September 18th, 2011 by Linda Burke-Galloway, M.D. in True Stories
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There are some patients that keep you humbled. Barbara Tate was one of those patients. With a shopping list of chronic conditions a mile long, she was told she could never carry a baby because she had miscarried two during her early 20’s. She suffered the hammer blows of diabetes, high blood pressure, congestive heart failure and asthma. And it doesn’t stop there. Tate also had a history of two slipped disks, a cellulitis infection and a non-cancerous tumor on her adrenal gland. In fact she was scheduled to have surgery until she discovered she was pregnant at the age of 43. She was strongly encouraged to terminate the pregnancy because of her multiple medical conditions but she didn’t. Tate viewed her pregnancy as a miracle and for all intent purposes, it was. After age 37, there is a rapid decline in the ability to conceive although not impossible.
Her baby was born three months early and it appears that she was unaware of the classic signs of premature labor. On the day of her child’s birth, Read more »
*This blog post was originally published at Dr. Linda Burke-Galloway*
September 18th, 2011 by DrWes in Health Policy
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It was kind of funny reading this recent article from the New York Times that focuses on a relatively small health data breach from Stanford Hospital’s emergency room:
A medical privacy breach involving Stanford Hospital in Palo Alto, Calif., led to the public posting of data for 20,000 emergency room patients, including names and diagnosis codes, on a commercial Web site for nearly a year, the hospital has confirmed.
Since discovering the breach last month, the hospital has been investigating how a detailed spreadsheet made its way from one of its vendors, a billing contractor identified as Multi-Specialty Collection Services, to a Web site called Student of Fortune, which allows students to solicit paid assistance with their schoolwork.
Gary Migdol, a spokesman for Stanford Hospital and Clinics, said the spreadsheet first appeared on the site on Sept. 9, 2010, as an attachment to a question about how to convert the data into a bar graph.
Although medical security breaches are not uncommon, the Stanford breach was notable for Read more »
*This blog post was originally published at Dr. Wes*
September 17th, 2011 by Bongi in True Stories
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In quite a few of the cultures in south africa people tie ribbons, strings and tassels around their own and their children’s wrists and waists. These tassels are imbibed with power to keep evil spirits at bay, I am told. If these tassels come off then the patient is completely unprotected from any and all marauding evil spirits that may be lurking around. Of course, not wanting to be responsible for the unopposed assault by multiple evil spirits, most people are fairly reticent to remove these things. I saw it slightly differently.
As a student I took my lead from my senior. If he removed the tassels then I would be ok with it. If he felt that we should respect the culture of the patient and sort of try to move the tassels out of the way of the operating area or even operate around them, despite the increased infection risk, I sort of reasoned it was his patient and even if I medically didn’t agree with him, the reasoning of respecting the patient’s culture surely held some water at least and I didn’t argue. The fact of the matter was that a number of the sisters would become quite aggressive with the doctor if they thought he was going to remove the tassels and strip the patient of his evil spirit protection, and I think some of the doctors were scared. Then one day something happened that cemented my views and actions for the future. Read more »
*This blog post was originally published at other things amanzi*
September 17th, 2011 by CynthiaBaileyMD in Health Tips
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It could be a common dry skin rash called pityriasis alba.
With pityriasis alba, the white patches of fine dry scale are usually located on the sides of the cheeks and the outer side of the upper arm. They’re more likely to occur when activities or weather conditions dry out the skin such as swimming in chlorinated pools or with the temperature extremes of a cold and dry winter. They also show up more when skin is tanned because the scaly patches stay white and contrast against the tanned skin. That means that towards the end of summer, they may well be in full bloom if you live in a dry climate.
What is pityriasis alba?
It’s a subtle form of eczema (also called dermatitis). It’s an unusual rash though because there really isn’t much, if any, inflammation. This means the involved skin doesn’t itch, it just looks funny. Most people mistake it for a fungus, which it isn’t. It’s just a form of dry skin eczema.
What treatments will help get rid of the white spots from pityriasis alba? Read more »
*This blog post was originally published at Dr. Bailey's Skin Care Blog*
September 17th, 2011 by admin in Health Tips
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With the release of the movie Contagion, I thought it would be appropriate to post my cheat sheet on how to investigate a disease outbreak. Aspiring disease detectives take notes!
What do you think of when you hear the word “outbreak”? Maybe you envision a population decimated by a terrible, novel, and incurable disease like in the aformentioned movie Contagion or you think of Dustin Hoffman roaming around California in a blue biocontainment suit with Rene Russo trying to protect folks from a tiny monkey and narrowly preventing an airstrike by the US military?
Hollywood has done their best to capture what an outbreak is…but here are the facts. An outbreak, or epidemic, occurs when there are more cases of disease than would normally be expected in a specific time and place. The disease may be something doctors have already seen before just in a new form or abnormally high numbers, such as foodborne or healthcare-associated infections, or it may be an emerging disease that we don’t know much about like SARS. Either way, we need to investigate to determine why it is happening and how to prevent other people from getting sick or dying. 
Outbreaks are usually noticed by an astute clinician, such as those who first noticed AIDS in New York City and San Francisco, but there are also many high tech disease detection systems available to help us spot any increase in illness. PulseNet is a laboratory network that uses PFGE (pulsed-field gel electrophoresis) to help identify foodborne outbreaks by monitoring the genetic make-up of the bacteria causing what may otherwise look like unrelated illnesses. In the recent events of the Salmonella outbreak in ground turkey, PulseNet and the National Antimicrobial Resistance Monitoring System helped identify the cause of the outbreak as well as determine how widely it had spread. Programs such as Biosense and First Watch monitor the chief complaint or reason that someone called 9-1-1 or went to the hospital (aka syndromic surveillance). We also monitor news media for reports of outbreaks and websites such as Google Flu trends, which tracks circulating viruses and illnesses. With new technology ordinary citizens can also increasingly report outbreaks in their communities too.
The Magic Formula
So how do you figure out the who, what, when, and where of a disease outbreak? Read more »
*This blog post was originally published at Public Health Matters Blog*
There are some patients that keep you humbled. Barbara Tate was one of those patients. With a shopping list of chronic conditions a mile long, she was told she could never carry a baby because she had miscarried two during her early 20’s. She suffered the hammer blows of diabetes, high blood pressure, congestive heart failure and asthma. And it doesn’t stop there. Tate also had a history of two slipped disks, a cellulitis infection and a non-cancerous tumor on her adrenal gland. In fact she was scheduled to have surgery until she discovered she was pregnant at the age of 43. She was strongly encouraged to terminate the pregnancy because of her multiple medical conditions but she didn’t. Tate viewed her pregnancy as a miracle and for all intent purposes, it was. After age 37, there is a rapid decline in the ability to conceive although not impossible.
