Category Archives: Neurology

Lee Memorial Health System is pleased to announce the following physicians joined our medical staff during the month of June:

- Amanda J. Avila, M.D. Neurology obtained her medical degree at the University of Vermont College of Medicine. She completed an Internal Medicine Internship and Neurology Residency at Rhode Island Hospital and a Movement Disorder Fellowship at the University of Florida. She is certified in Neurology by the American Board of Psychiatry and Neurology and has joined Florida Neurology Group.

- Alfonso Garcia-Bello, M.D. Internal Medicine obtained his medical degree at The Higher Institute of Medical Sciences of Havana. He completed an Internal Medicine Residency at Bronx Lebanon Hospital Center. Dr. Garcia-Bello has joined Cape Coral Hospitalists.

- Douglas J. Gottschalk, D.O. Pediatric Otolaryngology obtained his degree at Des Moines University of Osteopathic Medicine. He completed a General Surgery Internship at Via Christi Riverside Medical Center, A Surgery Residency at Wilford Hall USAF Medical Center, Lackland AFB and a Pediatric Otolaryngology Fellowship at Arkansas Children's Hospital. Dr. Gottschalk is certified by the American Board of Otolaryngology and has joined Lee Physician Group.

- Cindy J. Harris, D.O. Family Practice obtained her degree at the University of New England. She completed a Rotating Internship and Family Medicine Residency at Wilson Memorial Regional Medical Center. She is certified by the American Board of Family Medicine and has joined Hope HealthCare.

- Alejandro J. Miranda-Sousa, M.D. Urology obtained his medical degree at the University Peruana Cayetano Heredia. He completed a General Surgery Internship, Urology Residency and Neurourology & Urodynamics Fellowship at the University of South Florida. Dr. Miranda-Sousa is certified by the American Board of Urology and has joined Gulfstream Urology.

- Houtan Sareh, M.D. Pulmonary Medicine obtained his medical degree at the University of Miami School of Medicine. He completed an Internal Medicine/Pediatric Internship and Internal Medicine Residency at the University of Miami-Jackson Memorial Hospital; a Sleep Medicine Fellowship at Mount Sinai medical Center and a Pulmonary Medicine/Critical Care Fellowship at the University of Maryland Medical Center. Dr. Sareh is certified by the American Board of Internal Medicine in Internal Medicine, Pulmonary Disease and Sleep Medicine and has joined LPG Pulmonary, Critical Care and Sleep Medicine.

- Jennifer A. Springer, M.D. Emergency Medicine obtained her medical degree at Temple University School of Medicine. She completed an Emergency Medicine Residency at the Medical College of Pennsylvania. She is certified by the American Board of Emergency Medicine and has joined Lee Convenient Care.

- Leonid B. Trost, M.D. Dermatology obtained his medical degree at Ohio State University. He completed a Dermatology Residency and Mohs Surgery Fellowship at Cleveland Clinic. Dr. Trost is certified by the American Board of Dermatology and is a solo practitioner.

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Physicians join Lee Memorial Health System medical staff

Dr. Henry Echiverri, neurologist, Edward Neurosciences Institute.

storyidforme: 34017862 tmspicid: 12447744 fileheaderid: 5660247

Updated: July 24, 2012 2:02PM

Neurologist Henry Echiverri recently joined the Edward Neurosciences Institute. Dr. Echiverri is board certified in psychiatry, neurology and vascular neurology (stroke). He comes to Edward from NeuroMed Clinic in Warrenville where he was president and clinic director. Echiverri earned his medical degree from the University of the Philippines College of Medicine in Manila.

After spending time in surgical residencies at Philippine General Hospital in Manila and Northwest Hospital in Chicago, he completed a transitional internal medicine year at Edward Hines Jr. VA Hospital, followed by neurology residencies at Loyola University Medical Center and Hines VA Hospital.

Echiverri is a member of the American Academy of Neurology, American Academy of Electrodiagnostic Medicine, American Academy of Pain Management and American Heart Association. He was an Advisory Committee member of the Illinois CAPTURE (Care and Prevention Treatment Utilization Registry) Stroke Program.

Visit http://www.edward.org/neuro or call 630-527-7730 to learn about Dr. Echiverri and the Edward Neurosciences Institute.

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Dr. Echiverri joins Edward Neurosciences Institute

Public release date: 23-Jul-2012 [ | E-mail | Share ]

Contact: Rachel Seroka rseroka@aan.com 612-928-6129 American Academy of Neurology

MINNEAPOLIS Watching videos on YouTube may be a new way to show the treatment for a common cause of vertigo, which often goes untreated by physicians, according to a study published in the July 24, 2012, print issue of Neurology, the medical journal of the American Academy of Neurology.

Benign paroxysmal positional vertigo (BPPV) is an inner ear disorder that is a common cause of dizziness.

"This type of vertigo can be treated easily and quickly with a simple maneuver called the Epley maneuver, but too often the maneuver isn't used, and people are told to 'wait it out' or given drugs," said study author Kevin A. Kerber, MD, of the University of Michigan Health System in Ann Arbor and a member of the American Academy of Neurology. "We found that accurate video demonstrations of the maneuver that health care providers and people with vertigo can use are readily available on YouTube."

For the study, Kerber and his colleagues searched YouTube for videos showing the Epley maneuver and rated their accuracy. They also reviewed the comments posted regarding the videos to see how the videos were used.

"It was good to see that the video with the most hits was the one developed by the American Academy of Neurology when it published its guideline recommending the use of the Epley maneuver in 2008 and then posted on YouTube by a lay person," Kerber said. "But it was also good that the majority of the videos demonstrated the maneuver accurately."

Some comments showed that health care providers are using the videos as a prescribed treatment or to help patients learn about the maneuver. People with dizziness also seem to be using the videos to treat themselves.

"One shortcoming of the videos was that they did not include information on how to diagnose BPPV, and some of the comments indicate that people who do not have BPPV may be trying these maneuvers because of dizziness from other causes," Kerber said. "Despite this, we found it encouraging to think that YouTube could be used to disseminate information about this maneuver and educate more people about how to treat this disorder." Kerber and his colleagues are currently working on projects to test the effectiveness of video interventions on patient outcomes.

The disorder is likely caused by loose calcium carbonate crystals that move in the sensing tubes of the inner ear. The maneuver moves the calcium crystals out of the sensing tube and into another inner chamber of the ear, where they do not cause symptoms.

See the original post:
Is YouTube a prescription for vertigo?

Physicians would need to use their EMRs to meet 20 functionality objectives at minimum levels to earn bonuses and avoid penalties.

Core set (must meet all objectives listed below)

Use computerized physician order entry for medication, lab and radiology orders
Prescribe electronically
Record patient demographics
Record and chart vital signs
Record smoking status
Use clinical decision support
Incorporate clinical lab results into EMR
Generate lists of patients by specific condition
Set patient reminders for preventive and follow-up care
Provide patient portal access
Provide clinical summaries for patients
Identify education resources for patients
Use secure messaging with patients
Use medication reconciliation
Send summary of care records for referrals and care transitions
Send electronic data to immunization registries
Ensure EMR privacy and security

Menu set (must select and meet 3 objectives from the list below)

Access imaging results
Record patient family histories as structured data
Send electronic syndromic surveillance data to public health agencies
Have ability to report cancer cases to state registries
Have ability to report noncancer cases to state registries

Electronic medical record (EMR) - review of pros and cons in the Cleveland Clinic medical journal

Some negatives regarding the use of EMR:

- So far, electronic systems are not interconnectable
- Do electronic records improve or worsen the quality of care?
- Accuracy vs copying and pasting
- A third party in the examination room
- Devoid of real medical thought

A contrasting view:

- Connectivity will improve
- Staying focused on the patient, even with a computer in the room
- Doctor-doctor communication is enhanced

References:

Centers for Medicare & Medicaid Services, Electronic Health Record Incentive Program -- Stage 2, Feb. 23, 2012.
First look at the next stage of meaningful use - amednews.com

The electronic medical record: Diving into a shallow pool? CCJM.
The electronic medical record: Learning to swim. CCJM.
"The iPatient is getting wonderful care across America. The real patient wonders, "Where is everybody?" NYTimes, 2011.

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Here are my suggestions for some of the top articles in medicine for July 2012:

Participation in sport is associated with a 20-40% reduction in all-cause mortality. Exercise is a fifth vital sign! http://goo.gl/gyxYf

Renal denervation to treat resistant hypertension: Guarded optimism - CCJM http://goo.gl/svAvZ

Dengue: A reemerging concern for travelers. There is no antiviral treatment - CCJM http://goo.gl/gY6DO

POLST: An improvement over traditional advance directives - CCJM http://goo.gl/NhhbX POLST = Physician Orders for Life-Sustaining Treatment

Tonsillectomy changes: More children are operated for sleep disordered breathing and fewer for recurrent pharyngitis http://goo.gl/UXTfO

Bariatric surgery provides sustained weight loss, major improvements in severely obese individuals with diabetes type 2 http://goo.gl/OkV61

Twitter Use at American Society of Clinical Oncology Annual Meetings: 14-40 doctors generated 29% of meeting dialogue http://goo.gl/fw94I

Tweeting the Meeting: An In-Depth Analysis of Twitter Activity at Kidney Week 2011 - PLoS ONE http://goo.gl/eOmLO

Is your cat hosting a human suicide parasite? Toxoplasma gondii in chicagotribune http://goo.gl/oMW8M

How safe is your hospital? Consumer Reports magazine rates best (and worst) hospitals http://goo.gl/uHcTh

Conservatives Are Happier Than Liberals, and Extremists Are Happiest of All - NYTimes http://goo.gl/h67w9

Chronic hyperglycaemia and microvascular disease contribute to cognitive dysfunction, mental and motor slowing in both DM 1 and 2 http://goo.gl/hTTcK

5-10% of people per year with prediabetes will progress to diabetes (same proportion converts back to normoglycemia) http://goo.gl/oYbTk

Suicide is second to only accidental death as the leading cause of mortality in young men across the world. High-lethality methods of suicide are preferred by young men: hanging and firearms in high-income countries, pesticide poisoning in the Indian subcontinent, and charcoal-burning in east Asia. Lancet, 2012, http://goo.gl/DqMfF

Ethics of mitochondrial donation discussed in The Lancet http://goo.gl/JAVFC

Hepatitis E virus (HEV) was discovered during the Soviet occupation of Afghanistan in the 1980s, after an outbreak of unexplained hepatitis at a military camp. A pooled faecal extract from affected soldiers was ingested by a member of the research team. He became sick, and the new virus (named HEV), was detected in his stool by electron microscopy. Globally, HEV is the most common cause of acute viral hepatitis. http://goo.gl/vkaGB

The seventh cholera pandemic began in 1961 and still affects 3-5 million people each year, killing 120 000 http://goo.gl/bz07X

Psychiatry's identity crisis - The Lancet http://goo.gl/XfsM6

Paralympic medicine - Lancet review - 20 sports at Summer Paralympic Games, 5 at Winter Paralympic Games http://goo.gl/rpJhI

The articles were selected from my Twitter and Google Reader streams. Please feel free to send suggestions for articles to clinicalcases@gmail.com and you will receive an acknowledgement in the next edition of this publication.

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Performed in front of a live TV audience, Deep Purple storm through 'Child In Time', featuring the classic Mark II line up of Gillan/Glover/Lord/Paice/Blackmore:

From Jon Lord's official website:

Jon Lord has sadly passed away, July 16, 2012

It is with deep sadness we announce the passing of Jon Lord, who suffered a fatal pulmonary embolism today, Monday 16th July at the London Clinic, after a long battle with pancreatic cancer. Jon was surrounded by his loving family.

Jon Lord, the legendary keyboard player with Deep Purple co-wrote many of the bands legendary songs including Smoke On The Water and played with many bands and musicians throughout his career.

Best known for his Orchestral work Concerto for Group & Orchestra first performed at Royal Albert Hall with Deep Purple and the Royal Philharmonic Orchestra in 1969 and conducted by the renowned Malcolm Arnold, a feat repeated in 1999 when it was again performed at the Royal Albert Hall by the London Symphony Orchestra and Deep Purple.

Jon’s solo work was universally acclaimed when he eventually retired from Deep Purple in 2002.

Jon passes from Darkness to Light.

Jon Lord 9 June 1941 – 16 July 2012.

Here is a short clip of Jon Lord receiving and responding to the presentation of the Honorary Degree (Doctor of Music) from the University of Leicester, 2011:

I had the chance to see Jon Lord at a Deep Purple concert in 2001, and he was truly amazing.

Related reading:

Jon Lord obituary | Music | The Guardian - http://goo.gl/sohGI
BBC News - Deep Purple's Jon Lord dies at 71 - http://goo.gl/qvhiq
Malc Deakin talks to Jon Lord on Vimeo - http://goo.gl/cDvjU
Jon Lord death: Deep Purple founder dies aged 71 | Mail Online - http://goo.gl/G9FzX
Jon Lord & Steve Balsamo "Child In Time", May 2010 - YouTube http://goo.gl/SU231
BBC's Last Word: Ritchie Blackmore, Rick Wakeman, Geoff Barton pay tribute to Jon Lord. Also, Jon on how he'd like to be remembered. http://goo.gl/fW3VT
GTFM's Jon Lord Special by Andy Fox http://goo.gl/WqAcc

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