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On Alzheimer’s, Death, And Patients With Intellectual Disabilities

The Boerewors Emergency Medicine Chronicles has a great post which I think is worth your time:  On alzheimer’s

……..…I think it is beautifully written and provides a real window into the difficulty of loving someone who has this disease.

“The thing with this sentence, this arrest of dementia, is that its greatest victims aren’t those who have it. That’s not to say that the diagnosis isn’t dreadful for the recipient, but there is a peculiar and particular hammering sadness for those that love and care for an Alzheimer’s spouse or parent.

It is a wearying and lonely obligation, but with the added cruelty that the person you’re looking after vanishes, escapes before your eyes. In the end, you’re caring for the case that someone came in………”

………………………………….

Check out this post from @JordanGrumet who blogs at In My Humble OpinionFrom Birth To Death Read more »

*This blog post was originally published at Suture for a Living*

Small Study Looks At The Use Of Abdominal Panniculectomy In Patients Awaiting Kidney Transplants

There is an interesting article in the current edition of the Plastic & Reconstructive Surgery Journal (December 2011). The focus of the article is a small subset of renal patients who need kidney transplants but whose abdominal panniculus excludes them due. A significant panniculus creates an infrapannicular area prone to increased moisture, skin maceration, and elevated bacterial counts, predisposing the patient to postoperative wound infections, necrosis, and dehiscence. Not good for anyone, but really not for someone on immunosuppression.

The article discusses the use of abdominal panniculectomy in these patients in preparation for the transplant. Nine patients, 3 men and 6 women, with a mean age of 54.5 years and a mean BMI 28.3 are the focus of the article. The focus is not Read more »

*This blog post was originally published at Suture for a Living*

Article Discusses The Importance Of DVT Prevention

There were two articles regarding deep venous thrombosis prevention in the November 2011 issue of the Plastic and Reconstructive Surgery Journal.  Both are worth reading.  I have supplied the full references below with links.

From the second article:

Between 1 and 7 percent of surgeons have personally experienced a venous thromboembolism–related patient death after high-risk plastic surgery.  Plastic surgeons’ self-reported practice patterns indicate a disparity between clinical understanding and clinical practice. The majority of surgeons can identify patients at high risk for postoperative venous thromboembolism. However, examination of their self-reported practice patterns indicates that a substantial proportion of surgeons (>50 percent) provide inadequate levels of venous thromboembolism prophylaxis for high-risk patients.  In addition, surgeons recognize modifiable venous thromboembolism risk factors (such as oral contraceptive use) but may fail to modify those factors before surgery.

“Never event” is a poor descriptor for venous thromboembolism, as it implies that Read more »

*This blog post was originally published at Suture for a Living*

Study Looks Into The Added Benefits Of Breast Reduction Surgery

This article (full reference below) on the additional benefits an individual gains from having a reduction mammoplasty (RM) has been published online ahead of print.  The authors performed a systemic review of the literature focusing on functional outcomes after RM with regard to physical and psychological symptom improvement.

The authors performed a systematic review of the English literature using PUBMED for the period between 1977 to 2010. Studies were chosen that addressed the physical and psychological benefits of RM using a validated questionnaire.

The authors note that nearly eighty thousand breast reductions were performed in 2009.  For insurance coverage in the United States a woman seeking breast reduction must have complaints of physical symptoms (i.e., Read more »

*This blog post was originally published at Suture for a Living*

Preventing Surgical Fires

A month ago during a storm with significant straight line winds we had a tree near the house loss it’s top half.

Upon inspection, it turned out the pine tree was infested with pine beetles. We were encouraged to burn the debris to help protect the other trees from the beetles.

This past week my husband cut up the felled tree (we still need to get a tree cutter out to cut down the 2/3s of the tree still standing) and carried it to an area of the front property.  Yesterday morning after a light rain, he decided it was a good time to set it afire and burn it.  Note the red container under the tree to the left.  It contains gasoline.  [Even though he told me he wouldn’t use an accelerant.]  He did run a water hose down from the house which is barely visible in the forefront of the photo.

Medscape has a really nice article with video by Kenneth L. Silverstein, MD; Stephanie Josephon —  Surgical Fires: How They Start and How to Prevent Them: Read more »

*This blog post was originally published at Suture for a Living*

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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