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Guidelines For The Treatment And Prevention Of Frostbite

Led by Scott McIntosh, MD and his colleagues, the Wilderness Medical Society has published “Practice Guidelines for the Prevention and Treatment of Frostbite” (Wild Environ Med 2011:22;156-166). These guidelines are intended to provide clinicians about best evidence-based practices, and were derived from the deliberations of an expert panel, of which I was a member. The guidelines present the main prophylactic and therapeutic modalities for frostbite and provide recommendations for their roles in patient management. The guidelines also provide suggested approaches to prevention and management of each disorder that incorporate the recommendations.

In outline format, here is what can be found in these guidelines: Read more »

This post, Guidelines For The Treatment And Prevention Of Frostbite, was originally published on Healthine.com by Paul Auerbach, M.D..

Is A Compressed Spinal Nerve Causing Itchy Arms?

Medical science is getting closer to understanding one of the most common causes of chronically itchy arms called brachioradial pruritus.

This means we’re also getting closer to helping people who suffer from this extremely frustrating condition!

A new study exploring the cause of brachioradial pruritus was just reported in the October issue of the Journal of the American Academy of Dermatology.  The authors used MRI imaging to look at the cervical spine of 41 patients suffering from chronic itching of what was otherwise normal appearing skin on the outer surface of their forearms arms (called brachioradial pruritus).  MRI imaging showed a very strong correlation between the itch and nerve compression in the patient’s neck. In fact, the exact site of the itch on the skin correlated precisely with the spinal location in the neck where the nerve resides that supplies that part of the arm skin (we call this a dermatome*).

What’s so interesting is that Read more »

*This blog post was originally published at Dr. Bailey's Skin Care Blog*

Chinese Study Compares Flu Treatments: Prescription Drug Vs. Herbal Remedy

During the early days of the 2009 H1N1 influenza A pandemic, the popular herbal formula maxingshigan–yinqiaosan was used widely by TCM practitioners to reduce symptoms. (It’s hard to pronounce and spell, so I’ll refer to it as M-Y.) A new study was done to test whether M-Y worked and to compare it to the prescription drug oseltamivir. It showed that M-Y did not work for the purpose it was being used for: it did not reduce symptoms, although it did reduce the duration of one sign, fever, allowing researchers to claim they had proved that it works as well as oseltamivir.

“Oseltamivir Compared With the Chinese Traditional Therapy: Maxingshigan–Yinqiaosan in the Treatment of H1N1 Influenza” by Wang et al. was published in the Annals of Internal Medicine earlier this month. The study was done in China, which is notorious for only publishing positive studies. Even if it were an impeccable study, we would have to wonder if other studies with unfavorable results had been “file-drawered.” It’s not impeccable; it’s seriously peccable.

It was randomized, prospective, and controlled; but not placebo controlled, because they couldn’t figure out how to prepare an adequate placebo control. They considered that including Read more »

*This blog post was originally published at Science-Based Medicine*

How To Help Your Dog Survive The Snow

If you’ve ever had an Italian greyhound you know they hate the snow.  They hate the cold.  In general they hate the water but ours are starting to discover how fun water can be.  They hate being uncomfortable.  Mrs Happy and I have discovered that Marty and Cooper, our precious little babies, have a very tight range of comfort between 72 and 72.5 degrees Fahrenheit.  Anything below that and they’re shivering.  Cooper, our grey Iggy with the white boots, is slightly more tolerant of having cold feet.  But Marty, our little white Iggy with the grey helmet, has no tolerance for snow or cold feet.

Just the other day I heard a whimper coming from outside only to discover little Marty struggling to climb the stairs of our deck.  He hobbled into the house limping on three feet and  crying, making high pitched shrieking noises and trying to garner all the attention he could get.  Why you ask?  Because his feet got cold after walking on the snow for less than a minute. Read more »

*This blog post was originally published at The Happy Hospitalist Blog*

Can You Diagnose A Cough By Its Sound?

DiscoveryNews is reporting on a Bedford, Massachusetts company developing software that can detect the difference between a typical cough and one caused by a cold, flu, COPD, or a number of other respiratory diseases. STAR Analytical Services is working with a database of pre-recorded coughs to determine signatures that point to underlying conditions.

The final 100 to 150 milliseconds of the cough contains the distinctive sounds that could help doctors and nurses remotely diagnose a cough as the common cold or more serious pneumonia.

Even with a limited amount of data, scientists can distinguish between a healthy, voluntary cough and the involuntary cough of a sick person. Healthy people have slightly louder coughs, about 2 percent louder than a sick person. 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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