Last Post of 2008

It is time to start thinking again.

No wardround meeting on Friday but for Tuesday we can have a paper to discuss: Culture shock - patient as Icon, Icon as Patient. A Verghese. NEJM 2008: 359(26); 2748–2751. Elibrary

Read and think.

MJM

Merry Christmas

The Christmas break in talks is upon us. Almost.

For Tuesday, come ready to tell us about a book or film (or other text) that has influenced you as a doctor.

Interesting Topics

Following on from our discusions about adverse drug reactions, you may want to have a look at Managing Drug-Drug Interaction Risks and Recognizing, Reporting, and Reducing Adverse Drug Reactions.

You are challenged to find at least one ADR from each of the groups A-F. Get to it.

MJM

Wardound 12xii8

If you are not in DGRI you will see a screen shot above. I hope it will give a clue how to get the article for Tuesday's discussion. So yet again get it, read it and think about it. In a stew. Michael A Lacombe. American Journal of Medicine. 1991;91:276-278. from the E-library. There is an accompanying editorial if you are up to it.

The two minute talks will be about adverse drug reactions:
Epidemiology R
Mechanisms E
Management Dr Pope
Prevention G

There are a number of excellent resources available about this subject..see what you can find. Remember, time the talk for two minutes, quote your sources and make a handoiut which will be useful.

Interesting topics this week
Progressive supranuclear palsy
Refeeding syndrome

MJM

We don't need no stinkin' help findin' book learnin'

I ridicule your pathetic excuses for failing to get the "In a Stew" article. I got the pdf at the weekend and again tonight without problems. 

Get it....it's a challenge... and we can then discuss it.

MJM

Wardround 5xii8

Sepsis bundle summary ↑ (you cannot see it at DGRI...images blocked)

The reading for Tuesday is In a stew. Michael A Lacombe. American Journal of Medicine. 1991;91:276-278. from the E-library. There is an accompanying editorial if you are up to it.

This week's talks were about antibiotics. This led to a discussion of the precipitants for MRSA such as antibiotic pressure and the ways we might try to limit this. Dr Jones outlined a method of deferring antibiotic use in non-urgent cases and stressed the need to identify specific about diagnoses. It should be clear to all that MJM and GAJ do not regard antibiotics as harmless, and MJM in particular decries the term "chest infection"....never use this in his hearing since it has the effect of decoupling frontal lobe function. Our hospital policy regarding IV antibiotics is a must read as is the antibiotic prescribing policy. Remember to look at the HPS site about C. difficile.

For next Friday the theme is decompensated liver disease:
Epidemiology G
Varices L
Ascites E
Encephalopathy R
Transplantation ?

Two minutes please. Be concise and precise. Quote your sources so others can read up more if inclined. Handouts can have more than bullet points again....but not mini-essays please. Think before you speak. Make the talk count. Don't tell us things we already know; there isn't time.

Interesting topics

Sepsis in Coeliac Disease (Dr Else's journal club talk about Gut 2008 Aug;57(8):1034-5).
Sepsis bundles

Remember we have some textbooks in the right hand Ward office