DocTalk

Regarding George Steinbrenner's passing. Just why do people die of a heart attack. The Cliff notes answer is on the web today.

www.MDdirect.org/blog

 

Gone for a month, tied up wit hwork adn editing a variety of medical articles. I presume that nobody missed my weekly diatribes but they have returned.

Headlines recently have been filled with overdoses and it offers opportunity t talk briefly about tylenol and aspirin.

Thanks for waiting; it's good to be back.

www.MDdirect.org/blog

 

My patients always want to know why I ask so many questions. I may not be smart enough to visualize their issues and it's the only way that I can figure out what they are trying to tell me. A short philosophy blurb on the web today.

www.MDirect.org/blog

 

It's note sports related (unless you count Rocky shakes) but how can you ignore a half billion egg recall. This week it's about salmonella and how it really doesn't matter. More on the web

 

Latest research says that more kids are showing up in ERs with head injuries, even though there are 13% less kids playing organized sports. It may be that kids are bigger, stronger and faster. It may be that equipment and coaching are lacking. Or it may be that 10-15 years ago, guideline recommendations said that getting your bell rung was no big deal and you could return to the game within a few minutes.

Here is he original article:
http://pediatrics.aappublications.org/cgi/reprint/peds.2010-2005v1?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=concussion&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT

and/or you could read my two cents worth.

 

I'm new to these boards, and new to journalism, but this seems like a great resource. I will most definitely be coming to you for information. Cool idea Doc!

 

Concussion discussion...the NFLPA and the Eagles go it wrong with Steward Bradley.

www.MDdirect.org/blog

 

http://sports.espn.go.com/nfl/news/story?id=5575885

It goes without saying that a concussion victim would not clear enough in three days to return to play. Many teams from high school through the pros use the IMPACT testing program to provide an objective score fro reflexes and emotional stability after a concussion has occurred.

A player takes a baseline test in the off season and then repeats it after the concussion has occurred. Scores that return near baseline are just one part of the evaluation that leads to the player being cleared to play. Because of the learing effect of taking a test more than once, scores are adjusted to make them valid. Still, it is up to the medical staff to decide that it is safe for the player to return.

Aside from the risk of repetitive concussions and their long term effect, the major concern is the potential for second impact syndrome. This occurs when the injured brain has had time to completely recover and a second injury causes the auto regulatory system of gthe brian to fail leading to brain swelling (cerebral edema) and death.

Shall we look at the Bradley replay again?

 

For those who wonder or care, it has been a difficult month of night shifts in the ER culminating with Oktoberfest weekend, the opportunity for otherwise reasonable people to become drunk and loos their sense and sensibilities. Night shifts happen every four months but now that sleep is happening when its dark out, the web articles too can become more regular.

This week talks about Mike Dantonio and chest pain. While heart disease remains a major public health issue, the approach to the chest pain patient in the ER is becoming more standardized and routine. The ability to diagnose and treat the cause sometimes occurs in a matter of minutes instead of the days and weeks it took a generation ago.The goal of treatment is more aggressive as well, hoping to return patients to their full level of pre MI activity instead of just being satisfied that they are alive.

More on the web.

www.MDdirect.org/blog

 

My opinion: NFL pregame shows have become untamed monsters. They concoct story lines that are often carried through the game broadcast regardless of the story unfolding on the field. Imagine the potential problems with medical care if patients and physicians carried preconceived notions into their visit.

More in this week's web entry.

Thanks for reading.

Ben

 

I know that it's not Tuesday, but...

The latest research about CPR sayst hat simpler is better...push hard and fast on the chest until help arrives. The chances of survival double compared to complexity of standard CPR. How easy is that; almost anybody can do that. Hopefully everybody will. More on the web.

www.MDdirect.org/blog

 

Am I the only one that gets tired of reading about business on the sports page? It's like reading about health care reform. Nothing in the discussion revolves around improving medical care; the focus is about who's going to pay for what.

Moe on the web.