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Study Investigates The Role Of Fluid Resuscitation In Treatment Of Life-Threatening Infections

Dehydration is a common phenomenon in those suffering from infectious diseases, particularly if the diseases cause vomiting and/or diarrhea. We are all familiar with having the “stomach flu,” “traveler’s diarrhea,” or food poisoning. However, severe infections of all sorts can cause profound illness, debilitation, and fluid losses. In many developing countries, very large numbers of small children are afflicted with non-gastrointestinal infectious diseases that rapidly cause relatively large fluid losses, and therefore profound, life-threatening dehydration, which is manifested in part by dangerously low blood pressure and subsequent failure to deliver precious liquid, nutrients and oxygen to the tissues of the body. This is called “shock.”

The following discussion is cutting edge information, but not simplistic or necessarily easy to understand or apply. However, I have learned that my readers are often volunteers in settings where intensive care medicine must be applied, and want to read more than simple approaches to therapy. So, I am going to do my best to interpret for you what has recently been published in the New England Journal of Medicine in an article entitled “Mortality after Fluid Bolus in African Children with Severe Infection” (N Engl J Med 2011; 364:2483-95) written by Kathryn Maitland and her colleagues.

The focus of their investigation was Read more »

This post, Study Investigates The Role Of Fluid Resuscitation In Treatment Of Life-Threatening Infections, was originally published on by Paul Auerbach, M.D..

Criminal Trial For Michael Jackson’s Physician Is Underway

The 2nd degree manslaughter trial of Dr. Conrad Murray, the doctor who attended Michael Jackson at the time of his death June 25, 2009,  is now underway in LA.  The testimony that is taking place is certainly revealing of the last day of Mr. Jackson’s life.  Michael Jackson died of an acute Propofol overdose and the toxicology report also revealed Valium, Lorezepam, Versed, Lidocaine  and Ephedrine in his system.  There were no illegal drugs.

Propofol is used as a powerful anesthetic and is given intravenously.  It is not a drug that would be used outside of a medical facility or hospital.  Versed (Midazolam) is also a drug that is used for conscious sedation for procedures in hospitals.

Dr. Conrad Murray is a cardiologist and served as Michael’s personal physician.  He was trained at Meharry Medical College and did post graduate work at Mayo Clinic and Loma Linda University Medical Center in California.  He studied Cardiology at Read more »

*This blog post was originally published at EverythingHealth*

Changing The Micropore Density On The Skin: Advancement In Drug Delivery

One of the major areas of research in the medical device industry is how to effectively deliver drugs to their target sites. The gold standard for systemic delivery of drugs is an intravenous (IV) injection, though it is not a great way to deliver meds that address chronic needs because of the pain and inconvenience. There have been exciting developments in transdermal delivery, such as the nicotine and birth control patches, though certain molecules and drugs do not easily diffuse through the epidermal layer to reach the more vascularized layers below.

One potential solution is to Read more »

*This blog post was originally published at Medgadget*

The New Way To Find A Vein: Vein Lights For IV Access

Here’s how we used to find a difficult vein.  If a floor nurse could not get an IV in, they asked one of their colleagues to try.  If their colleague could not find the impossible-to-locate vein, they contacted an ICU nurse.  If the ICU nurse couldn’t get one, sometimes an ER nurse or a flight nurse would try.  If they still couldn’t get an IV, then I would be paged to ask if they could get an order for an anesthesiologist to try.  And if the anesthesiologist couldn’t figure out how to find a difficult vein, we got a PICC line with the PICC nurse or with the radiologist or I placed a central line if the patient could not wait for a PICC line.
That’s how we used to find a difficult IV.

How do we find one now?  If you’re on the floor, you use one of these cheaper vein lights to find the difficult vein and place your IV.  However, if you work in Happy’s ER, now you have a $6,000 Star Trek looking vein finder for those dehydrated nursing home patients and cracked out meth heads. Read more »

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

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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