Archive for ‘Uncategorized’

November 18, 2018

A Country Doctor Reads is Moving

When I started blogging I put my random reads on a separate blog. After much pondering I have decided to bring both blogs under one roof. So from now on I’ll put both kinds of posts on A Country Doctor Writes with a separate category for “Reads”.

Older posts from A Country Doctor Reads will remain as an archive at its original address: https://acountrydoctorreads.wordpress.com

November 12, 2018

Vitamin D for the masses? Nope

Supplementation with vitamin D did not result in a lower incidence of invasive cancer or cardiovascular events than placebo, another example of how theory guided practice before the scientific research was done.

https://www.nejm.org/doi/full/10.1056/NEJMoa1809944?query=featured_home

October 28, 2018

Small practice, less doctor burnout?

“Just 13.5 percent of providers who work in SIPs reported being burnt out, according to a study published in the Journal of the American Board of Family Medicine, titled “Correlates of Burnout in Small Independent Primary Care Practices in an Urban Setting.” The survey’s respondents included 204 physicians and 31 nurse practitioners or physician assistants.

The survey used a one-item variant of the Maslach Burnout Inventory. Earlier results, such as the December 2015 Mayo Clinic Proceedings study, found that 54.4 percent of 6,880 physicians reported at least one symptom of burnout.”

https://wire.ama-assn.org/practice-management/small-practice-less-doctor-burnout-4-reasons-may-be

October 28, 2018

Cold, Wind, Darkness Kill

Fellow Swedes prove cold, wind, darkness and low pressure cause more heart attacks. So I moved to the northern coast of Maine… app.jamanetwork.com/?doi=10.1001/j…

October 26, 2018

BBC News: New ‘Trojan horse’ antibiotic promising

Bacteria crave iron. Our bodies try to keep iron from them. This antibiotic is bound to iron and bacteria gobble it up, only to be killed.

New ‘Trojan horse’ antibiotic promising_104034475_gettyimages-162534536.jpgIt uses a clever trick to sneak inside bacteria in order to kill the bugs.
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October 21, 2018

Doxycycline and Tooth Staining | CDC

  • Doxycycline is the most effective antibiotic for the treatment of suspected rickettsial infections, including Rocky Mountain spotted fever (RMSF).Misperceptions about the use of doxycycline for children prevent kids from getting lifesaving treatment.
  • Delay in treatment of rickettsial diseases may lead to severe illness or death. Children are five times more likely than adults to die from RMSF.
  • Misperceptions about the use of doxycycline for children prevent kids from getting lifesaving treatment.
  • Doctors often avoid prescribing doxycycline to young children because of a warning that tooth staining may occur when used in children less than 8 years old.
  • In a new study, experts at the CDC and Indian Health Service (IHS) found that short courses of the antibiotic doxycycline can be used in children without causing tooth staining or weakening of tooth enamel.

https://www.cdc.gov/rmsf/doxycycline/index.html

August 23, 2018

Minority of GP trainees to stay in full-time clinical work

“Less than a quarter of GP trainees plan to practise full-time one year after qualifying, a think tank survey has revealed.

The survey of 729 GP trainees, conducted by the King’s Fund, found that just 22% of respondents ‘planned to work in full-time clinical general practice one year after qualifying.”

http://www.pulsetoday.co.uk/news/gp-topics/education/less-than-a-quarter-of-gp-trainees-to-stay-in-full-time-clinical-work-survey-finds/20037315.article

August 19, 2018

NYTimes: Vitamin D, the Sunshine Supplement, Has Shadowy Money Behind It

I never thought the vitamin D hysteria was making doctors rich; after all, you can buy it over the counter. But some docs are profiting…

“The doctor most responsible for creating a billion-dollar juggernaut has received hundreds of thousands of dollars from the vitamin D industry.”

https://www.nytimes.com/2018/08/18/business/vitamin-d-michael-holick.html?smprod=nytcore-ipad&smid=nytcore-ipad-share

August 7, 2018

Doxycycline for Young Children (after tick bite)?

I always wondered if a single dose of doxycycline after a tick bite would be all that risky for children under 8 as far as tooth staining goes. Well, I missed this two year old information from The Medical Letter:

“Lyme disease, unlike Rocky Mountain spotted fever, is seldom fatal and can be treated with antibiotics other than doxycycline. A single dose of doxycycline is recommended for prophylaxis after a tick bite. Given the CDC’s statement about its safety, it would seem reasonable to use doxycycline for prophylaxis in all age groups. When longer treatment courses (10, 14, or 28 days) are recommended for the various clinical manifestations of Lyme disease in children <8 years old, alternative antibiotics generally could be used instead.”

https://secure.medicalletter.org/w1497e

July 29, 2018

AAFP Updates Its PSA Screening Recommendation

“The AAFP and USPSTF recommendations on the topic share similarities, but whereas the UPSTF statement is rather ambiguous about whether it recommends screening for men ages 55-69, the AAFP clearly states that it does not recommend routine PSA-based prostate cancer screening.”

The article continues:

“it’s estimated that after 13 years, of 1,000 men ages 55-69 who were screened for prostate cancer, 100 will be diagnosed with the disease.

“As the result of early treatment, 1.3 men will avoid dying of prostate cancer, while five men will die of prostate cancer despite treatment,” the recommendation said. “It is also estimated that screening will result in three fewer cases of metastatic prostate cancer.”

Additionally, the Academy said that although the mortality benefit of prostate cancer screening results from early treatment, it is the treatment of prostate cancer that causes the most serious harms.

“These potential harms are particularly concerning given the high rate of overdiagnosis associated with prostate cancer screening,” the recommendation noted. “Overdiagnosis involves the diagnosis of asymptomatic cancer that never would have resulted in symptoms or death.”

http://news.doximity.com/entries/13251948