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Germs, Kids, And School

Everyone knows that when it comes to germs and kids, it can sometimes be difficult to limit the spread of infection — especially in a school or daycare setting. In this video, I talked with local TV news last week about germs and kids, and about preventing infections in college students during finals week:


If you find this video helpful, I invite you to check out my other videos at MikeSevilla.TV. Enjoy!

*This blog post was originally published at Doctor Anonymous*

Healthcare Transparency: Patient Experts At Medical Conventions

Interviewing Dr. Emile Mohler from the University of Pennsylvania at AHA Scientific Session 2010We are invading their home turf. Increasingly, in among the thousands of doctors, scientists, and medical industry marketers at the largest medical conventions you are finding real patients who have the conditions discussed in the scientific sessions and exhibit halls. Patients like me want to be where the news breaks. We want to ask questions and — thanks to the Internet — we have a direct line to thousands of other patients waiting to know what new developments mean for them.

I vividly remember attending an FDA drug hearing a few years ago and how there were stock analysts sitting in the audience, BlackBerries poised for the “thumbs up” or “thumbs down” on whether a proposed new drug would be recommended for approval. (At that session it was thumbs down.) When the analysts got their thumbs moving, a biotech stock tanked in minutes and before long the company was announcing layoffs. Those analysts were powerful reporters.

Now patients are reporters, too, and their thumbs are just as powerful. So are their video cameras and microphones. These folks are a different breed than the folks from CNN or the scientist/journalists from MedPageToday. Their questions are all-encompassing: “What do the discussions about my disease or condition here mean for me? What should change in my treatment plan? What gives me hope? What’s important for my family to know?” Read more »

*This blog post was originally published at Andrew's Blog*

New Recommendations For Vitamin D

Vitamin D has been talked about as the vitamin — the one that might help fend off everything from cancer to heart disease to autoimmune disorders, if only we were to get enough of it.

“Whoa!” is the message from a committee of experts assembled by the Institute of Medicine (IOM) to update recommendations for vitamin D (and for calcium).

The IOM committee’s report, released this morning, says evidence for many of  the health claims for vitamin D is “inconsistent and/or conflicting or did not demonstrate causality.” The exception is the vitamin’s well-documented (and noncontroversial) benefits on bone growth and maintenance.

The IOM panel’s report also says most North Americans (Canadians as well as Americans) have more than enough vitamin D in their blood to achieve the desired effect on bone. The committee said a blood level of 20 nanograms per milliliter (ng/mL) is sufficient for most people.

The panel set 600 International Units (IU) as the recommended daily intake for children and for adults ages 19 to 70. People ages 71 and older are supposed to get an additional 200 IU, or 800 IU a day.

That’s a fairly sizable increase over the previous recommendations of 200 IU per day through age 50, 400 IU for people ages 51 to 70, and 600 IU for people ages 71 and older. Read more »

*This blog post was originally published at Harvard Health Blog*

Understanding Treatment: The Communication Disconnect Between Doctors And Patients

Over the long week­end I caught up on some read­ing. One arti­cle* stands out. It’s on informed con­sent, and the stun­ning dis­con­nect between physi­cians’ and patients’ under­stand­ing of a procedure’s value.

The study, pub­lished in the Sept 7th Annals of Inter­nal Med­i­cine, used sur­vey meth­ods to eval­u­ate 153 car­di­ol­ogy patients’ under­stand­ing of the poten­tial ben­e­fit of per­cu­ta­neous coro­nary inter­ven­tion (PCI or angio­plasty). The inves­ti­ga­tors, at Baystate Med­ical Cen­ter in Mass­a­chu­setts, com­pared patients’ responses to those of car­di­ol­o­gists who obtained con­sent and who per­formed the pro­ce­dure. As out­lined in the article’s intro­duc­tion, PCI reduces heart attacks in patients with acute coro­nary syn­drome — a more unsta­ble sit­u­a­tion than is chronic sta­ble angina, in which case PCI relieves pain and improves qual­ity of life but has no ben­e­fit in terms of recur­rent myocar­dial infarc­tion (MI) or survival.

The main result was that, after dis­cussing the pro­ce­dure with a car­di­ol­o­gist and sign­ing the form, 88 percent of the patients, who almost all had chronic sta­ble angina, believed that PCI would reduce their per­sonal risk for hav­ing a heart attack. Only 17 percent of the car­di­ol­o­gists, who com­pleted sur­veys about these par­tic­u­lar patients and the poten­tial ben­e­fit of PCI for patients fac­ing sim­i­lar sce­nar­ios, indi­cated that PCI would reduce the like­li­hood of MI.

This strik­ing dif­fer­ence in patients’ and doc­tors’ per­cep­tions is all the more sig­nif­i­cant because 96 percent of the patients “felt that they knew why they might undergo PCI, and more than half stated that they were actively involved in the decision-making.” Read more »

*This blog post was originally published at Medical Lessons*

Sudoku-Solving E. Coli

E. coli is a Gram negative rod-shaped bacterium that is a regular inhabitant of the human gastrointestinal tract and certain strains can cause a lot of trouble. A team from the University of Tokyo in Japan, however, have manipulated the bacterium to perform a more noble task: Solving Sudoku.

The bacterium managed to solve 4×4 grid Sudoku puzzles, and in theory the more common 9×9 grid puzzles should be solvable as well. Read more »

*This blog post was originally published at Medgadget*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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