Monday, November 4, 2013
Carmat - Artificial Heart (France)
Thursday, September 12, 2013
Measles cases on the rise in US - Related to anti-vaccine sentiment?!
Excerpts from CNN article dt. 9/12/13
159 cases so far (Jan 1, 2013 - Aug 24, 2013)
92% of them were not vaccinated against measles.
Most of them are from communities that refuse vaccination.
WHO announced measles as 'eradicated' in 2000.
Expected to exceed 222 reported in 2012.
500 cases were reported in 1996.
Sunday, August 11, 2013
Friday, July 26, 2013
Night before X-mas in CMHH - Dr. J.T.Bricker
The night before Christmas at Children’s Memorial
Hermann…
'Twas the night before Christmas with the
hospital packed
Cardiology fellows were poised to react
Progress notes were recorded with care
even though other services never looked at them
there
The PICU team briefly headed to bed
expecting new wheezers to land overhead
Cardiology fellows decked out in scrubs
had listened to each of the little lub-dubs
When outside the window there was such a sound
"Must just be one more LifeFlight
inbound"
But update by phone made it quite clear
that Anesthesia and Surgery soon would be here
Across Hermann Park it came lively and quick
a red helicopter with Bill, Mike, and the Brick
More blue babies, new babies, on a LifeFlight
ride
some needing new treatments before never tried
To NICU and PICU new patients were brought
"Let's get them all fixed before viruses are
caught"
On Henry, on Tharak, on Doshis A and Doshi U,
they can help do stuff that's brand-new
On Julie, Ashish, Nazari, and Claudeen
scanning and checking that everything's seen
Doug, Beth, and Rebecca will get it all done
moving cases on just as a new one’s begun
Our attendings, PICU, surgeons and all
helped make this Christmas Eve a memorable on
call
As the excitement calmed down we heard a
prediction
that seemed to us all to be more fact than
fiction
"Merry Christmas to all, we all believe
even
more babies are coming to us New Year's Eve"
Sunday, April 28, 2013
Sunday, April 21, 2013
Saturday, April 20, 2013
Wednesday, April 17, 2013
Saturday, April 13, 2013
Monday, April 8, 2013
Tuesday, March 26, 2013
Fewer Work Hours for Medical Trainees - More Mistakes.
Time article link
Doctors & Nurses
Fewer Hours for Doctors-in-Training Leading To More Mistakes
By Alexandra SifferlinMarch 26, 20130
MARTIN BARRAUD / GETTY IMAGES/OJO IMAGES RF
Giving residents less time on duty and more time to sleep was supposed to lead to fewer medical errors. But the latest research shows that’s not the case. What’s going on?
Since 2011, new regulations restricting the number of continuous hours first-year residents spend on-call cut the time that trainees spend at the hospital during a typical duty session from 24 hours to 16 hours. Excessively long shifts, studies showed, were leading to fatigue and stress that hampered not just the learning process, but the care these doctors provided to patients.
And there were tragic examples of the high cost of this exhausting schedule. In 1984, 18-year old Libby Zion, who was admitted to a New York City hospital with a fever and convulsions, was treated by residents who ordered opiates and restraints when she became agitated and uncooperative. Busy overseeing other patients, the residents didn’t evaluate Zion again until hours later, by which time her fever has soared to 107 degrees and she went into cardiac arrest, and died. The case highlighted the enormous pressures on doctors-in-training, and the need for reform in the way residents were taught. In 1987, a New York state commission limited the number of hours that doctors could train in the hospital to 80 each week, which was less than the 100 hour a week shifts with 36 hour “call” times that were the norm at the time. In 2003, the Accreditation Council for Graduate Medical Education followed suit with rules for all programs that mandated that trainees could work no more than 24 consecutive hours.
(MORE: Should Your Doctor Be Napping on the Job?)
In 2011, those hours were cut even further, but the latest data, published online in JAMA Internal Medicine, found that interns working under the new rules are reporting more mistakes, not enough sleep and symptoms of depression. In the study that involved 2,300 doctors from more than a dozen national hospitals the researchers compared a population of interns serving before the 2011 work hour limit was implemented, to interns working after the new rule, during a three-month period. The former group were on-call every fourth night, for a maximum of 30 hours, while the latter group worked no more than 16 hours during any one shift. They gathered self-reported data from on their duty hours, sleep hours, symptoms of depression, well-being and medical errors at three, six, nine and 12 months into their first year of residency.
Read more: http://healthland.time.com/2013/03/26/fewer-hours-for-doctors-in-training-leading-to-more-mistakes/#ixzz2OeP7W4A2
Doctors & Nurses
Fewer Hours for Doctors-in-Training Leading To More Mistakes
By Alexandra SifferlinMarch 26, 20130
MARTIN BARRAUD / GETTY IMAGES/OJO IMAGES RF
Giving residents less time on duty and more time to sleep was supposed to lead to fewer medical errors. But the latest research shows that’s not the case. What’s going on?
Since 2011, new regulations restricting the number of continuous hours first-year residents spend on-call cut the time that trainees spend at the hospital during a typical duty session from 24 hours to 16 hours. Excessively long shifts, studies showed, were leading to fatigue and stress that hampered not just the learning process, but the care these doctors provided to patients.
And there were tragic examples of the high cost of this exhausting schedule. In 1984, 18-year old Libby Zion, who was admitted to a New York City hospital with a fever and convulsions, was treated by residents who ordered opiates and restraints when she became agitated and uncooperative. Busy overseeing other patients, the residents didn’t evaluate Zion again until hours later, by which time her fever has soared to 107 degrees and she went into cardiac arrest, and died. The case highlighted the enormous pressures on doctors-in-training, and the need for reform in the way residents were taught. In 1987, a New York state commission limited the number of hours that doctors could train in the hospital to 80 each week, which was less than the 100 hour a week shifts with 36 hour “call” times that were the norm at the time. In 2003, the Accreditation Council for Graduate Medical Education followed suit with rules for all programs that mandated that trainees could work no more than 24 consecutive hours.
(MORE: Should Your Doctor Be Napping on the Job?)
In 2011, those hours were cut even further, but the latest data, published online in JAMA Internal Medicine, found that interns working under the new rules are reporting more mistakes, not enough sleep and symptoms of depression. In the study that involved 2,300 doctors from more than a dozen national hospitals the researchers compared a population of interns serving before the 2011 work hour limit was implemented, to interns working after the new rule, during a three-month period. The former group were on-call every fourth night, for a maximum of 30 hours, while the latter group worked no more than 16 hours during any one shift. They gathered self-reported data from on their duty hours, sleep hours, symptoms of depression, well-being and medical errors at three, six, nine and 12 months into their first year of residency.
Read more: http://healthland.time.com/2013/03/26/fewer-hours-for-doctors-in-training-leading-to-more-mistakes/#ixzz2OeP7W4A2
Saturday, February 16, 2013
Friday, February 15, 2013
Saturday, January 5, 2013
Spitzer's Laws of Neonatology
(I found these "laws" after Dr. Bricker directed me to do so. Interesting and have to agree with several of them!) I have included some personal exchanges that were part of the posting. Link to original posting.
Spitzer's Laws of Neonatology
--------------------------------------------------------------------------------
Spitzer's Laws have been handed down to us from the very dawn of Neonatology, or perhaps one should say from the meconium-stained birth of our fine specialty. In those days, men were men, women were women, giants walked the earth, computers were the size of moving vans, and neonatology fellows were on call every other night but still found time for basic research on prostaglandins in fetal sheep. The subtler interpretations and corollaries of these laws have been lost in the mists of time, but they still contain useful kernels of truth for the post-modern pediatric house officer.
-- RD
--------------------------------------------------------------------------------
1. The more stable a baby appears to be, the more likely he will "crump" that day.
2. The distance that you have to go for a transport is directly proportional to the degree of illness of the baby.
3. The incidence of transport calls is inversely proportional to the number of available beds.
4. The nicer the parents, the sicker the baby.
5. The incidence of neonatal problems increases dramatically if either parent is a physician or a nurse.
6. Endotracheal tubes are designed to fall out (or become plugged, etc.) at the most critical moment.
7. The milder the RDS, the sooner the infant will find himself on 100% oxygen and maximal ventilatory support.
8. The likelihood of BPD is directly proportional to the number of physicians involved in the care of the baby.
9. The longer a patient is discussed on rounds, the more certain it is that no one has the faintest idea what's going on or what to do.
10. The patient who is glossed over quickly on rounds is the most likely to crump that day.
11. The sickest infant in the nursery can always be discerned by the fact that he is being cared for by the newest, most inexperienced nursing orientee.
12. The surest way to have an infant linger interminably is to inform the parents that death is imminent.
13. The more miraculous the "save," the more likely that you'll be sued for something totally inconsequential.
14. The probability of infection is directly proportional to the number of antibiotics that the infant is already receiving.
15. If it ain't CHD, it's PFC (or vice versa).
16. If they're not breathin', they may be seizin'.
17. Lasix (Vitamin L) will squeeze urine out of bricks. Unfortunately, it doesn't always work as well in babies.
18. Antibiotics should always be continued for --- days (fill in the blank with any number from 1 to 21).
19. If you can't figure out what's going on with a baby, call the surgeons. They won't figure it out either, but they'll sure as hell do something about it.
20. The month you are on service always has three times as many days as any other month on the calendar.
--------------------------------------------------------------------------------
From: Alan Spitzer
Sent: Saturday, January 18, 1997 1:09
To: rduncan@mailgate.csmc.edu
Subject: Spitzer's Law of Neonatology
Ray-
I was both surprised and pleased to find my laws of neonatology on your extremely well-done web site. And while I am getting on in years (50 in 2 weeks!), I don't know that these laws were created at the "dawn of neonatology." It makes me sound like I brought them down from the mountain with Moses and his Top 10. In any event, though, I appreciate the PR, although it gets tougher and tougher for me to admit that with over 150 publications and a big fat textbook to my credit, the laws are my number one citation! I'm glad, though, that people have enjoyed them over the years. Thanks again for posting them.
Alan Spitzer
--------------------------------------------------------------------------------
Created 11/27/94 / Last modified 1/18/97
Neonatology on the Web / webmaster@neonatology.org
Spitzer's Laws of Neonatology
--------------------------------------------------------------------------------
Spitzer's Laws have been handed down to us from the very dawn of Neonatology, or perhaps one should say from the meconium-stained birth of our fine specialty. In those days, men were men, women were women, giants walked the earth, computers were the size of moving vans, and neonatology fellows were on call every other night but still found time for basic research on prostaglandins in fetal sheep. The subtler interpretations and corollaries of these laws have been lost in the mists of time, but they still contain useful kernels of truth for the post-modern pediatric house officer.
-- RD
--------------------------------------------------------------------------------
1. The more stable a baby appears to be, the more likely he will "crump" that day.
2. The distance that you have to go for a transport is directly proportional to the degree of illness of the baby.
3. The incidence of transport calls is inversely proportional to the number of available beds.
4. The nicer the parents, the sicker the baby.
5. The incidence of neonatal problems increases dramatically if either parent is a physician or a nurse.
6. Endotracheal tubes are designed to fall out (or become plugged, etc.) at the most critical moment.
7. The milder the RDS, the sooner the infant will find himself on 100% oxygen and maximal ventilatory support.
8. The likelihood of BPD is directly proportional to the number of physicians involved in the care of the baby.
9. The longer a patient is discussed on rounds, the more certain it is that no one has the faintest idea what's going on or what to do.
10. The patient who is glossed over quickly on rounds is the most likely to crump that day.
11. The sickest infant in the nursery can always be discerned by the fact that he is being cared for by the newest, most inexperienced nursing orientee.
12. The surest way to have an infant linger interminably is to inform the parents that death is imminent.
13. The more miraculous the "save," the more likely that you'll be sued for something totally inconsequential.
14. The probability of infection is directly proportional to the number of antibiotics that the infant is already receiving.
15. If it ain't CHD, it's PFC (or vice versa).
16. If they're not breathin', they may be seizin'.
17. Lasix (Vitamin L) will squeeze urine out of bricks. Unfortunately, it doesn't always work as well in babies.
18. Antibiotics should always be continued for --- days (fill in the blank with any number from 1 to 21).
19. If you can't figure out what's going on with a baby, call the surgeons. They won't figure it out either, but they'll sure as hell do something about it.
20. The month you are on service always has three times as many days as any other month on the calendar.
--------------------------------------------------------------------------------
From: Alan Spitzer
Sent: Saturday, January 18, 1997 1:09
To: rduncan@mailgate.csmc.edu
Subject: Spitzer's Law of Neonatology
Ray-
I was both surprised and pleased to find my laws of neonatology on your extremely well-done web site. And while I am getting on in years (50 in 2 weeks!), I don't know that these laws were created at the "dawn of neonatology." It makes me sound like I brought them down from the mountain with Moses and his Top 10. In any event, though, I appreciate the PR, although it gets tougher and tougher for me to admit that with over 150 publications and a big fat textbook to my credit, the laws are my number one citation! I'm glad, though, that people have enjoyed them over the years. Thanks again for posting them.
Alan Spitzer
--------------------------------------------------------------------------------
Created 11/27/94 / Last modified 1/18/97
Neonatology on the Web / webmaster@neonatology.org
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