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Surgery Is An Organized Chaos Of Cords, Tubes And Wires

Surgery is messy… and I don’t mean in terms of blood and guts…

What I mean are wires, cables, tubing, etc.

Electric cord for the operating tableLet’s take a routine tonsillectomy and adenoidectomy for example…

  1. Electric cord for the anesthesia machine
  2. Electric cord for the surgeon’s headlight
  3. Light cord from the surgeon’s headlight to the lightbox
  4. Breathing circuit tube from the patient to the anesthesia machine
  5. Carbon dioxide outflow tube from the patient to the anesthesia machine
  6. Suction tubing from the surgical table to the vacuum canister
  7. Vacuum cable from the vacuum canister to the wall socket
  8. Electrocautery cable (along with electric cord to power the machine)
  9. Coblation cable (along with electric cord to power the machine)
  10. IV fluids lines from patient to IV bags
  11. EKG lines
  12. Grounding pad cable
  13. All the wires and cables that go with running a computer
  14. etc. etc. etc. Read more »

*This blog post was originally published at Fauquier ENT Blog*

Is There Scientific Evidence Suggesting Risks Associated With Prenatal Ultrasounds?

Several questionable sources are spreading alarms about the possible dangers of prenatal ultrasound exams (sonograms). An example is Christine Anderson’s article on the ExpertClick website. In the heading, it says she “Never Liked Ultrasound Technology.”

[She] has never been sold on the safety using Ultrasounds for checking on the fetuses of pregnant women, and for the last decade her fears have been confirmed with a series of studies pointing to possible brain damage to the babies from this technology.

Should We Believe Her?

Should we avoid ultrasounds because Anderson never liked them? Should we trust her judgment that her fears have been confirmed by studies? Who is she?

“Dr.” Christine Anderson is a pediatric chiropractor in Hollywood who believes a lot of things that are not supported by science or reason. Her website mission statement includes

We acknowledge the devastating effects of the vertebral subluxation on human health and therefore recognize that the spines of all children need to be checked soon after birth, so they may grow up healthy.

It also states that “drugs interfere… and weaken the mind, body, and spirit.” Anderson is Read more »

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

Will Physicians Soon Trade In Their Stethoscopes For Tiny Ultrasound Machines?

Recently, the Wall Street Journal did a great piece on how mobile technology is being used in medicine. They looked at the major avenues of use — from the hospital to personal to emergency care settings.

They gave an example of how a cardiologist has stopped carrying a stethoscope, and now just uses mobile ultrasound, a modality we have highlighted numerous times in the past.

Dr. Topol, a cardiologist in San Diego, carries with him instead a portable ultrasound device roughly the size of a cellphone. When he puts it to a patient’s chest, the device allows him to peer directly into the heart. The patient looks, too; together, they check out the muscle, the valves, the rhythm, the blood flow.

“Why would I listen to ‘lub dub’ when I can see everything?” Dr. Topol says. Read more »

*This blog post was originally published at iMedicalApps*

Book Review: Atlas of Ultrasound-Guided Procedures in Interventional Pain Management

Narouze SN, ed. Atlas of Ultrasound-Guided Procedures in Interventional Pain Management.  Springer 2011, 372 pages, 465 illustration, $189.00.

In 1941, Dr. Karl Theodore Dussik of Austria introduced the idea of using ultrasound waves as a diagnostic tool. Over the next few decades he, along with others like Professor Ian Donald of Scotland, developed the practical technology and applications of ultrasound in the field of medicine. Since then, ultrasound (US) has become progressively more useful across a wide range of medical specialties, for both diagnostic and therapeutic procedures. US is quickly becoming the imaging modality of choice to guide practitioners in pain management and musculoskeletal interventions. Although fluoroscopy has long been a mainstay in image-guidance for such procedures, US provides an attractive alternative given its superior soft tissue resolution, allowance of real-time needle guidance, absence of iodinated contrast and lack of ionizing radiation.

The Atlas of Ultrasound-Guided Procedures in Interventional Pain Management by Narouze et al. is a comprehensive review of the principles of US-guidance as an aid in current pain management practices. It is divided into six parts and 30 chapters arranged by system and discipline. Leading experts in each discipline have contributed to this body of work, providing an extensive literature review encompassing each chapter. This text is meant to serve as a user-friendly manual, covering the anatomy, treatment rationale, and technical aspects of US-guided interventional pain management procedures. Read more »

*This blog post was originally published at AJNR Blog*

Need An Ultrasound? There’s An App For That

Imagine walking into the room of a patient with ascites and pulling out your iPad (which you were just using to put in orders on another patient), pulling an ultrasound probe out of your pocket, connecting the two, and finding a fluid pocket from which to drain the abdominal fluid.

We’ve already shown how iPad’s can be useful in the OR. Now they, along with other tablets and smartphones, can be applied to bedside diagnostics and therapeutics to enhance patient safety while reducing costs. It’s a pretty exciting prospect being put forth by an mHealth startup called Mobisante. And having won awards at an MIT Enterprise Forum as well as the Mobile Health Expo, others certainly seem to buying in as well.

Mobisante, an mHealth company based in Redmond, WA, has recently been showing a new smartphone peripheral at conferences across the country: An ultrasound probe. According to the MIT Technology Review, the current prototype connects to a Toshiba TG01 smartphone and was originally developed as a laptop peripheral by David Zar, a computer engineer at Washington University in St. Louis. Read more »

*This blog post was originally published at iMedicalApps*

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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