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The most viewed discussions on doc2doc this month

Everest Deaths - 2012

Posted in Expedition and Mountain medicine at Thu, 23 May 2013 20:46:27

John D

Posts: 2060
Joined: 01 Feb 2010
The news coming through have been reporting about the deaths on Everest Climbers this year. It seems it is close to a dozen but most widely publicised was when four diead along with a Canadian woman. The manner was typical of a climber on Everest (as I can see):


and other climbers passing by the dead bodies when they try to summit:

CT and cancer risk in children - so much more to consider...

Posted in Radiology at Fri, 24 May 2013 08:39:35

hip radiologist

Posts: 322
Joined: 27 Oct 2011
A fresh Lancet article has outlined a tripled risk of leukaemia and brain cancer in children exposed to over 50 mGy of radiation through CT examination (link here). Understandably, this generates media interest, with a reasonably well balanced article by the Guardian highlighting the need to judge exposure according to whether the benefits outweight the risks.

Several important points arise from this news:
1) Just how can we really judge benefit vs risk in such situations on a case-by-case basis (as we the DoH claims we must in the Gaurdian article)?  Humans are notoriously bad at doing this, often relying on crude heuristics.

2) The study was conducted between 1985 and 2002, since when there have been significant improvements in dose reduction and a tightening of the belts when it comes to scanning in children. This underlines the signficant issue of just how can be we best understand the impact of what we do in the present?

3) What about adults?  We scan so frequently in some groups of individuals, often with the feeling from the radiology perspective that the imaging is just to reassure the clinicians rather than diagnose or guide therapy. How is the patient doing? Is the scan actually necessary? As many as 30% of adult CTs have been judged to be unnecessary (BMJ article link)

Thoughts, wisdom and debate all welcomed.  Please also post links to salient papers on the topic of cancer risk and iatrogenic radiation...

Should doctors who work night shifts get free travel home?

Posted in Careers at Fri, 24 May 2013 17:16:12

MustafaA

Posts: 26
Joined: 10 Jul 2012
I was just going through the notes of the latest BMA Junior Doctor report and one of the motions listed was: 

"That this meeting acknowledges that doctors are not always safe to drive home after night shifts.Therefore the BMA is strongly urged to campaign for free access to hospital accommodation/transport for doctors, upon completing a night shift."


Do you agree? Should staff receive free accomondation or travel expenses if they've worked a night shift? What do other professions do?  Would you appreciate help getting home?

Ignorant doctors and blood pressure

Posted in Cardiology at Thu, 23 May 2013 21:47:06

Majid Hameed

Posts: 50
Joined: 22 Feb 2013
Richard Smith says in his blog that blood pressure is everyone's responsibility and that patients need to reclaim it from their ignorant doctors.  He also makes an interesting point as to whether high blood pressure is a 'disease' or a risk factor for CV disease. I personally favour the latter approach but I am asking the doc2doc community for their thoughts.
http://blogs.bmj.com/bmj/2013/05/16/richard-smith-reclaiming-blood-pressure-from-doctors/

BMJ Diabetes Team of the Year 2013 - Diabetes Care in Primary School

Posted in Diabetes at Thu, 23 May 2013 22:19:53

RP OUH UK

Posts: 2
Joined: 23 May 2013
I attended the BMJ Awards last night which was an impressive event showcasing some real advances in improving the quality of healthcare.

The winners of the Diabetes Team of the Year award went to Oxford University Hospitals NHS Trust, which improve diabetes care provision for primary school children who have type 1 diabetes. According to their blurb, "there are 29,000 children with Type 1 diabetest in the UK, around 40% of whom are in the primary school age-group." The problem is, however, that generally speaking there is a lack of people that work in schools who can actually administer insulin and blood testing whilst at school.

However, "after successfully overcoming barriers, the team negotiated a system with the PCT and Local Authority whereby diabetes specialist nurses (DSNs) train up volunteers identified by the school, and, together with the parents, draw up a comprehensive care plan and utilise a hand-held communication record book. By July 2012, a total of 342 volunteers were providing care for 132 children."

The team had to work hard to persuade the authorities -who were fearful about litigiation and the prospect of something going wrong- that this would be a successful and positive thing to implement - luckily they were able to go ahead and hopefully we will see more initiatives like this springing up across the country.

How does your region (in the UK or further afield) provide diabetes care for school children? Do you have a school nurse? Does a doctor or a parent have to come specially in? Or do you have trained up volunteers? 

Recommended Vitamin D dosage??

Posted in General at Fri, 24 May 2013 16:01:54

Michael Berry

Posts: 31
Joined: 10 Oct 2012
What should be the recommended dosage of vitamin D- 100 IU daily or 60,000 IU weekly? What would you prescribe a patient with or without vitamin D deficiency? 

Qatar jails a foreign teacher on charges of insulting Islam

Posted in General at Fri, 24 May 2013 06:53:29

kirked

Posts: 962
Joined: 08 Oct 2010
I am sure many here have worked in Qatar and other Golf countries (in their system) as their employee (foregin employee). It looks tough and things can twist easily which seems in this case as well. A foreign (Nepali) teacher has been jailed in Qatar in charges of insulting Islam:


What do you think in this case?

Is it this tough to work out there as a foreign national?

What are the odds of getting a surgical training place for non-EU graduates of UK medical schools?

Posted in Careers at Fri, 24 May 2013 03:24:53

SCMB

Posts: 2
Joined: 28 Apr 2013

Hello all,

I am an international student coming to the UK to study medicine. I have always wanted to study and train in the UK, but the later part of my aspiration is what has me paranoid and slightly confused. So here is my question. Is there really a good/fair chance that I (as a non EU citizen) would be able to obtain a training post in surgery granted that I successfully complete medical school and foundation training in the UK? How is the current situation in the UK for non EU graduates of UK medical schools? I am also interested in pursuing cardiothoracic surgery as a specialty.

Should everyone’s DNA be put on record?

Posted in Medical ethics at Fri, 24 May 2013 13:27:04

Carolin

Posts: 537
Joined: 16 Aug 2012

This is the topic of the latest BMJ Head to Head.  Would you want your genome sequenced and on file?

 

In the Yes camp. Professor John Burn says that this would provide a way to prevent, diagnose and treat disease quicker. “Genetic predisposition plays a central role in most common diseases,” he writes. “Clinically relevant discoveries are entering practice at a rate of more than 30 a month.” By sequencing our genomes we could understand patient populations and use this to develop drugs and even combat  lethal pathogens. http://www.bmj.com/cgi/doi/10.1136/bmj.f3133

 

However, Professor Frances Flinter in the No camp argues that just because we can do this technically speaking, doesn’t mean it is justified, pointing to sticky ethical questions that arise. She says “Our current, extremely limited, knowledge of most of the information that would be generated means that providing a meaningful interpretation is impossible.” The more sceptical or dystopian of us would say this is a step into a Big Brother state. Is it really necessary for everybody to be sequenced? Or just specific patient groups (e.g. cancer patients)?  Plus, would this just create a larger group of the ‘worried well’. Would you want to know you have a chance of getting a particular disease? Does it make sense to sequence the genomes of health individuals? http://www.bmj.com/cgi/doi/10.1136/bmj.f3132

Would you be willing to facilitate force feeding of Guantanamo Bay detainees?

Posted in News & media at Fri, 24 May 2013 16:29:53

sken

Posts: 182
Joined: 13 Oct 2009
International Media have been reporting for the last fortnight or so that about 100 detainees out of about 168 being held at Guantanamo Bay (GB) are on hunger strike (some detainees Lawyers have put the number of hunger strikers as closer to 130). Since GB became operational after Sept 11th attacks there have been intermittent such refusals to eat throughout its first twelve years. Forty extra Naval Doctors and Nurses have been deployed at GB to assist in force-feeding detainees with the use of Nasogastric tubes. GB has been very controversial since its inception ny messirs Bush/Cheney/Rumsfeld and leading Jurists have described it as a 'scab on Americas reputation around the world'. The former US Chief Prosecutor at GB has himself said that the detention facility has tarnished the United States reputation and that to hold detainees without trial is wholly wrong. The United Nations has specifically condemned the force feeding policy. It is understood that detainees are refusing nutrition because of their indefinite detention without fair trial; nor indeed any trial at all. One early case reveals only too clearly the legal limbo detainees are in. In the US Supreme Court Case of Hamdan v Rumsfeld 548 557 (2006) the Court ruled that Military Commissions established by the Bush Administration to try detainees at GB violated the Uniform Code of Military Justice and the Four Geneva Conventions signed in 1949 (and more specifically Common Article 3). On 5th June 2007 Hamdan had all charges dismissed. However, in December 2007 a tribunal determined that Hamdan was an 'unlawful enemy combatant' and in August 2008 was convicted by a military commission of the lesser of two charges and was sentenced to 66 months incarceration, reduced to five and a half months for time already served. In November 2012 The US Appeals Court for The District of Colombia overturned Hamdans conviction on all charges acquitting him - he had served over a decade incarcerated when he had committed no offence. There are believed to be a total of 6 people detained at GB who have been tried, convicted and sentenced. It is understood that two thirds of the detainees still being held at GB have been cleared for release - many of them were given clearance more than 3 years ago. With this in mind would you be willing to use your medical skills and knowledge to facilitate forced feeding of detainees?

Should you take vitamins and supplements?

Posted in News & media at Fri, 24 May 2013 13:42:16

Carolin

Posts: 537
Joined: 16 Aug 2012

This week Katy Perry posted a picture of all the many supplements she takes daily (three big bag fulls of vitamin tables per day).

What are people's views on vitamins and supplements - are they a waste of time and money or do they have some health benefits?

http://www.dailymail.co.uk/tvshowbiz/article-2329482/Katy-Perry-tweets-picture-bags-healthy-supplements.html

How should murderers be treated?

Posted in Medical ethics at Fri, 24 May 2013 16:03:03

John D

Posts: 2060
Joined: 01 Feb 2010
Following yesterday's appalling murder in London and the news that the attackers are in hospital after being shot by police, I was interested to explore the ethics of their treatment. As a student, much of my ethics training has been confined to fairly clear-cut scenarios where ethical principles neatly applied. Some may consider this to be different from a textbook example.
Facilitators have told of cases where practitioners have handed care over to another after they felt unable to continue due to cultural/religious/personal beliefs. I'm not suggesting that people who commit such crimes shouldn't be treated - doctors have a duty of care - but would you be able to continue to the best of your ability if you had objections against a patient?
How do you think personal beliefs could impact on the service you provided?

I'd be interested to hear your thoughts, thank you.

Looking for medical students in Uk to show me around their medical school

Posted in Student BMJ at Fri, 24 May 2013 08:02:18

Ms.L

Posts: 2
Joined: 09 Mar 2013
Hello,
  I am an african medical student, i ve just finished my pre clinical and will be starting my clinical years in august. i am here in england for the duration of my vacation and would like to meet a medical student who if interested would show me around their school. let me know asap

doc2doc interviews... Leifur Bardarson

Posted in General at Thu, 23 May 2013 20:54:16

DundeeChest

Posts: 1181
Joined: 15 Apr 2010

Our next member to be interviewed is Leifur Bardarson who joined doc2doc in 2010 and has recently being involved in the discussion Will Angelina Jolie's NY Times piece increase the rate of preventative mastectomy?, providing some thought-provoking analysis.  His specialty is paediatric surgery, which he studied in Gothenburg, Sweden in 1983. He worked as a paediatric surgeon for 15 years at Landspitalinn, the University Hospital in Reykjavik Iceland. In 1999 he studied Quality Improvement at The University of Bergen In Norway and after that worked as project manager at the Department of Quality Assurance again at Landspitalinn Reykjavík.  Since then Quality and Safety of healthcare has been his main focus and he had not missed a single International Forum of Quality and Safety in Health Care organised by BMJ and IHI since 2000. Since this spring he has been working at Directorate of Health in Iceland as a Chief Medical Doctor on quality and safety in healthcare.



doc2doc interviews... Leifur Bardarson

 

What made you want to be a doctor?  

Probably my desire to work with people and besides being a doctor looked exciting for a young man. What also helped was that I had already met my wife and she was determined to become a nurse. Ever since we have both worked in the healthcare. By now she is Director General at the Ministry of wellfare and I am chief medical doctor at the Directorate of Health in Iceland


Why did you choose your specialty?

Working with children means teamwork and when the team consists of both recievers of healthcare and caregivers, the mixture is ideal to solve clinical problems. I was determined to become a surgeon so paediatric surgery was the natural thing.


What’s the most interesting thing about your speciality/job? 

Speciality: Children are the most honest patients you can ever dream of meeting. If you honestly tell them the truth they will do walk through ice and fire for you


What has been your best moment in medicine?

In my younger days when working as a paediatric surgeon and you succeeded  with a newborn with very serious congenital malformation. You kind of got to be one of the family. In my later days when working as manager of  quality improvement at the University hospital and having designed and implemented an electronic incident reporting system hearing fellow doctors talking about incident reporting as normal part of their work.


And your worst?

Losing  a young child after surgery. Later when I get the feeling that we have only moved few inches on the road of delivery of health care toward patient safety while we have on the same time moved miles in clinical research. 


What advice would you give prospective doctors?

Try to learn from seniors within healthcare how show your patients dignity and respect. How to win their trust and loyalty. The hardcore facts in medicine is the easy part. You can reach that on Apps in your IPhone or IPAD. Apps for behavior is not on Apps.


What’s been your favourite doc2doc discussion of all time?

Probably the first one, about the eruption in Eyjafjallajökull.  Maybe it was mostly because this was something new to me. The discussion was very emotional at that time but quickly faded away and was forgotten when the eruption stopped. It is not forgotten here in Iceland because we are still fighting the ash which is still laying around in millions of tons.


What do you do when you are not being a doctor?

Travel to enjoy the diversity of the world. But what  I like most is standing by some beautiful river here in Iceland and catching salmon or being with my whole family at our vacation house at the national park at Þingvellir and enjoying the peace and beauty of mother nature.

Medical students behaving badly

Posted in General at Fri, 24 May 2013 17:05:47

Carolin

Posts: 537
Joined: 16 Aug 2012
.....in social media.

Yesterday I came across a medical student's account in twitter whose tweets were unconformable to read ( too many mentions to alcohol, very sexually charged....that sort).

Do you think we have any responsibility as senior doctors to call their attention and ask them to behave in a professional way?

But what if the medical student doesn't even belong to your own country of practice? Do we have any obligation to protect the corporative ethical image of doctors in this new global virtual world?

(I sent him a direct message, I must say his response was extremely polite)


Gun technology - what is acceptable to the American people?

Posted in News & media at Thu, 23 May 2013 21:05:07

John D

Posts: 2060
Joined: 01 Feb 2010

A self-aiming rifle has been announced.   An American company, XactSystems, is marketing the TrackingPoint, Precison Guided Firearm (PGF) rifle:
http://tracking-point.com/

This weapon is laser guided, in that once it is 'locked onto' its target, it then calculates the best moment to fire, based on the way the shooter holds it, wind speed, barometric pressure and temperature(air density) as well as the range to the target.   The only impediment is the price.  At $22,000 it's not a Saturday Night Pistol, and, as Duane has taught us, the manufacturers will inform the Federal liicencing system of who buys one.  But this gives anyone capable of lifting the device the ability to kill humans from three quarters of a mile away, and as we have established before, it could be sold on to anyone, without telling the Feds.
If, as we should, we recognise the right of Americans to decide if they should be armed or not, this then raises the question, what with?    Automatic weapons, extra large magazines, very high powered ammunition and now this, which in the wrong hands can make anyone a expert sniper.  To quote the website, "Using the PGF, you can be an elite, long-range marksman in minutes.

Inevitably, i appeal to Duane to explain what Americans think and why.   

John

Has UK law gone mad?

Posted in General at Fri, 24 May 2013 08:13:52

sken

Posts: 182
Joined: 13 Oct 2009
http://www.bbc.co.uk/news/uk-england-gloucestershire-22639675 Every year in Gloucestershire there is an annual cheese rolling contest. Participants chase a 7lb wheel of cheese down a hill, and the event has picked up a large following in recent years, with spectator numbers exceeding safe numbers for the site where the event is held. But this year a pensioner, who's wheels of cheese have been used for the last 25 years, has been told by police that she may be held responsible for any injuries the participants sustain should she go ahead and supply the cheese for this years events. Is this a legal system gone mad? I can accept that if there are safety issues due to crowd numbers, or the nature of the safety & medical provision the event organisers should be held responsible, but does supplying the cheese constitute sufficient responsibility? Can you really be held responsible for the uses of items you have produced? Should the makers of knives, guns & other weapons be held responsible for injuries caused by them? Should surf board manufacturers be responsible for those injured in surfing competitions? Where do you draw the line?

Cartoon: what do you need to be a doctor?

Posted in General at Fri, 24 May 2013 11:54:11

monica.lalanda

Posts: 7
Joined: 23 May 2013



What would you add? 
What would you remove?

Girl trouble

Posted in Cardiology at Fri, 24 May 2013 06:29:03

sadian

Posts: 878
Joined: 17 Jun 2011

my title comes from this session at EuroPCR
Unusual causes of STEMI in young women
It seems that the number of STEMI in young women is increasing and that that there is a worse outcome associated. This seems to me to be in keeping with lots of other observational data that suggests women's heart health is 'neglected'. How can we change this?

sadian

bed wetting in adults

Posted in Cardiology at Fri, 24 May 2013 05:47:10

Dr.Chid

Posts: 66
Joined: 21 Feb 2012
A 50 years old female visited me at the clinic seeking for advice about her secondary bed wetting, the only positive thing in history is optic glioma that operated on 2 years ago is it related? Please help me.

My way in the War against Five Stages of type 2 Diabetes Mellitus

Posted in Diabetes at Fri, 24 May 2013 09:40:54

Stagnaro

Posts: 59
Joined: 24 Jun 2009
According to WHO competent Authorities, in 2010 there were  250 milion of diabetics, and they will be 366 milion in 2030, indicating that type 2 DM is today's growing epidemics (1-16).   In my opinion, the primary prevention ot T2DM, especially when initiated in the first two stages, according to Quantum Biophysical Semeiotics classification,  among the five of the natural history of the disease, is far better than the therapy, as usually.
Unforunately, Diabetic "and" Dislipidemic Constitutions, conditio sine qua non of T2DM, are nowadays overlooked by the majority of physicians all around the world (12-14). A long well established clinical experience allows me to state that with the aid of Quantum Biophysical Semeiotics, physicians can bedside recognize, quickly and easily,  the "microcirculatory remodelling", based on newborn-pathological, subtype a) oncological , and b), aspecific, type I, Endoarteriolar Blocking Devices in tissue, wherein does really exist the inherited real risk of human common and severe diseases, as diabetes mellitus(12-16).
Obviously that happens in individuals with defined Biophysical Semeiotics Constitutions, in our case, Diabetic “and” Dislipidaemic, according to Joslin (1-6, 12-16).
To realize on vast scale Diabetes Primary Prevention (PP),  enrolling exclusively individuals at Inherited Real Risk, we need new clinical tools, aiming to lower the increasing number of patients, because the present, expensive screening has failed (14). For instance, in the normal Langheran’s islets microcirculatory bed, there are exclusively “normal” type II (= in arterioles, according to Hammersen), but not type I (= in small arterioles) endoarteriolar blocking devices, i.e. EBD, of first and second classes, according to S.B.Curri (See http://www.semeioticabiofisica.it/microangiologia). In health, i.e., not involved by Diabetic Constitution, we cannot observe type I, newborn- pathological, EBD in above-mentioned biological system. On the contrary, in individuals involved by diabetic constitution, as well as diabetic Inherited Real Risk and overt diabetes, of course, we observe with the aid of Quantum Biophysical Semeiotics also type I, newborn-pathological, subtype b) a-specific , EBD, facilitating the diagnosis and consequently diabetes primary prevention. In addition, the evaluation of Insulin Secretion Acute Pick Renal Test is significantly impaired, corroborating the clinical diagnosis (1-3) (See above cited- website, Practical Applications, and Glossary). Finally, an interesting clinical tool in recognizing diabetic constitution-dependent inherited real risk, as well as in diagnosing diabetes since early stages and diabetic monitoring proved to be bedside Biophysical-Semeiotic Osteocalcin Test and especially Siniscalchi's Sign, more easily to ascertain in daily practice (10, 15, 16).
As a matter of fact, Pre-Hypertension during Young Adulthood may be involved by Coronary Calcium Later in Life exclusively in presence of Inherited Real Risk of CAD, typical for individuals with lithyasic Constitution, present in about 50% OF ALL CASES of Pre-Metabolic and Metabolic Syndrome (www.semeioticabiofisica.it; Constitutions and Bibliography). Considering the frequent association between hypertension and diabetes, more important, in my opinion based on 57-year-long clinical experience, is bedside recognizing diabetic predisposition, now-a-days possible since birth, utilising a lot of methods, different in difficulty, but all reliable. For the first time, from the clinical view-point, I have previously illustrated an original manoeuvre, based on a singular activity of osteocalcin, and reliable in bedside detecting diabetes in one minute, with the aid of a stethoscope (10).
In fact, osteocalcin, a product of osteoblasts, among other action mechanisms, stimulates both insulin secretion and insulin receptor sensitivity. As a consequence, osteocalcin, secreted by above-mentioned bone cells during mean-intense lasting digital pressure – for instance – applied upon lumbar vertebrae, brings about increasing pancreatic diameters, i.e., technically speaking, type I, associated, Langherans’s islet microcirculatory activation, so that doctors assess pancreas size augmentation, which in health, lasts 10 seconds exactly (1-11). After that, pancreas diameters return to basal value for 3 sec. The second pancreas size increasing lasts 20 sec., and finally the third show the highest value: 30 sec. I terme such as clinical investigation. On the contrary, in case of diabetic constitution (3, 4, 11, 13) the first pancreas increasing persists normally (10 sec.), but both the second and the third are less than physiological ones (i.e., less than 20 sec. and respectively 30 sec.). In presence of intense inherited real risk of diabetes (6), such as impairment is greater. Finally, in case of diabetes the alteration is present already in the first evaluation, wherein duration appears less than 10 sec., inversely related with disorder seriousness. Subsequently, I have ascertained that Ronald’s Manoeuvre result pathological already in individuals involved by both Diabetic Constitution and Inherited Diabetic Real Risk (1-11). Interestingly, not only in examining subject, but also in all others, even if kilometers way from him (her), according to Lory’s experiment, based of no local realm in biological systems (12, 15), pancreas show identical modifications, allowing doctors to made clinical diagnosis until now impossible (1-15).

References
1)Stagnaro S., Stagnaro-Neri M. Valutazione percusso-ascoltatoria del Diabete Mellito. Aspetti teorici e pratici. Epat. 32, 131, 1986
2) Stagnaro-Neri M., Stagnaro S. Introduzione alla Semeiotica Biofisica. Il Terreno Oncologico. Travel Factory, Roma, 2004. http://www.travelfactory.it/semeiotica_biofisica.htm
3) Stagnaro S., Stagnaro-Neri M., Le Costituzioni Semeiotico- Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. Travel Factory, Roma, 2004. http://www.travelfactory.it/libro_costituzionisemeiotiche.htm
4) Stagnaro S., Stagnaro-Neri M. Single Patient Based Medicine.La Medicina Basata sul Singolo Paziente: Nuove Indicazioni della Melatonina. Travel Factory, Roma, 2005. http://www.travelfactory.it/libro_singlepatientbased.htm
5) Stagnaro S. Pivotal role of Biophysical Semeiotic Constitutions in Primary Prevention. Cardiovascular Diabetology, 2:1, 2003 http://www.cardiab.com/content/2/1/13/comments#5753
6) Stagnaro S. Stagnaro Sergio. Newborn-pathological Endoarteriolar Blocking Devices in Diabetic and Dislipidaemic Constitution and Diabetes Primary Prevention. www.fce.it, http://www.fceonline.it/index.php?option=com_content&task=view&id=3736&Itemid=47
7) Stagnaro S., West PJ., Hu FB., Manson JE., Willett WC. Diet and Risk of Type 2 Diabetes. N Engl J Med. 2002 Jan 24;346(4):297-298. [Medline]
8) Stagnaro Sergio. New bedside way in Reducing mortality in diabetic men and women. Ann. Int. Med.2007. http://www.annals.org/cgi/eletters/0000605- 200708070-00167v1
9) Stagnaro Sergio. Single Patient Based Medicine: its paramount role in Future Medicine. Public Library of Science. http://medicine.plosjournals.org/perlserv/?request=read-response 2005
10) Stagnaro Sergio. Teoria Patogenetica Unificata, 2006, Ed. Travel Factory, Roma.
11) Stagnaro Sergio. Il test Semeiotico-Biofisico della Osteocalcina nella prevenzione primaria del diabete mellito. www.fce.it, http://www.fcenews.it/index.php?option=com_content&task=view&id=909&Itemid=47
12) Stagnaro Sergio e Paolo Manzelli. L’Esperimento di Lory. Scienza e Conoscenza, N° 23, 13 Marzo 2008. http://www.scienzaeconoscenza.it//articolo.php?id=17775
13) Stagnaro Sergio. Reale Rischio Semeiotico Biofisico. I Dispositivi Endoarteriolari di Blocco neoformati, patologici, tipo I, sottotipo a) oncologico, e b) aspecifico. Ediz. Travel Factory, www.travelfactory.it, Roma, Luglio 2009.
14) . Sergio Stagnaro. New Renaissance in Medicina. Prevenzione Primaria del Diabete Mellito tipo 2. Sito del Convegno, http://qbsemeiotics.weebly.com/atti-del-convegno.html, 16 novembre 2010; English version: http://qbsemeiotics.weebly.com/uploads/5/6/8/7/5687930/report_stagnaro.pdf
15) Sergio Stagnaro. Siniscalchi's Sign. Bedside Recognizing, in one Second, Diabetic Constitution, its Inherited Real Risk, and Type 2 Diabetes Mellitus.
24 December, 2010, www.scivox.com, http://www.sci-vox.com/stories/story/2010-12-25siniscalchi%27signi.bedside++diagnosing+type+2+dm.html; www.sciphu.com; http://wwwshiphusemeioticscom-stagnaro.blogspot.com/ Italian version: http://www.sisbq.org/uploads/5/6/8/7/5687930/segnodisiniscalchi.pdf
16) Caramel Simone. Primary Prevention of T2DM and Inherited Real Risk of Type 2 Diabetes Mellitus http://ilfattorec.altervista.org/T2DM.pdf

Top 5 things on doc2doc this week: How to get published, free travel & is high blood pressure a disease?

Posted in News & media at Fri, 24 May 2013 09:14:52

mbillingsley

Posts: 1451
Joined: 27 Sep 2010

Here are the top 5 things on doc2doc this week:


1.  How to get published in the BMJ, career decisions and specialty training. Listen to our podcast with dpatel who talks to us about deciding on his specialty and his experience of attending a BMJ research paper meeting.

2.
Should everyone’s DNA be put on record? This is the topic of the latest BMJ Head to Head. Would you want your genome on record? Would this be a useful way to prevent diseases? Would it create a larger group of the worried well? Vote here.

3.
Is blood pressure a ‘disease’ or a risk factor? Former BMJ editor Richard Smith asks whether high blood pressure should be defined as a 'disease' or a risk factor for CV disease? Have we over medicalised blood pressure? Vote in our poll

4.
Medical students least likely to experiment with drugs.  A recent survey by The Tab reports that philosophy students take the most drugs, with medics at the bottom of the list. However, medical students are said to be the third hardest working – devoting 35 hours a week to their studies.

5.
  Should doctors who work night shifts get free travel home? This topic has attracted a lot of debate this week, with two doc2doc members saying that they know of two trainees who died on their way home from a night shift.


Also, catch up on our latest doc2doc interviews...  series with Leifur Bardarson, who works in Iceland in Quality Improvement in healthcare and has recently contributed some great insights to the discussion: Will Angelina Jolie's NY Times piece increase the rate of preventative mastectomy?,

Should Diabetes in Schools be a National or Local Community Response?

Posted in Diabetes at Thu, 23 May 2013 22:48:34

RP OUH UK

Posts: 2
Joined: 23 May 2013

Our success in ‘Volunteer skills training’ has wide ranging possibilities – that  communities can be empowered to partake in the National Diabetes Care Plan.


The implications are not only that this requires formulating a sustainable structure of support within all our institutions, but to gear all our community services in readiness for the future - the undeniable increase of diabetes patients.


Should the Nation respond to........

On average two young people aged 15 to 34 with diabetes may be dying each week from avoidable causes.


Around 3.1 million people in UK (7.4% total population) and 347 million people worldwide have diabetes (Type 1 and Type 2). The forecast rise to 4.6 million (9.5% UK population) by 2030, together with morbidity complications brought on by diabetes requires a lifelong package of care for each person and places a considerable burden on the UK Health Service.


WHO projects that diabetes will be the 7th leading cause of death by 2030. Mortality from the National Diabetes Audit found up to 24,000 people with diabetes are dying in England each year from causes that could be avoided through better management of their condition; worse still is the gap in death rates between those who have and do not have diabetes becomes more and more extreme with younger age: (1 in 3,300 female, 1 in 1,530 male in England will die between the ages of 15 to 34 years; Risk increases to nine-fold among those with type 1 diabetes to 1 in 360).


Should the Community respond to...........

Cost-effectiveness for NHS is only one of a number of criteria that should be employed in determining whether this schools intervention should be made available.  


An alternative to determining the cost-effectiveness of schools DSN support, would be to evaluate this after a ‘health needs assessment’. Then issues of equity, needs, priorities and so on should also form part of the decision-making process.

 

Analysis of health information could be reviewed as part of a “community need” as part of ‘participatory needs assessment.’


Rifkin describes a checklist for assessing the levels of participation in community development projects. Professionals and local people form a partnership to identify community needs, set priorities and develop an action plan. The overall aim of the participatory needs assessment is to understand the health needs of the community from their own perspective rather than from the provider or commissioner’s view point.

Healthcare Informatics Survey

Posted in General clinical at Fri, 24 May 2013 11:02:21

Dr. Ashish

Posts: 1
Joined: 24 May 2013
Healthcare Informatics Survey
Dear All,
We are conducting a research to gather insights on usage of Healthcare IT systems by the doctor community. 
Request you to access the below link and answer the short survey. 

Take the Survey
Looking forward to your response and thank you for your time.

Sincere Regards,
Kasper Consulting Research Team


About Kasper Consulting
Kasper Consulting, setup in 2009, is an Information Technology and Business Process consulting firm founded by a group of CIOs, CTOs and experienced management professionals. Kasper advises its clients on IT strategy, business efficiencies and transformation.

www.kasperconsulting.com

How do you get informed about educational events (seminars etc.)?

Posted in Careers at Fri, 24 May 2013 13:10:50

LukeNovak

Posts: 1
Joined: 23 May 2013
Hi,
I' m a doctor and i missed few really good conferences in past 6 months because I wasn't informed on time ... i was wondering how you get informed about educational events like seminars, conference etc. Do check web pages or get mails? Thanks for any help.