In ankylosing spondylitis Discovertebral lesions are frequently termed Andersson lesions. Many reports have emphasised on destructive abnormalities at discovertebral junction in this disorder. These lesions have been observed in the early and late phases of the disease and occur in traumatic and nontraumatic situations. This is a case of ankylosing spondylitis with history of trauma. This can mimic tuberculosis especially in our countrySecond opinion- Teleradiology ProvidersFrom Sumer's Radio...

via medpagetoday.com Insider will stick with his 40mg of simvastatin! Posted via web from Jack's posterous

An atypical episode of House as it focused on a day in Dr. Cuddy’s life, moving every other character to the background. A change of pace, but a solid and enjoyable show nonetheless. Cuddy gets up at five AM and starts the day with some yoga. Her daughter Rachel wakes up a little while [...]

(from the Atlanta Journal-Constitution, via Drudge) A 25 year old man recently died during a sleep study at Emory:Harris, a medical assistant, entered the Emory sleep center on Jan. 22, said his mother....... By the next morning he was dead.Emory said in a statement that he died of sudden cardiac arrest....The article doesn't give many details and doesn't specify whether Mr. Harris was having a diagnostic study or a CPAP titration study. Usually the most dangerous part of a sleep study is t...

A study out of Boston University School of Medicine, presented last week at the annual Triological Society meeting, has looked into the effectiveness of Medtronic's Slide-On Sensory Sheath as an alternative to germicidal immersion for flexible nasopharyngolaryngoscopes in between procedures. The condom-like device is wrapped over the fiber optic cable to prevent ENT scopes from getting dirty in the first place. The scope still requires an "enzymatic detergent cleaning and disinfection wi...

Growing stem cells efficiently and preventing contamination is a major stumbling block in developing them for therapeutic applications. Still these days, animal byproducts are used in Petri dishes that grow stem cells, leading to infection that may trigger an immune response once these cells are transplanted into the body. To overcome this issue, researchers at University of Washington in Seattle have developed a 3 dimensional structure to serve as a nesting site for stem cells to comfortably...

by Alex Smith, MD Words have power. Language has power. The words we use may comfort or shock, allay or provoke, sooth or batter. Words often imply layers of meaning that are not explicitly articulated, yet rest beneath the surface: “I worry that time is short for you” (You are dying) (I care about you) “I wish we could [...]Posted at KevinMD.com. Stay updated and subscribe, follow me on Twitter, or connect on Facebook. Related posts:Information is power Dr. SSS: The two most expens...

Despite the recent diminution in the indications for corticosteroids in septic shock, they are still used in limited situations, particularly when hypotension is refractory to pressor agents. When glycemic control deteriorates during the use of steroids should it be approached differently? A new JAMA study looked at this question and investigated the effect of fludrocortisone as a secondary objective:Patients were randomly assigned to 1 of 4 groups: continuous intravenous insulin infusion w...

---it's that we need to spend more time with patients:The demand for complementary medicine (CM) is growing worldwide and so is the supply. So far, there is not much insight in the activities in Dutch CM practices nor in how these activities differ from mainstream general practice. Comparisons on diagnoses and visit length can offer an impression of how Dutch CM practices operate...The CM physicians registered activities in a total of 5919 visits in 1839 patients. In all types of CM practices...

This is a very useful update from the Perioperative Medicine Summit.

via yorkpress.co.uk Is this part of an ongoing "parallel exporting" issue? You tell me. Posted via web from Jack's posterous

Take a break form your day to have a quick laugh at the expense of Cordis (a J&J company) and their accidental product manual that wasn't much of, well, a manual......

Sonitus Medical out of San Mateo, California is a company that's betting on bone conducting dental hearing implant technology. The SoundBite Hearing System that the firm is developing consists of a unit that has a microphone and wireless transmitter, and a tiny speaker that attaches to rear teeth to resonate and transmit the audio mechanically to the cochleae. The idea for this technology is not new and maybe risky, but Sonitus Medical seems confident it can earn regulatory approval and intro...

Jamie Heywood founded a website called PatientsLikeMe. Just like other social networks, PatientsLikeMe provides a place for people to discuss their condition, exchange information on countless diseases, etc. What makes PatientsLikeMe unique is the information that the firm mines from the content contributed by users. Here's Heywood giving a TEDMED talk about how his website can serve a similar function as large scale clinical trials and what useful data can be obtained from it. Link: Patients...

Bill Davenhill asks, “Can your health depend on where you live?” From TEDMED 2009. Posted at KevinMD.com. Stay updated and subscribe, follow me on Twitter, or connect on Facebook. Related posts:KevinMD Live Q&A on health care reform, today at 11:30am Eastern A vasectomy, live on Twitter KevinMD Live Q&A today at 2:00pm Eastern Posted at KevinMD.com. Stay updated and subscribe, follow me on Twitter, or connect on Facebook. Related posts:KevinMD Live Q&A...

Originally published in MedPage Today by John Gever, MedPage Today Senior Editor A Massachusetts anesthesiologist accused of fabricating data in studies of pain drugs will plead guilty to federal criminal charges under an agreement with prosecutors. Scott Reuben, MD, a well-known pain researcher at Baystate Medical Center in Springfield, Mass., was charged with one count of healthcare [...]Posted at KevinMD.com. Stay updated and subscribe, follow me on Twitter, or connect on Facebook. Re...

Each year, the Advisory Committee on Immunization Practices (ACIP), together with the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP), publishes new recommendations for immunizations for children and teens. While there were some changes in the 2010 childhood immunization schedule, these changes likely won't mean any extra shots for most kids. Review the latest immunization schedule and make sure your kids' shots are up-to-date. Related: Combination V...

Faces of America premieres nationally Wednesdays, February 10 - March 3, 2010 on PBS: "What made America? What makes us? These two questions are at the heart of the new PBS series Faces of America with Henry Louis Gates, Jr. who turns to the latest tools of genealogy and genetics to explore the family histories of 12 renowned Americans." Posted at Clinical Cases and Images. Stay updated and subscribe, or follow me on Twitter.

Health News of the Day is a daily summary made from the selected links I post on Twitter. It is in bullet-point format with links to the original sources which include 350 RSS feeds that produce about 2,500 items per day: Procalcitonin-guided strategy to treat suspected bacterial infections reduced antibiotic exposure in ICU by 2.7 days http://goo.gl/mws0 Both low and high HbA1c associated with increased mortality in diabetes. Guidelines for minimum HbA1c value may be needed. Survival a...

Obama Plans Bipartisan Summit on Health Care Morning Joe had a nice discussion of this plan.? I agree with two of his three points. My agenda (if anyone cares) True tort reform.? I would not go after caps, but rather focus on health courts.? Tort reform would attract several Republican votes.? Can the Democrats vote for a [...] Related posts:In which Evan Falchuk explores health care reform Why not make health insurance competitive? Why this libertarian favors health care reform

<img src="http://feeds.feedburner.com/~r/PhysiciansFirstWatch/~4/Af2WwAJT6wA" height="1" width="1"/>

via harlowherald.co.uk Posted via web from Jack's posterous

I got a letter from a patient's insurer the other day, warning me that this woman, who had just refilled my prescription for a bisphosphonate I had prescribed almost a year ago for severe osteoporosis (yes, I do still prescribe dugs, despite how I feel about Big Pharma marketing), also had a claims diagnosis in their system for a bleeding peptic ulcer, and was I really sure she should be taking this medication, which could worsen her ulcer?So ?do what any conscientious physician would do - I...

Atul Gawande to NPR: Doctors are human, and that their profession is like any other. "We miss stuff. We are inconsistent and unreliable because of the complexity of care," Gawande says. "I got a chance to visit Boeing and see how they make things work, and over and over again they fall back on checklists. The pilot's checklist is a crucial component, not just for how you handle takeoff and landing in normal circumstances, but even how you handle a crisis emergency when you on...

Gawande&#8217;s &#8220;Checklist Manifesto&#8221; Instead, I&#8217;d like to focus on the subjects that don&#8217;t come through in reviews and interviews (such as Atul&#8217;s charming appearance on The Daily Show) but, I believe, are much deeper and more valuable. &#8220;For nearly all of history, people&#8217;s lives have been governed primarily by ignorance,&#8221; Gawande writes. But in healthcare, he [...] Related posts:The Checklist Manifesto T...

  Running ward-attending rounds has more in common with jazz than symphony.?Patients do not follow a script.?Admissions do not follow a script.?The ward attending has multiple responsibilities each day. ?These responsibilities include directing patient care, teaching, evaluating, and coaching learners to grow.?We believe that we should combine directing [...] Related posts:Reflections on 30 years of ward attending An old post &#8211; focus on basics Can a 3rd year student influence his...

Vladimir Putin meets with Anatoly Chubais, CEO of Russian Corporation of Nanotechnologies... [Prime Minister of the Russian Federation] FDA Issues Guidance to Help Streamline Medical Device Clinical Trials... [FDA] Pfizer's Bad Political Bet... [WSJ] White House announces televised health meet... [Politico] Baucus Quotes Gandhi; Obama Wants $80 Billion HHS Boost... [MedPageToday] A State Looks to Create Cheap, Limited Health Insurance... [WSJ] First US patent issued for induced stem cell prot...

Jean-Michel Halfon, head of emerging markets for Pfizer, said: "The eCard is an innovative way to partner with society, patients and governments to help manage chronic diseases at an affordable price." Each patient presents their eCard to a pharmacist to receive an automatic discount on the normal retail price, giving Pfizer information on the drug purchases so it can reimburse the difference to the pharmacist and track patient use directly. By allowing it to offer discounts o...

StoryRIP 2006

David Agus, professor of medicine at the University of Southern California and co-founder of personal genomics company Navigenics, spoke at last year's TEDMED about the state of available cancer therapy treatments and how far they've come from fifty years ago. Turns out the progress made so far has not been very promising and Agus is calling for a new strategy in attacking this multifaceted disease. > Link: TEDMED......

DMG America, a dental technology company out of Englewood, N.J., is selling a light cured infiltrant resin that is useful for treating early cavities. At the very early stage of tooth decay, before a formal, treatable cavity has developed, fluoride treatment is often used as prophylaxis. But after a certain level of tooth decay, fluoride will be of no use, yet drilling the tooth to treat the cavity is not merited either, since filling a cavity with this method destroys healthy tooth tissue, a...

Link... Previously: A Message from Dr. Fiona Godlee, Editor-in-Chief of British Medical Journal; Global Warming Beliefs and The Hippocratic Oath: How BMJ Leadership Fails on Both; BMJ Urges Others, Fails to "Lead by Example" on Climate Change; Fionagate: An Illustrated, Interactive Website; Feet to the Fire: Responding to Dr. Godlee ; Carbon Footprint, or How to Spot Other People's Garbage...

http://www.pharmareform.com/Here's a recent post:No single event, single offense, issue, or individual company can be identified as the source of or considered responsible for the market distrust of the pharmaceutical industry. This has been a cumulative affect over the past 30 years or so of modern day Pharma. It is important to identify, recognize, and acknowledge the sources of distrust before solutions can credibly and effectively be formulated. Here are the 5 major sources of market di...

Monday morning, time for Rule of Dog.

It took years before the truth was uncovered; the charming doctor was a cold-blooded killer. Add a bit of information here, an element or two of data there, and slowly the complete picture appears - if someone has access to...

"Fingertongs are silicone cooking tongs you wear on your hand." "For cooks who love to be close to their food, no more burned fingers." "Slides onto either hand and gives precise control when flipping food, turning sausage, stir-frying, etc." $17.95....

Answer here this time tomorrow.

via pubs.acs.org The Dilithium crystals cannae take it Cap'n! Posted via web from Jack's posterous

A woman kills her 8 yo son and attempts suicide in a room at the Peninsula (a Midtown hotel). The Daily News reports the story and assorted people offer more or less appropriate comments. Nothing out of the ordinary so far.And then you notice the picture accompanying the story and you have to wonder: what is wrong with the Daily News and, more importantly, with Bellevue Hospital?Nothing in this story justifies publishing a picture of an inpatient. And nothing, ever justifies a hospital allowi...

A quiet riot is occurring in the state of Washington. Thanks to Dr. Bob Boyles for this update. The Physical Therapy Association of Washington State (PTWA) held their Legislative Impact Day at the state capitol in Olympia on January 28th....

The best way to lower health care costs and improve outcomes is to spend more on excellent primary care.? The data are consistent, and the concept has great face validity. This article is intriguing &#8211; For Diabetes, P4P Improves Patient Care, Outcomes As one reads the article, skepticism about the title enters. High-quality care &#8212; defined as receiving [...] Related posts:Must read article on primary care Guidelines and performance measures need testing It&#8217;s the...

When I wrote earlier this week about peer review, I did so from the heart and from my observations over the years.? My timing was somewhat random.? Apparently my post was somewhat prescient.? I will present 2 links that make the point much better than I did. Peer review trickery? Two researchers &#8212; Robin Lovell-Badge, who spoke [...] Related posts:Who watches the watchers? &#8211; more on peer review Does peer review help medicine? Does peer review work?

NEW LINK. Best interview with Atul Gawande I've read. On health care reform and checklists. Go look. http://ping.fm/oS6wY

Can you guess what part of the body this is and how it relates to reproduction? [Yes, of course this is a trick question!](Answer here and here.)

The picture above is of a Calvin Klein store on Madison. Had the ad featured a nude female model the first thing I would've probably noticed was the use of yet another depiction of a woman in a vulnerable position. But since the ad features a male model all I managed to notice was its, um, aesthetic qualities with nary a thought about the implication of public displays of nudity.

Originally published in MedPage Today by John Gever, MedPage Today Senior Editor More than 85% of American military medical evacuations from the Middle East were not the direct result of enemy action, but the result of non-battle injuries and disease, researchers said. Of some 34,000 military personnel in Iraq and Afghanistan who shipped out for medical reasons [...]Posted at KevinMD.com. Stay updated and subscribe, follow me on Twitter, or connect on Facebook. Related posts:Extended mil...

From Hurricane Vanessa: "The inaccurately named iTrust is an app for people who leave their cellphone lying around the house but don’t trust spouses, friends or family not to pry." "The UK Telegraph reports that Jorgnsn, the company behind the...

Two inches wide. $7.