12.29.2006

Battlefield Medicine In Iraq


The men of Charlie 2-4 fly Black Hawks over a landscape too dangerous, too wrecked for road travel. They fly into the hot, violent cities, the mud-brick towns, the nowhere stretches of desert, picking up American and Iraqi soldiers, civilians, and, sometimes, enemy fighters. For medevac crews, there are missions, and the space in between. Earlier today, Charlie 2-4 rescued three Iraqi boys wounded in a bomb blast in a rural field. Blood and mud caked their bodies, stubs of straw clung to their bare backs like a pelt. The mission reset the clock, the psychic countdown. Now comes a rush of static and an anxious, tinny voice on the radio: Insurgents have attacked a U.S. Army patrol somewhere on a highway south of Baghdad. One of the soldiers is badly wounded.

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My hat is really off to these soldier-health care providers. I don't know how they truly can do the job they do. I get annoyed when we run out of something in the supply room on the floor, and yet they can function on a battlefield.




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On the Speed of Surgery

Above all, interns love the fast surgeons. The longer an operation takes, the less time to do your work when finally released from the tiled temple. A whole OR day with a plodder guarantees a night without sleep. There are other reasons to appreciate fast surgery, and to consider why some surgeons are so much faster than others. But before doing so, let this be made clear: speed, per se, is not a sine qua non (or even the sine qua not much) of good surgery. Doing it right is paramount; a slow and careful surgeon is better than a fast and sloppy one.

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Housework Is Good For You

A study of 200,000 European women has found that doing housework is more likely to protect you against breast cancer than job- or leisure-based physical activity.

The study is published in Cancer Epidemiology Biomarkers & Prevention.

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The results suggest that total physical activity reduces risk of breast cancer only in postmenopausal women. However, and perhaps more surprisingly, housework on its own reduces breast cancer risk in both pre- and postmenopausal women - the former by 19 per cent and the latter by 29 per cent. The study found no significant link between reduced breast cancer risk and either leisure or work-related physical activity.

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Get the Fat Out! Trans That Is...

The Universal Studios theme park in Hollywood earned positive publicity after the menu changed on Christmas Eve to cut artery clogging trans fats from many popular junk foods, The Associate Press reported Dec. 27.

Universal Parks & Resorts has begun serving many items that are free of artificial trans fats at its three domestic attractions in California and Florida.

Universal Studios Florida, Islands of Adventure in Florida and Universal Hollywood got rid of trans fat from over 90 percent of food served last week.

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Cutting Down On Infection

Hospitals in Michigan nearly eliminated often-deadly infections involving tubes that deliver fluids and medicine to patients by stressing better hygiene and other preventive steps, a U.S. study showed.

The catheters cause about 80,000 bloodstream infections per year in the United States, infections so serious that up to 28,000 of the patients die. Fighting the infections costs about $2.3 billion annually.

Hoping to reverse that trend, 108 intensive care units in the state of Michigan joined a project launched in October 2003 that included procedures designed to reduce infection -- from better hand-washing to special cleaning and insertion procedures to removing unnecessary catheters when possible.

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Movie Review: Side Effects

Side Effects is a comedy that comments on the current state of physician advertising via the so called pharmaceutical reps. While far from a documentary, it does impart a fair amount of information along the way, like that there is one pharmaceutical rep for every four doctors in the country.

I think every doctor should watch this film and think about it when they are holding their prescription pad.

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12.22.2006

Give That Patient an Emmi


At last! A web-based solution for outsourcing the surgeon-patient relationship! Why ask your doctor about your major operation, when you can fill out a web-form and watch a flash video instead?

Ah, but seriously, we recognize the need for a service like Emmi (it gets patients up-to-speed on the basics, while leaving more time for surgeons to handle specifics. And cut into things).

And what if the patient has a question? Maybe they can IM their doctor...


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And More.




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Burning Holiday Calories

Oh, those holiday pitfalls: a martini and a handful of Chex mix at the office party, Grandma’s fruitcake, the plate of gingerbread cookies from your neighbor.

Eating all those goodies will definitely cost you.

To burn off the calories in one gingerbread cookie, you will have to swim 18 minutes. The martini and party mix will take 47 minutes on the bike.

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Plastic Surgey...Not Just For Women Anymore

They're exercising, they've quit smoking and they're eating more healthy foods. But men who end up in the plastic surgeon's chair often say they don't think they look as good as they feel, according to doctors. Some patients are fresh off a divorce or looking for a competitive edge in an office full of young bucks. Others are inspired by wives who have had successful procedures — or are kind enough to ask why their husbands' once-smooth brows now appear permanently furrowed.

From 2000 to 2005, there was a whopping 44 percent increase in minimally invasive cosmetic procedures among men, according to the American Society of Plastic Surgeons. While the jump in demand isn't unique to the gender, doctors say it speaks to many men's desire to boost their looks — often through quickie treatments that don't cause a lot of bruising or require lengthy recovery times.

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Filtering Out CJD

A new blood filter device could in future prevent people being infected with the human form of mad cow disease through transfusions, it was revealed today.

The technique can effectively remove the rogue prion proteins responsible for transmitting brain diseases such as variant CJD.

Although so far only tested on hamster blood containing the prions that cause scrapie, a related disease affecting sheep, scientists believe it can be developed for humans.

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Blame the Microbes!

US scientists have discovered that "gut microbes" - bacteria that live in our digestive tract - could be powerful clues to the cause and treatment of obesity.

This remarkable news was published in Nature this week and conducted at Washington University School of Medicine in St. Louis.

The clue lies in the relative abundance of two major families of intestinal bacteria: Firmicutes and Bacteroidetes.

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The Mistletoe Controversy

From Forbes:

Adding a new twist to the debate over the value of mistletoe as an alternative cancer treatment, British doctors are reporting the case of a patient whose consumption of an extract from the Christmas decoration led to a tumor-like growth.

An accompanying commentary suggests the case provides yet another reason to avoid using mistletoe as anything other than a holiday decoration. But an alternative medicine specialist points out that risks are inherent in conventional medicine, too.

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Who knew that mistletoe was so controversial?




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12.01.2006

GHealth

At Google, we often get questions about what we're doing in the area of health. I have been interested in the issues of health care and health information for a while. It is now one of my main focuses here, and I've decided to start posting about it. I've been motivated in this field in part by my personal experiences helping to care for my mother, who recently died from cancer after a four-year battle. While the quality of the medical care my mother received was extraordinary, I saw firsthand how challenged the health care system was in supporting caregivers and communicating between different medical organizations. The system didn't fail completely, but struggled with these phases:

* What was wrong -- it took her doctors nine months to correctly identify an illness which had classic symptoms
* Who should treat her -- there was no easy way to figure out who were the best local physicians and caregivers, which ones were covered by her insurance, and how we could get them to agree to treat her
* Once she was treated, she had a chronic illness, and needed ongoing care and coordinated nursing and monitoring, particularly once her illness recurred


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As we generate more and more data in healthcare, the challenge is keeping it all organized and accessible. I often think as I'm trying to jog the memory of an older patient at 2 AM for their medication list in the Emergency Room, there really needs to be a better way to organize and keep folks healthcare information. As another example, I know someone that ended up going to three different hospitals, and three different abdominal CT's for abdominal pain. The fascinating thing, is that even though they were done within a month of each other, there were three different diagnoses! If only someone had access to all the films, the accuracy of the diagnosis could be improved. As we focus on patient safety, and reducing healthcare costs, this is an idea whose time has arrived. I welcome Google to taking on this challenge!




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