Wisconsin Senate Approves Limits On Noneconomic Damages In Malpractice Suits:
[Via UK Medical News Today]
My smart wife tells me that this article is really big news: Early Downward Trends in Neurodevelopmental Disorders Following Removal of Thimerosal-Containing Vaccines (pdf). I've quoted the entire abstract below:
The big news is the last sentence: trends in newly diagnosed ND's [ed: autistic spectrum disorders] correspond directly to the expansion and subsequent contraction of the cumulative mercury dose to which children were exposed from TCVs through the U.S. immunization schedule.
There were suspicions during the time that vaccines contained Thimerisol that it was responsible for an associated increase is the so-called autistic spectrum disorders. The suspicion was based on reports of increases in autism in the community. These were explained away by the observation that diagnosis had become much better during the same time period and the fact that scientific data supporting such a link were of very poor quality. Nonetheless, many parents chose to forgo immunization of their children out of concern that vaccination would increase their risk of autism or related disorders. Skipping immunization did not increase their risk of infectious disease because of herd immunity, up until enough members of a population are unprotected and disease can once again propagate among the non-immunized.
There are ongoing flame wars among blogs about this issue, but his article should cause many of those involved to rethink their position.
Desperate for Dollars - The Nation of Guinea Pigs:
[Via digg]
Bird Flu Found in Cat in Germany after eating infected bird.
Injury and Liability Associated with Monitored Anesthesia Care: A Closed Claims Analysis.:
[Via Anesthesiology]
Would you treat patients any different if you knew you only had six weeks to live? The iTunes Music Store has an Oscar-nominated short film titled Our Time Is Up (requires iTunes). If you're a therapist or psychiatrist, it's worth the $1.99 price ten times over.
Gum Chewing May Speed Recovery From Postoperative Ileus:
Something to mention across the ether screen Monday....
[Via Medscape Headlines]
[via LifeHacker]
Just Google 'Olympic Medals' to see the top three countries in the medals race.
via [LifeHacker]
The anesthetist can have a significant impact on the operating conditions a neurosurgeon has to work with. One example is a situation where the surgeon (or anesthetist) notices the brain no longer appears relaxed but begins to get 'tight' within the craniotomy window. Rather that a knee-jerk response of further hyperventilating the patient and/or giving Mannitol, it is prudent to first consider possible causes as follows:
As taught to me by John Drummond, M.D. at UCSD
Aspect Medical is the company that sells the 'awareness' monitors for anesthesia. Their product is the one featured so prominently in photos accompanying every print story I've seen on intra-operative awareness. This Yahoo Finance headlines seems to indicate it's paying off:
Full disclosure: I still don't use a BIS monitor
[Via Yahoo Search: anesthesia]
I think this is noteworthy because, in terms of complications, we used to think that one would need to quit smoking for at least six weeks before surgery for there to be any benefit. Though that may still be true, this review seems to indicate that if someone were to quit around time of surgery, their chances of success are better.
[via Newswise]An organization called Doctor's Advocate is announcing it's first successful effort to stop a 'frivolous' lawsuit in Pennsylvania: Doctor's Advocate Terminates First Frivolous Medical Malpractice Lawsuit; Case Against OB-GYN Dropped in Seven Weeks:
Here's the background on the organization: "Doctor's Advocate works to reverse the medical malpractice crisis and keep doctors in Pennsylvania by raising public awareness, lobbying for legislation to produce tort reform, and combating frivolous lawsuits with an inexpensive legal service."
Looks like being a member costs $1200 per year.
My Google News section on 'epidurals' came up with an interesting hit: Lower-back tattoos are popular with women, but do they make having epidurals during childbirth more dangerous?. It's a very good question because, at least in my practice, lower back tattoos are extremely common in laboring women. So common, in fact, that Saturday Night Live has a commercial parody for a product called Turlington's Lower Back Tattoo Remover (quicktime | windows media).
I was taught to avoid putting an epidural needle through tattooed skin and have gone to great lengths to do so. For example, one patient had a very large tattoo of what appeared to be the face of the devil on her lower back. On closer inspection, I noticed that the devil's right nares (which was free of tattoo ink) was right over her L3-4 interspace. I wished I'd taken a picture of that epidural catheter snaking out of the devil's nose.
I can't seem to find much science on the subject save for one abstract which makes a very reasonable suggestion to avoid coring out tattooed skin by making a small incision, if necessary. This may sound like a lot of trouble, but all it takes is a 16 gauge (or similarly large) hypodermic needle inserted into the skin first, then the epidural needle through that 'incision'.
Also via A Chance To Cut is a Chance to Cure, a pointer to a new stethoscope: 3M Littmann Electronic Stethoscope Model 3000
Listening to a patient's heart and lungs before anesthesia is something I don't do nearly enough. This may just be the gadget that makes it fun again...
A Chance To Cut is a Chance to Cure points to a cartoon or music that may not be right for the operating room.
It reminded me of a post at my first blog (which I'm reposting below):
A colleague pointed out to me that there are certain songs one should probably not play, or at least not while the patient is awake. What follows is his list of songs not to play while the patient is awake (with iTunes Music Store links where possible):
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