Faster X-Ray Vision

Just when you thought that there was nothing new in plain radiography, I read about Statscan.

The Statscan Critical Imaging System is a flexible format digital radiography (DR) system aimed specifically at the needs of emergency medical centers and is designed to meet the radiography needs of both trauma patients and standard emergency patients. Statscan gives critical life-saving

information to the medical staff by enabling them to have a complete picture—literally from head to toe—of a patient’s injuries, faster and with less interference with patient stabilization efforts than ever before possible.

I remember once that we had a trauma patient with multiple fractures, but no internal injury. I was trying to get the X-rays done so that the ortho team could take the patient to the OR. The junior ortho resident told me not to worry about it, they would just fluoro the entire patient as a screen, and then get dedicated films of the positive fractures. It was quick, and worked well for that patient. Now I hear that Lodox came up with a product that takes this concept one step further.

The idea of entire body radiogrpahy grew out of the need for security at South African diamond mines. I'm not sure a daily X-ray at the end of your shift is the greatest idea, but it definitely kept the miners from getting sticky fingers, and taking some product sample home from the mine.

Now the Statscan machine claims that they can radiograph an entire body in as little as 13 seconds. At my institution, I can't even find the radiology tech that quickly to get the portable X-ray machine! Seriously, we can often get a CT scan faster than a plain film. This could definitely help speed up care in many patients. The Statscan would also be wonderful for those trauma patients that complain of pain from head to toe, and you're obligated to order a ton of X-rays.

Reportedly, the entire body film is viewed on a computer workstation monitor. The standard is an AP view, but a lateral can also be done. There seem to be some issues in neck clearance by Statscan imaging alone, but this is useful as a screen, and for fracture workup.

The Statscan is on my Christmas list!


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X-ray Diagnosis of the Week...

From Oldster-

For the diagnosis, click here.



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What's that sound?

From TechNudge:

An electronic stethoscope that doubles as a virtual patient [by simulating patients' heart sounds] dramatically improved the accuracy of medical residents in identifying heart sounds, according to a study presented today at the American College of Cardiology.

Research has revealed an alarmingly low 21 percent accuracy rate among medical residents using a stethoscope to discern abnormal heart sounds. To address this handicap, ...Michael Barrett, M.D., clinical associate professor of medicine and cardiologist at Temple University School of Medicine and Hospital, used an electronic stethoscope that plays back recorded heart sounds with a group of residents and asked them to listen repeatedly to each one.

Good to know, just in case the echo machine is getting serviced.

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On Bird Flu & Person To Person Transmission

From Red Herring:

Scientists said Thursday they have pinned down why the H5N1 bird flu virus has trouble jumping from person to person, even though it can replicate efficiently in human lungs.

Currently, nearly all the 184 cases of H5N1 human infections, which have led to 103 deaths, have occurred because people picked up the virus from birds.

The virus has the potential to become a pandemic strain if it develops the ability to move easily between people in their coughs and sneezes, for instance, much like seasonal influenzas.

Published in the journal Nature, scientists from the University of Wisconsin, Madison and the University of Tokyo, Japan, have found that H5N1 needs to replicate more in cells higher up in the airway to make this possible.

The human viruses responsible for seasonal flus and the deadly H5N1 bird flu virus bind to slightly different versions of the same molecule. Found on the surface of cells which line the airways of the lungs, this molecule seems to hold the key to the development of a pandemic strain.

The version bound by common human flus tends to be found higher up in the respiratory tract, whereas the version of the molecule bound by H5N1 occurs in the air sacs located at the deepest part of the lungs.

Put simply, the higher up in the lungs the virus replicates, the better chance it has of being carried out of the lungs in a cough or a sneeze.

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On Hand Sanitizers

From NY Times:

Many such sanitizers — whether a brand name or a generic version — work well, and are increasingly found in hallway dispensers in hospitals, schools, day care centers and even atop the gangways of cruise ships as one more safeguard against the hand-to-mouth spread of disease. Several studies from such settings have shown that use of the alcohol-based rubs on hands that aren't visibly soiled seems particularly helpful in curbing the spread of bad stomach and intestinal bugs.

But a study published in this month's issue of the journal Emerging Infectious Diseases found that at least one brand of sanitizer found on store shelves, as well as some recipes for homemade versions circulating on Web sites about crafts or directed at parents, contain significantly less than the 60 percent minimum alcohol concentration that health officials deem necessary to kill most harmful bacteria and viruses.

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TGIF

Here is a little something for first year students or those wishing to enter. It was originally published under another name. Hope this helps.

Dont ask me but somehow I received your message about Medical School. I am just starting my 3rd year clerkships as a medical student at LSU in New Orleans, LA. There are a few things I would like to tell you before you start medical school....and, of course, these are only my opinions and may not represent the opinions of anyone else in this entire world....so take it with a grain of salt.

01 - Everyone, including my doctor, told me to get the hell out of medicine before I got in.

02 - I busted my ass in high school, college, etc...to get to med school.

03 - Once in medical school, what you did to get you there no longer matters.

04 - Be prepared to study....then study somemore, and then a little more... and then be prepared to not do well on the test.

05 - Be prepared to accept the reality that you may be an idiot (this came as a shock to me).

06 - Be thankful that everyone else in your class is also an idiot and no one expects you to know everything all at once, and for every test.

07 - Realize that getting ahead in med school means making lots of friends ... those who step on toes to get to the top are quickly shunned by the rest of the class. This is very bad since people tend to get a hold of old tests, helpful hints, book recommendations, etc..that will be of great benefit to you. If you are the smartest person in the class...dont try to show off and be cocky. There will be plenty of opportunities for people to undermine you if they decide they dont like your attitude. In short, have fun, be nice....make sure you are likable to a large number of people.

08 - No one can go through medical school 8 times, so dont be such a "pal" that you end up doing extra work (typing a review sheet, for example) for your friends while they are out having a good time.

09 - For me, the first year was NOT the hardest. This is b/c I was used to busting my ass to get into medical school that I never slowed down. For some, it is the "wake up call" if you never studied in college.

10 - The second year IS the hardest, its survival of the fittest. They want you to know everything about everything, and some more in between. People quit after every exam.

Lot's More...

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Sleep Eating

From CBS:

Some people don't just walk in their sleep, they eat as well.

As sleep disorders go, it's one of the more bizarre, observes CBS News Correspondent John Blackstone.

He says Dr. Mark Mahowald and other sleep researchers have discovered that nocturnal eating may be a side effect of the popular sleep medication, Ambien.

That comes on the heels of reports that some Ambien users may drive while sleeping.

Mahowald, who's medical director of the Minnesota Regional Sleep Disorders Center in Minneapolis, tells Blackstone, "We've had people eat very inappropriate things that they would never eat while awake. Some example would be buttered cigarettes, salt sandwiches, raw bacon."

And sleep-binging could leave its mark – on waistlines.

"I put on over 100 pounds since I've been on Ambien," says Brenda Pobre, who couldn't figure out why she was gaining so much weight.

"I would wake up in the morning and there would be candy wrappers all around the bed," she says. "There would be crumbs in the bed. There would be all kinds of evidence that someone had been eating in the bed. But I had absolutely no recollection of it."

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Prostate Cancer Doesn't Like It Hot

From Forbes:

Capsaicin, the component that gives jalapeno peppers their heat, may also kill prostate cancer cells, a new study suggests.

Initial experiments in cancer cells and mice show that capsaicin causes prostate cancer cells to undergo a kind of suicide. Researchers speculate that, in the future, pills containing capsaicin might be used as therapy to prevent prostate cancer's return.

According to their report, capsaicin caused almost 80 percent of prostate cancer cells in the mice to die. In addition, prostate cancer tumors treated with capsaicin were about one-fifth the size of tumors in untreated mice.

"Capsaicin inhibits the growth of human prostate cancer cell in Petri dishes and mice," said lead researcher Dr. H. Phillip Koeffler, director of hematology and oncology at Cedars-Sinai Medical Center and a professor of medicine at the University of California, Los Angeles. Based on the findings, Koeffler believe the next step is a trial to see if it works in patients with prostate cancer.

The report appears in the March 15 issue of Cancer Research.

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Magnets Associated with Pediatric Death

From Seattle Times:

The hospitalization of a second child who swallowed small magnets from a popular toy led Public Health — Seattle & King County and Children's Hospital & Regional Medical Center to issue an official warning Thursday about the toy's dangers.

Doctors blamed the Magnetix building toys for the death of a toddler in November and the illness of a 5-year-old boy currently in serious condition at Children's.

The 5-year-old's parents took him to the hospital last week with abdominal pain, vomiting and fever. During surgery, doctors found two small magnets from the Magnetix toys had eroded holes through his intestine.

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Atkins Causing Ketoacidosis

From Daily Mail:

People who strictly follow the Atkins diet could develop a potentially fatal blood disorder, doctors say.
A medical team described how one 40-year-old woman developed the dangerous condition after cutting out carbohydrates and living on meat, cheese and salads for a month.

The obese woman, who had lost nine kilograms, was taken to casualty after vomiting up to six times a day and feeling increasingly short of breath.

The Atkins diet is "far from healthy" say doctors. Sticking to just salads, meat and cheese could put you at risk of a dangerous blood condition.

She was diagnosed as having ketoacidosis, where dangerous levels of acids had built up in the blood and was placed in an intensive care unit.

The woman had rigorously followed the Atkins diet, which claims to produce rapid weight loss, and taken the recommended precautions, including using vitamins and other supplements.

She was discharged after four days in February 2004.

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Statins May Reverse Coronary Plaque

From ABC News:

Dr. Christopher Cannon, a cardiologist at Brigham and Women's Hospital in Boston, said that his patients often ask him if there is anything they can do to shrink the blockages in their heart arteries.

"Until now, the answer was no, but now for the first time we can say yes," he said.

Cannon was referring to a new study released today that shows Crestor, one of the popular statin drugs that lowers cholesterol, could actually shrink plaque that builds up in heart arteries. This finding has implications for millions of Americans who suffer from coronary artery disease, although it's too early for the research to lead to immediate changes in treatment guidelines.

What is the difference between Crestor and other commonly used statins, such as Lipitor and Zocor? "The difference is the potency," Cannon said. Forty milligrams of Crestor works better at lowering LDL, or "bad" cholesterol, than 80 milligrams of Lipitor. The study also found that taking Crestor significantly increases HDL, or "good" cholesterol, a finding that was not seen with statins.

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Bird Flu Resource

An informed and prepared public is essential to minimizing the health effects of a pandemic and the resulting consequences to society.

Learn important health and safety information concerning pandemic influenza, with material targeted for specific groups such as families, travelers, workers, communities, and health professionals.

www.pandemicflu.gov is the CDC web site that has relevant info for both patients and health care providers. It has a wealth of resources including checklists for families, and plans for hospitals. I hope we never need it, but it's a great reference to bookmark. Scientists are expecting bird flu to cross into North America at Alaska in the next couple of weeks.

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Sean Connery's Kidney Tumor

From MSNBC:

Sean Connery has undergone surgery for a kidney tumor and is recovering at his home in the Bahamas, his spokesman said Sunday.

The 75-year-old Scottish actor underwent the operation a few weeks ago in New York, spokesman James Barron said.

“He’s very fit — he’s 100 percent plus,” Barron said of the former James Bond actor, who won a 1988 Academy Award as supporting actor for “The Untouchables.” In 2000, he was knighted by Queen Elizabeth II.

We wish Mr. Connery a speedy recovery.

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TGIF

A List of Things You Don't Want to Hear During Surgery:

Oops!
Has anyone seen my watch?
Come back with that! Bad Dog!
Wait a minute, if this is his spleen, then what's that?
Hand me that...uh...that uh.....thingy
What do you mean he wasn't in for a sex change!
Damn, there go the lights again...
Everybody stand back! I lost my contact lens!
Well folks, this will be an experiment for all of us.
What do you mean, he's not insured?
Let's hurry, I don't want to miss "Bay Watch"
What do you mean "You want a divorce"!
FIRE! FIRE! Everyone get out!

Sugary Drinks Decay Teeth

From Fox news:

Gatorade erodes teeth faster than Coke, a new study shows.

That doesn't mean that Gatorade and other sports drinks are necessarily harder on your teeth than are Coke and other soft drinks. But it may be a surprise that they aren't any better, either, says researcher Leslie A. Ehlen, a student at the University of Iowa School of Dentistry.

"I don't think everybody realizes how erosive these things are, especially Gatorade and Red Bull," Ehlen tells WebMD. "People need to be aware that all sorts of beverages can be causing dental erosion."

Ehlen presented the study at this week's annual meeting of the American Association for Dental Research in Orlando, Fla.

More and more dentists now think sugary drinks are the major culprit in tooth decay, says Brian Burt, PhD, professor emeritus of epidemiology at the University of Michigan School of Public Health.

"There is pretty good evidence now that this is not just sports drinks, but soft drinks and juices in general," Burt tells WebMD. "They have become the main source of sugars in the diet. It comes down to the more sugar in the drink, the more risk of [cavities] to the person drinking it."

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Equality of the Sexes: Female Binge Drinking

From ABC News:

Drinking to excess has always been a tradition and a problem among college men. But now it's also college women who are causing concern. They're binge drinking in alarming numbers — and not just on Spring Break. They're out in public, staggering in the streets, falling down drunk, and becoming easy targets for sexual assault.

"They are not only drinking more than their male peers, but they are now more likely to drink more heavily than their male peers," said David Jernigan, executive director of The Center for Alcohol Marketing and Youth at Georgetown University.

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Economy Class Syndrome: DVT's Formation In Flight

From Bloomberg:

Reduced oxygen levels and low air pressure in airplanes may contribute to the development of blood clots in some passengers, according to a study published in this week's Lancet medical journal.

The study by researchers at the Leiden University Medical Center in the Netherlands measured clotting activity in 71 healthy volunteers before, during and after eight-hour flights.

British Airways Plc, Delta Air Lines Inc. and other carriers have been sued by travelers who claimed they developed a disorder called deep vein thrombosis on flights. The condition, nicknamed ``economy-class syndrome,'' occurs when a clot develops in veins deep in the body and can be fatal if the mass breaks free and lodges in the lungs.

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Coffee Or Soda: They'll Both Kill You

Don't drink the coffee...

COFFEE drinkers who have more than three cups a day could significantly increase their chances of suffering a heart attack.
Research suggests that some people who carry a particular variation of a gene cannot process caffeine as quickly as other people. Such individuals could be 60 per cent more likely to have a heart attack if they drink large amounts of coffee.

It is not known how common the gene variation is in the British population. Some studies indicate that up to a third of Caucasians may carry it.

Canadian scientists have discovered that people with the slower metabolism gene variation, known as *1F, run a dramatically higher risk even if they drink only two cups a day.

Researchers found that heavy coffee drinkers under the age of 50 were four times as likely to have an attack compared with those who had one cup a day.

The soda is no better, associated with obesity in teenagers...

Giving teenagers noncaloric alternatives to sweetened beverages seems to help them lose weight and might stem the rise in childhood obesity, according to a new study.

Researchers from Children's Hospital in Boston found that a novel intervention to limit consumption of sugary drinks -- home deliveries of noncaloric beverages -- had a beneficial effect on weight loss.

The trial enrolled 103 children aged 13 to 18, through a Boston area high school. The teens were offered a $100 mall gift certificate if they stuck with the six-month study.

All stayed in the trial, but those who did not receive home deliveries of four daily nonsweetened drinks gained weight, said Cara Ebbeling, who co-led the study with Dr. David Ludwig of the hospital's Division of Endocrinology.

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Chinese Bird Flu Death

From Bloomberg:

China halted the supply of live poultry, day-old chicks and pet birds to Hong Kong for three weeks after a man in Guangzhou died of avian influenza, Hong Kong's government said in a statement.

Hong Kong will step up inspection of local farms and wholesale and retail markets and will step up efforts to combat bird and poultry smuggling, the government said in a faxed statement received late yesterday evening.

China's Health Ministry told Hong Kong that a 32-year-old man who died in Guangdong province March 2 probably had the H5N1 virus, the Hong Kong government said March 5. The diagnosis has been confirmed, yesterday's statement said.

``Surveillance of avian influenza indicate a growing risk of an outbreak in Hong Kong, preventive measures thus need to be strengthened,'' the statement said. Should there be no further avian or human cases of the virus, the supply of live birds will resume in three weeks, it said.

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Marital Discord Can Cause Broken Heart

From USA Today:

Couples who routinely trade nasty or controlling remarks during marital spats might be harming their hearts — and not just emotionally, a study suggests.
The findings fit in with a body of research suggesting that hostile and domineering men and women are at risk of developing heart disease, the No. 1 killer in the USA.

"This kind of anger can be bad for the heart," says Redford Williams of Duke University, an expert on anger management. Williams and others have shown a link between anger and heart disease.

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Canadian Healthcare Tries Two Tier Model

From The Calgary Sun:

Canada's national health system, often held up before Americans as a model method of delivering medical care, has been gradually falling to pieces in recent years.

Last week, it received what many fear will prove a knock-out blow from Alberta, where Premier Ralph Klein is defying federal laws intended to safeguard the system against private medical practice.

Klein unveiled a plan to institute a controversial "two-tier system" in his province -- meaning two levels of medical care, one run by the government and delivered without fee, the other delivered privately with a fee attached.

This would end in Alberta the utopian socialist vision that inspired the institution of state medicine in Canada four decades ago, wherein rich and poor alike were to get the same level of care.

But it was a vision increasingly belied by reality, because the rich could acquire the best care simply by travelling to the U.S.

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They Won't Give Up...

From Tom's Hardware:

A radiation watchdog group in Finland called the Radiation and Nuclear Safety Authority will be testing the effects of cellphone radiation on the skin of human volunteers. The ten volunteers, who are all employees at the group, will have small areas of their skin exposed to cellphone radiation for the duration of a long call or about one hour. Skin samples will be taken after the exposure and compared with one before.

Some high-profile and very expensive lawsuits have alleged that excessive radiation from mobile phones cause cancer, namely brain tumors. In November of last year, the United States Supreme Court refused to throw out several class-action suits, which totaled several hundred million dollars, against Motorola, Nokia, Nextel Communications, Sprint and Cingular Wireless. Lower courts had dismissed the lawsuits, but the Supreme Court reversed the decision.

I hope the pathologists are blinded to the samples that they are looking at...

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Anything Better Than Nothing...At Least For Migraines

From Fox News:

Acupuncture may be as good as prescription drugs in preventing migraines -- even if sham acupuncture is used, German researchers report.

Their study, published in The Lancet’s online edition, included more than 400 people who had two to six migraines per month. Participants got one of three treatments:

Daily drug therapy, with beta-blockers as the first choice Sham acupuncture, with needles placed in spots not used in real acupuncture Real acupuncture

All three groups had fewer days of migraines during the 26-week study. Both types of acupuncture were similar to drug therapy in reducing migraine days.

Hey, I think even I can do "sham" acupuncture!

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Vaccinating Away Ear Infections

From Reuters:

A new vaccine from GlaxoSmithKline Plc could help to reduce middle ear infection, a common problem in toddlers, scientists said on Friday.

Researchers at the University of Defense in Hradec Kralove in the Czech Republic said the vaccine they tested against middle ear infection, or otitis media, reduced cases of the illness by about 30 percent in babies who had been vaccinated in the first six months of life.

"We found a reduction in ear, nose and throat specialist-confirmed episodes of acute otitis media by about a third in infants in the vaccine group compared with controls," said Dr Roman Prymula, who headed the Phase III study reported in the Lancet medical journal.

Middle ear infection causes fever, pain and sometimes a decrease in hearing. The infection often follows a cold. It is most common in young children and is usually treated with antibiotics.

Prymula and his team tested the vaccine on nearly 5,000 infants who were either given three doses of the new vaccine -- Streptorix -- and a booster before 15-months-old or a vaccine for hepatitis A.

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Breast Screening

From BBC News:

Swedish researchers looked at some 42,000 women in a breast screening trial from 1976 to 1986.

The scientists, writing in the British Medical Journal, accept screening can reduce deaths, but say "over-diagnosis" is a problem.

But a spokeswoman for the NHS screening programme said the benefits outweighed the risks.

Over-diagnosis is defined as cases of cancer that would never have come to the attention of doctors during a woman's lifetime if it were not for screening.

This can result in invasive treatment such as surgery and radiotherapy which might never have been necessary had the woman had not attended for breast screening.

And the debate continues on...

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TGIF

A prisoner who is desperate to get out of jail has been teaming with his doctor and has been in & out of the hospital on some pretext of illness. He is now in one of such visits and very desperate to get out of jail permanently, tells the doctor, "Look here, doc! You've already removed my spleen, tonsils, adenoids, and one of my kidneys. I only came to see if you could get me out of this place!"

To which the doctor calmly replies, "I am - bit by bit".

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Sleep Deprived America

From SF Gate:

A record 43 million sleeping-pill prescriptions were filled in this country last year, fueled by almost $300 million in drug companies' ad spending and resulting in more than $2 billion in sales.

We are, to put it mildly, an increasingly sleepless nation. It's a big problem -- and a big business, especially for the pharmaceutical industry, which according to some estimates could be pulling in $5 billion annually from sleep remedies within four years.

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Stem Cell, No Go

From The International Herald Tribune:

A radical new treatment for heart attack patients turns out to be wholly ineffective when tested under rigorous conditions, researchers in Germany say in a report published Wednesday that severely undercuts an apparently promising form of stem cell therapy.

Their finding, reported in The Journal of the American Medical Association, renews a longstanding debate among medical researchers as to whether the basic biology of stem cells needs to be far better understood before testing cell-based therapies in patients is worthwhile.

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Darvon & Darvocet Under Review

From Reuters:

The long-time leading prescription painkiller Darvon and its generic versions have been linked to thousands of deaths and should be taken off the U.S. market, a consumer group told federal health regulators on Tuesday.

In a petition to the U.S. Food and Drug Administration, Public Citizen said the drug propoxyphene, sold by Xanodyne Pharmaceuticals under the brand Darvon, had been linked to 2,110 deaths between 1981 and 1999 -- nearly 6 percent of all drug-related fatalities.

While the drug has been around for decades, last year British health authorities announced a phased withdrawal, and the U.S. advocacy group called on the FDA to follow suit.

FDA spokeswoman Laura Alvey confirmed that the agency received the petition and would review it carefully but could not comment further.

The risks outweigh the minimal benefits of the drug, which may also be addictive and "has repeatedly been shown in controlled clinical trials to be a relatively weak painkiller," Public Citizen wrote.

Twenty-three million propoxyphene-based U.S. prescriptions were filled in 2004, making it the 12th top-selling generic drug with $291 million in sales, according to the petition.

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