A resident tells us what he really thinks
As someone who went through a city hospital residency, I can understand that sometimes things look pretty bleak. Complaining about insurance companies, lawyers, or the government is fine - however, blaming the patients isn't really the answer.

Dr. Centor writes about a physician's "code of silence"
"I guess we live in a 'secret society'. We must hold these stories confidential - except as stories to share with colleagues (omitting names and identifiers of course).

But, it really is not a lonely life. It is a life full of the privilege of caring for others. But we often cannot talk about it or explain it. And ...


code blog with the twenty days of Grand Rounds

Some experts are suggesting using the Framingham 10-year CVD risk calculator to help determine whether patients should stay on COX-2s
That's not a bad idea. The calculator can be found here.

Beware of what you buy over the internet
Salves bought over the internet for non-melanoma skin cancers can cause deep tissue necrosis.

40 percent of the low-income, rural women over age 40 did not know mammograms check for breast cancer
That is not acceptable in this day and age. Clearly we have more work to do with patient education.

An update on the people who injected themselves with real botulism toxin
Botulism was pretty low on the differential - dehydration was the initial diagnosis.

An interesting study correlating left-handedness with a society's homicide rate
"While there is no suggestion that left-handed people are more violent than the right-handed, it looks as though they are more successfully violent. Perhaps that helps to explain the double meaning of the word 'sinister'." (via kottke.org)

Lung Ailment May Have Killed White
The diseases in question are sleep apnea (discussed yesterday) and sarcoidosis (a disease that causes inflammation of the body's tissues - especially affecting the lung). Medrants has more on this.

The Painkiller Panic
"One of the most frustrating things about the latest news on painkillers is that almost none of the people reporting it understand the concept of relative risk--i.e., that a doubling of adverse events like heart attacks still doesn't mean that event is very likely. A doubled risk might well be a chance worth taking, especially if the baseline risk is low to begin with and the drug's ...


shrinkette has a good list of charitable organizations for victims of the tsunami disaster
This was the world's most powerful earthquake in 40 years, measuring 9.0 in magnitude.

Both films accurately portray amnesia. Regarding Memento:

Writing in the BMJ, Dr Sallie Baxendale of the National Society for Epilepsy, said: "Unlike most films in this genre, this amnesiac character retains his identity, has little retrograde amnesia [where memories of the period just prior to the injury are lost] and shows several of the severe everyday memory difficulties associated with the disorder."
The same ...


Today was a sad day in the NFL, as future Hall-of-Famer Reggie White passed away Sunday morning.

Cause of death wasn't clear, with an autopsy planned in the next few days. His wife suggested it was due to his sleep apnea:

Through the family pastor, Sara White confirmed her husband's death, saying that she believes White died of respiratory failure related to his sleep ...


Studies on Painkillers In Jeopardy
"John Breitner of the University of Washington in Seattle, who led the Alzheimer's trial, said the hint of risk for naproxen was far from clear from his data, and the main reason his trial shut down was because so many participants were worried about Celebrex.

'The reasons we had to suspend the treatments had less to with the perception of danger . . ...


Mass Chaos
A physician in Iraq blogs from the front lines (via Medpundit). This incredible story was from the attack in Mosul last week. Here were the grisly statistics that day:

91 total patients arrived.
18 were dead on arrival.
4 patients died of wounds shortly after arrival, all of these patients had non-survivable wounds.

Of the 69 remaining patients, 20 were transferred to military hospitals in other ...


Risks lead doctors to prescribe fewer pain meds
"Siff said legal liability concerns also played a role in his decision to discourage patient use of Celebrex and Bextra. Merck & Co. already is facing litigation over Vioxx.

'Many of the things we do we do to protect ourselves from being sued,' Siff said."

So true. The data is still preliminary (and in the case of Naproxen,

Baby believed to be world's smallest at birth ready to leave Chicago hospital

"A baby who weighed less than a can of pop when she was born by Caesarean section three months ago is nearly ready to be released from hospital.

She is believed to be the smallest baby in the world ever to survive. The little girl, named Rumaisa, whose parents came from Hyderabad, India, weighed 8.6 ...


Pay Bills or Pay for Medications?
"With her prescription drugs totaling more than $550 a month, 70-year-old Virginia Norman often had to choose between taking her medications and paying her bills. Norman is just one of the millions of Americans who can't afford to purchase their necessary medications each month."

An unfortunate choice for many seniors. A previous study reported the price of not taking medication hurts ...


West Boca Medical Center sued over woman's death
"Barbara Masterson, 52, deteriorated from cerebral bleeding in the
emergency room of the West Boca Medical Center as hospital staff
unsuccessfully tried to find a neurosurgeon to perform life-saving
surgery, according to a lawsuit filed Friday in Palm Beach County
Circuit Court."

According to the lawyer: "They refused to take any neuromedical emergency," Cohen said. "The hospital knew this was a ...


Lawsuits limit cancer tests
"Experts and doctors agree that not enough Florida women are getting mammograms, but the cause of the shortfall has provoked a sharp debate.

Now, a task force appointed by the Legislature and the governor is blaming lawsuits for discouraging radiologists from offering mammograms, which could reduce the availability of the test."

Mammograms can be notoriously subjective, and thus a perfect area for ...


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