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How many babies can one woman carry?

That’s a question I was asked more than once, in light of this week’s story about the birth of octuplets.

For the answer, I’ll refer to this article in Slate. The largest reported number of fetuses in a single womb is 15.

The limit is not so much the number of fetuses, but the combined size and weight. As Christopher Beam explains, “once the total …

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Does the President need blood stored in his limousine?

Apparently, the Presidential limousine has a compartment that stores pre-crossmatched blood, just in case.

How necessary is this, considering the fact that a designated emergency department will never be far off for the President?

And in case the unforeseen happens, is transfusing blood in the field the best option for fluid resuscitation, rather than simply giving intravenous saline or crystalloid?

If anything, emergency physician Shadowfax writes, …

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Her hands and feet amputated, a Brazilian model dies from Pseudomonas aeruginosa sepsis. What happened?

Mariana Bridi da Costa, a 20-year old Brazilian model, tragically died early Saturday morning from Pseudomonas aeruginosa urosepsis.

How can this happen?

Miss Bridi da Costa initially presented on December 30th, and was diagnosed with kidney stones. An ultrasound, plain film, or CT scan likely would have been done to confirm the diagnosis. I assume that a urinalysis was also performed, and if …

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Is The Dark Knight’s Two-Face a realistic depiction of third-degree burns?

The answer is no.

Patient-blogger Duncan Cross takes exception to the cavalier treatment director Christopher Nolan gives to third-degree burns in Aaron Eckhart’s super-villain.

“There is no way that eye would have survived intact, much less be able to function without a lid and tear ducts,” he writes.

And his refusal of pain medications in the film? “The idea that someone could suffer Dent’s injuries, …

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What do doctors look for when they examine the abdomen?

A primary care doctor guides us through the abdominal physical exam.

He deciphers the much-written notation of “Abd: Soft, NT, Normal BS, no HSM or masses*,” and explains what physicians look for when they poke, prod, percuss, and listen to when examining a patient’s belly.

You’d be surprised at some of the things we find simply by pressing on the abdomen.

* For those who need translation, …

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Are there too many hospitals?

Should hospitals be run more like fire departments?

“Each neighborhood has its own firehouse,” says #1 Dinosaur, adding that “because the training is generally similar from one company to another, you don’t have huge, expensive advertising campaigns touting the superiority of the Main Street Fire Company over the one on Church Street.”

Calling it “the ultimate in capitation,” he envisions hospitals to be funded like police and …

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Jett Travolta’s seizure and death, was Scientology a factor?

Jett Travolta tragically passed away yesterday, after being found unconscious in his hotel room by his caretaker. There is speculation that he had a seizure and hit his head on a bathtub.

Travolta apparently had a long history of medical problems, including Kawasaki disease, which is a vasculitis that primarily affects children. It is one of the most common causes of acquired heart disease in children, and …

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Can you be too aggressive in silencing disruptive doctors?

What if a doctor wanted to speak up to promote better patient care?

It can be difficult under the new Joint Commission guidelines, which casts a wide definition of what a “disruptive physician” means, giving examples like “reluctance or refusal to answer questions, return phone calls or pages; condescending language or voice intonation; and impatience with questions.”

Like any profession, some doctors are indeed jerks. But Doug …

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Can Good Samaritans be sued for providing medical help?

A controversial ruling in California is making people think twice before stopping to help.

California’s Supreme Court has ruled that “the state’s ‘Good Samaritan’ law providing tort immunity for rescuers applies only to medical personnel providing medical help at an emergency scene, and not to civilians.”

But are physicians really protected? This doctor cites colleagues who are “afraid to stop at the scene of an …

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How Hurricane Ike destroyed a medical center

Last month’s hurricane hit the University of Texas Medical Branch at Galveston particularly hard, with the institution suffering $700 million in damage:

It cannot begin to take on patients, open up wings and generate revenue until it repairs critical operations like its blood bank, pharmacy, kitchens and radiology department, but it lacks the millions needed for the repairs, and so far the federal and state governments have not come through …

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Buy a condo, concierge medicine included

In the tough real estate market, luxury condominiums have to be creative with marketing:

Along with butler and concierge service, spa and sauna, buyers who purchase homes at the new luxury high-rise the Mansion on Peachtree receive two years of service from MD on Call, a mobile medical practice that treats patients in their homes.

Doctors from the service can see patients in their homes, and offer “everything from a throat culture …

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The fourth year of medical school

It’s often seen as the light at the end of a rigorous tunnel of training. Filled with residency interviews, sub-internships, and elective rotations, this year is often the most enjoyable. Here’s what to expect.

topics: medical school, residency

How doctors are losing compassion

In his regular WSJ column, family physician Ben Brewer laments the lack of compassion and empathy in the medical profession:

Somewhere along the line too many doctors stopped being healers and became prescribers and technicians.

We became business people and started thinking in terms of relative value units — the coin of the medical finance realm — as much as how to make patients better. We took seminars …

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Sharpie for surgery

Surgeons use markers to identify the right body part for procedures. Unfortunately, they care become contaminated with bacteria which can lead to surgical site infections.

Enter the Sharpie: “As it turns out, the ink used in a Sharpie pen has an alcohol base, making it an unexpected germ fighter.”

Who knew? The Sharpie is probably also many times cheaper than the single-use “sterile” pen used …

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Tom Brady and his knee infection

New England Patriots quarterback Tom Brady recently underwent repair of his anterior cruciate ligament at the Kerlan-Jobe Orthopaedic Clinic in Los Angeles. His doctor was Neal S. ElAttrache, who’s a renowned orthopedic surgeon and former team physician of an NFL team.

Unfortunately, his post-op course has been complicated by an infection. On his website, TomBrady.com, he acknowledged this and said that the original procedure was …

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Free health care in Hawaii

Doug Farrago comments on the failure of universal children’s coverage in Hawaii, where the program was discontinued after 7 months. It’s a good example of what would happen if health care was “free”:

Families that had private coverage were dropping it so they could get the free care as well. I don’t think this experiment should be ignored. It really needs to be examined to see what went wrong …

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Are MRI results accurate?

Most physicians and patients think that the MRI scan is one of the more sensitive and comprehensive diagnostic tests.

However, there is significant variability in reading and performing the scans, which makes having it done at a reputable institution more imperative:

Magnetic resonance machines, though, vary enormously, and not just in the strength of their magnets. Even more important, radiologists say, is the quality of the imaging …

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Medical school and suicide

A recent Annals study brings attention to medical school burnout, with 11 percent of students contemplating suicide in the past year. “The link was strong and independent of symptoms of depression,” says Tait D. Shanafelt, MD, director of the Mayo Clinic Dept. of Medicine Program on Physician Well-Being.

Scary.

Perhaps one reason is that, with a proportion of students getting a “C” grade or lower, it’s the …

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