This week’s two minute tutorials were:
Dr Tuck: Colchicine overdose (6/8)
Dr Mohan: Glucocorticoids and the risk of heart disease (6/8)
Dr Queen: Using interpreters (6/8)
(would you each post the references/links in the comments, please)
Dr Jones has now given her considered opinion on last week’s emergency drug choices:
The prize is awarded to Dr Queen for emphasis on sanitation and oral rehydration therapy. I liked his idea to use mefloquine for prophylaxis and treatment. I would have chosen a broader spectrum penicillin in this setting (not on the ward) and a once daily cephalosporin for ease of administration. Vancomycin could be swapped for clindamycin for the penicillin allergic, for ease of treatment and broader cover including anaerobes and reducing the need for anti-tetanus. Dr Tuck had started with a slightly different approach, considering how to treat the most common conditions worldwide which perhaps influenced her choice more than the rest of us who focussed on survival in a disaster area. Dr Mohan produced a well balanced list with oxygen, fluids and I see has been persuaded to make antibiotic changes.
The week’s reading had been The case for an all-female crew to Mars. William J. Rowe. Journal of Men’s Health and Gender. 2004 Dec Vol 1 (No.4) 341-344
You will remember that I posed the questions: Is this for real or is it a spoof? How do you assess the credibility of a paper like this?
It was interesting to see that the first methods of addressing the credibility question were attempts to identify the character of the author and publication. Though this is a common way of approaching the problem of credibility, I would argue that these are not really valid ways to test the credibility of this paper’s content. In logic these are well enough recognised as fallacies to have been named: argumentum ad hominem (arguing against a person, rather than against what a person says) and arguing from authority (the prestige of the journal does not guarantee the paper’s truth). Returning to the content, the paper presents a hypothesis based on inductive reasoning. This is the method by which most scientific hypotheses are produced. The paper however, describes the hypothesis as if it is the result of a deductive argument. The difference is that a hypothesis (produced by inductive reasoning) would need to be further tested by experiment whereas deductive reasoning produces a ready proven answer. It is important to recognise and differentiate hypothesis (possibility) from deduction (certainty). A good hypothesis will come with suggestions as to the experiments needed to test it…remember that when you hypothesise a diagnosis.
Ok…checking the credibility of a hypothesis…Check that the propositions on which the reasoning is based are correct; check the reasoning is valid (logical); look for a clear exposition of the hypothesis and suggestions as to how it can be checked. Enough logic for now.
The reading for next week is:
Timing of Antibiotic Administration and Outcomes for Medicare Patients Hospitalized With Community-Acquired Pneumonia. Houck P, Bratzler D, Nsa W, Ma A, Bartlett G
Archives of Internal Medicine, 2004 (22 March);164(6):637–644
You should be able to get the PDF from NHSES elibrary using your Athens password.
Interesting topics this week:
RS3PE, pitting oedema of the hands
Exercise tolerance tests, tell me more
Vertebro-basilar insufficiency, how is it diagnosed?
Cellulitis, do you really know about it?
Alcohol associated collapse, alcohol effects
Clostridium perfringens, tell me more
LBBB, tell me more (use uptodate on the intranet)
Don’t forget your two minute tutorials…make them concise and precise.
The tutorial topics this time are not free choices: you are given a specific pneumonia to both speak about and produce an A4 size sheet highlighting important features and facts.
Sandip Mycoplasma
Naveen Pneumococcus
Dilshad Legionairres
Nawaz Chlamydia
Bhasker Q-fever
MJM Aspiration
GAJ Gp A Strep
If anyone out there would like to submit two minute tutorials for the podcast, just leave me a note in one of the comments.
MJM
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