The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head. — William Osler
A intussuception as seen on CT
An intussusception is a medical condition in which a part of the intestine has invaginated into another section of intestine, similar to the way in which the parts of a collapsible telescope slide into one another.This can often result in an obstruction. The part that prolapses into the other is called the intussusceptum, and the part that receives it is called the intussuscipiens.Early symptoms can include nausea, vomiting (sometimes bile stained [green color]), pulling legs to the chest area, and intermittent moderate to severe cramping abdominal pain. Pain is intermittent not because the intussusception temporarily resolves, but because the intussuscepted bowel segment transiently stops contracting. Later signs include rectal bleeding, often with “red currant jelly” stool (stool mixed with blood and mucus), and lethargy. Physical examination may reveal a “sausage-shaped” mass felt upon palpation of the abdomen.
Large field-of-view pulmonary MR angiography
How a human lung is kept alive and breathing for a transplant
Lung in a box. Very cool.
To extend the time an organ can last before it’s transplanted into a recipient, engineers have developed the Organ Care System — which is essentially a box pumping blood and oxygen to the lung.
As Gizmodo explains:
What’s especially neat about the OCS is that they can actually be used to improve imperfect donor lungs by flushing it with antibiotics and nutrients. Like refurbishing a lung, sort of. Putting donor lungs through the OCS helps increase and improve the number of potential donor lungs. Not every donor lung is usable, donor lungs that go through the OCS may be.
Learn more about lung transplants at Al Jazeera America.
Quiet Please! Silencing Many Hospital Alarms Leads To Better Health Care
Go into almost any hospital these days and you’ll hear a constant stream of beeps and boops. To most people it sounds like medical Muzak.
But to doctors and nurses, it’s not just sonic wallpaper. Those incessant beeps contain important coded messages.
"The three-burst is a crisis alarm," systems engineer James Piepenbrink of Boston Medical Center explains on a tour of 7 North, the hospital’s cardiac care unit. That might signal that a patient’s heart has gone into a potentially fatal arrhythmia or even stopped altogether.
"Two tones is a warning," he says. That can mean something ominous — or nothing worth worrying about.
Alarms are good and necessary things in hospital care, except when there are so many of them that caregivers can’t keep track of the ones that signal a crisis that requires immediate attention. Then it may be that less technology can actually be more effective.
In the case of Boston Medical Center, an analysis found that 7 North was experiencing 12,000 alarms a day, on average. That kind of cacophony was producing a growing problem known as “alarm fatigue.”
"Alarm fatigue is when there are so many noises on the unit that it actually desensitizes the staff," says Deborah Whalen, a clinical nurse manager at the Boston hospital. "If you have multiple, multiple alarms going off with varying frequencies, you just don’t hear them."
That can be dangerous. Patients can die when an important alarm is missed, or an electrode on a patient’s chest comes unstuck, or a monitor’s battery goes dead.
Boston Medical Center hasn’t recorded any patient deaths because of alarm failure, but, Whalen says, “we were lucky.” A Boston Globe investigation in 2011 found more than 200 deaths nationally related to alarm problems. Last year, the Joint Commission, a national quality-control group, warned of 98 alarm-related instances of patient harm, including 80 deaths and 13 cases of permanent disability.
The known alarm-related problems are just the tip of an iceberg, according to Dr. Ana McKee, the Joint Commission’s chief medical officer, because such cases are seriously underreported.
"It is pervasive in almost any accident that occurs in a hospital," McKee says. "If you look carefully, you will most likely find that there was an alarm as a contributing factor."
That’s why the Joint Commission has put alarm problems at the top of its current list of issues that hospitals are expected to tackle.
Photo: Amanda Gerety, a staff nurse at Boston Medical Center, checks monitors that track patients’ vital signs. Fewer beeps means crisis warnings are easier to hear, she says. (Richard Knox/NPR)
Syria’s War Creates A Market For Artificial Legs : Parallels
Before Syria’s civil war, there was no real need for a clinic that could teach the disabled how to walk on artificial legs. Now there’s huge demand, not only for the legs, but also for training.
Photo: Deborah Amos/NPR
[Johns Hopkins neuroscientist Michael] Yassa’s research team gave people 100 to 300 milligrams of caffeine after looking at some images. The next day, those who got 200 or 300 milligrams of caffeine remembered the images better than people who took a placebo. “We report for the first time a specific effect of caffeine on reducing forgetting over 24 hours,” Yassa said. “We conclude that caffeine enhances consolidation of long-term memories in humans.” —
Scientists find that in addition to sharpening short-term attention and alertness, caffeine can improve long-term memory consolidation. There is, however, a tipping point – go over a certain dosage (200 mg, or the equivalent of one strong cup of coffee) and you might experience “some unfortunate side effects.”
Also see the secret illustrated history of coffee, how it conquered the world, and Esquire’s vintage guide to brewing the perfect cup.(via explore-blog)
(Source: , via explore-blog)
Primary care physicians report that anxiety is one of the most frequent complaints driving patients to their offices — more frequent, by some accounts, than the common cold.
Few people today would dispute that chronic stress is a hallmark of our times or that anxiety has become a kind of cultural condition of modernity. — The culture, causes, and costs of anxiety
(Source: , via explore-blog)
"The number of overweight and obese in the low- and middle-income countries now outnumbers those in richer countries, a study finds.” NPR’s Jason Beaubien explains.
For Two Young Doctors, Working On Christmas Was A Privilege
December is supposed to be the time of year filled with family gatherings and holiday good cheer. For medical residents, quite the opposite is true.
There are no school breaks during residency. Being a medical resident is a real job, and a stressful one at that. Residents work long shifts, even with caps that max out at 16 hours for the newbies and up to 28 hours for those beyond the first year.
For many of our trainees — especially those fresh out of medical— this will be the first holiday season without time off.
I remember lamenting my first December having to work straight through. A wise mentor helped me reframe my self-pity.
"It’s a privilege to work on Christmas," he told me. "Our patients count on us. You may not want to be in the hospital, but think of what they’re going through." He smiled, as if he were welcoming me to a special club, one that I wasn’t wholeheartedly ready to join. "Your mere presence helps reduce each patient’s sense of loss."
I was rotating in intensive care, where the outlook for patients can be quite grim on any day, regardless of the season.
A 30-something patient I’ll call Will was brought in after paramedics found him unconscious on the street.
He was in a coma. We didn’t know the cause, but set to work trying to give him every opportunity to arise from the slumber of his critical illness.
I was on the rotation with two other interns. We took turns spending nights in the hospital — each of us taking every third night on call. The first night, my buddy Paul spent the night at Will’s bedside trying to figure out a way to replenish his body with fluid, given the massive output that was draining into his urine bag.
Will had suffered a brain injury. One effect was diabetes insipidus, a condition that meant his kidneys couldn’t hold onto his body’s water. The result can be rapid dehydration and death.
Illustration by Katherine Streeter for NPR