GRAND ROUNDS, Vol 2, No 4: Go Meds!

I am honored to host this week’s Grand Rounds, the weekly roundup of what’s happening in the health and medical blogosphere, going strong for over a year now.

This looks to be the first hosting by a blogger from the other side of the medical ledger (!), patient that I am. Quite right, I believe, in this new era of Citizen Journalism and Participatory Medicine, that the Informed Patient should stand up and be heard!

That said, there’s nothing like being diagnosed with a chronic disease to give you new respect for the medical profession. Thank you, doctors. Thank you, researchers. Thank you, nurses, lab technicians, pharmacists, educators, physicians assistants, interns and med students! Our lives are in your hands.

Doctors_and_nurses_4
Without further ado, here’s what they’re grappling with this week, by ward:



ADMINISTRATION & POLICY

* M. Simon at Power and Control is in heated discussion over the War on Unpatented Drugs: Can clever wording disguise side effects?

* Dr. Emer of Parallel Universes considers the plight of Filipino doctors-turned-nurses in the US, getting their hands slapped for overstepping their bounds. What shall we do with these overqualified individuals? Doctors will be doctors, ay?

* Elisa C. of HealthConcerns.com relates the exciting news of a new vaccine to prevent the sexually-transmitted virus (HPV) that causes most cervical cancers. Trouble is, the issue is not too PC. Patients may be in for a bad rap.

* Dr. Parker of Cut to Cure responds to the recent Wall St. Journal feature on medical vetting. When the Credentials Committee breaks down, things certainly can go awry. MSSP Nexus Blog also responds to the resultant letters to the editor.

THE IT DEPARTMENT

* SimuConsult Cases reports about using free diagnostic software to pinpoint and correct diagnoses. A link to an adrenoleukodystrophy (!) case featured inHospitalsign_3 the Wall St. Journal illustrates their case.

* “Connectologist” Tim Gee reviews some recent articles on physicians’ use of PDAs, cell phones, and other wireless devices. Are SmartPhones really useful for clinical applications?

* The pros at the Clinical Cases and Images Blog ask why doctors don’t consult Google first when diagnosing. See Google M.D. in Action, Part II for an eye-opening bit on Google “blogoscoped.”

DEPARTMENT OF RADIOLOGY

* Sumer’s Radiology Site is looking at an Interesting Vascular Case on Indian Radiology. Have a look at that angiogram! This is call for an on-line consult.

* Jeff J. at the Pulmonary Roundtable is also agonizing over a puzzling case: unexplained multiple pulmonary nodules. Here you too can review the CAT scan (looks like pumpkins to the untrained eye).

CCU (Cardiac Care Unit)

Nursessign_2* Geena, the nurse-host of CodeBlog, tells a harrowing tale of what happens when the surgeon forgets to show up for the operation. This would have been Geena’s first open-heart patient. Not good.

* On the other hand, GruntDoc tells an amusing tale of what can happen when you sing where you work: a tech was convinced he had a DNR (that’s a do-not-resuscitate order to prevent CPR if the patient’s breathing or heartbeat stops, for us laymen types).

OBSTETRICS/GYNECOLOGY

* Health Business Blog by MedPharma Partners looks into avoiding malpractice suits amidst growing Cesearan rates. Perhaps OBs and assistants should undergo Electronic Fetal Monitoring (EFM) training from a risk management perspective, or stop using the systems altogether.

* It is clinically proven that normalizing blood glucose values during pregnancy will reduce the risk of birth defects in infants of diabetic women. RedStateMoron discusses physicians’ moral responsibility for glycemic control in pregnant women.

* Less obvious is the impetus to stop the heinous practice of female genital mutilation, brought to light at Doc Around the Clock. <cringe>

* At Holding Pattern, a struggling DES survivor writes about why infertility should be covered by insurance: it’s a treatable medical condition, and withholding treatment results in sub-optimal outcomes and higher costs to the overall system. Wise words!

BEDSIDE

* Keith Carlson is an RN working with the Latino community in Western Massachusetts, and chronicling his nursing adventures on Digital Doorway. This week, Keith explores What it Means to Witness Suffering. Painful, but powerful good.

* Dr. E over at Galen’s Log reflects on the Art of Internal Medicine, which is currently pushing the threshold for various disorders lower and lower for more aggressive treatment. Maybe it’s time to draw a line in the sand, i.e. do patients really benefit from being on 11 drugs at once?

* From the patient’s perspective, Josh Cohen of Multiple Minds is sampling Migraine pills: Axert, Maxalt, Imitrex, and telling us what he thinks. Should be enough to “kick those migraines to the curb!”

Take_a_number_3

MEDICAL LIBRARY

* Academic surgeon and scientist Orac digs deep into the psyche of judging the value of life at Respectful Insolence. His explorations of Nazi justification of euthanasia will make you shudder.

* S.Smith of Medpundit is scouring the journals for info on the biology of Avian flu. Read it and learn.

* At the Biotech Weblog, microbiologist Ruth Schaffer is reviewing a research report on the SEPS1 (Selenoprotein S) gene and its role in inflammation, diabetes, and obesity.

* Meanwhile, Violetta of Sneezing Po is curling up next to the convection heater with a good medical book, learning all about precipitation, acid-base and oxidation-reduction reactions. Ah, the premed life!


THE CHILDREN’S WARD

* Diagnosing a toddler’s rash is not as intuitive as you might think. Take the Photoquiz at Cacoethes Cognitum.

* And never underestimate the misery of a little girl’s fat lip. Dr. Charles knows all about how inconsolable kids can be. Luckily, this one was just spilt milk.

FACILITIES

* The Chapel (or…?): Kent Bottles at Soundpractice.net muses on the role of spirituality in health care in Should Doctors Pray with Their Patients? And where does that leave the Clergy?

* Food Service: T.C. of Hospital Impact recounts how hospitals are becoming more and more like hotels. New menus feature full breakfast items, baked fish, hamburgers, gourmet grill plates and more. Why go home?

IN THE FIELD: NEW ORLEANS

* Enoch C. of Medmusings reports live from physicians’ HQ at “the striking scene … of so much need.”

* For N.Olson of The Haversian Canal, it was quite a Friday night: a car fire on a bridge, then a psychotic truck driver drives over 16 cars, including some friends’ … “Other than that, it was just a usual weekend spent salvaging our lives out of the largest national disaster in American history.”

DISCHARGED

* Speaking of going home, a new home HIV test is as exciting as it is risky — how will patients Discharge_wheelchairact/react to test results without guidance? Aaron at Two Terms Later discusses the impending FDA ruling and the NY Times coverage.

* Over at Intueri, there’s nothing to be done about the appearance of quiet, subtle psychosis. Nothing but Cast Away.

* Finally, our gracious host Nick of Blogborygmi speaks of Decay: what heavy drinking can do to people, their relationships, and their extremeties.

All the more power to the medical professionals with the stomach to deal with these ends! Society needs YOU. Put crudely: Go Meds!

* * *

Apologies to any participants whose submissions this week do not appear here; this facility hit max capacity. Next Week’s Grand Rounds will be hosted at Hospital Impact. See you there.

16 Responses

  1. Tony
    Tony October 17, 2005 at 9:09 pm | | Reply

    very thoughtfully done! Nice job!

  2. Graham
    Graham October 17, 2005 at 9:51 pm | | Reply

    And Graham proposes a meme for the blogosphere as a whole: Blogging Your Health Wishes to communicate what bloggers would want done in case of an emergency.

    http://www.grahamazon.com/2005/10/blogging-your-health-wishes/

  3. DP
    DP October 17, 2005 at 10:13 pm | | Reply

    Great job! I’m excited and encouraged to see Grand Rounds hosted by a fellow patient!

  4. The Biotech Weblog
    The Biotech Weblog October 18, 2005 at 1:02 am | | Reply

    Grand Rounds Vol 2, No 4: Medical Blogging

    This week’s compendium of the best in medical blogging is up at Amy’s Diabetes Mine. Amy delivers this week’s issue is especially insightful, having been delivered from the perspective of the patient, the most-important, but sometimes neglected, entit…

  5. GruntDoc
    GruntDoc October 18, 2005 at 5:16 am | | Reply

    Medblogs Grand Rounds 2:4

    I am honored to host this week’s Grand Rounds, the weekly roundup of what’s happening in the health and medical blogosphere, going strong for over a year now. This looks to be the first hosting by a blogger from the…

  6. sumer sethi
    sumer sethi October 18, 2005 at 9:36 am | | Reply

    great job, excellent reading material!!

  7. Multiple Mentality
    Multiple Mentality October 18, 2005 at 9:44 am | | Reply

    Carnivalized!

  8. MedSleuth
    MedSleuth October 18, 2005 at 11:44 am | | Reply

    Great compilation. Thanks for your efforts. It is nice to see a patient included in the Grand Rounds.

  9. Modulator
    Modulator October 18, 2005 at 1:02 pm | | Reply

    Interested in Things Medical?

    The latest Grand Rounds is up. Via medpundit….

  10. Elisa Camahort
    Elisa Camahort October 18, 2005 at 2:29 pm | | Reply

    Great job. I am also a fellow bloger from the other side of the medical ledger (and hosted GR #49.)

    Here I thought I was the only one :)

  11. Dr Emer
    Dr Emer October 18, 2005 at 5:11 pm | | Reply

    Great work, Amy. I tried sending a trackback ping but it failed. Anyway, I’ve linked you.

  12. Michael
    Michael October 18, 2005 at 6:06 pm | | Reply

    I posted the following comparison of two of the items in this Grand Rounds on one of the two blogs but twice my comment was deleted after appearing. Should medical blogs that delete posts disagreeing with their blog items disclose this policy on their blog?

    Here is my second item as it appeared before it was deleted from http://casesblog.blogspot.com/2005/10/google-md-in-action-part-ii.html (I re-added below in parentheses a hyperlink that did not survive the pasting):

    The problem with using Google for medical diagnosis is that it is a very blunt instrument for medical diagnosis. It does not do well with sensitivity and specificity, and it does not handle the absence of a finding well. Also, it does not make use of temporal information very well. Diagnostic software is a much better approach for making a medical diagnosis.

    As an example, consider the other diagnosis story to appear in this week’s Grand Rounds – the case of adrenoleukodystrophy in a Wall Street Journal story blogged by the SimulConsult Cases Blog (http://www.simulconsult.com/neurologicalsyndromes/news/ald.html). If you search for the three relevant terms (slurring clumsy and hearing) the search results include a large number of extraneous neurological diseases. Adrenoleukodystrophy appears in the list only because Google finds the blog entry cited above.

  13. David E. Williams of the Health business blog

    Very nicely done, Amy!

    Michael’s comment above is a good one. It’s disturbing to see debate squashed like that.

    Is the Clinical Cases and Images Blog afraid of decision support tools?

    David Williams

  14. Nio
    Nio October 19, 2005 at 5:31 pm | | Reply

    Thank you, doctors. Thank you, researchers. Thank you, nurses, lab technicians, pharmacists, educators, physicians assistants, interns and med students!

    You forgot the low paid/invisable staff–those who do the back breaking work and messy work–such as PCTs, housekeeping, dietary, infectious waste removers…

  15. Keith Carlson
    Keith Carlson October 26, 2005 at 5:24 pm | | Reply

    Thank you so much for doing such a comprehensive and sensitive job (and for including my submission!). An excellent GR if there ever was one!

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