April 10th, 2011 by admin in Book Reviews
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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*
April 10th, 2011 by Elaine Schattner, M.D. in Opinion
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An article in the March 24 NEJM called Specialization, Subspecialization, and Subsubspecialization in Internal Medicine might have some heads shaking: Isn’t there a shortage of primary care physicians? The sounding-board piece considers the recent decision of the American Board of Internal Medicine to issue certificates in two new fields: (1) hospice and palliative care and (2) advanced heart failure and plans in-the-works for official credentialing in other, relatively narrow fields like addiction and obesity.
The essay caught my attention because I do think it’s true that we need more well-trained specialists, as much as we need capable general physicians. Ultimately both are essential for delivery of high-quality care, and both are essential for reducing health care errors and costs.
Primary care physicians are invaluable. It’s these doctors who most-often establish rapport with patients over long periods of time, who earn their trust and, in case they should become very ill, hold their confidence on important decisions — like when and where to see a specialist and whether or not to seek more, or less, aggressive care. A well-educated, thoughtful family doctor or internist typically handles most common conditions: prophylactic care including vaccinations, weight management, high blood pressure, diabetes, straightforward infections – like bacterial pneumonia or UTIs, gout and other routine sorts of problems. Read more »
*This blog post was originally published at Medical Lessons*
April 10th, 2011 by ChristopherChangMD in Health Tips, Research
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Researchers in Turkey found that there is an association between nasal hair density and risk of asthma developing in patients with seasonal rhinitis patients. No joke… They published their findings in the International Archives of Allergy and Immunology in March 2011.
The rate of asthma found in patients with little or no nasal hair was 44.7% whereas only 16.7% of patients with a dense forest of nasal hair had asthma.
They hypothesize that increased nasal hair improves allergen filtration thereby preventing the allergens from irritating the airway. The assumption here being that allergen irritation of the airway can potentially cause asthma.
IF this is true (and that’s a big if)… patients with allergies should be encouraged to grow nice thick nasal hair to prevent future asthma!
Read the research abstract here!
Reference:
Does Nasal Hair (Vibrissae) Density Affect the Risk of Developing Asthma in Patients with Seasonal Rhinitis? Int Arch Allergy Immunol. 2011 Mar 30;156(1):75-80
*This blog post was originally published at Fauquier ENT Blog*
April 10th, 2011 by PeterWehrwein in Health Policy, Health Tips
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Opening Day, the first day of the 2011 major league baseball season, was March 31st. The first pitch was thrown a little after 1 p.m., and sometime after that baseball fans heard the first crack of the bat of a brand-new season.
Even nonfans can rejoice at this sign of spring, and a promise that summer days are ahead.
But you won’t hear the crack of the bat very much these days from other diamonds—Little League, high school, and college. It has been replaced by pings and thunks as most players at those levels now use metal bats or composite ones, which that are made with a mixture of materials, including graphite.
Players started using metal (usually aluminum) bats about 30 years ago. They last longer than wooden bats and send the ball farther. The composite models have come on strong more recently.
But there’s growing concern that nonwood bats may pose a safety hazard to fielders—especially pitchers— because they make a hit baseball go faster. The added speed gives fielders less time to react and, if they are hit, increases their risk of injury. Read more »
*This blog post was originally published at Harvard Health Blog*
April 9th, 2011 by Edwin Leap, M.D. in Opinion
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I sometimes see men and women who come to the emergency department and tell me about their PTSD, caused by service in Iraq or Afghanistan. I believe some of them; others I doubt, since their PTSD seems directly connected to a desire for Percocet, Lortab, MS-Contin or other prescriptions for back pain. Sadly, the VA system does not lend itself to inquiry by outside physicians, so in many instances I am treating them in an information vacuum.
However, as I contemplate their allegations of PTSD, I wonder how many physicians and nurses from emergency departments have the disorder. I’m no psychiatrist, but it just seems probable that the years of cummulative stress, the years of sleeplessness and snap decisions, the untold shifts filled with unpredictable chaos, pain, threats, death and anxiety would add up to significant emotional turmoil for providers who work in that environment.
It is appropriate that we are attentive to the needs of those who serve in combat zones. And yet, they may spend only spend one or two years there. Granted, that can be terrible enough. Read more »
*This blog post was originally published at edwinleap.com*
