wrath of chemicals that would see them dead. Mutation has been their MO, an approach that&rsquo;s worked out better and faster than we ever expected when we first designed our drugs. Which is why we now find ours...

We have a brilliant debate ongoing in the comment section of yesterday&#39;s problem.? I will refrain from commenting for 24 hours.? Please join the debate &#8211; then I will weigh in some time tomorrow. I cannot answer every question about this patient, but I can answer some key questions. Related posts:Duty hours &#8211; no easy answers (h/t [...] Related posts:Duty hours &#8211; no easy answers (h/t @FutureDocs) 15 days at the VA – day 2 March 8, 2010 &#8211; an...

Answer here this time tomorrow.

[via hektik.org]

Stentys Inc. of Paris, France has received the CE Mark of approval to take to the European market the firm's self-expanding coronary stent. The bare-metal system has been developed to allow physicians to work on coronary arteries that have an uneven diameter in the treatment area and when large branch vessels are involved. From the product page: The stent&rsquo;s short, expandable segments and its self-expansion features allow for excellent vessel conformability as well as continuous appo...

Three years ago we wrote about an EEG brain-computer interface that was going to be available to consumers. Well, it turns out, there's been a slight delay and g.tec Guger Technologies from Graz, Austria has only just launched a marketing campaign for its technology. The intendiX system supposedly uses visually evoked EEG potentials to detect which on-screen option a user wants to select. The EEG triggers can be letters, words, actions, or just about anything that can be programmed into a com...