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Nurses With “Do Not Disturb” Signs: Government-Directed Health Careemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
It was supposed to be one of a series of “measures to improve safety, reliability, patient experience, staff satisfaction and efficiency of medicine management.” Instead, the wearing of red “tabards” by nurses that read “Do Not Disturb” while they distributed medications has proven to be the straw that broke the camel’s back in England. While the “Do Not Disturb” message on the tabards was replaced with a message that reads “Drug Round in Progress,” isn’t the message the same? Directive Number 99365.23a: “In the Name of Safety, Do Not Bother Me W...
Source: Better Health - September 11, 2011 Category: Health Medicine and Bioethics Commentators Authors: DrWes Tags: Health Policy Opinion Affordable Care Act Central Patient Safety Authority Do Not Disturb Drug rounds Government-directed health care Health Care Reform Lowering Cost medicaid Medicare Medications Nurses Quality Quantity unin Source Type: blogs

Grand Rounds 7-50: Dr. Rich Did a Great Job… Jobs, Jobs, Jobs…email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
In the old days, bloggers whose posts were included in the Grand Rounds would link to that post from their own blog. Grand Rounds, for those who are not familiar, is a  weekly compilation of the best of the medical blogosphere. I used to refer to the Grand Rounds once in a while, but quit this [...]
Source: Laika's MedLibLog - September 6, 2011 Category: Medical Librarians Authors: laikaspoetnik Tags: Medical Grand Round Blog Blog Carnival Grand rounds Medical Grand rounds Medicine Source Type: blogs

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Dr. Rich, Covert Rationing,  is the host for this week’s Grand Rounds. You can read this week’s edition here. While Grand Rounds is normally the highlight of everybody’s week here in the medical blogosphere, this time it’s different. ………….. But be assured that there is good stuff to follow. So, if you find yourself incapable of focusing your attention on Grand Rounds at the moment, simply bookmark this page, and return to it once your sense of soaring happiness returns (as it inevitably must) to a more normal state. Be assured that this week’s entries are timeless enough to outlive your ecstasy (a...
Source: Suture for a Living - September 6, 2011 Category: Plastic Surgeons Tags: Blogging grand rounds shout outs medicine poetry Source Type: blogs

Metabolic disarray – understanding and treating the hyponatremiaemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Now obviously this is my opinion, and other may differ. We have an alcohol abusing woman who presented with a Na of 110 mEq/L and depressed mental status.  She awoke as saline increased her sodium quickly to 120 mEq/L.  This occurred because her urine osms of 150. This patient admitted to a beer diet.  Her history fit beer potomania.  Normally the urine osms in beer potomania are less than 100, but she also presented with volume contraction from vomiting.  I suspect that she had some ADH from the volume contraction. Given her dilute urine and underlying alcohol abuse, we worried that she had a pred...
Source: DB's Medical Rants - September 3, 2011 Category: Health Medicine and Bioethics Commentators Authors: rcentor Tags: Acid-Base & Lytes Attending rounds Source Type: blogs

Metabolic disarray – more informationemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
To recap:   47-year-old woman found stuporous and hypotensive.  She has known alcohol abuse and decreased LVEF around 30%.   Her labs come back, and you should provide plausible reconstructions of these results. Fluid Balance Panel  110 59 38 73 3.2 30 2.2 8.0 Arterial Blood Gas on 2L nasal oxygen pH 7.57 pCO2 31 pO2 99 c HCO3 29 What do you think her acid-base diagnosis is?  What additional information do you want (history, physical and/or labs)? ======= New information: The ER gave 3000 cc of NS (plus a banana bag).  Her BP slowly increased. Her sodium incre...
Source: DB's Medical Rants - September 1, 2011 Category: Health Medicine and Bioethics Commentators Authors: rcentor Tags: Acid-Base & Lytes Attending rounds Source Type: blogs

Metabolic disarrayemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
47-year-old woman found stuporous and hypotensive.  She has known alcohol abuse and decreased LVEF around 30%.   Her labs come back, and you should provide plausible reconstructions of these results.   Fluid Balance Panel  110 59 38 73 3.2 30 2.2 8.0   Arterial Blood Gas on 2L nasal oxygen   pH 7.57 pCO2 31 pO2 99 c HCO3 29 What do you think her acid-base diagnosis is?  What additional information do you want (history, physical and/or labs)?
Source: DB's Medical Rants - August 30, 2011 Category: Health Medicine and Bioethics Commentators Authors: rcentor Tags: Acid-Base & Lytes Attending rounds Source Type: blogs

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Health 3.0 Blog  is the host for this week’s Grand Rounds. You can read this week’s edition here. Welcome to this week’s edition of Grand Rounds. You can find the medical blogosphere’s best next week at Covert Rationing. We’ve taken a different approach this week to organizing Grand Rounds. You can find all the submissions below in this post. But, we’ve also selected quotes from each blog and highlighted those on the main page. Consistent with our themes, we’ve also tagged all the posts related to health, happiness, design or innovation. You can search for these tags to see how each theme plays out. W...
Source: Suture for a Living - August 30, 2011 Category: Plastic Surgeons Tags: bloggers grand rounds shout outs Women medicine Source Type: blogs

Grand Rounds Volume 7 Number 48email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Thank you for coming to Grand Rounds 7:48, the weekly collection of the some of the best in online medical writing from all (doctors, nurses, patients, healthcare professionals).  Next week’s will be hosted by Health 3.0 Blog. Along with the excellent posts, I’ve included pictures of the changes cameras have gone through over the years – from the pin-hole camera to digital phone cameras.  Enjoy!   Dr. Charles hasn’t had much time lately, but I was able to scribble down this pediatric poem:  A Beating.  As one commenter figured out, Dr. Charles is a new father.  Congratulations! and tha...
Source: Suture for a Living - August 23, 2011 Category: Plastic Surgeons Tags: Blogging grand rounds Source Type: blogs

Quick acid-base answeremail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Kudos to torontointernist.  The Canadian understood the big clues.  Here we have a patient with a normal gap metabolic acidosis plus a proximal tubule leak – 2+ urine glucose with a normal serum glucose.  This suggests strongly Fanconi's syndrome.  I mentioned a chronic disease and a medication.  Several medications can cause Fanconi's, but the most likely in 2011 is tenofovir, an HIV drug. So Torontointernist nailed it using careful logic.  And db claps wildly!!!
Source: DB's Medical Rants - August 17, 2011 Category: Health Medicine and Bioethics Commentators Authors: rcentor Tags: Acid-Base & Lytes Attending rounds Medical Rants Source Type: blogs

Suture for a Living to Host Grand Roundsemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
I’ll be your host next Tuesday, August 23rd, for Grand Rounds Volume 7 Number 48.   It will be my fifth time as host of this the weekly compilation of the best of the medical bloggers.  I have no specific theme in mind, but if you need a “spark of a suggestion” think of  changes:  schools are back in session, football season will soon begin, and there is just a hint of fall with no more triple digit weather here in the south.   Now apply that to medicine/surgery. Submissions should be recent.  Please, only submit one (your best) post per blog.  Submissions are welcome unti...
Source: Suture for a Living - August 16, 2011 Category: Plastic Surgeons Tags: Blogging grand rounds medicine Source Type: blogs

Quick acid-base quizemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
45-year–old man with a chronic disease, gets admitted for increased creatinine and abnormal urinalysis.  His previous creatinine was less than 1.0. 140 107 9 105 4.1 21 1.9   ABG confirms metabolic acidosis with appropriate compensation. U/A includes 2+ protein, 2+ glucose, 2+ blood U Na 24, K 12, Cl 18 Day 2 K drops to 3.1, Phos 1.8, Mg 2.1 What is the underlying disease, and what medication caused these abnormalities?  
Source: DB's Medical Rants - August 16, 2011 Category: Health Medicine and Bioethics Commentators Authors: rcentor Tags: Acid-Base & Lytes Attending rounds Source Type: blogs

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Dr. Pullen  is the host for this week’s Grand Rounds. You can read this week’s edition here (photo credit). I think I learned my lesson this time.  The first two times I hosted Grand Rounds many of the posts seemed to come from happy bloggers.  I think the lesson this time is don’t be a host when all the news is bad.  Maybe it’s the drought and heat wave in much of the U.S.  Or maybe using the words of Bill Clinton “It’s the economy, Stupid.”  For whatever the reason this week’s Grand Rounds is dominated by rants and whines from bloggers around the globe.  ……… ...
Source: Suture for a Living - August 16, 2011 Category: Plastic Surgeons Tags: quilting grand rounds shout outs medicine Source Type: blogs

Anion gap puzzle – my answeremail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
To repeat: 44-year-old man has had a recent drinking binge.  He has fallen several times (unclear whether this is syncope or not)     Fluid Balance Panel (6 pm) 137 92 15 91 4.9 16 0.7     Arterial Blood Gas(midnight)   pH 7.45 pCO2 30 pO2 84 c HCO3 21 What do you think his acid-base diagnosis is?  What tests would you order? He initially had a significant anion gap.  His U/A was positive for ketones, but a serum ketone test was negative.  He had a slightly elevated lactate of 6.2.  I suspect he came in with a mild lactic acidosis and perhaps alcoholic...
Source: DB's Medical Rants - July 27, 2011 Category: Health Medicine and Bioethics Commentators Authors: rcentor Tags: Acid-Base & Lytes Attending rounds Source Type: blogs

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Center for Advancing Health (CFAH), Prepared Patient Forum, is the host for this week’s Grand Rounds. You can read this week’s virtual tour edition here (photo credit). Welcome to Better Health’s Grand Rounds Volume 7, Number 44! This is our second time hosting Grand Rounds and we’re excited about sharing the posts we received.  The theme of this week’s collection came from a recent Health Affairs blog post by CFAH president, Jessie Gruman, Patient Advocates: Flies In The Ointment Of Evidence-Based Care, which addresses a few of the many challenges of basing health care practices, policies, and decisio...
Source: Suture for a Living - July 26, 2011 Category: Plastic Surgeons Tags: NPR grand rounds shout outs end-of-life issues CDC Source Type: blogs

An increased anion gap puzzleemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
44-year-old man has had a recent drinking binge.  He has fallen several times (unclear whether this is syncope or not)   Fluid Balance Panel (6 pm) 137 92 15 91 4.9 16 0.7     Arterial Blood Gas(midnight)   pH 7.45 pCO2 30 pO2 84 c HCO3 21 What do you think his acid-base diagnosis is?  What tests would you order?
Source: DB's Medical Rants - July 19, 2011 Category: Health Medicine and Bioethics Commentators Authors: rcentor Tags: Acid-Base & Lytes Attending rounds Medical Rants Source Type: blogs

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Dr. Elaine Schattner, Medical Lessons, is the host for this week’s Grand Rounds. You can read this week’s virtual tour edition here (photo credit). Live, from New York, it’s med-​​blog Grand Rounds, volume 7, number 43! As I’m staying home for the summer, I’ve asked bloggers to share images of where they’re from, or where they go, so we could take a virtual tour together: We’ll start with a post from the Wash­ington, DC-​​based Pre­pared Patient Forum, where Jessie Gruman clar­ifies that Engagement Does Not Mean Com­pliance. As Jessie says, “I am com­pliant if I do what my doctor tells me t...
Source: Suture for a Living - July 19, 2011 Category: Plastic Surgeons Tags: Music grand rounds shout outs history medicine Source Type: blogs

On seeing death for the first timeemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Earlier this week, our 3rd year students saw a patient die.  Every time we see this passage we come to terms with mortality.  But the first time has a profound impact.  We spent some time discussing this aspect of doctoring on rounds the next morning. Sometimes we do things that have a major positive effect for patients.  We prolong life; we improve the quality of life.  Even when we cannot prolong life we can comfort patients and make the dying process a natural passage. But this unfortunate patient died suddenly and unexpectedly.  We had a good treatment plan and expected a good short term o...
Source: DB's Medical Rants - July 10, 2011 Category: Health Medicine and Bioethics Commentators Authors: rcentor Tags: Attending rounds Source Type: blogs

Diuretics – some teaching pointsemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Over the past several years, I have noted that many students and residents have a very simple approach to diuretic use.  They furosemide as their main loop diuretic; they use hydrochlorothiazide as their antihypertensive.  Many of them do not really know the alternatives, and therefore resort to a single standard. Here are my main teaching points: 1. Many patients do not respond well to oral furosemide.  Furosemide has very variable absorption with an average of only 50%.  We have two other loop diuretics – bumetanide and torsamide.  Bumetanide is on all the $4 lists. It has almost 100% consi...
Source: DB's Medical Rants - July 3, 2011 Category: Health Medicine and Bioethics Commentators Authors: rcentor Tags: Attending rounds Source Type: blogs

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Colorado Health Insurance Insider is the host for this week’s Grand Rounds.  You can read this week’s edition here. Welcome to Grand Rounds!  It’s the third time we’ve hosted Grand Rounds at the Colorado Health Insurance Insider and we’re honored to be hosting again. It was a pleasure to read so many great articles for this edition.  Since our blog tends to focus on health care policy and reform, I’m starting things off with the posts that pertain to that topic.  Enjoy!  . …….. …………………………… TBTAM responds to the Supreme Court ruling on the Vermont Law:  ...
Source: Suture for a Living - June 28, 2011 Category: Plastic Surgeons Tags: medical practice Blogging Physicians grand rounds medicine Source Type: blogs

Diagnostic processes that enhance our successemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Recently I have become obsessed with learning about the diagnostic process.  Some colleagues have taught me about dual process diagnostic thinking, and of course I have been reading articles. Here is my summary: As we develop experience we start the diagnostic process with an intuitive model.  I don't like the label, because it suggests that we are not thinking at all.  What I believe we are doing is matching a problem representation to an illness script.  We could call this pattern recognition, but there are really two concepts at play here.  We must know enough about the illness scripts to de...
Source: DB's Medical Rants - June 24, 2011 Category: Health Medicine and Bioethics Commentators Authors: rcentor Tags: Attending rounds Source Type: blogs

Explaining the actual numbersemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
60-year-old man admitted for 3-5 days of nausea, vomiting (undigested food), watery diarrhea (volume not specified) and alcohol on his breath. Patient has significant orthostasis with pulse increase (just raising head of bed).  PMH of hypertension – only prescribed metoprolol. Predict the electrolyte disorders and acid base disorders. There are no surprises here – we predicted the direction of everything at morning report. 139 75 13 159 2.3 15 1.3     Unfortunately we do not have an ABG, but we can get quite close to the truth. First, I assumed that an alcohol abuser with vomiting and wat...
Source: DB's Medical Rants - June 16, 2011 Category: Health Medicine and Bioethics Commentators Authors: rcentor Tags: Acid-Base & Lytes Attending rounds Source Type: blogs

AKI – part 2email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
A 60+ year old man was admitted for a 1 day history of abdominal pain, hematochezia, and a rash developing over his lower extremities bilaterally.  No significant PMH other than chronic pain. H&P revealed a history of nausea and vomiting the day previous to admission with 6 bright red bloody stools and diffuse abdominal pain. Later that day he noticed a rash developing over his left foot which eventually progressed to involve both lower extremities to the knee. Exam was notable for a benign abdomen and palpable, nonblanching petechiae present from the soles proximally to the thighs.  Physical exam is otherwis...
Source: DB's Medical Rants - June 15, 2011 Category: Health Medicine and Bioethics Commentators Authors: rcentor Tags: Acid-Base & Lytes Attending rounds Source Type: blogs

The actual numbersemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
60-year-old man admitted for 3-5 days of nausea, vomiting (undigested food), watery diarrhea (volume not specified) and alcohol on his breath. Patient has significant orthostasis with pulse increase (just raising head of bed).  PMH of hypertension – only prescribed metoprolol. Predict the electrolyte disorders and acid base disorders. There are no surprises here – we predicted the direction of everything at morning report. 139 75 13 159 2.3 15 1.3  
Source: DB's Medical Rants - June 15, 2011 Category: Health Medicine and Bioethics Commentators Authors: rcentor Tags: Acid-Base & Lytes Attending rounds Source Type: blogs

Acute kidney injuryemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
  A 60+ year old man was admitted for a 1 day history of abdominal pain, hematochezia, and a rash developing over his lower extremities bilaterally.  No significant PMH other than chronic pain. H&P revealed a history of nausea and vomiting the day previous to admission with 6 bright red bloody stools and diffuse abdominal pain. Later that day he noticed a rash developing over his left foot which eventually progressed to involve both lower extremities to the knee. Exam was notable for a benign abdomen and palpable, nonblanching petechiae present from the soles proximally to the thighs.  Physical exam is o...
Source: DB's Medical Rants - June 14, 2011 Category: Health Medicine and Bioethics Commentators Authors: rcentor Tags: Acid-Base & Lytes Attending rounds Source Type: blogs

Has resident education become compromised?email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This past weekend I attended an internal medicine meeting during which several internists expressed strong concerns about medical education with the new work hour restrictions.  Readers know that I make rounds often (probably > 150 days each year) and in two disparate sites – a large community hospital with family medicine residents and a VA hospital with internal medicine residents.  We also have 3rd year students in each program. I first served as ward attending in January 1980.  Much has changed since then, but more has stayed the same. Patients still present with a variety of diseases.  Som...
Source: DB's Medical Rants - June 6, 2011 Category: Health Medicine and Bioethics Commentators Authors: rcentor Tags: Attending rounds Source Type: blogs

Predict the numbers (electrolyte panel)email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
60-year-old man admitted for 3-5 days of nausea, vomiting (undigested food), watery diarrhea (volume not specified) and alcohol on his breath. Patient has significant orthostasis with pulse increase (just raising head of bed).  PMH of hypertension – only prescribed metoprolol. Predict the electrolyte disorders and acid base disorders. There are no surprises here – we predicted the direction of everything at morning report.
Source: DB's Medical Rants - June 2, 2011 Category: Health Medicine and Bioethics Commentators Authors: rcentor Tags: Acid-Base & Lytes Attending rounds Source Type: blogs

#sgim2011 Friday’s activities – Better ward attending roundsemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
We presented several posters on this topic during the meeting.  The workshop allows participants to discuss the many techniques one can use to improve attending rounds. I can't blog too much about our data, because we have not yet published our results.  We did provide a copy of this article, which provides a good abridgment of our discussions – Become a better ward attending. I actually reread this periodically to remind myself of everything I might consider.
Source: DB's Medical Rants - May 7, 2011 Category: Health Medicine and Bioethics Commentators Authors: rcentor Tags: Attending rounds Source Type: blogs

On doctoringemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Over the past few weeks I have considered doctoring philosophically.  My thoughts started to coalesce after Rich Baron's outstanding keynote address at IM 2011.  His remarks struck a chord and enhanced some ideas that I have considered the last few years. Many academicians, many wonks, most congressmen, and most "suits" believe that we can define high quality care easily.  They view doctoring like flying an airplane.  If A happens, then clearly we should do B. They forget that a pilot trains on each variety of airplane and becomes an expert on that particular plane.  Each plane of tha...
Source: DB's Medical Rants - April 14, 2011 Category: Health Medicine and Bioethics Commentators Authors: rcentor Tags: Attending rounds Source Type: blogs

Top stories in health and medicine this morning, April 14, 2011email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This series is brought to you by MedPage Today, Putting breaking medical news into practice.1. Cardiac Arrest Offers Alzheimer’s Clue. A huge rush of beta-amyloid protein into the blood was found in patients suffering cardiac arrest, possibly shedding light on the origin of Alzheimer’s disease plaques.(...)Read the rest of Top stories in health and medicine this morning, April 14, 2011 on KevinMD.comNo comment | Tags: | Category: Morning rounds
Source: Kevin, M.D. - Medical Weblog - April 14, 2011 Category: Family Physicians Authors: Kevin Tags: Morning rounds Source Type: blogs

Top stories in health and medicine this morning, April 13, 2011email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This series is brought to you by MedPage Today, Putting breaking medical news into practice.1. Docs Choose Different Paths for Themselves, Patients. When asked for their recommendations about treatment, doctors were more likely to recommend that their patients go with the less risky procedure but would choose the riskier one for themselves.(...)Read the rest of Top stories in health and medicine this morning, April 13, 2011 on KevinMD.comNo comment | Tags: | Category: Morning rounds
Source: Kevin, M.D. - Medical Weblog - April 13, 2011 Category: Family Physicians Authors: Kevin Tags: Morning rounds Source Type: blogs

Top stories in health and medicine this morning, April 11, 2011email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This series is brought to you by MedPage Today, Putting breaking medical news into practice.1. HIV HAART Therapy Urged for All. Putting HIV patients on treatment is like a mortgage — the more you pay now, the less you pay later.(...)Read the rest of Top stories in health and medicine this morning, April 11, 2011 on KevinMD.comNo comment | Tags: | Category: Morning rounds
Source: Kevin, M.D. - Medical Weblog - April 11, 2011 Category: Family Physicians Authors: Kevin Tags: Morning rounds Source Type: blogs

Top stories in health and medicine this morning, April 10, 2011email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This series is brought to you by MedPage Today, Putting breaking medical news into practice.1. HIV Boosts Risk of Heart Disease. HIV increases the risk of coronary heart disease independent of other risk factors.(...)Read the rest of Top stories in health and medicine this morning, April 10, 2011 on KevinMD.comNo comment | Tags: | Category: Morning rounds
Source: Kevin, M.D. - Medical Weblog - April 10, 2011 Category: Family Physicians Authors: Kevin Tags: Morning rounds Source Type: blogs

Top stories in health and medicine this morning, April 8, 2011email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This series is brought to you by MedPage Today, Putting breaking medical news into practice.1. Afib Clinic Improves Outcomes. An atrial fibrillation clinic in which specialized nurses coordinated much of the care was associated with improved clinical outcomes compared with usual care.(...)Read the rest of Top stories in health and medicine this morning, April 8, 2011 on KevinMD.comNo comment | Tags: | Category: Morning rounds
Source: Kevin, M.D. - Medical Weblog - April 8, 2011 Category: Family Physicians Authors: Kevin Tags: Morning rounds Source Type: blogs

Top stories in health and medicine this morning, April 7, 2011email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This series is brought to you by MedPage Today, Putting breaking medical news into practice.1. Bad News, Good News for BRCA and Ovarian Ca. Genetic mutations that increase the risk of ovarian cancer also confer a more favorable prognosis for women who develop it.(...)Read the rest of Top stories in health and medicine this morning, April 7, 2011 on KevinMD.comNo comment | Tags: | Category: Morning rounds
Source: Kevin, M.D. - Medical Weblog - April 7, 2011 Category: Family Physicians Authors: Kevin Tags: Morning rounds Source Type: blogs

Top stories in health and medicine this morning, April 5, 2011email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This series is brought to you by MedPage Today, Putting breaking medical news into practice.1. Meds Equal to Surgery in Ischemic Heart Failure. Surgery for ischemic heart failure doesn’t save more lives than medical therapy alone.(...)Read the rest of Top stories in health and medicine this morning, April 5, 2011 on KevinMD.comNo comment | Tags: | Category: Morning rounds
Source: Kevin, M.D. - Medical Weblog - April 5, 2011 Category: Family Physicians Authors: Kevin Tags: Morning rounds Source Type: blogs

The LITFL Review 013email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care.
Source: Life in the Fast Lane - April 4, 2011 Category: Emergency Medicine Doctors Authors: Kane Guthrie Tags: Blog News Emergency Medicine Infectious Disease LITFL review Reviews Website Grand rounds podcast Source Type: blogs

How important is the ward attending?email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
CONCLUSION: Certain clerkship characteristics are associated with better student examination performance, the most salient being caring for more patients per day.    
Source: DB's Medical Rants - April 4, 2011 Category: Health Medicine and Bioethics Commentators Authors: rcentor Tags: Attending rounds Source Type: blogs

Top stories in health and medicine this morning, April 4, 2011email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This series is brought to you by MedPage Today, Putting breaking medical news into practice.1. Academics Profit By Making the Case for Opioid Painkillers. As an epidemic of narcotic painkiller abuse raged across America in 2006, researchers at the U.S. Centers for Disease Control and Prevention issued a medical journal report connecting deaths from those drugs to up to a 500% increase prescriptions.(...)Read the rest of Top stories in health and medicine this morning, April 4, 2011 on KevinMD.comNo comment | Tags: | Category: Morning rounds
Source: Kevin, M.D. - Medical Weblog - April 4, 2011 Category: Family Physicians Authors: Kevin Tags: Morning rounds Source Type: blogs

Top stories in health and medicine this morning, April 3, 2011email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This series is brought to you by MedPage Today, Putting breaking medical news into practice.1. Quality of Nursing Home No Predictor of Suit Risk. The highest-quality nursing homes are sued almost as frequently as those with the worst performance.(...)Read the rest of Top stories in health and medicine this morning, April 3, 2011 on KevinMD.comNo comment | Tags: | Category: Morning rounds
Source: Kevin, M.D. - Medical Weblog - April 3, 2011 Category: Family Physicians Authors: Kevin Tags: Morning rounds Source Type: blogs

Top stories in health and medicine this morning, April 2, 2011email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This series is brought to you by MedPage Today, Putting breaking medical news into practice.1. Diabetes Testing Down Among Inner-City Minorities. The percentage of poor, minority, inner-city diabetes patients 40 and older who received recommended testing annually declined from 2002 to 2007.(...)Read the rest of Top stories in health and medicine this morning, April 2, 2011 on KevinMD.comNo comment | Tags: | Category: Morning rounds
Source: Kevin, M.D. - Medical Weblog - April 2, 2011 Category: Family Physicians Authors: Kevin Tags: Morning rounds Source Type: blogs

Top stories in health and medicine this morning, April 1, 2011email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This series is brought to you by MedPage Today, Putting breaking medical news into practice.1. Ca Risk Lower After Liver Transplant if Smokers Quit. Liver transplant patients who quit smoking significantly lower their risk of subsequently developing a smoking-related malignancy.(...)Read the rest of Top stories in health and medicine this morning, April 1, 2011 on KevinMD.comNo comment | Tags: | Category: Morning rounds
Source: Kevin, M.D. - Medical Weblog - April 1, 2011 Category: Family Physicians Authors: Kevin Tags: Morning rounds Source Type: blogs

Centor’s rules for attending roundsemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Attending rounds in internal medicine in many ways define the internal medicine rotation.  We who love making attending rounds each develop our own implicit rules.  In this post I am working to make those rules explicit.  I do not pretend that my list is comprehensive or complete.  I would appreciate additions and suggestions. Be timely – there is nothing worse than abusing time when you are the attending.  You should arrive on time (5-10 min leeway is acceptable) and end on time.  Residents and interns work hard.  When we spend too much time rounding they have difficulty getting t...
Source: DB's Medical Rants - March 31, 2011 Category: Health Medicine and Bioethics Commentators Authors: rcentor Tags: Attending rounds Medical Rants Source Type: blogs

Top stories in health and medicine this morning, March 31, 2011email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This series is brought to you by MedPage Today, Putting breaking medical news into practice.1. PSA Screening in Older Men Often Unnecessary. Almost a third of older men with limited life expectancy continue to have unnecessary PSA tests.(...)Read the rest of Top stories in health and medicine this morning, March 31, 2011 on KevinMD.comNo comment | Tags: | Category: Morning rounds
Source: Kevin, M.D. - Medical Weblog - March 31, 2011 Category: Family Physicians Authors: Kevin Tags: Morning rounds Source Type: blogs

Top stories in health and medicine this morning, March 30, 2011email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This series is brought to you by MedPage Today, Putting breaking medical news into practice.1. Docs Get Advice on Medical Marijuana. Doctors in every state in the U.S. have the right to recommend medical marijuana for patients with a qualifying condition, such as cancer or HIV, but they can find themselves in legal hot water if they actually prescribe it — even in those states where medical marijuana has been legalized.(...)Read the rest of Top stories in health and medicine this morning, March 30, 2011 on KevinMD.comNo comment | Tags: | Category: Morning rounds
Source: Kevin, M.D. - Medical Weblog - March 30, 2011 Category: Family Physicians Authors: Kevin Tags: Morning rounds Source Type: blogs

Top stories in health and medicine this morning, March 29, 2011email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This series is brought to you by MedPage Today, Putting breaking medical news into practice.1. Some Psychotropics Risky in Older Patients. Psychotropic drugs are often used to control behavioral symptoms in nursing-home residents, but data on almost 11,000 older patients found a significantly increased risk of death and other adverse outcomes in those treated with conventional antipsychotic drugs, antidepressants, and benzodiazepines, compared with atypical antipsychotic drugs.(...)Read the rest of Top stories in health and medicine this morning, March 29, 2011 on KevinMD.comNo comment | Tags: | Category: Morning rounds
Source: Kevin, M.D. - Medical Weblog - March 29, 2011 Category: Family Physicians Authors: Kevin Tags: Morning rounds Source Type: blogs

Top stories in health and medicine this morning, March 28, 2011email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This series is brought to you by MedPage Today, Putting breaking medical news into practice.1. Capsaicin Patch Eases HIV Neuropathy Pain. Difficult-to-treat HIV-associated neuropathic pain appears to be eased for at least three months with a one-time, 30-minute application of an 8% capsaicin patch (NGX-4010, Qutenza).(...)Read the rest of Top stories in health and medicine this morning, March 28, 2011 on KevinMD.comNo comment | Tags: | Category: Morning rounds
Source: Kevin, M.D. - Medical Weblog - March 28, 2011 Category: Family Physicians Authors: Kevin Tags: Morning rounds Source Type: blogs

Top stories in health and medicine this morning, March 25, 2011email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This series is brought to you by MedPage Today, Putting breaking medical news into practice.1. Patients Need Bigger Role in Treatment, Panel Says. Treatment should involve a two-way decision-making process between patients and healthcare professionals.(...)Read the rest of Top stories in health and medicine this morning, March 25, 2011 on KevinMD.comNo comment | Tags: | Category: Morning rounds
Source: Kevin, M.D. - Medical Weblog - March 25, 2011 Category: Family Physicians Authors: Kevin Tags: Morning rounds Source Type: blogs