Category Archives: Neurology

35% of UpToDate topics are updated every four months. The editors select a small number of the most important updates and share them via "What's new" page. I selected the brief excerpts below from What's new in endocrinology:

Physicians as a group are leaner, fitter and live longer than average Americans. Male physicians keep their cholesterol and blood pressure lower.

However, doctors are less likely to have their own primary care physician—and more apt to abuse prescription drugs.

Lifestyle habits

Exercise: Many physicians say they "embed" it into their lives, making it a non-negotiable part of their daily routine, often early in the morning before demands pile on. One doctor says he gets up at 4:45 a.m. virtually every morning to train for marathons he runs. "But by 8:30 at night, I have the IQ of a zucchini," he says.

Smoking: Only 2% to 4% of physicians smoke cigarettes, compared to roughly 24% of the U.S. population.

Stress: For all their good habits, it's no secret that doctors are under enormous pressure.

References:
What Patients Can Learn from the Ways Physicians Take Care of Themselves. WSJ.

The American Heart Association is adopting new cardiopulmonary Resuscitation (CPR) guidelines that do away with mouth to mouth resuscitation and focus on chest compressions. Do fast, forceful compressions; the beat of "Stayin' Alive" is the right pace - 100 beats per minute. Queen's "Another one bites the dust" was rejected as an alternative song choice.

Currently, this recommendation only applies to laymen CPR. The professional rescuers (EMTs, doctors, etc.) should use the previous approach with a compression-breathing (ventilation) ratio of 30:2.

However, “chest compression only” CPR is recommended if the rescuer is not trained (for example, in dispatcher assisted CPR) or is not willing to give rescue breaths. The aim is now to compress the chest to a depth of 5-6 cm (rather than 4-5 cm). This recommendation is based on several studies showing that deeper compressions were associated with improved short term outcomes.

Dr. Sanjay Gupta shows Matthew McConaughey the new way of doing CPR on Larry King Live.

Bee Gees - Stayin' Alive (1977).

References:
New CPR is spelled C-A-B. CNN.
New international guidelines on resuscitation. BMJ, 2010.

Updated: 10/27/2010

From BMJ:

If you search "medicine" on Google Images, you get a hundred million photographs.

The most common image is a stethoscope. The next is a bottle of pills (or, sometimes, red and black capsules). The next is a surgeon, masked and gowned, slicing skin with a scalpel.

Try "patient" and you will find lots of people in stripy pyjamas, lying obediently in bed, often with a spotty rash or a leg strung up in an orthopaedic hoist.

New images are needed to break the century-old stereotypes in medical photographs.

References:
New images needed: stereotypes in medical photographs. BMJ 2010;340:c1524.

Wendy Sue Swanson, who blogs as Seattle Mama Doc, is a pediatrician in Seattle who recently gave a keynote at the Swedish Medical Center as part of their 2010 Health Care Symposium. See for yourself why doctors must use social media to stay uptodate and educate the public:

Link via KevinMD

Gonorrhea is a common sexually transmitted bacterial infection. If left untreated, gonorrhea can lead to pelvic inflammatory disease, ectopic pregnancy, and infertility in women. Treatment for gonorrhea usually consists of a single dose of one of two antibiotics, cefixime or ceftriaxone.

The current drugs of choice, ceftriaxone and cefixime, are still very effective but there are signs that resistance, particularly to cefixime, is emerging and soon these drugs may not be a good choice.

Only one remaining class of antibiotics is recommended for the treatment of gonorrhea - cephalosporins. Historically, gonorrhea has progressively developed resistance to the antibiotic drugs prescribed to treat it. Thus, it is critical to continuously monitor antibiotic resistance in Neisseria gonorrhoeae.

As a side note that highlights the prevalence of the problem, there are at least 10 songs titled "Gonorrhea" by various artists in the Amazon.com MP3 music store.

CDCStreamingHealth | April 16, 2010: This video, produced by Be Smart. Be Well., raises awareness of Sexually Transmitted Diseases (STDs): 1) What are they? 2) Why they matter? and, 3) What can I do about them? Footage courtesy of Be Smart. Be Well. http://www.besmartbewell.com, featuring CDC's Dr. John Douglas, Division of Sexually Transmitted Disease Prevention.

References: