Category: Medlinks

State-Of-The-Art Surgery

From Medical News Today

Medical Center Accreditated by the American College of Surgeons:

The Beth Israel Deaconess Medical Center’s Carl J. Shapiro Simulation and Skills Center has been formally accredited as a Level 1 facility by the American College of Surgeons (ACS), the first in Boston and New England – and one of only six inaugural certified centers in the United States – to provide simulation-based skills training to health care students and professionals from all medical and surgical disciplines.

I would love to get that training.

Dr. Jon Mikel Iñarritu

Screening Measures for Cancer

Elisa Camahort wrote at Healthy Concerns a Frequently Asked Question: What are the best preventative screeinngs -of cancer- we all should do?
By now, there is evidence for three types of cancer, the recommendations of the US Preventive Services Task Force are the following:

Breast Cancer

  • Screening mammography, with or without clinical breast examination, every 1-2 years for women aged 50 and older.
  • Discusse with women in their 40s.
  • Women should be screened until their predicted life expectancy is less than 10 years.
  • Women with a strong family history should receive counseling for several options, which may include genetic testing for BRCA-1 and BRCA-2 and more intensive screening for breast cancer.
  • Regular clinical breast examinations.

Cervical Cancer

  • Target sexually active women with an intact cervix, starting three years from age of onset of sexual activity or at age 21.
  • Screening is routinely done by cytological examination.
  • Among women with repeatedly negative findings, screening more often than every three years rarely detects important conditions.
  • Screening women with previous negative findings every three years is a reasonable approach.

Colorectal Cancer

  • Target patients over age 50 years: Annual FOBT (Fecal Occult Blood Test) plus flexible sigmoidoscopy every five years OR colonoscopy every 10 years.
  • Patients should be asked about first and second degree relatives who have had colorectal cancer (number of relatives and age of diagnosis).
  • In order to screen high risk patients, ask the following questions starting at age 30 and update every 5 years: Have you ever had colorectal cancer or an adenomatous polyp? Have you had inflammatory bowel disease (ulcerative colitis or Crohn’s disease)? Has a family member had colorectal cancer or an adenomatous polyp? If so, how many, was it a first-degree relative (parent, sibling, or child), and at what age was the cancer or polyp first diagnosed?.
  • Patients at high risk should have screening colonoscopy starting at age 40 years, or 10 years younger than the earliest diagnosis in their family, whichever comes first, and repeated every five years.

Other Types of Cancer

  • There are not evidence to recommend screening.

Regards,

Dr. Jon Mikel Iñarritu

New ePOCRATeS

With new look, new content and new features appears the new ePOCRATeS Rx.

I’ve been trying this brand new version of ePOCRATeS and I think that it’s quite better than the previous version.

The main features are:

  • My Epocrates personalized homepage
    • Go straight to the drug monographs you recently viewed
    • Create shortcuts to get to your favorite applications faster
    • Launch MobileCME activities in your specialty
    • Edit your profile
My ePOCRATes My ePOCRATeS News and updates Lookup
  • New drug safety content
    • Therapeutic Drug Levels
    • Monitoring Parameters
    • Non-Interchangeable Forms
    • Pregnancy and lactation information
  • New decision support tools
    • Corticosteroid Converter
    • Narcotic Analgesic Converter
    • Heparin Dosing Protocol
    • INR Calc
    • Topical Corticosteroids
  • Memory Card support (this is nice)
  • More than 3,300 brand and generic drug monographs, searchable by name or class
  • Peer-reviewed drug content summarized from a wide range of authoritative sources
  • MultiCheck drug-interaction checker (30 drugs simultaneously)
  • Integrated health insurance formularies
  • MedMath* medical calculators, e.g., Body Mass Index, Creatinine Clearance
  • Ability to personalize the application to suit your needs
  • DocAlert messaging — relevant, timely clinical and specialty news
  • AutoUpdate

Give it a try.

Regards,

Jon Mikel Iñarritu, M.D.

Mobile Data Visualization

At Quinn Lab, San Diego Supercomputer Center, doctor Quinn, has an outstanding project called Patient Notes with mobile devices.

The famous and enthusiastic project of Dr. Quinn and Dr. Wright, consists in the transmission of medical data to mobile devices such as PDAs and cell phones to enable medical workers in the field to instantaneously gain access to, view and prognosticate on complex medical visualizations.

With this software, medical notes and patient tests can be downloaded onto a cell phone or PDA in just minutes.

All the data on a phone is stored in the memory expansion slot. In these medical phones, however, Instead of music and digital pictures, it could hold a virtual scan of the body and much more.

Examples:

Dr. Quinn's Patient Notes
The 3-D mobile medical data program should be available within a year.

This is a good start to revolutionize the way of getting access to medical information about our patients.
Its uses are endless: ambulance, emergency departments, office, etc.

McGraw-Hill’s Access Surgery

With a “very cheap” subscription rate of $995 (OMG!!) you can have access to Access Surgery, inside you can find this stuff:

  • Surgical Videos: Columbia University College of Physicians and Surgeons Surgical
  • Animations: Adapted from Zollinger’s Atlas of Surgical Operations, 8th Edition
  • Textbook: Schwartz’s Principles of Surgery, 8th Edition
  • Textbook: CURRENT Surgical Diagnosis & Treatment, 12th Edition
  • Surgical Atlas: Zollinger’s Atlas of Surgical Operations, 8th Edition
  • Surgical Anatomy: Skandalakis’ Surgical Anatomy
  • Board Review: Surgery Review Illustrated
  • Quick Answers: CURRENT Consult Surgery Table of contents (see the image below).

AccessSurgery

Special Features:

  • Create your own Board Review test from Surgery Review Illustrated, then email results to your program director
  • View Surgical Videos on your iPod from the Schwartz editorial team
  • Look up a symptom or disease in our Differential Diagnosis (DDx) tool
  • Download the free PDA diagnostic tool from CURRENT Consult Surgery
  • Assess the extent of disease through Cancer Staging Tables
  • Discover related Government Guidelines by clicking a pre-populated search box
  • Launch a Customized Search for just videos, just images, or view full-site results
  • Research medication indications, dosages, and contraindications through an integrated Drug Database provided by Gold Standard.

The site was launched on July 18th.

Will you pay for this material? (It’s a question, because I don’t)

Regards,

Jon Mikel Iñarritu, M.D.

Getting NOT enough or TOO MUCH sleep increases risk of type 2 Diabetes Mellitus

Via Diabetes Care Journal.

A cohort study (made by Yaggi, Araujo and McKinlay) who enroll men from 1987-9 to 2004 showed the next results:

Men reporting short sleep duration (< =5 and 6 h of sleep per night) were twice as likely to develop diabetes, and men reporting long sleep duration (>8 h of sleep per night) were more than three times as likely to develop diabetes over the period of follow-up.

So, If you get too much or not enough sleep, you can develop Diabetes Mellitus.

Source: Diabetes Care 2006;29:657-661.

Regards,

Jon Mikel Iñarritu, M.D.