Medical group said key elements well woman exams

Tuesday, 24 July, HealthDay News)--the latest guidelines for cervical cancer screening say that most women don't need annual Pap smears, but they still need yearly exams well woman with their obstetrician/gynecologist, according to the American College of Obstetricians and Gynecologists (ACOG).

In the opinion of the Committee, released Monday, the College outlines when women should undergo pelvic exams, which women need clinical examination of mammary glands and why the Bureau visit the annual well woman is important.

Annual well woman exam is an opportunity for doctors to advise patients about following a healthy lifestyle and reducing health risks. The trip includes a physical exam that assesses general health, including blood pressure and weight.

A pelvic exam is a common part of the visit, the OB-GYN and includes three parts: external examination, an internal exam and exam mirror internal/external keyboard, according to the press release of the APS. Women should begin annual pelvic exams are held at the age of 21.

Young women do not have to pass an internal examination, if they do not have signs of menstrual disorders, vaginal discharge, pelvic pain or other symptoms related to reproductive, said College.

Screening for sexually transmitted infections can be done using urine or vaginal tampons without an internal exam.

Another important part of the visit, the good woman is a clinical breast exam. This should be done every one to three years for women aged 20 to 39, according to ACOG and other groups, health/medical. Women aged 40 years and older must have annual mammograms and clinical breast exams annually, ACOG recommends.

Decisions on the appropriateness of the internal pelvic exam breast exams or should always be with the consent of the patient, "said ACOG.

In the August issue of the journal obstetrics and Gynecology & appears in the Committee's opinion.

--Robert Preidt Copyright © 2012 HealthDay. All rights reserved. Source: American College of Obstetricians and Gynecologists, press release, July 23, 2012

View the original article here

"Steered" common marijuana among Teens and medical devices: study

THURSDAY, Aug. 2--HealthDay News) for the treatment of substance abuse among young people, many were used for medical marijuana, which was recommended for someone else, also known as "directed" medical marijuana, found that the new study.

The authors of the study, from the University of Colorado Anschutz Medical Campus in Aurora, Colorado, Idaho, suggest that the policy changes are needed to deter the misuse of medical marijuana by young people.

During the test, the lead Author Stacy Salomonsen-Sautel and colleagues questioned 164 young people aged 14-18 in two adolescent substance abuse treatment programs in Denver about their use of medical marijuana. Researchers found that nearly 74 teens use marijuana, which was recommended for someone else on average 50 times.

Compared with teens who do not use medical marijuana, those who began using drugs regularly in younger age and were also more dependent on marijuana and showed more signs of the disorder, according to the report published in the July issue of the Journal of the American Academy of | Child and Adolescent Psychiatry.

The researchers, however, stressed that the majority of teens believed that drug comes with little or no risk.

Because of recent changes to the rules of the State and Federal have door open to more legalized marijuana medical use in Colorado, the researchers suggested that teens using medical marijuana most likely got it from the registry identification card of an adult important for drugs.

The authors of the study concluded that the improved security measures are necessary to prevent medical marijuana in the hands of people that he should not, particularly teenagers.

"The high risk of many patients in the treatment of adolescent substance abuse medical marijuana transalpine were used on a number of occasions, which means that considerable changes direction takes place from registered users," Salomonsen-Sautel said in the journal messages. "Our results support the need for changes in the rules, which protect against medical marijuana to teenagers cross trade."

--Mary Elizabeth Dallas Copyright © 2012 HealthDay. All rights reserved. Source: Journal of the American Academy of Child and Adolescent Psychiatry, news release, 31 July 2012

View the original article here

Best of Medical Blogs-weekly review and blog carnival

The "Best of Medical Blogs-weekly review and blog carnival" is a weekly summary of the best medical Blog post. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best medical blog (BMB) is published every Tuesday, just like the old Grand Rounds.

Cultivate followers on social media, if you want to communicate science

From the blog science Soapbox http://goo.gl/cPQq1 and medical Museion http://goo.gl/QmEU7:

Social media platforms can be very limiting. For example, you can define genotype and Phenotype in 140 characters or less? If you want to use social media to communicate effectively, necessary for readers to drive somewhere.

Write a blog gives substance to your social media presence. You have the opportunity to talk about science in a meaningful way, which ultimately helps people better understand the world around them. Answering these questions is probably because you have first in science. Don't be afraid to share what you've discovered.

Are the doctors are afraid to be wrong?

From blogging to surgeon skeptical Scalpel: «I once did some work as an expert on a malpractice insurance company. Rarely there is a case that doesn't have many opportunities for second-guessing. When you know the outcome, you can always find something in the medical record that could have been done differently.

The current security climate and medicolegal patient creates a feeling among doctors that any mistake is to be extensively examined. This results in a similar situation to an athlete trying not to lose a game instead of trying to win. For those of you unfamiliar with the sport, that the strategy usually fails. Fear of being wrong can lead to excessive test too. " http://goo.gl/FWTbC

When did stop teaching the basics for residents and medical students?

Dr.% of the blog Rants Medical db loves ACGME competency 6 just fine, but also suggests a simple list of http://goo.gl/2sqip:

1. Take a complete history, relevant, accurate
2. make a proper physical examination
3. order the appropriate laboratory tests and interpret them completely and accurately
4. order the correct images and interventions and interpret them

Happy 5th Blogiversary!

Former plastic surgeon and blogger extraordinaire Dr. Bates of Ramona reflects on his 5 years of blogging and the medical community blogging. http://goo.gl/0EVJW

As blogging has helped me academically. According to Dr. cent: why I write almost everyday, my writing has improved dramatically http://goo.gl/GLNsL

Medicine-Stanford University Grand Rounds and social media

Graham Walker was one of the first medical blogger. Went on a break during his residency in emergency medicine (EM) and now has found new reasons to blog like a EM attending at Stanford University medical center. This is his talk on social media and medicine at Stanford University Grand Rounds: http://youtu.be/qtkggenLmlE

Dr. Walker: "my speech on the dissemination of medical information over time, as the internet and social networking are changing medication, how to use digital tools to be a better doctor at the bedside."

Here is the list of Graham of digital tools to improve the specialty.

Paper-based charts: how soon we forget http://goo.gl/Vspmp -Dr. Wes: suddenly, don't miss the paper charts anymore.

Dr. Wes: is how bad the cardiovascular risk of azithromycin? http://goo.gl/yVgfo -"Big data" related to "big mistake"?

Comments from Twitter:

Seth Trueger @ MDaware: some great stuff in there

Skeptical scalpel @ Skepticscalpel: thanks for including me.

View the original article here

Best of Medical Blogs-weekly review and blog carnival

The "Best of Medical Blogs-weekly review and blog carnival" is a weekly summary of the best medical Blog post. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best medical blog (BMB) is published every Tuesday, just like the old Grand Rounds.

Cultivate followers on social media, if you want to communicate science

From the blog science Soapbox http://goo.gl/cPQq1 and medical Museion http://goo.gl/QmEU7:

Social media platforms can be very limiting. For example, you can define genotype and Phenotype in 140 characters or less? If you want to use social media to communicate effectively, necessary for readers to drive somewhere.

Write a blog gives substance to your social media presence. You have the opportunity to talk about science in a meaningful way, which ultimately helps people better understand the world around them. Answering these questions is probably because you have first in science. Don't be afraid to share what you've discovered.

Are the doctors are afraid to be wrong?

From blogging to surgeon skeptical Scalpel: «I once did some work as an expert on a malpractice insurance company. Rarely there is a case that doesn't have many opportunities for second-guessing. When you know the outcome, you can always find something in the medical record that could have been done differently.

The current security climate and medicolegal patient creates a feeling among doctors that any mistake is to be extensively examined. This results in a similar situation to an athlete trying not to lose a game instead of trying to win. For those of you unfamiliar with the sport, that the strategy usually fails. Fear of being wrong can lead to excessive test too. " http://goo.gl/FWTbC

When did stop teaching the basics for residents and medical students?

Dr.% of the blog Rants Medical db loves ACGME competency 6 just fine, but also suggests a simple list of http://goo.gl/2sqip:

1. Take a complete history, relevant, accurate
2. make a proper physical examination
3. order the appropriate laboratory tests and interpret them completely and accurately
4. order the correct images and interventions and interpret them

Happy 5th Blogiversary!

Former plastic surgeon and blogger extraordinaire Dr. Bates of Ramona reflects on his 5 years of blogging and the medical community blogging. http://goo.gl/0EVJW

As blogging has helped me academically. According to Dr. cent: why I write almost everyday, my writing has improved dramatically http://goo.gl/GLNsL

Medicine-Stanford University Grand Rounds and social media

Graham Walker was one of the first medical blogger. Went on a break during his residency in emergency medicine (EM) and now has found new reasons to blog like a EM attending at Stanford University medical center. This is his talk on social media and medicine at Stanford University Grand Rounds: http://youtu.be/qtkggenLmlE

Dr. Walker: "my speech on the dissemination of medical information over time, as the internet and social networking are changing medication, how to use digital tools to be a better doctor at the bedside."

Here is the list of Graham of digital tools to improve the specialty.

Paper-based charts: how soon we forget http://goo.gl/Vspmp -Dr. Wes: suddenly, don't miss the paper charts anymore.

Dr. Wes: is how bad the cardiovascular risk of azithromycin? http://goo.gl/yVgfo -"Big data" related to "big mistake"?

Comments from Twitter:

Seth Trueger @ MDaware: some great stuff in there

Skeptical scalpel @ Skepticscalpel: thanks for including me.

View the original article here

Best of Medical Blogs-weekly review and blog carnival

The "Best of Medical Blogs-weekly review and blog carnival" is a weekly summary of the best medical Blog post. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best medical blog (BMB) is published every Tuesday, just like the old Grand Rounds.

Cultivate followers on social media, if you want to communicate science

From the blog science Soapbox http://goo.gl/cPQq1 and medical Museion http://goo.gl/QmEU7:

Social media platforms can be very limiting. For example, you can define genotype and Phenotype in 140 characters or less? If you want to use social media to communicate effectively, necessary for readers to drive somewhere.

Write a blog gives substance to your social media presence. You have the opportunity to talk about science in a meaningful way, which ultimately helps people better understand the world around them. Answering these questions is probably because you have first in science. Don't be afraid to share what you've discovered.

Are the doctors are afraid to be wrong?

From blogging to surgeon skeptical Scalpel: «I once did some work as an expert on a malpractice insurance company. Rarely there is a case that doesn't have many opportunities for second-guessing. When you know the outcome, you can always find something in the medical record that could have been done differently.

The current security climate and medicolegal patient creates a feeling among doctors that any mistake is to be extensively examined. This results in a similar situation to an athlete trying not to lose a game instead of trying to win. For those of you unfamiliar with the sport, that the strategy usually fails. Fear of being wrong can lead to excessive test too. " http://goo.gl/FWTbC

When did stop teaching the basics for residents and medical students?

Dr.% of the blog Rants Medical db loves ACGME competency 6 just fine, but also suggests a simple list of http://goo.gl/2sqip:

1. Take a complete history, relevant, accurate
2. make a proper physical examination
3. order the appropriate laboratory tests and interpret them completely and accurately
4. order the correct images and interventions and interpret them

Happy 5th Blogiversary!

Former plastic surgeon and blogger extraordinaire Dr. Bates of Ramona reflects on his 5 years of blogging and the medical community blogging. http://goo.gl/0EVJW

As blogging has helped me academically. According to Dr. cent: why I write almost everyday, my writing has improved dramatically http://goo.gl/GLNsL

Medicine-Stanford University Grand Rounds and social media

Graham Walker was one of the first medical blogger. Went on a break during his residency in emergency medicine (EM) and now has found new reasons to blog like a EM attending at Stanford University medical center. This is his talk on social media and medicine at Stanford University Grand Rounds: http://youtu.be/qtkggenLmlE

Dr. Walker: "my speech on the dissemination of medical information over time, as the internet and social networking are changing medication, how to use digital tools to be a better doctor at the bedside."

Here is the list of Graham of digital tools to improve the specialty.

Paper-based charts: how soon we forget http://goo.gl/Vspmp -Dr. Wes: suddenly, don't miss the paper charts anymore.

Dr. Wes: is how bad the cardiovascular risk of azithromycin? http://goo.gl/yVgfo -"Big data" related to "big mistake"?

Comments from Twitter:

Seth Trueger @ MDaware: some great stuff in there

Skeptical scalpel @ Skepticscalpel: thanks for including me.

View the original article here

Best of Medical Blogs-weekly review and blog carnival

The "Best of Medical Blogs-weekly review and blog carnival" is a weekly summary of the best medical Blog post. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best medical blog (BMB) is published every Tuesday, just like the old Grand Rounds.

Cultivate followers on social media, if you want to communicate science

From the blog science Soapbox http://goo.gl/cPQq1 and medical Museion http://goo.gl/QmEU7:

Social media platforms can be very limiting. For example, you can define genotype and Phenotype in 140 characters or less? If you want to use social media to communicate effectively, necessary for readers to drive somewhere.

Write a blog gives substance to your social media presence. You have the opportunity to talk about science in a meaningful way, which ultimately helps people better understand the world around them. Answering these questions is probably because you have first in science. Don't be afraid to share what you've discovered.

Are the doctors are afraid to be wrong?

From blogging to surgeon skeptical Scalpel: «I once did some work as an expert on a malpractice insurance company. Rarely there is a case that doesn't have many opportunities for second-guessing. When you know the outcome, you can always find something in the medical record that could have been done differently.

The current security climate and medicolegal patient creates a feeling among doctors that any mistake is to be extensively examined. This results in a similar situation to an athlete trying not to lose a game instead of trying to win. For those of you unfamiliar with the sport, that the strategy usually fails. Fear of being wrong can lead to excessive test too. " http://goo.gl/FWTbC

When did stop teaching the basics for residents and medical students?

Dr.% of the blog Rants Medical db loves ACGME competency 6 just fine, but also suggests a simple list of http://goo.gl/2sqip:

1. Take a complete history, relevant, accurate
2. make a proper physical examination
3. order the appropriate laboratory tests and interpret them completely and accurately
4. order the correct images and interventions and interpret them

Happy 5th Blogiversary!

Former plastic surgeon and blogger extraordinaire Dr. Bates of Ramona reflects on his 5 years of blogging and the medical community blogging. http://goo.gl/0EVJW

As blogging has helped me academically. According to Dr. cent: why I write almost everyday, my writing has improved dramatically http://goo.gl/GLNsL

Medicine-Stanford University Grand Rounds and social media

Graham Walker was one of the first medical blogger. Went on a break during his residency in emergency medicine (EM) and now has found new reasons to blog like a EM attending at Stanford University medical center. This is his talk on social media and medicine at Stanford University Grand Rounds: http://youtu.be/qtkggenLmlE

Dr. Walker: "my speech on the dissemination of medical information over time, as the internet and social networking are changing medication, how to use digital tools to be a better doctor at the bedside."

Here is the list of Graham of digital tools to improve the specialty.

Paper-based charts: how soon we forget http://goo.gl/Vspmp -Dr. Wes: suddenly, don't miss the paper charts anymore.

Dr. Wes: is how bad the cardiovascular risk of azithromycin? http://goo.gl/yVgfo -"Big data" related to "big mistake"?

Comments from Twitter:

Seth Trueger @ MDaware: some great stuff in there

Skeptical scalpel @ Skepticscalpel: thanks for including me.

View the original article here

Scanning the news about concerns over explosion in medical imaging scans

In case you missed them, many stories reported on a new analysis of the explosion in the use of CT, MRI and other advanced imaging methods.

The Los Angeles Times: “Use of imaging tests soars, raising questions on radiation risk.”

Researchers looked at “data from patients enrolled in six large health maintenance organizations,” and “found that doctors ordered CT scans at a rate of 149 tests per 1,000 patients in 2010, nearly triple the rate of 52 scans per 1,000 patients in 1996.” Meanwhile, “MRI use nearly quadrupled during the period, jumping from 17 to 65 tests per 1,000 patients.”

The New York Times: “Radiation Concerns Rise With Patients’ Exposure.”

 ”The study, published in the Journal of the American Medical Association, says that while advanced medical imaging has undoubted benefits, allowing problems to be diagnosed earlier and more accurately, its value needs to be weighed against potential harms, which include a small cancer risk from the radiation.”

WebMD: “CT Scan Rates Tripled at HMOs in the Last 15 Years, Doubling Radiation Exposure to Patients”

Reuters:

The average radiation dose from a chest CT scan is 7 millisieverts, compared with 0.1 millisieverts for a typical chest X-ray, according to the American College of Radiology. But those levels can vary widely by machine, with some low-dose scanners delivering as little as 1.5 millisieverts for a chest CT, and some older machines delivering far higher doses.

Researchers say a radiation dose of 50 millisieverts starts to raise concerns about human health, and a dose of 100 millisieverts is thought to raise the risk of cancer.

MedPage Today: “Expanding indications, patient and physician demand, medical uncertainty, and defensive medicine likely all contributed to those trends.”

View the original article here

Scanning the news about concerns over explosion in medical imaging scans

In case you missed them, many stories reported on a new analysis of the explosion in the use of CT, MRI and other advanced imaging methods.

The Los Angeles Times: “Use of imaging tests soars, raising questions on radiation risk.”

Researchers looked at “data from patients enrolled in six large health maintenance organizations,” and “found that doctors ordered CT scans at a rate of 149 tests per 1,000 patients in 2010, nearly triple the rate of 52 scans per 1,000 patients in 1996.” Meanwhile, “MRI use nearly quadrupled during the period, jumping from 17 to 65 tests per 1,000 patients.”

The New York Times: “Radiation Concerns Rise With Patients’ Exposure.”

 ”The study, published in the Journal of the American Medical Association, says that while advanced medical imaging has undoubted benefits, allowing problems to be diagnosed earlier and more accurately, its value needs to be weighed against potential harms, which include a small cancer risk from the radiation.”

WebMD: “CT Scan Rates Tripled at HMOs in the Last 15 Years, Doubling Radiation Exposure to Patients”

Reuters:

The average radiation dose from a chest CT scan is 7 millisieverts, compared with 0.1 millisieverts for a typical chest X-ray, according to the American College of Radiology. But those levels can vary widely by machine, with some low-dose scanners delivering as little as 1.5 millisieverts for a chest CT, and some older machines delivering far higher doses.

Researchers say a radiation dose of 50 millisieverts starts to raise concerns about human health, and a dose of 100 millisieverts is thought to raise the risk of cancer.

MedPage Today: “Expanding indications, patient and physician demand, medical uncertainty, and defensive medicine likely all contributed to those trends.”

View the original article here

Medical Arms Race tale

Kudos to Gregory Warner of Marketplace and colleagues for creating this video.  I thought I’d posted this months ago, but apparently forgot.  Never too late.

View the original article here

Medical Arms Race tale

Kudos to Gregory Warner of Marketplace and colleagues for creating this video.  I thought I’d posted this months ago, but apparently forgot.  Never too late.

View the original article here

Best of Medical Blog - recensione settimanale e blog carnevale

The "Best of Medical Blogs-weekly review and blog carnival" is a weekly summary of the best medical Blog post. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best medical blog (BMB) is published every Tuesday, just like the old Grand Rounds.

Cultivate followers on social media, if you want to communicate science

From the blog science Soapbox http://goo.gl/cPQq1 and medical Museion http://goo.gl/QmEU7:

Social media platforms can be very limiting. For example, you can define genotype and Phenotype in 140 characters or less? If you want to use social media to communicate effectively, necessary for readers to drive somewhere.

Write a blog gives substance to your social media presence. You have the opportunity to talk about science in a meaningful way, which ultimately helps people better understand the world around them. Answering these questions is probably because you have first in science. Don't be afraid to share what you've discovered.

Are the doctors are afraid to be wrong?

From blogging to surgeon skeptical Scalpel: «I once did some work as an expert on a malpractice insurance company. Rarely there is a case that doesn't have many opportunities for second-guessing. When you know the outcome, you can always find something in the medical record that could have been done differently.

The current security climate and medicolegal patient creates a feeling among doctors that any mistake is to be extensively examined. This results in a similar situation to an athlete trying not to lose a game instead of trying to win. For those of you unfamiliar with the sport, that the strategy usually fails. Fear of being wrong can lead to excessive test too. " http://goo.gl/FWTbC

When did stop teaching the basics for residents and medical students?

Dr.% of the blog Rants Medical db loves ACGME competency 6 just fine, but also suggests a simple list of http://goo.gl/2sqip:

1. Take a complete history, relevant, accurate
2. make a proper physical examination
3. order the appropriate laboratory tests and interpret them completely and accurately
4. order the correct images and interventions and interpret them

Happy 5th Blogiversary!

Former plastic surgeon and blogger extraordinaire Dr. Bates of Ramona reflects on his 5 years of blogging and the medical community blogging. http://goo.gl/0EVJW

As blogging has helped me academically. According to Dr. cent: why I write almost everyday, my writing has improved dramatically http://goo.gl/GLNsL

Medicine-Stanford University Grand Rounds and social media

Graham Walker was one of the first medical blogger. Went on a break during his residency in emergency medicine (EM) and now has found new reasons to blog like a EM attending at Stanford University medical center. This is his talk on social media and medicine at Stanford University Grand Rounds: http://youtu.be/qtkggenLmlE

Dr. Walker: "my speech on the dissemination of medical information over time, as the internet and social networking are changing medication, how to use digital tools to be a better doctor at the bedside."

Here is the list of Graham of digital tools to improve the specialty.

Paper-based charts: how soon we forget http://goo.gl/Vspmp -Dr. Wes: suddenly, don't miss the paper charts anymore.

Dr. Wes: is how bad the cardiovascular risk of azithromycin? http://goo.gl/yVgfo -"Big data" related to "big mistake"?

Comments from Twitter:

Seth Trueger @ MDaware: some great stuff in there

Skeptical scalpel @ Skepticscalpel: thanks for including me.

View the original article here

Best of Medical Blog - recensione settimanale e blog carnevale

The "Best of Medical Blogs-weekly review and blog carnival" is a weekly summary of the best medical Blog post. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best medical blog (BMB) is published every Tuesday, just like the old Grand Rounds.

Cultivate followers on social media, if you want to communicate science

From the blog science Soapbox http://goo.gl/cPQq1 and medical Museion http://goo.gl/QmEU7:

Social media platforms can be very limiting. For example, you can define genotype and Phenotype in 140 characters or less? If you want to use social media to communicate effectively, necessary for readers to drive somewhere.

Write a blog gives substance to your social media presence. You have the opportunity to talk about science in a meaningful way, which ultimately helps people better understand the world around them. Answering these questions is probably because you have first in science. Don't be afraid to share what you've discovered.

Are the doctors are afraid to be wrong?

From blogging to surgeon skeptical Scalpel: «I once did some work as an expert on a malpractice insurance company. Rarely there is a case that doesn't have many opportunities for second-guessing. When you know the outcome, you can always find something in the medical record that could have been done differently.

The current security climate and medicolegal patient creates a feeling among doctors that any mistake is to be extensively examined. This results in a similar situation to an athlete trying not to lose a game instead of trying to win. For those of you unfamiliar with the sport, that the strategy usually fails. Fear of being wrong can lead to excessive test too. " http://goo.gl/FWTbC

When did stop teaching the basics for residents and medical students?

Dr.% of the blog Rants Medical db loves ACGME competency 6 just fine, but also suggests a simple list of http://goo.gl/2sqip:

1. Take a complete history, relevant, accurate
2. make a proper physical examination
3. order the appropriate laboratory tests and interpret them completely and accurately
4. order the correct images and interventions and interpret them

Happy 5th Blogiversary!

Former plastic surgeon and blogger extraordinaire Dr. Bates of Ramona reflects on his 5 years of blogging and the medical community blogging. http://goo.gl/0EVJW

As blogging has helped me academically. According to Dr. cent: why I write almost everyday, my writing has improved dramatically http://goo.gl/GLNsL

Medicine-Stanford University Grand Rounds and social media

Graham Walker was one of the first medical blogger. Went on a break during his residency in emergency medicine (EM) and now has found new reasons to blog like a EM attending at Stanford University medical center. This is his talk on social media and medicine at Stanford University Grand Rounds: http://youtu.be/qtkggenLmlE

Dr. Walker: "my speech on the dissemination of medical information over time, as the internet and social networking are changing medication, how to use digital tools to be a better doctor at the bedside."

Here is the list of Graham of digital tools to improve the specialty.

Paper-based charts: how soon we forget http://goo.gl/Vspmp -Dr. Wes: suddenly, don't miss the paper charts anymore.

Dr. Wes: is how bad the cardiovascular risk of azithromycin? http://goo.gl/yVgfo -"Big data" related to "big mistake"?

Comments from Twitter:

Seth Trueger @ MDaware: some great stuff in there

Skeptical scalpel @ Skepticscalpel: thanks for including me.

View the original article here

Examples of medical marketing for the week: full body skin cancer scans, robotic hysterectomy

Both of these were sent to me by journalists:

An email pitch letter from a medical group:

Medical Office has First Full Body Scanner to Protect Against Skin Cancer

Dear xxxxx,

We thought that this might make for a very interesting and informative article. With the approach of summer break, this is a time when most people head outdoors. It’s important for people to remember to protect their families against one of the most common forms of cancer today: skin cancer. Current statistics show that 1 in 5 Americans will develop skin cancer in their lifetime.

—- uses the latest technology to detect and protect against skin cancer. They are the only practice in central (could be any state) to offer this system which creates a digital map of the entire body.

Now let’s look at the evidence:  The US Preventive Services Task Force states that “the current evidence is insufficient to assess the balance of benefits and harms of using a whole-body skin examination by a primary care clinician or patient skin self-examination for the early detection of cutaneous melanoma, basal cell cancer, or squamous cell skin cancer in the adult general population.”

The other example came from a journalist who wrote, “Doesn’t it seem particularly exploitative to use a 26-year-old woman’s hysterectomy for this?” The news release/pitch:

Surgeons at xxx Health Center have completed the first robot-assisted surgery in xxxx County.

The first patient was 26-year-old xxx, who underwent a robot-assisted hysterectomy April 13.

Hysterectomies and other gynecological procedures are the first of many robot-assisted surgical procedures that will be offered at xxx.

“We are proud to offer the most high-tech, minimally invasive treatment options available anywhere right here at xxx. Now our patients can benefit from the latest surgical technologies without leaving home,” says (the) president of xxx Health Center.

For advertising disguised as news, see this puff piece in the business section of The Tennessean online, “daVinci robot works miracles.” 

Addendum 5 hours later:  The Nashville Scene website reports, “Tennessean Farms Out Health Section to Hospital Flacks.“  And Paul Raeburn of the Knight Science Journalism Tracker writes:

“The changes come as the Tennessean institutes a paywall for many of its stories. (Newspaper management) said that because of the paywall, “The Tennessean will continue its mission of serving Middle Tennesseans for years to come.”

With regard to some things, maybe. But not with regard to health news. The paper has already failed in that mission.”

Finally, for absurdity in robot hype, see a Seattle doc’s You Tube video of how he used a robotic surgical system to fold a paper airplane – and see how the blogger known as The Skeptical Scalpel grounds that hype.

View the original article here

Examples of medical marketing for the week: full body skin cancer scans, robotic hysterectomy

Both of these were sent to me by journalists:

An email pitch letter from a medical group:

Medical Office has First Full Body Scanner to Protect Against Skin Cancer

Dear xxxxx,

We thought that this might make for a very interesting and informative article. With the approach of summer break, this is a time when most people head outdoors. It’s important for people to remember to protect their families against one of the most common forms of cancer today: skin cancer. Current statistics show that 1 in 5 Americans will develop skin cancer in their lifetime.

—- uses the latest technology to detect and protect against skin cancer. They are the only practice in central (could be any state) to offer this system which creates a digital map of the entire body.

Now let’s look at the evidence:  The US Preventive Services Task Force states that “the current evidence is insufficient to assess the balance of benefits and harms of using a whole-body skin examination by a primary care clinician or patient skin self-examination for the early detection of cutaneous melanoma, basal cell cancer, or squamous cell skin cancer in the adult general population.”

The other example came from a journalist who wrote, “Doesn’t it seem particularly exploitative to use a 26-year-old woman’s hysterectomy for this?” The news release/pitch:

Surgeons at xxx Health Center have completed the first robot-assisted surgery in xxxx County.

The first patient was 26-year-old xxx, who underwent a robot-assisted hysterectomy April 13.

Hysterectomies and other gynecological procedures are the first of many robot-assisted surgical procedures that will be offered at xxx.

“We are proud to offer the most high-tech, minimally invasive treatment options available anywhere right here at xxx. Now our patients can benefit from the latest surgical technologies without leaving home,” says (the) president of xxx Health Center.

For advertising disguised as news, see this puff piece in the business section of The Tennessean online, “daVinci robot works miracles.” 

Addendum 5 hours later:  The Nashville Scene website reports, “Tennessean Farms Out Health Section to Hospital Flacks.“  And Paul Raeburn of the Knight Science Journalism Tracker writes:

“The changes come as the Tennessean institutes a paywall for many of its stories. (Newspaper management) said that because of the paywall, “The Tennessean will continue its mission of serving Middle Tennesseans for years to come.”

With regard to some things, maybe. But not with regard to health news. The paper has already failed in that mission.”

Finally, for absurdity in robot hype, see a Seattle doc’s You Tube video of how he used a robotic surgical system to fold a paper airplane – and see how the blogger known as The Skeptical Scalpel grounds that hype.

View the original article here

Dr Topol to med students: "when I was in medical school, the term" digital "was reserved for the rectal exam"

Here are some excerpts of the Baylor College of Medicine commencement address by Dr. Eric Topol, Director of the Scripps Translational Science Institute, delivered yesterday, May 22, 2012. This should be required reading for anyone involved in health care, which is basically all because everyone of us will be a patient one day.

Eric Topol to medical students: "when I was in medical school, the term" digital "was reserved for the rectal examination".

"Sleep with your cell phone and premium right up there with food and water. We have evolved into a new species of man. We are Homo distractus! "

The benefits of digital medicine are clear to Topol Dr. who shares the story of a patient who has seen last week: "I asked him to put your fingers on the 2 sensors on the back of my iPhone case so I could make her electrocardiogram, ECG — that was normal. And access, among others. Then instead of using a stethoscope to listen to his heart, I used a handheld high-resolution ultrasound pocket and in a minute I could see each facility — heart muscle thickness and heart function, valves, size of 4 Chambers. Why would you ever listen to lub-dub when I can see everything? I have not used a stethoscope for over 2 years to listen to a patient's heart. "

From the YouTube channel of Baylor College of Medicine (BCM): 2012 commencement Speaker, Dr. Eric Topol, May 21, 2012: spoke

Here's the presentation by Eric Topol at the health of Google:

References:

Start address of Baylor College of Medicine by Dr. Eric Topol, Director of the Scripps Translational Science Institute

Comments from Twitter

Trinh Quoc-Dien, MD @ qdtrinh: makes it sound fresh. "@ DrVes: Dr Topol to studs med: when I was in school, the term" digital "was reserved for the rectal exam"

View the original article here

Dr Topol to med students: "when I was in medical school, the term" digital "was reserved for the rectal exam"

Here are some excerpts of the Baylor College of Medicine commencement address by Dr. Eric Topol, Director of the Scripps Translational Science Institute, delivered yesterday, May 22, 2012. This should be required reading for anyone involved in health care, which is basically all because everyone of us will be a patient one day.

Eric Topol to medical students: "when I was in medical school, the term" digital "was reserved for the rectal examination".

"Sleep with your cell phone and premium right up there with food and water. We have evolved into a new species of man. We are Homo distractus! "

The benefits of digital medicine are clear to Topol Dr. who shares the story of a patient who has seen last week: "I asked him to put your fingers on the 2 sensors on the back of my iPhone case so I could make her electrocardiogram, ECG — that was normal. And access, among others. Then instead of using a stethoscope to listen to his heart, I used a handheld high-resolution ultrasound pocket and in a minute I could see each facility — heart muscle thickness and heart function, valves, size of 4 Chambers. Why would you ever listen to lub-dub when I can see everything? I have not used a stethoscope for over 2 years to listen to a patient's heart. "

From the YouTube channel of Baylor College of Medicine (BCM): 2012 commencement Speaker, Dr. Eric Topol, May 21, 2012: spoke

Here's the presentation by Eric Topol at the health of Google:

References:

Start address of Baylor College of Medicine by Dr. Eric Topol, Director of the Scripps Translational Science Institute

Comments from Twitter

Trinh Quoc-Dien, MD @ qdtrinh: makes it sound fresh. "@ DrVes: Dr Topol to studs med: when I was in school, the term" digital "was reserved for the rectal exam"

View the original article here

Best of Medical Blogs-weekly review and blog carnival

The "Best of Medical Blogs-weekly review and blog carnival" is a weekly summary of the best medical Blog post. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best medical blog (BMB) is published every Tuesday, just like the old Grand Rounds.

Cultivate followers on social media, if you want to communicate science

From the blog science Soapbox http://goo.gl/cPQq1 and medical Museion http://goo.gl/QmEU7:

Social media platforms can be very limiting. For example, you can define genotype and Phenotype in 140 characters or less? If you want to use social media to communicate effectively, necessary for readers to drive somewhere.

Write a blog gives substance to your social media presence. You have the opportunity to talk about science in a meaningful way, which ultimately helps people better understand the world around them. Answering these questions is probably because you have first in science. Don't be afraid to share what you've discovered.

Are the doctors are afraid to be wrong?

From blogging to surgeon skeptical Scalpel: «I once did some work as an expert on a malpractice insurance company. Rarely there is a case that doesn't have many opportunities for second-guessing. When you know the outcome, you can always find something in the medical record that could have been done differently.

The current security climate and medicolegal patient creates a feeling among doctors that any mistake is to be extensively examined. This results in a similar situation to an athlete trying not to lose a game instead of trying to win. For those of you unfamiliar with the sport, that the strategy usually fails. Fear of being wrong can lead to excessive test too. " http://goo.gl/FWTbC

When did stop teaching the basics for residents and medical students?

Dr.% of the blog Rants Medical db loves ACGME competency 6 just fine, but also suggests a simple list of http://goo.gl/2sqip:

1. Take a complete history, relevant, accurate
2. make a proper physical examination
3. order the appropriate laboratory tests and interpret them completely and accurately
4. order the correct images and interventions and interpret them

Happy 5th Blogiversary!

Former plastic surgeon and blogger extraordinaire Dr. Bates of Ramona reflects on his 5 years of blogging and the medical community blogging. http://goo.gl/0EVJW

As blogging has helped me academically. According to Dr. cent: why I write almost everyday, my writing has improved dramatically http://goo.gl/GLNsL

Medicine-Stanford University Grand Rounds and social media

Graham Walker was one of the first medical blogger. Went on a break during his residency in emergency medicine (EM) and now has found new reasons to blog like a EM attending at Stanford University medical center. This is his talk on social media and medicine at Stanford University Grand Rounds: http://youtu.be/qtkggenLmlE

Dr. Walker: "my speech on the dissemination of medical information over time, as the internet and social networking are changing medication, how to use digital tools to be a better doctor at the bedside."

Here is the list of Graham of digital tools to improve the specialty.

Paper-based charts: how soon we forget http://goo.gl/Vspmp -Dr. Wes: suddenly, don't miss the paper charts anymore.

Dr. Wes: is how bad the cardiovascular risk of azithromycin? http://goo.gl/yVgfo -"Big data" related to "big mistake"?

Comments from Twitter:

Seth Trueger @ MDaware: some great stuff in there

Skeptical scalpel @ Skepticscalpel: thanks for including me.

View the original article here

Best of Medical Blogs-weekly review and blog carnival

The "Best of Medical Blogs-weekly review and blog carnival" is a weekly summary of the best medical Blog post. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best medical blog (BMB) is published every Tuesday, just like the old Grand Rounds.

Cultivate followers on social media, if you want to communicate science

From the blog science Soapbox http://goo.gl/cPQq1 and medical Museion http://goo.gl/QmEU7:

Social media platforms can be very limiting. For example, you can define genotype and Phenotype in 140 characters or less? If you want to use social media to communicate effectively, necessary for readers to drive somewhere.

Write a blog gives substance to your social media presence. You have the opportunity to talk about science in a meaningful way, which ultimately helps people better understand the world around them. Answering these questions is probably because you have first in science. Don't be afraid to share what you've discovered.

Are the doctors are afraid to be wrong?

From blogging to surgeon skeptical Scalpel: «I once did some work as an expert on a malpractice insurance company. Rarely there is a case that doesn't have many opportunities for second-guessing. When you know the outcome, you can always find something in the medical record that could have been done differently.

The current security climate and medicolegal patient creates a feeling among doctors that any mistake is to be extensively examined. This results in a similar situation to an athlete trying not to lose a game instead of trying to win. For those of you unfamiliar with the sport, that the strategy usually fails. Fear of being wrong can lead to excessive test too. " http://goo.gl/FWTbC

When did stop teaching the basics for residents and medical students?

Dr.% of the blog Rants Medical db loves ACGME competency 6 just fine, but also suggests a simple list of http://goo.gl/2sqip:

1. Take a complete history, relevant, accurate
2. make a proper physical examination
3. order the appropriate laboratory tests and interpret them completely and accurately
4. order the correct images and interventions and interpret them

Happy 5th Blogiversary!

Former plastic surgeon and blogger extraordinaire Dr. Bates of Ramona reflects on his 5 years of blogging and the medical community blogging. http://goo.gl/0EVJW

As blogging has helped me academically. According to Dr. cent: why I write almost everyday, my writing has improved dramatically http://goo.gl/GLNsL

Medicine-Stanford University Grand Rounds and social media

Graham Walker was one of the first medical blogger. Went on a break during his residency in emergency medicine (EM) and now has found new reasons to blog like a EM attending at Stanford University medical center. This is his talk on social media and medicine at Stanford University Grand Rounds: http://youtu.be/qtkggenLmlE

Dr. Walker: "my speech on the dissemination of medical information over time, as the internet and social networking are changing medication, how to use digital tools to be a better doctor at the bedside."

Here is the list of Graham of digital tools to improve the specialty.

Paper-based charts: how soon we forget http://goo.gl/Vspmp -Dr. Wes: suddenly, don't miss the paper charts anymore.

Dr. Wes: is how bad the cardiovascular risk of azithromycin? http://goo.gl/yVgfo -"Big data" related to "big mistake"?

Comments from Twitter:

Seth Trueger @ MDaware: some great stuff in there

Skeptical scalpel @ Skepticscalpel: thanks for including me.

View the original article here

Industry editorial makes outlandish claim about impact of medical devices

Minnesota is the home of several medical device makers.  So there’s been a lot of editorializing about the medical device tax in the Affordable Care Act. There has been some criticism of Minnesota politicians over whose interests they represent on the issue.

Today’s Star Tribune carries a commentary from an industry spokesman – Dale Wahlstrom, president and CEO of LifeScience Alley. He retired from Medtronic in 2006 after 24 years.  His commentary includes this claim:

Medical devices save and improve lives. Between 1980 and 2000, medical device technology slashed the death rate from heart disease by a stunning 50 percent and cut the death rate from stroke by 30 percent. As a result, life expectancy was extended by more than three years.

Please note: I’ve written to a contact at LifeScience Alley asking for the source of that data.  In fairness, he hasn’t had much time to respond but I don’t expect an answer on the data source because I don’t think there is one. I’ll be happy to post an amendment/addendum if/when an answer is forthcoming. That editorial has been published for hours already and I think it’s important to publish even this quick analysis as quickly as I can.

This quote attributes ALL cardiovascular health improvements to devices rather than siphoning off the mere fraction that might be attributable to devices versus drug therapies versus lifestyle changes.

One analysis published in the New England Journal of Medicine concluded:

Approximately 47% of this decrease (in coronary disease death rate) was attributed to treatments, including secondary preventive therapies after myocardial infarction or revascularization (11%), initial treatments for acute myocardial infarction or unstable angina (10%), treatments for heart failure (9%), revascularization for chronic angina (5%), and other therapies (12%). Approximately 44% was attributed to changes in risk factors, including reductions in total cholesterol (24%), systolic blood pressure (20%), smoking prevalence (12%), and physical inactivity (5%), although these reductions were partially offset by increases in the body-mass index and the prevalence of diabetes, which accounted for an increased number of deaths (8% and 10%, respectively).

So a little less than half is attributable to changes in risk factors.  A little more than half to ALL treatments – including drugs, surgery, etc.

The largest reductions in deaths came from the use of secondary-prevention medications or rehabilitation after acute myocardial infarction or after revascularization (a total reduction of approximately 35,800 deaths) and from the use of initial treatments for acute myocardial infarction or unstable angina (approximately 35,145 deaths), followed by treatments for heart failure and hypertension, statin therapy for primary prevention, and treatments for chronic angina.

The editorial is more than a matter of playing loose with the numbers; it is a vast overstatement and a distortion of the evidence. There’s no question that medical devices have contributed to the decline.  It is disingenuous to attribute ALL of the benefit to devices.

I’m not going to comment on the medical device tax.  For now, I’ll leave that to the politicians and special interests.

But on this site, we address and try to correct any misleading claims about medical interventions whenever we see them – whatever the source.  And this editorial made a whopper!

I only hope that such whopping misleading claims aren’t misleading politicians into positions they wouldn’t take if they evaluated the claims.

View the original article here

Industry editorial makes outlandish claim about impact of medical devices

Minnesota is the home of several medical device makers.  So there’s been a lot of editorializing about the medical device tax in the Affordable Care Act. There has been some criticism of Minnesota politicians over whose interests they represent on the issue.

Today’s Star Tribune carries a commentary from an industry spokesman – Dale Wahlstrom, president and CEO of LifeScience Alley. He retired from Medtronic in 2006 after 24 years.  His commentary includes this claim:

Medical devices save and improve lives. Between 1980 and 2000, medical device technology slashed the death rate from heart disease by a stunning 50 percent and cut the death rate from stroke by 30 percent. As a result, life expectancy was extended by more than three years.

Please note: I’ve written to a contact at LifeScience Alley asking for the source of that data.  In fairness, he hasn’t had much time to respond but I don’t expect an answer on the data source because I don’t think there is one. I’ll be happy to post an amendment/addendum if/when an answer is forthcoming. That editorial has been published for hours already and I think it’s important to publish even this quick analysis as quickly as I can.

This quote attributes ALL cardiovascular health improvements to devices rather than siphoning off the mere fraction that might be attributable to devices versus drug therapies versus lifestyle changes.

One analysis published in the New England Journal of Medicine concluded:

Approximately 47% of this decrease (in coronary disease death rate) was attributed to treatments, including secondary preventive therapies after myocardial infarction or revascularization (11%), initial treatments for acute myocardial infarction or unstable angina (10%), treatments for heart failure (9%), revascularization for chronic angina (5%), and other therapies (12%). Approximately 44% was attributed to changes in risk factors, including reductions in total cholesterol (24%), systolic blood pressure (20%), smoking prevalence (12%), and physical inactivity (5%), although these reductions were partially offset by increases in the body-mass index and the prevalence of diabetes, which accounted for an increased number of deaths (8% and 10%, respectively).

So a little less than half is attributable to changes in risk factors.  A little more than half to ALL treatments – including drugs, surgery, etc.

The largest reductions in deaths came from the use of secondary-prevention medications or rehabilitation after acute myocardial infarction or after revascularization (a total reduction of approximately 35,800 deaths) and from the use of initial treatments for acute myocardial infarction or unstable angina (approximately 35,145 deaths), followed by treatments for heart failure and hypertension, statin therapy for primary prevention, and treatments for chronic angina.

The editorial is more than a matter of playing loose with the numbers; it is a vast overstatement and a distortion of the evidence. There’s no question that medical devices have contributed to the decline.  It is disingenuous to attribute ALL of the benefit to devices.

I’m not going to comment on the medical device tax.  For now, I’ll leave that to the politicians and special interests.

But on this site, we address and try to correct any misleading claims about medical interventions whenever we see them – whatever the source.  And this editorial made a whopper!

I only hope that such whopping misleading claims aren’t misleading politicians into positions they wouldn’t take if they evaluated the claims.

View the original article here