Clostridium difficile colitis and you, a video tutorial

Learning can be fun!

Just say no to antibiotics you don’t need.

The ultra-awesome ZDoggmd.com

How large is a British watermelon?

You’ll probably regret asking.

A Las Vegas man who suffers from a rare condition that made his scrotum swell to 100 pounds is basking in the fame that his giant organ has brought him.

The watermelon-size scrotum Mr Warren carries between his legs has landed him on the Howard Stern Show and the Comedy Central program Tosh.0 and made him a local celebrity in his hometown.

via Wesley Warren Jr: Man with 100-pound scrotum REJECTS free $1m corrective surgery | Mail Online.

Emphasis added.

Here’s a family safe pic:

how large are British watermelons, again?

Okay, how large are British watermelons, anyway?

Our unrealistic views of death, through a doctor’s eyes – The Washington Post

I know where this phone call is going. I’m on the hospital wards, and a physician in the emergency room downstairs is talking to me about an elderly patient who needs to be admitted to the hospital. The patient is new to me, but the story is familiar:

via Our unrealistic views of death, through a doctor’s eyes – The Washington Post.

Very Well Done. #fb

HCC Blog calls it quits

Dear Readers,

It has been my pleasure over the last 4 years to blog on HCC-related topics and exchange ideas with many of you. I have learned a ton from everyone.

This is my last post and I anticipate retiring the blog by the end of the month.

via HCC Blog » hccblog.

Another good blogger taps out. Too bad.

The Worst Quackery of 2011: Battlefield Acupuncture – Forbes

So: the 2011 winner of the worst quackery award is: battlefield acupuncture. This bizarre practice, invented just 10 years ago, offers a trifecta of ills:

It offers no medical benefit and carries a real risk of harm for some patients.

The U.S. government is wasting tens of millions of dollars per year on it, and plans to increase its spending next year.

The patients are wounded combat veterans who have no choice about where to get treatment.

In battlefield acupuncture, the “doctor” (no competent doctor would do this) sticks needles into the patient’s ear to relieve pain.

via The Worst Quackery of 2011: Battlefield Acupuncture – Forbes.

Incredible. And infuriating.

(Found on Twitter, but I cannot recall who tweeted it).

Just Say No: FDA permits marketing of the first hand-held device to aid in the detection of bleeding in the skull

I read that headline and said, “Wow!, finally I won’t need to CT all those patients’ heads!”

FDA permits marketing of the first hand-held device to aid in the detection of bleeding in the skull

Helps to determine if immediate CT scan is needed

The U.S. Food and Drug Administration today allowed marketing of the first hand-held device intended to aid in the detection of life-threatening bleeding in the skull called intracranial hematomas, using near-infrared spectroscopy.

via Press Announcements > FDA permits marketing of the first hand-held device to aid in the detection of bleeding in the skull.

But then, wait, said I, is it any good? Apparently Not:

The FDA granted the de novo petition for the Infrascanner Model 1000 based on a review of data comparing results from 383 CT scans of adult subjects with Infrascanner scan results. The Infrascanner was able to detect nearly 75 percent of the hematomas detected by CT scan. When CT scans detected no hematoma, the Infrascanner detected no hematoma 82 percent of the time. The Infrascanner Model 1000, however, is not a substitute for a CT scan.

Anyone considering purchasing one of these based on those numbers? If so, I’ll sell you a random number generator for 1/2 of what they’re asking.

Stated another way, this device will miss more than 25% of intracranial hematomas that are present, and will tell you it’s there when it’s not 18% of the time.

Not ready for prime time. I feel bad for the detailers who are sent out to see this thing, and worse for the patients it’s used on.

 

Brought to my attention by @EMNews on twitter. (In case you missed it, I’m getting a lot of my bloggable stuff from Twitter. I don’t blog most of what I comment on. Imagine what you’re missing! Get to twitter, and follow me @gruntdoc).

How Doctors Die « Zócalo Public Square

Worth your time.

It’s Not Like the Rest of Us, But It Should Be

via How Doctors Die « Zócalo Public Square.

We Are All Criminals Now : PANDA BEAR, MD

Panda has resurfaced.

This is not a Panda that eats bamboo, but from all appearances feasts on spleens. Angry ones.

In fact, I was once texting while standing at the nursing station and some supervisor of something-or-another told me that cell-phones were not allowed and then looked on in helpless fury as I laughed and took his pictures to text to my friend. This is a good way to make enemies and I’m sure I’m going to be the first one up against the wall when “Papa Doc” Press Gainey is installed as out Great Leader and Ruler for Life but I did not come through the irritating hell of medical school and residency to be scolded by a bureaucrat like some wayward candy striper.

via We Are All Criminals Now : PANDA BEAR, MD.

I wish I wrote that well.

[AP] Doctor in nurse retaliation surrenders license | arafiles, retaliation, roberts – Odessa American Online

Update: 2 months in jail, then probation.

TO recap: Sheriff Roberts and County Attorney Tidwell got jail time for their role in this sordid misuse of power, and the doctor at the center of this mess now cannot practice medicine.

We’ll have to wait to see if he gets jail time from this.

[AP] Doctor in nurse retaliation surrenders license

November 04, 2011 4:19 PM

THE ASSOCIATED PRESS

AUSTIN A doctor accused of retaliating against two whistle-blowing West Texas nurses has agreed to surrender his medical license.

Dr. Rolando G. Arafiles signed an agreed order with the Texas Medical Board Friday stating he will stop practicing medicine.

via [AP] Doctor in nurse retaliation surrenders license | arafiles, retaliation, roberts – Odessa American Online.

Unfortunately, it’s still not over. Arafiles is still under indictment for aggravated perjury in Andrews County for his statements in the Nurse trial.

None of this restores the careers of the two nurses who were the victims of this.

World’s first malaria vaccine works in major trial | Reuters

Okay, like all of us I want an effective and safe malaria vaccine, and the tone of the article is hopeful. But…

The trial is still going on, but researchers who analyzed data from the first 6,000 children found that after 12 months of follow-up, three doses of RTS,S reduced the risk of children experiencing clinical malaria and severe malaria by 56 percent and 47 percent, respectively.

Loucq said widespread use of insecticide-treated bednets in the trial — by 75 percent of people taking part — showed that RTS,S can provide significant protection on top of other existing malaria control methods.

via World’s first malaria vaccine works in major trial | Reuters.

We’ll have to read the study, but if you’re mixing a change in bednet use AND a new vaccine, well, let’s hope they were measuring what they thought they were.

Obama Administration to Ban Asthma Inhalers Over Environmental Concerns

This underestimates the increased cost by a huge factor…

Remember how Obama recently waived new ozone regulations at the EPA because they were too costly? Well, it seems that the Obama administration is would rather make people with Asthma cough up money than let them make a surely inconsequential contribution to depleting the ozone layer:

Asthma patients who rely on over-the-counter inhalers will need to switch to prescription-only alternatives as part of the federal government’s latest attempt to protect the Earth’s atmosphere.

…But the switch to a greener inhaler will cost consumers more. Epinephrine inhalers are available via online retailers for around $20, whereas the alternatives, which contain the drug albuterol, range from $30 to $60.via Obama Administration to Ban Asthma Inhalers Over Environmental Concerns.

I added the bold in the quote to show where the increased cost is coming from: these people (who were buying these old inhalers without a prescription) are now going to have to see someone with a prescription pad, pay for that visit, and then go buy the more expensive inhalers.

The FDA made the prescription inhaler manufacturers take out the CFC’s a few years ago, and the prices of those inhalers went up substantially.

For the record, I think all these inhalers should be OTC: they’re safe and affective. Off the top of my head, 90% of the meds on the WalMart $4 list should be OTC as well.

Congressman Phil Roe performs CPR on man at airport | Reuters

Nice!

(Reuters) – Representative Phil Roe retired from his medical career to go to Congress, but on Tuesday he put his doctor skills to use to help save a man’s life at a Charlotte, North Carolina airport.

via Congressman Phil Roe performs CPR on man at airport | Reuters.

via Drudge

Police arrest teen impersonating physician assistant

Oof. Stand by for a LOT of hospital HR overreaction…

KISSIMMEE, Fla. (WOFL FOX 35) – Seventeen-year-old Matthew Scheidt is in custody at a juvenile detention center after Kissimmee Police arrested him for allegedly impersonating a physician’s assistant. They say he posed as P.A. for two weeks at Osceola Regional Medical Center.

via Police arrest teen impersonating physician assistant.

There’s a point where ambition meets crazy, and I think this guy found it.

Dr. Wes: On Closure

Nice post!

“Closure” is the time in medicine where we either revel in our success or squirm in our failure. It’s where we must face the music – good or bad – with our patients. More often than not, it’s the time for doctors that brings meaning to our efforts and the hours we work.

via Dr. Wes: On Closure.

Suture for a Living: Changes

Wow. Imagine stopping being a surgeon. It’s such a part of your life, your identity.

Due to many things, I will be closing my practice over the next few months and going to work for the Arkansas Disability Determination Services DDS. I only recently made the final interview and signed the contract. My first day there will be October 3rd. I don’t want to discuss the reasons, but I want you to know how difficult a decision this has been for me.

via Suture for a Living: Changes.

We’re lucky she shares what she does with us, and I hope someday she can tell us what happened, if only to give courage to other docs looking at a career transition.

 

Best of Luck, Dr. Bates!