A JAMA Surgery Viewpoint recently suggested that because of the findings of a Finnish randomized trial, surgeons now should give patients with appendicitis a choice between an appendectomy or treatment with antibiotics. The paper acknowledged my criticisms of the Finnish study that found that simple appendicitis could be treated successfully with antibiotics in almost 75 percent of patients. I respect the authors of the JAMA Surgery article and am happy they ...

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A Kentucky appeals court ruled that a surgeon was not responsible for a burn caused by an instrument that had been removed from an autoclave and placed on an anesthetized patient's abdomen. According to an article in Outpatient Surgery, the surgeon was not in the room when the injury occurred and only discovered it when he was about to begin the procedure. An insufflator valve had been sterilized and was ...

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Incident reports are frequently submitted by hospital personnel. Did you ever wonder what happens to them? I have. Over the years, I estimate that I’ve heard of hundreds of such reports being filed, but rarely have I heard of a problem being solved or for that matter, any action being taken at all. In fact, I don’t even know where they went or who dealt with them. When I was a department ...

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A new television series called Code Black debuted on CBS. The show’s name supposedly means the emergency department has too many patients and not enough staff. In my over 40 years in medicine, I’ve seen many busy, understaffed EDs but never heard anyone call it a Code Black. There is the usual array of standard medical characters -- the inexperienced new residents on their first day at work, the savvy nurses, ...

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At the end of an otherwise informative article about the nuances of performing a Heimlich maneuver, New York Times science reporter Jane E. Brody recommends that if all else fails, a cricothyrotomy should be attempted. She goes on to briefly explain how the procedure is done. In the right hands, a cricothyrotomy is safer and easier to perform than a formal tracheostomy. However, for a layperson who has never seen either ...

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In 2013, the American Medical Association recognized obesity as a disease. Dr. Peter Ubel, writing in his blog on the Forbes website, thought this was a bad idea. He feared that calling obesity a disease will result in people having less motivation to lose weight and cited a study which found that people who were told that obesity is a disease tended to be less concerned about their ...

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shutterstock_280962767 The long-awaited Finnish randomized controlled trial of antibiotics vs. surgery for appendicitis was just published in JAMA. Depending on your perspective, 73 percent of patients were successfully treated with antibiotics or 27 percent of patients failed antibiotics and needed surgery. The good news is that it was a large multicenter study involving 273 patients randomized to surgery and 257 to ...

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shutterstock_144006859 A loyal reader alerted me to news of a lawsuit brought by an obstetrician in South Carolina who is suing a hospital for suspending his privileges. He had performed a cesarean section while sitting on a stool because he had a foot fracture secondary to diabetes. Several witnesses said that the doctor "had been unable to properly view the ...

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shutterstock_111214139 A chief resident about to graduate wrote the following to me:

I just read -- twice -- the New Yorker's review of Henry Marsh's memoir you tweeted about. Wow. It seems like he is grappling with so many of the things I'm feeling now, as I'm trying to sort out if I'm trained "enough" to head out into the world. Of ...

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A company has produced prototype robots that can draw blood from human arms. The video above is a 48-second video showing one of them in action. Using an infrared camera, the robot identifies a suitable vein and accesses the vein with ultrasound guidance. A second video, not embedded in this post, explains that the robot is about 83 percent successful at drawing blood that compares favorably to the success ...

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