Did the Canadian health system fail Natasha Richardson?

Would Natasha Richardson be alive today if she had gone skiing in the United States instead?

I don’t think it would have made a difference.

To recap the tragedy, Ms. Richardson died from an epidural bleed, after she fell while skiing. Her presentation was somewhat classic, with the well-described “lucid” period before she deteriorated.

According to Canada’s Globe and Mail, “ambulance workers were not …

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Why do I need a rectal exam, and what can doctors find with the gloved finger?

Have you ever wondered why doctors have to perform a digital rectal exam?

Well, look no further, as primary care doctor Rob Lamberts gives us the answers discerning readers demand.

Simply by looking at the rectum, which by the way, indeed “takes some getting used to,” can lead to significant diagnostic findings. Furthermore, does tight sphincter tone matter? And should you be worried about the large hands …

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Relative value units, and how the RVU payment system doesn’t allow doctors to practice good medicine

For those who don’t know, every piece of work that a doctor performs is quantified and measured.

The base unit of physician work is known as the relative value unit (RVU). Most physician salaries are determined by the amount of RVUs a doctor produces in a given year, and in most cases, can range between$35 and $45 per RVU in primary care, depending on geographic location and …

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Ways you can die from having sex

Cosmo Magazine, that bastion of reliable medical advice, declares, “An orgasm almost killed her.”

Intrigued, gynecologist Amy Tuteur reads further, and finds its about case where a woman developed stroke-like symptoms after intercourse, and was diagnosed with an embolic stroke.

The patient was taking the birth control pill, which can raise the risk of blood clots. In this case, it was also combined with the presence of …

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How many babies can one woman carry?

That’s a question I was asked more than once, in light of this week’s story about the birth of octuplets.

For the answer, I’ll refer to this article in Slate. The largest reported number of fetuses in a single womb is 15.

The limit is not so much the number of fetuses, but the combined size and weight. As Christopher Beam explains, “once the total …

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Her hands and feet amputated, a Brazilian model dies from Pseudomonas aeruginosa sepsis. What happened?

Mariana Bridi da Costa, a 20-year old Brazilian model, tragically died early Saturday morning from Pseudomonas aeruginosa urosepsis.

How can this happen?

Miss Bridi da Costa initially presented on December 30th, and was diagnosed with kidney stones. An ultrasound, plain film, or CT scan likely would have been done to confirm the diagnosis. I assume that a urinalysis was also performed, and if …

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What do doctors look for when they examine the abdomen?

A primary care doctor guides us through the abdominal physical exam.

He deciphers the much-written notation of “Abd: Soft, NT, Normal BS, no HSM or masses*,” and explains what physicians look for when they poke, prod, percuss, and listen to when examining a patient’s belly.

You’d be surprised at some of the things we find simply by pressing on the abdomen.

* For those who need translation, …

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Jett Travolta’s seizure and death, was Scientology a factor?

Jett Travolta tragically passed away yesterday, after being found unconscious in his hotel room by his caretaker. There is speculation that he had a seizure and hit his head on a bathtub.

Travolta apparently had a long history of medical problems, including Kawasaki disease, which is a vasculitis that primarily affects children. It is one of the most common causes of acquired heart disease in children, and …

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Is there a place for a part-time medical residency?

Doctors in training often do so in their prime family-rearing years.

A few pediatric residencies are offering part-time residency options, designed for those who also want to raise their own families. Proponents argue that residents can not only get more rest, but also avoid depression, which affected almost a quarter of pediatrics residents.

Combined with the talk of further limiting work hours down to 56 …

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Sharpie for surgery

Surgeons use markers to identify the right body part for procedures. Unfortunately, they care become contaminated with bacteria which can lead to surgical site infections.

Enter the Sharpie: “As it turns out, the ink used in a Sharpie pen has an alcohol base, making it an unexpected germ fighter.”

Who knew? The Sharpie is probably also many times cheaper than the single-use “sterile” pen used …

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Tom Brady and his knee infection

New England Patriots quarterback Tom Brady recently underwent repair of his anterior cruciate ligament at the Kerlan-Jobe Orthopaedic Clinic in Los Angeles. His doctor was Neal S. ElAttrache, who’s a renowned orthopedic surgeon and former team physician of an NFL team.

Unfortunately, his post-op course has been complicated by an infection. On his website, TomBrady.com, he acknowledged this and said that the original procedure was …

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Are MRI results accurate?

Most physicians and patients think that the MRI scan is one of the more sensitive and comprehensive diagnostic tests.

However, there is significant variability in reading and performing the scans, which makes having it done at a reputable institution more imperative:

Magnetic resonance machines, though, vary enormously, and not just in the strength of their magnets. Even more important, radiologists say, is the quality of the imaging …

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Bernie Mac, pneumonia, and sarcoidosis

Comedian Bernie Mac dies at age 50 from pneumonia. Sad news.

He had been recently hospitalized, and as recently as two days ago, it was reported he was stable and responding well to treatment. What happened?

There is very little medical information to go on. It was known that he had …

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My take: Tim Russert

WSJ Health Blog: “Russert’s doctor Michael Newman said the tough-questioning but congenial host of NBC’s ‘Meet the Press’ had been under treatment for asymptomatic coronary disease, but that it was under control with medication. He was carrying excess weight, Newman observed, but he got regular exercise and he performed well on an exercise stress test in April.”

GruntDoc: “I therefore propose a new sign in …

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My take: What makes a good medical blog?

Maria writes: “I’d like your take on what you think constitutes a ‘good’ medblog . . . I am continually surprised with what people like about medblogs. Some people like brief links, some people like critical discussions, some people like stories.

This ultimately all boils down to opinion, but I’d like to know what traits you like in medblogs.

Can you start by opining that you strongly dislike …

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Abortion by massage

Disturbing:

The petite 44-year old, who declined to give her last name, paid 150 pesos ($3) for a hilot, or traditional midwife like Minda, to crush her three-month old fetus using rough strokes and pincer-like grips on her belly.

The procedure, which can also involve pounding the lower abdomen to trigger a miscarriage, is called a massage.

(via Healthbolt)

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What killed Beethoven?

Lead poisoning is the common answer. However, new analysis (found in the Beethoven Journal – which I never knew existed) sheds new light:

Christian Reiter has conducted months of painstaking work applying CSI-like methods to strands of Beethoven’s hair.

He says his analysis, published last week in the Beethoven Journal, found that in the final months of the composer’s life, lead concentrations in his body spiked …

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