April 28th, 2011 by Paul Auerbach, M.D. in Health Tips
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Along with blisters and sprains, muscle strains are among the most common afflictions for active persons in the outdoors. Common medical dogma is to use the “RICE” approach for sprains and strains of—rest, ice (application of cold), compression, and elevation.
This is more applicable to sprains (e.g., an ankle sprain) than to strains, because the sprained body part is usually a limb (ankle, knee, wrist)
that is amenable to this approach. Strains more often involve larger muscle
groups, such as those in the back, chest, thigh or abdomen, or difficult-to-approach areas, such as the neck or groin.
Prevailing theory for treatment of a muscle strain is that one applies external cold for 24 to 48 hours, and discontinues it after 72 hours, at which time one begins application of external heat. The rationale is
that swelling (from leakage of blood and tissue fluid) and inflammation prevail in the first two days, and that after three days, one wishes to increase local circulation and augment reabsorption of the fluid that has collected. There is some science to this, and these recommendations have been around for as long as I can recall. Read more »
This post, Muscle Strain: Should You Treat It With Hot Packs Or Cold Packs?, was originally published on
Healthine.com by Paul Auerbach, M.D..
April 28th, 2011 by Elaine Schattner, M.D. in News, Opinion
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A few days ago I read that Dr. Lazar Greenfield, Professor Emeritus at the University of Michigan, resigned as the president-elect of the American College of Surgeons over flak for authoring a Valentine’s Day-pegged, tacky, tasteless and sexist piece in Surgery News. The February issue is mysteriously absent in the pdf-ied archives. According to the Times coverage: “The editorial cited research that found that female college students who had had unprotected sex were less depressed than those whose partners used condoms.
From Pauline Chen, also in the Times:
It begins with a reference to the mating behaviors of fruit flies, then goes on to discuss studies on the menstrual cycles of heterosexual and lesbian women who live together. Citing the research of evolutionary psychologists at the State University of New York, it describes how female college students who had been exposed to semen were less depressed than their peers who had not, concluding: “So there’s a deeper bond between men and women than St. Valentine would have suspected, and now we know there’s a better gift for that day than chocolates.”
Not that I’m OK with any of this, as I’ve known the ickiness of older male physicians who don’t even realize when they’re being inappropriate. Read more »
*This blog post was originally published at Medical Lessons*
April 28th, 2011 by Toni Brayer, M.D. in Health Policy, Opinion
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Everyone knows about “Octomom” and her octuplets born after in-vitro fertilization (IVF). That was an extreme case, but multiple births resulting from unregulated artificial reproductive technologies have skyrocketed over the last decade. The increased rate of twins, triplets and even higher multiples are due to in-vitro treatments and those women and infants are at much higher risk of pregnancy complications, premature birth and long term health problems.
New research, published in theJournal of Pediatrics, looked at admissions at just one hospital in Montreal, Quebec and found multiple embryo transfers was responsible for a significant proportion of admissions to the neonatal intensive care unit (NICU). These infants were born severely preterm. Six babies died and 5 developed severe intraventricular hemorrhage or bronchopulmonary dysplasia. The researchers extrapolated their data to the entire country of Canada and said that a universal single-embryo transfer policy would have prevented 840 NICU admissions, 40 deaths and 42,488 days in the NICU. The cost was $40 million annually. Read more »
*This blog post was originally published at EverythingHealth*
April 27th, 2011 by Michael Kirsch, M.D. in Health Policy, News, Opinion
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Recently, nine patients died in Alabama when they received intravenous nutrition that was contaminated with deadly bacteria. This type of nutrition is called total parenteral nutrition, or TPN, and is used to nourish patients by vein when their digestive systems are not functioning properly. It is a milestone achievement in medicine and saves and maintains lives every day.
What went wrong? How did an instrument of healing become death by lethal injection? What is the lesson that can emerge from this unimaginable horror?
This tragedy represents that most feared ‘never event’ that can ever occur – death by friendly fire. No survivors. Contrast this with many other medical ‘never events’ as defined by the Centers for Medicare and Medicaid Services, such as post-operative infections, development of bed sores in the hospital or wrong-site surgery. Under the ‘never events’ program, hospitals will be financially penalized if a listed event occurs. Many physicians and hospitals are concerned that there will be a ‘never events’ mission creep with new outcomes added to the list that don’t belong there. Medical complications, which are unavoidable, may soon be defined as ‘never events’.
Do we need a new category of ‘never ever ever events’ to include those that lead to fatal outcomes? Read more »
*This blog post was originally published at MD Whistleblower*
April 27th, 2011 by AnneHansonMD in Health Tips, Opinion
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Sideways Shrink posed a great question recently in a comment on my post “When A Thick Skin Helps.” The question was whether or not physicians are allowed to hit a patient who tries to assault them.
Certainly, physical assaults on patients are not the standard of practice in psychiatry or any other medical specialty. Psychiatrists do undergo some training about physical management of violent patients: I remember in residency we had to get trained in “take down” and restraint procedures. As a group we practiced applying pressure point joint locks on each other in order to make a patient break a grip on us, and to do two person restraints to hold someone immobile until security could arrive. None of this involved any “Crouching Tiger, Hidden Dragon”-type kung fu moves, there was no kicking or hitting or loud kiai karate yells. There was a lot of talk about the importance of being as least forceful as possible. Frankly, I’m not sure how much of that I would have remembered if I had ever been in a position to have to use it. The few times when I was actually assaulted by patients the incidents happened so fast there really wasn’t anything I could have done. (OK, so the little manic lady who hit me with a stuffed dog really couldn’t count as an assault, and she was already restrained in a geri-chair to begin with.)
But the real question is: will a doctor get into trouble for defending him or herself? Read more »
*This blog post was originally published at Shrink Rap*
