Practical advice on prostate examination

Tundra PA summarizes a few practical points on prostate examination:

"When I told Dr. H. about the physical exam and my concern that I had felt a nodule in Evan’s prostate, he held out his arm with the wrist extended. Pressing the bony prominence just distal to the radial pulse, he said “prostate nodule.” Pressing the large muscle at the base of the thumb, he said “normal prostate.” Pressing the space on the back of his hand between thumb and forefinger, he said “boggy prostate.”

Update 09/03/2007:
Tundra PA has a follow-up of the story.

References:
A PSA Story. Tundra Medicine Dreams, 08/2007.
Cancer: Digital Rectal Examination for Prostate Problems. WebMD.
Image source: Wikipedia, public domain.

Related:
Prostate Cancer with Bone Metastases and PSA of 900
3 New Diagnoses This Year

Embeddable Maps by Google - As Easy as YouTube

This is where I go to work every weekday and many weekends -- one of the best hospitals in the world -- Cleveland Clinic:


View Larger Map

From Google Maps blog:

"Today we're excited to announce a new feature on Google Maps that allows you to add maps to your blog or website just by copying and pasting a snippet of HTML. And once you embed the map, it has all the same functionality of the Google Maps you know and love; it's clickable, draggable, and zoomable.

Adding a map to your website or blog is now as easy as embedding a YouTube video. No programming skills are required, and there's no need to sign up for a Maps API key."

And this is not all -- Google turns Google Earth into a telescope.

References:
YouTube-style Embeddable Maps. Google LatLong Blog.
Sky: The final frontier. Google LatLong Blog.
Google turns Google Earth into a telescope. Googling Google.

WSJ Blog: How I treat high cholesterol in rural Illinois?

Ben Brewer, a family doctor in rural Illinois, tries to get LDL to 100 or lower. For patients with heart disease or diabetes he tries to get it to 70.

He uses generic statins like simvastatin which his patients can afford.

More questions are answered in Dr. Brewer's forum at WSJ.com.

References:
A Family Doc Asks Three Questions About Cholesterol Drugs. Jacob Goldstein, WSJ Health Blog, 07/2007.

Related:
A 33-year-old man has a low HDL level. Should you treat him? Clinical Cases and Images.
Pfizer Discontinues Drug Which Increases HDL Due to Higher Death Rate. CasesBlog, 12/03/2006.
Health: Nothing but a number: Lifestyle changes to control cholesterol. Dr. Sidney Gottlieb, Cleveland Clinic Canada, National Post, 01/2008.
Image source: Cholesterol. Wikipedia (public domain).

Updated: 01/31/2008

Weekly Dermatology Podcast

Dermatology Weekly Update is weekly podcast of the latest research and news in dermatology.

It looks interesting but there is no word on who the authors are, so use it at your own risk. Most web sites should have at least 2 mandatory sections:

- About us
- Contact us

With the latest update of Google Reader, you can play podcasts directly from the application. Alternatively, click the "pop-out" link to detach the podcast player so that you can browse the rest of the feeds while listening.

Link via Medical Lecturer.
Image source: Dermatology Weekly Update.

Medicare Will Not Pay for Hospital Errors -- How Do You Define a Hospital Error?

According to KidneyNotes:

"Look for the definition of an "error" to be expanded dramatically... Central line infection? C. difficile colitis? Ventilator associated pneumonia?"

The initial six conditions on the Medicare list are:

1. pressure ulcers
2. catheter-associated urinary tract infections
3. Staphylococcus aureus (shown above) septicemia
4. air embolism
5. blood incompatibility
6. object left behind in surgical patient

Number 2 and 3 are hospital-acquired infections and numbers 4-6 were to be called "never events." Besides those on the list for 2008, seven more conditions are under consideration for 2009, according to AMNews.

Further reading:
Medicare Says It Won’t Cover ‘Preventable’ Hospital Errors. NYTimes, 08/2007.
Medicare plans to stop paying for 6 hospital-acquired conditions. AMNews staff, June 18, 2007.
Medicare No Longer Willing to Pay Hospitals for Preventable Medical Errors. MSSPNexus Blog, 08/2007.
Medicare won’t pay for mistakes? Notes from Dr. RW, 08/2007.
An Inexact Science. Musings of a Dinosaur, 08/2008.
Preventable medical errors, from Wikipedia, the free encyclopedia.
Let Me Sprinkle Some Fairy Dust On My Patient. The Happy Hospitalist, 01/2008.
Image source: Wikipedia, CDC.

Updated: 01/15/2008

Using Blog Software to Create a "Regular" Website

Web blog software can be used for more than writing blogs. The current blog platforms are suitable for creating and maintaining a "regular" web site, i.e. a site which is not a blog (with entries arranged in a reversed chronological order). I have adapted the free Blogger.com by Google to create 4 such web sites:

• ClinicalCases.org
• PeriopMedicine.org
• AllergyCases.org.
• ClevelandClinic.org/Hospitalist
  

BloggingPro.com has a nice summary on using the WordPress server installation (not the free WordPress.com version) as a content management system (CMS) rivaling Drupal: Feature: 5 Reasons to Use WordPress as CMS.


This Google video shows it takes about 2 minutes to start a blog on Blogger.com. Creating a web site has never been easier.

References:
What I Learned from Making the Website of the Cleveland Clinic Hospitalists, 8/11/2006.
Using Web Services to Enhance a Medical Education Course, 2/20/2007.
Using a Blog to Build an Educational Portfolio, 1/15/2007.
Tips for New Bloggers: Sticky Posts in Blogger, 08/20/2007.

Updated: 08/20/2007

Elvis Presley's personal physician

According to Wikipedia:

George Nichopoulos, also known as "Dr. Nick," was Elvis Presley's personal physician. He began treating Elvis in 1967, and took it on as a full time job in 1970 until Elvis' death in 1977.

In 1977 alone, Dr. Nick had prescribed 10,000 doses of amphetamines, barbiturates, narcotics, tranquilizers, sleeping pills, and laxatives for Presley. He says he did it because he 'cared'

Blood tests showed traces of 14 different drugs in Elvis's body at the time of his death.

In 1995 Nichopoulos had his license permanently suspended by the Tennessee Board of Medical Examiners, after it was revealed that he had been over prescribing to numerous patients for years.

After he was stripped of his credentials in 1995, Dr Nick took a job evaluating medical insurance claims by FedEx employees, where he still works today, paying off his many legal bills.

References:
Doctor Feelgood. The Observer, Sunday, August 11, 2002.
Rock Idol Elvis Presley Dies at 42. Washington Post, Thursday, August 17, 1977.
Image source: Dr.Nick - ο έλληνας γιατρός του Ελβις.