I've just noticed that this is my 100th post! It may have taken over 2 years to reach but none-the-less it feels like a significant moment. Had a harrowing experience this afternoon when I found out that one of my friends from work had been admitted to the neurosurgical department with a head injury he sustained at the weekend after he was knocked off his bike. He's pretty sore but sitting up and talking now, plus it was good to see his parents and brothers were up visiting at the same time as me. Get well soon Michael!
Today is the first episode of the new TV Series being run by the BBC called "Junior Doctors - Your Life in Their Hands". Firstly, I disapprove of the title. It smells of over-dramatisation and gives the impression that every moment of every working day is made up of life-or-death decision making. The junior doctor is very much part of a greater team that looks after the patient. I agree that the junior doctor may be the first person on scene in an emergency but back-up is always available so your life isn't really in their hands. It's a good job that the series is filmed over several weeks / months because approximately 95% of the job is ward rounds, writing letters, making referrals and so on and so forth. Whilst I agree that this is an important part of the job and I enjoy it - I don't necessarily think it makes for great TV viewing for the general public. After all, it's no Holby City! I'm looking forward to watching the series though to see how the TV spin on things looks and how the doctors being filmed cope with starting work.
A selection of interesting articles in the BMJ this week:
1) Multiple Myeloma - This is an easily missed disease. The condition is basically neoplasm of plasma cells characterised by production of monoclonal immunoglobins by malignant cells. It predominantly affects older adults. Normochromic, normocytic anaemia occurs in approximately 70% of patients. The other more common features are bone pain, renal impairment, fatigue and weight loss. Routine initial investigations include full blood count, biochemistry (renal impairment, hypercalcaemia), blood film (looking for roleaux), and liver function tests (raised total protein).
2) Mobile Phones - Harbouring Bacteria - This was a letter sent in from an infectious diseases registrar in London. He did a small study which looked at the increasing incidence of doctors using mobile phones for medical apps, stopwatch when checking the pulse etc. What he found is that mobile phones were harbouring significant amounts of bacteria and could be responsible for transmitting MRSA to patients. I think it's time for Apple to develop a bacteria repellant surface for their mobile phones. If I cracked that I'd be a millionaire.
3) Psoriasis & Psoriatic Arthritis - A 41 year old man presents with an itchy, scaly rash and is diagnosed with having plaque-type psoriasis. Psoriasis is a systemic condition and co-morbidities of psoriasis include cardiovascular disease, obesity, depression, type-2 diabetes and hypertension. Systemic treatments include methotrexate however this is contra-indicated in patients with large quantities of alcohol intake.
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