Acute otitis externa

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What is Acute otitis externa?

Acute otitis externa is a common condition involving inflammation of the ear canal. It is caused by bacteria such as Pseudomonas aeruginosa and Staphylococcus aureus. Acute otitis externa often occurs following swimming or minor trauma from inappropriate cleaning.

What are the symptoms of Acute otitis externa?

The rapid onset of ear canal inflammation leads to otalgia (earache), itching, canal edema, erythema, and otorrhea. Tenderness with movement of the tragus or pinna is a classic finding.

What is the treatment for Acute otitis externa?

For uncomplicated cases, use topical antimicrobials or antibiotics such as acetic acid, aminoglycosides, polymyxin B, and quinolones. Some of these agents come in preparations with topical corticosteroids which may help resolve symptoms more quickly.

There is no evidence that any one antimicrobial or antibiotic preparation is clinically superior to another. Here two suggested approaches:

- Neomycin/polymyxin B/hydrocortisone preparations are a reasonable first-line therapy when the tympanic membrane is intact.

- Oral antibiotics are used when the infection has spread beyond the ear canal or in patients at risk of a rapidly progressing infection.

References:

Acute otitis externa: an update. Schaefer P, Baugh RF. Am Fam Physician. 2012 Dec 1;86(11):1055-61.
Image source: Wikipedia, a GNU Free Documentation License.

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Medicine Neurology for MD Entrance Lec 04-06 – Video

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Medicine Neurology for MD Entrance Lec 04-06
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Medicine Neurology for MD Entrance Lec 04-06 - Video

Low-income urban youth are high users of technology but still prefer face-to-face meetings with doctor

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From This survey included urban youth (aged 14-24 years) to asses the Use of Technology with Health Care Providers.

Eight focus groups including 82 primarily low-income urban African-American adolescents and young adults were completed.

Low-income urban adolescents and young adults (mean age, 18.5 years) reported high access to and use of technology. However, they still preferred face-to-face meetings with a healthcare provider because they felt that the information provided would be better tailored to their individual needs and more credible. Many worried about the confidentiality of conversations conducted using technology.

In conclusion, although low-income urban youth are high users of technology, they still prefer face-to-face meetings with a healthcare provider.

References:

Use of Technology with Health Care Providers: Perspectives from Urban Youth. Sarah Lindstrom Johnson et al. The Journal of Pediatrics, Volume 160, Issue 6 , Pages 997-1002, June 2012.

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Rowe Neurology Institute MS

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Rowe Neurology Institute MS CNP Clinical Trial, Feb 2013
Rowe Neurology Institute MS CNP Clinical Trial Feb 2013. Rowe neurokc87 videos. Subscribe Subscribed Unsubscribe 20. No views. Like 0 Dislike 0. Like. Sign in to youtube. Sign in with your youtube Accountyoutube Google+ Gmail Orkut Picasa or Chrome to like Rowe neurokcs video. Sign in. I dislike this. Sign in to youtube. Sign in with your youtube Accountyoutube Google+ Gmail Orkut Picasa or Chrome to dislike Rowe neurokcs video. Sign in. About Share Add to. Sign in to youtube. Sign in with ...

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Rowe Neurology Institute MS

Hepatitis A

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Excerpts from a recent review in Am Fam Physician:

Hepatitis A is a common viral illness worldwide. It incidence in the U.S. has diminished as a result of immunization.

How is Hepatitis A transmitted?

Hepatitis A virus is transmitted through fecal-oral contamination, and there are occasional outbreaks through food sources.

What are the symptoms of Hepatitis A?

Young children are usually asymptomatic, although the likelihood of symptoms tends to increase with age.

What is the prognosis of Hepatitis A?

Most patients recover within 2 months of infection. However, 10-15% of patients will experience a relapse in the first 6 months. Hepatitis A virus does not usually result in chronic infection or chronic liver disease.

What is the treatment for Hepatitis A?

Supportive care is the mainstay of treatment, for example, PO and IV fluids if nausea and vomiting are severe, etc.

How to prevent Hepatitis A?

The CDC recommends routine vaccination of all children 12-23 months of age, as well as certain vulnerable populations.

What to do if you have just been exposed to Hepatitis A?

Hepatitis A vaccine is also recommended for most cases of postexposure prophylaxis. Immunoglobulin is an acceptable alternative.

References:

Hepatitis A. Matheny SC, Kingery JE. Am Fam Physician. 2012 Dec 1;86(11):1027-34.

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Common rashes – 2-minute video overview by a dermatologist for About.com

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The whole playlist is here: Does it Itch? | Common Rashes & Skin Conditions - YouTube http://bit.ly/12k3vFB

Here are some helpful resources:

Rash diagnosis algorithm - NCEMI eTools http://bit.ly/WvZ5IU

Academic Life in Emergency Medicine: Paucis Verbis: Approach to rashes http://bit.ly/WvZ3B1

Related:

Acne Treatments | Skin Care - YouTube http://bit.ly/12k3zVP

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As good as pills: Mediterranean diet prohibits nothing that was recognized as food by your great-grandmother

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From NYTimes: The Times's Gina Kolata talks about a new study, published on The New England Journal of Medicine's Web site, focusing on the health benefits of a Mediterranean diet.

When Diet Meets Delicious - The Mediterranean Approach http://buff.ly/XCsvTJ -- Mediterranean diet prohibits nothing that was recognized as food by your great-grandmother.

Here is the original research from NEJM:

In a multicenter trial in Spain, 7447 participants who were at high cardiovascular risk, but with no cardiovascular disease at enrollment (age range, 55 to 80 years, 57% were women), were randomly assigned to one of three diets:

- a Mediterranean diet supplemented with extra-virgin olive oil
- a Mediterranean diet supplemented with mixed nuts
- a control diet (advice to reduce dietary fat)

Participants received quarterly educational sessions and, and depending on group assignment, free provision of extra-virgin olive oil, mixed nuts, or small nonfood gifts.

The primary end point was the rate of major cardiovascular events (myocardial infarction, stroke, or death from cardiovascular causes). On the basis of the results of an interim analysis, the trial was stopped after a median follow-up of 4.8 years.

The two Mediterranean-diet groups had good adherence to the intervention. A primary end-point event occurred in 288 participants.

The multivariable-adjusted hazard ratios were 0.70 and 0.72 for the group assigned to a Mediterranean diet with extra-virgin olive oil (96 events) and the group assigned to a Mediterranean diet with nuts (83 events), respectively, versus the control group (109 events).

Among persons at high cardiovascular risk, a Mediterranean diet supplemented with extra-virgin olive oil or nuts reduced the incidence of major cardiovascular events (the study was funded by the Spanish government).

References:

Primary Prevention of Cardiovascular Disease with a Mediterranean Diet. February 25, 2013DOI: 10.1056/NEJMoa1200303
http://www.nejm.org/doi/full/10.1056/NEJMoa1200303

Comments from Twitter and Facebook:

Dr Kelly Sennholz @MtnMD: Better! RT .@DrVes: As good as pills: Mediterranean diet prohibits nothing recognized as food by ur grt-grandmother bit.ly/WuFQKv

Matthew Bowdish: My grandmother used to serve bacon-wrapped asparagus. Is that in the Mediterranean diet?

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Empathy and patient experience – video from Cleveland Clinic

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CEO Toby Cosgrove, MD, shared this video, titled "Empathy," with the Cleveland Clinic staff during his 2013 State of the Clinic address on Feb. 27, 2013. The video relates to any person - not only patients and physicians. It's so worth it 4 minutes of your time:

Physician Communication PEARLS from Cleveland Clinic

- Establish rapport and plan an encounter with the patient

- Elicit the patient perspective using FIFE (function, ideas, fears and
expectations)

- Apply PEARLS (partnership, empathy, acknowledgment, respect,
legitimation and support) to convey empathy

- Incorporate the patient into decision making and education using ART
(ask, respond, tell)

References:

Relationship-Centered Communication for Physicians (PDF) from Cleveland Clinic Academy

Comments from Twitter:

Dr Kelly Sennholz @MtnMD: This is JUST how I see the hospital. Magic place

PracticeMatch @PracticeMatch: Wow...great video!

Wouter van Furth @wvfurth: Take 4 min to watch this video. Worth it.

Mary Maier MD @MaryMaierMD: The Cleveland Clinic - it was/is a great place to train

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Neurology and Language Learning (Input vs. Output) – Video

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Neurology and Language Learning (Input vs. Output)
A quick explanation about what parts of the brain are involved in language acquisition, and how we should focus our language learning based on these facts. The neuroscience that I mentioned in the video is on a basic level, if you have a particular interest in the area and would like more information, let me know. Also, if you have more information that you would like to share about Neurology and language acquisition, I would love to hear and learn from you.

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Free Neurology PowerPoint Background – Video

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Free Neurology PowerPoint Background
http://www.medicaldump.com - Please visit the site for FREE medical PowerPoints, medical PowerPoint templates, medical e-books related to all specialties including ophthalmology, cardiology, neurology,nephrology, GI, etc. This is a Neurology PowerPoint Background for free download. Thanks to Free music by Rickvanman at http . I #39;ve added his #39; Summer Morning #39; as the background

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Free Neurology PowerPoint Background - Video