Tuesday, August 31, 2010

Google Health - Croup

Most cases of croup can be safely managed at home, but call your health care provider for guidance, even in the middle of the night.

Cool or moist air can bring relief. You might first try bringing the child into a steamy bathroom or outside into the cool night air. If you have a cool air vaporizer, set it up in the child's bedroom and use it for the next few nights.

Acetaminophen can make the child more comfortable and lower a fever, lessening his or her breathing needs. Avoid cough medicines unless you discuss them with your doctor first.

You may want your child to be seen. Steroid medicines can be very effective at promptly relieving the symptoms of croup. Medicated aerosol treatments, if necessary, are also powerful.

Serious illness requires hospitalization. Increasing or persistent breathing difficulty, fatigue, bluish coloration of the skin, or dehydration indicates the need for medical attention or hospitalization.

Medications are used to help reduce upper airway swelling. This may include aerosolized racemic epinephrine, corticosteroids taken by mouth, such as dexamethasone and prednisone, and inhaled or injected forms of other corticosteroids. Oxygen and humidity may be provided in an oxygen tent placed over a crib. A bacterial infection requires antibiotic therapy.

Increasing obstruction of the airway requires intubation (placing a tube through the nose or mouth through the larynx into the main air passage to the lungs). Intravenous fluids are given for dehydration. In some cases, corticosteroids are prescribed.

Here is a nice overview of croup, we are seeing a lot of this this week parents!! Google Health content!!

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Monday, August 30, 2010

In Practice: Dr. Google has mixed results

Here is a nice article from LA times regarding utilizing google search in practice. Doc's if you haven't taken a look at Google's health Content in a while now is the time to revisit it. It's not half bad, and don't underestimate it's power. Use this content with your patients to improve your doc/patient relationships and create participatory care.

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Wednesday, August 25, 2010

Natalie Hodge MD FAAP Innovation in Primary Care

Here is a 20 minute presentation which clarifies the differences in Incremental Innovation and Disruptive Innovation, making the cost case for the latter in Primary Care physician practice.

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Tuesday, August 24, 2010

Methicillin-resistant Staphylococcus aureus -

Here is one good reason not to take antibiotics for that cold this winter. This Wikipedia entry is not half bad either... Remember that a cold should be resolving by day 10 to 14 of the illness.

To Your Best Health,

Dr Hodge and the Personal Medicine Team

Posted via email from Personal Medicine

Monday, August 23, 2010

Recipes for Health - Tomatoes Pack a Nutritional Punch

Don't forget the tomatoes for dinner tonight!!

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Health and Wellness - Well Blog

This is sad, I have seen this over the years, very unprofessional to speak poorly about patients.

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

amednews: Physician smartphone popularity shifts health IT focus to mobile use :: Aug. 23, 2010 ... American Medical News

Physician smartphone popularity shifts health IT focus to mobile use

Doctors' embrace of such devices puts them at a disconnect with hospitals that rely on desktop-based health technology.

By Pamela Lewis Dolan, amednews staff. Posted Aug. 23, 2010.

With physician smartphone use nearing a saturation point, doctors are in an unfamiliar position when it comes to health information technology -- demanding that others adapt to their needs, rather than the other way around.

Physicians' rapid embrace of mobile devices -- well beyond the rate the general population uses them, as measured by several surveys -- has caught many involved in health information technology off-guard. That's particularly true of hospitals, which report being besieged by physician demands that electronic clinical information systems be available through their BlackBerrys or iPhones.

"Five to 10 years ago they were saying, 'If only my docs would be using computers,' " said C. Peter Waegemann, vice president for development of the mHealth Initiative, a Boston-based organization that promotes mobile technology in health care. Now hospital executives bemoan the fact that doctors are "using these smartphones all the time ... and I don't know how to integrate it," he said.

If numbers reported in late July from market research firm Spyglass Consulting Group are any indication, nearly every physician in the country is using a smartphone. Its survey of more than 100 physicians, taken in February, found that 94% use smartphones for personal and professional use, including at the point of care.

Even if that number seems high, other surveys bear out that many more physicians are using smartphones than are not. Manhattan Research, in its annual "Taking the Pulse" study of physicians and health care technology, reported in late April that 72% of doctors use smartphones personally and professionally, with that number expected to jump to 81% in 2012. By comparison, less than 20% of the general adult population in the United States uses smartphones.

72% to 94% of physicians use smartphones professionally and personally.

"In 2010, the conversation has shifted away from whether physicians are online to understanding the degree to which digital content is changing the way physicians practice medicine," said Meredith Ressi, vice president of research at Manhattan Research. "Professional use of smartphones and online user-generated content are no longer early-adopter activities of a tech-savvy few -- these types of activities are the norm for the majority of physicians today."

Experts say that like many people, physicians bought smartphones originally for personal rather than professional use. But the reason for smartphones' professional popularity, compared with desktop-based health technology, is fairly simple: Smartphones allow mobility, and desktops don't. This is critical for health professionals who don't spend their days sitting in one place.

"Doctors have indeed found a tool that naturally fits with their lifestyles and workflow needs, and the future is going to need to include mobile integration with [EMRs] and other clinical applications," said Brian Ahier, who holds the title of health IT evangelist for the Mid-Columbia Medical Center in The Dalles, Ore. He is also a health IT blogger.

Disconnect with hospitals

Gregg Malkary, managing director of Spyglass Group and author of that organization's study, said smartphones are ideally suited for physicians and the way they work. But physicians face one major obstacle: using their smartphones to connect with existing clinical applications, such as electronic medical records at their local hospitals.

George "Buddy" Hickman, executive vice president and chief information officer at Albany (N.Y.) Medical Center, recently surveyed fellow members of the College of Healthcare Information Management Executives on smartphone use. Of the 52 hospitals that responded to his survey, only 18 said they allow smartphones to access the hospitals' EMRs and other clinical tools.

Even those facilities that support smartphones have their limits. For example, only six of the 18 hospitals in Hickman's survey that support smartphones support more than one device, which poses a problem because physicians are not settled on just one. In Spyglass' survey, 44% of physicians used iPhones and 25% used BlackBerrys.

Hickman said hospital security policies also can stifle smartphone use. Hospitals that support smartphones generally have policies on passwords and automated timeouts, which lock the phone down after a few seconds of being idle.

Following those policies can make the phones less convenient and more cumbersome, Hickman said. Therefore, even if a hospital supports smartphone use, many doctors decide to use their phones for tasks not tied to the hospital.

Some hospitals have bought smartphones for their affiliated physicians and use them instead of pagers to communicate with doctors. In those cases, however, experts said hospitals tend to buy just one brand of smartphone, which might be different from the brand physicians use personally and professionally. Still, many hospitals report that they are beginning to investigate how they can allow access to their systems from multiple kinds of mobile devices.

Communication overload

Just because physicians' smartphone use gives them more control in the technology discussion doesn't mean they have control of the technology itself.

The Spyglass survey found that physicians feel overwhelmed by the volume of communication they receive on a daily basis. Malkary said smartphones actually can contribute to the problem, not help it, especially for older doctors unaccustomed to managing so much data at once. Part of the problem is the lack of automated tools to manage the varieties of incoming messages. Another issue is that even though physicians might have smartphones in their pockets, heavy patient loads still mean that messages aren't going to be checked as they come in.

Waegemann said app developers could help overcome these barriers.

For example, there could be an application that would allow e-mail dictation to save time, or an application that would file incoming messages by their importance or urgency. Waegemann said developers need to step up and make these tools available so that physicians can start using the devices in a way that makes them more efficient.

Experts say smartphones need to become an integral part of care delivery. Most suspect it will happen -- but when, they're not sure.

"One day we may be able to say, 'Happy doctors? Yup, there's an app for that,' " Ahier said.

This content was published online only.

Back to top

Copyright 2010 American Medical Association. All rights reserved.
» iPad stoking doctor interest in tablet computers  Column Feb. 22
» Choosing the smartphone that's right for you  Column Jan. 25
» Smartphones becoming clinical tools  Column Dec. 21, 2009
» Smartphone use pushed by hospitals  Column Oct. 26, 2009

Very Nice Article From Pam Dolan about the disconnect physicians ( yes we are using smartphones on a daily basis and depend on them to run our business, see patients, do telemedicine, IM visits, ecommerce aps for patient payments) are having with hospitals which are making hardware purchases for technology from 10 years ago, The mobile is leading us rapidly to " second generation" Health IT, fast search, Patient Health Record, Integrated Eprescribing, telemedicine and IM communications ( WITH Patients) This brings us BACK TO THE BEDSIDE! The purchases I see hospitals making this year bring us AWAY FROM PATIENTS. ( Out into corridors where desktops are installed, these are obsolete hardware purchases with expensive enterprise software, which contribute to the exorbitant hospital costs of implementing an EMR. Hope to see everyone at AAP national conference in October to illustrate more about PM virtual office.

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Wednesday, August 18, 2010

What the Doctor Is Really Thinking

Some doctors are taking an unusual new approach to communicate better with patients—they are letting them read the notes that physicians normally share only with each other.

When patients finish a checkup, doctors record notes on a range of topics. A new study looks at what happens when those notes become available for the patient to read electronically. Laura Landro has details.

After meeting with patients, doctors typically jot down notes on a range of topics, from musings about possible diagnoses to observations about how a patient is getting along with a spouse. The notes are used to justify the bill, and may be audited. But the main idea is to have a written record with insights into the patient's condition for the next visit or for other doctors to see.

A study currently under way, called the OpenNotes project, is looking at what happens when doctors' notes become available for a patient to read, usually on electronic medical records. In a report on the early stages of the study, published Tuesday in the Annals of Internal Medicine, researchers say that inviting patients to review the records can improve patient understanding of their health and get them to stick to their treatment regimens more closely.

But researchers also point to possible downsides: Patients may panic if their doctor speculates in writing about cancer or heart disease, leading to a flood of follow-up calls and emails. And doctors say they worry that some medical terms can be taken the wrong way by patients. For instance, the phrase "the patient appears SOB" refers to shortness of breath, not a derogatory designation. And OD is short for oculus dexter, or right eye, not for overdose.

Erik Jacobs for The Wall Street Journal

Tom Delbanco is leading a project to get doctors to bare their notes to patients.




Terms physicians use in their notes that could be confusing to patients:

SOBShortness of Breath
NERDNo evidence of recurrent disease
ThrillSound or movement felt on chest wall with an abnormal heart
ShottyMildly enlarged lymph nodes
SomatizingComplaints of physical symptoms with no physiological origin
Flat affectExpressionless face, which can mean depression, schizophrenia, or nothing
DementedMedical term for memory loss, inability to learn new materials
ImpShort for impression; doctor's conclusion of patient's condition
Patient denies...Patient reports no symptom
Congestive heart failureNo literal failure; a manageable heart condition
Crackles/RalesLung sounds that indicate respiratory disease

Sources: Annals of Internal Medicine, medicinenet.com

"If you are a patient that just goes in once a year for a checkup, the doctor's notes might be not that useful. But if you have a lot of medical problems, it helps you ask the doctor the right questions and lets you know what's going on," says Jeanne Hallissey, a patient at Beth Israel Deaconess Medical Center in Boston, who began reading her doctor's notes as part of the study.

Medical providers have been stepping up efforts to improve doctor-patient communication, in part because studies show it can result in better patient outcomes. The introduction of electronic medical records in recent years has allowed patients to contact their doctors by email, log on to secure websites to get lab results and get links to health information recommended by their doctors.

The year-long OpenNotes study, funded with a $1.5 million grant from the Robert Wood Johnson Foundation, involves 25,000 patients and their primary-care physicians at Beth Israel Deaconess, Geisinger Health System in Danville, Pa., and Harborview Medical Center in Seattle. "We want to break down an important wall that currently separates patients from those who care for them," says lead investigator Tom Delbanco, a Harvard Medical School professor who treats patients at Beth Israel.

Patients have a legal right to see their entire medical record including doctor's notes. An exception are psychiatric notes, which doctors can withhold if they judge it to be in the patient's best interest. But doctors and hospitals don't automatically include notes when a patient requests records, Dr. Delbanco says, and "we've made it as difficult as possible for patients to get them."

Patients often forget most of what they've heard after they leave the doctor's office, says Jan Walker, a Beth Israel nurse who is working on the OpenNotes project. Reading doctors' notes allows patients to review everything at home and share information with family and others who may be involved in their care.

Michael Meltsner, 73, a law professor and family therapist in Boston, logged onto Beth Israel's electronic medical record site for patients to view Dr. Delbanco's notes after an April visit. He showed his wife the notes from the visit, which was to discuss general aging issues and medication monitoring.

"Whenever we go to a doctor and anything is said that is the least bit difficult or problematic, we get a form of modified amnesia, " Mr. Meltsner says. "It's great to be able to go home and pull up the doctor's note a few days later and say, 'oh, so that's what I've got,' or 'that's what he said.' "

But, Mr. Meltsner adds, "it's going to take some work to walk people through it who are anxious and don't understand medical terminology."

Though the OpenNotes project doesn't ask doctors to dumb down their notes to make them easier for patients to understand, Dr. Delbanco says he has started using clearer language, fewer abbreviations and less technical jargon. But "I don't leave anything out. If I'm worrying about cancer the patient is probably worrying about it more than I am."

In one note Dr. Delbanco wrote about a patient, for instance, the patient wanted to stop taking the cholesterol-lowering statin that he had been on for six years. The doctor noted that the patient had lost weight in that time, and was now exercising more. "So we shall stop it, and he will return fasting in about six weeks to see what is going on. It is worth a try," the doctor wrote.

Other big health-care providers have been watching the OpenNotes study. Kaiser Permanente, based in Oakland, Calif., says it doesn't plan to offer its doctors' notes routinely on its patient website. A Kaiser spokeswoman says it may be confusing to patients to see raw doctor's notes with terminology that doesn't make sense to the average person. But, she says, if patients really want a copy of the notes they can ask. Kaiser currently allows members to check their lab results online, and exchange emails with their doctor over secure messaging systems. Its website also makes available to patients the doctors' after-visit summaries, but not full notes.

Another managed-care provider, Group Health Cooperative, of Seattle, is more open than Kaiser to the idea of showing patients notes. "I believe that we will eventually do this," says Matthew Handley, associate medical director of quality and informatics.

Dr. Handley says doctors may initially be hesitant to show patients their notes, much as they initially worried when Group Heath began providing lab results to patients online. But that has proven a useful and popular service for patients. "The old narrative is that we had to protect doctors from patients, but we've found that patients are very respectful of doctors' time, and can handle information," he says.

Ms. Hallissey, the Beth Israel patient, has had complications of surgery for diverticulitis and keeps close tabs on her medical records and lab results online. When she began reading her doctor's notes this spring, a glitch allowed her to see not only her primary-care doctor's notes, but also the notes of the surgeon who had performed her procedure. "It was really interesting reading to find out what happened in a five-hour surgery," says Ms. Hallisey. When she didn't understand words, she searched out their meanings online. She learned, for example, that a description of her as "supine" meant she was laying in a face-up position.

Dr. Delbanco, Ms. Hallissey's physician, says he hopes specialists and surgeons eventually will open their notes to patients as well.

Some aspects of opening notes to patients are "going to be a hassle for doctors," including communicating in language that is understandable to patients, but also precise medically, says Kelly Ford, a Beth Israel internist. Still, Dr. Ford agreed to participate in the OpenNotes project because she believes patients have the right to access their full medical records. "It's weird that someone's record of their own body is under the private domain of somebody else," she says.

Jennifer Potter, a Beth Israel physician who runs two women's health clinics and teaches, declined to participate in the OpenNotes study. She says that she already spends a great deal of time documenting the care she administers and finds that patients too often email and call her about inconsequential lab tests. Also, Dr. Potter says she prefers to use the billing and coding abbreviations and medical shorthand understood only by doctors.

"Theoretically it sounds wonderful for patients to be able to access their entire medical record," Dr. Potter says. "But with so many doctors leaving primary care because they can't manage the loads they already have, it's just an added burden."

—Email informedpatient@wsj.com

Nice Article from WSJ on use of PHR to help create more participatory care.

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Tuesday, August 17, 2010

An Updated Guide for Low-Carb Dieters - Well Blog

I did Atkins for two and a half years–the first six months saw a 40-lb. weight loss (which in retrospect, considering certain health repercussions) was too rapid. Ultimately I lost over 60 lbs. I chose it because as a musician touring in small towns, often not being able to eat until late at night when nothing but chain or fast food restaurants were open, I knew I could always get a simple (albeit boring) meal like a burger patty and salad, filling my belly while staying on course and not sabotaging my weight loss. Things like nuts, string cheese and hard boiled eggs are readily available at truck-stop and gas station mini-marts. But I also found it doable as a serious foodie–nearly every upscale restaurant I went to served the fresh seafood, green veggies, berries and cheeses that kept me from longing for the dessert tray and away from the bread basket. The key was that it was darned tasty too.

So what went wrong? Life happened. I found myself for two years interrupting my music career and instead ping-ponging between motels and hospitals in three cities, attending to the medical needs of three ailing elderly parents (my mother and in-laws). Hospital cafeterias often had eccentric hours and–when open–surprisingly unhealthful foods, as well as profoundly unpalatable healthy choices. One hospital had replaced its cafeteria with a 24/7 “gourmet” chain soup, sandwich and pastry shop serving nothing that fit Atkins, save a plain green salad….day after day for weeks. I would arrive back at my hotel starving late at night, after even the fast-food drive-throughs had closed; the staff would make the complimentary starchy-fatty cocktail-hour hot snacks available for night shift flight crews at nearby JFK. I began to rationalize that for all the running ragged and self-sacrificeI had to do (without the emotional reward of doing a validating show each night), I owed myself some meager pleasure….ergo, the pastries at the hospital and the hot hors d’oeuvres at the hotel. Then, the one surviving nonagenarian in-law moved in with us–and he has bizarre eating habits that dovetai with neither Atkins nor a balanced healthy diet. (He is steadfastly ignoring his doctor’s pleas to live a little). I could not stand to cook two different meals each day, or eat what he liked, so he relies on frozen dinners that meet his austere requirements. Sadly, I reacquired all the bad dietary habits I’ve been unable to break, and I regained 50 of those 60 lbs. (with stress rearranging the distribution of my body fat into a health-threatening silhouette). My gain also exacerbated my arthritis and led to knee injury–necessitating I reduce activity post-surgery. The only bright spot is that I still have sky-high HDLs. As much as I have grown to love artisanal breads, pastas and desserts, I realize that Atkins (or other carb-restricted diets) is the only way I can regain my health, fit my touring schedule, and partially please my palate–bariatric surgery would be unbearable.

But the flip side of the coin–no animal protein, no oil, no sweets, no dairy, no wine (and in some plans, only small portions of the most extremely complex of starches) is as unpalatable to me as the aftereffects and restrictions of gastric bypass. My husband, a cardiologist, reports that patients have an extremely difficult time sticking to diets such as Ornish; those who are successful eating that way tend not to derive pleasure from a variety of foods anyway and ate simply and unhealthfully before eating simply and austerely.

— Sandy in Chicago

Nice NYTimes articel on Updates on Atkins diet and Heart Health

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Monday, August 16, 2010

» 10 Things I Didn’t Prepare For - DiabetesMine: the all things diabetes blog

Don't Miss Amy's Post on her hypoglycemic episode on vacation. And if you have diabetes, or if you're a doc taking care of people with diabetes, or if you have a loved one with diabetes... you should definitely be reading her blog on a daily basis.

To Your Best Health,
The Personal Medicine Team

Posted via email from Personal Medicine

BodyShock The Future - Prizes

Meet with us at IFTF to see the best prize for the future of healthcare in Palo Alto on October 8th.

To Your Best Health,
the Personal Medicine Team

Posted via email from Personal Medicine

Thursday, August 12, 2010

Renewed effort to lure doctors to rural areas faces obstacles

Yep, had a nice conversation with Former Chairman of Intel Professor Barrett at mayo Clinic Last year about Wimax... need to have a wimax tower up in this little town, so doc's can take advantage of all wireless technologies and improve care here. Dial up, people. They are using dial up here.

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Tuesday, August 10, 2010

Little evidence antidepressants helpful for autism | Reuters

Little evidence antidepressants helpful for autism

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By Amy Norton

NEW YORK | Mon Aug 9, 2010 12:16pm EDT


(Reuters Health) - While antidepressants are commonly given to people with autism, there is no evidence from clinical trials that the drugs are helpful for children with the disorder, and only limited evidence that they benefit adults, a new research review finds.

The analysis, reported in the Cochrane Database of Systematic Reviews, adds to doubts about the use of antidepressants known as selective serotonin reuptake inhibitors (SSRIs) in autism.

Last year, a U.S.-government-funded study found that the SSRI citalopram (Celexa) was no better than a placebo at improving repetitive behaviors in children with autism. At the time, experts expressed surprise at the lack of benefit and said the results illustrated the need to test antidepressants against placebos in people with autism.

For the new review, researchers evaluated the findings of the Celexa study, along with those of six other -- much smaller -- clinical trials in the medical literature.

Overall, they found no evidence that SSRIs were better than placebos at improving repetitive behaviors or other symptoms in children with autism. And there was only limited evidence from two small clinical trials that certain SSRIs might improve anxiety, depression and other symptoms in autistic adults.

On the whole, there is no basis for recommending the routine use of SSRIs in treating autism, according to the researchers, led by Dr. Katrina Williams, a pediatrician at the University of New South Wales and Sydney Children's Hospital in Australia.

However, the researchers are not recommending that people with autism who are already on an SSRI and doing well stop taking their medication.

As it stands, no medications are specifically approved for treating autism spectrum disorders (ASDs), a group of developmental disorders that hinder people's ability to communicate and build relationships. The conditions range from severe cases of "classic" autism to the relatively mild Asperger's syndrome.

Behavioral and educational therapies that target the social, developmental and communication problems are the mainstay of autism treatment. But SSRIs are often prescribed to aid with certain symptoms; by one estimate, up to 40 percent of children with autism have been treated with an antidepressant.

In the U.S., three SSRIs - sertraline (Zoloft), fluoxetine (Prozac) and fluvoxamine (Luvox) -- are FDA approved for children older than seven.

Part of the rationale for SSRI use in ASDs is that the drugs can be effective for anxiety and obsessive-compulsive disorder, conditions whose features are similar to some behaviors seen in autism. For example, repetitive behaviors -- such as repeating specific words or actions, or obsessively following a routine or schedule -- are a main feature of autism.

In addition, SSRIs enhance levels of the brain chemical serotonin, and serotonin is thought to influence sleep, mood, aggression and other brain processes that are often altered in autism, Williams told Reuters Health in an email.

But few clinical trials have been done to test the drugs' effectiveness in improving the symptoms of children or adults with autism.

Williams and her colleagues were able to find only seven small, short-term trials where people with autism were randomly assigned to take an SSRI or a placebo for comparison.

The Celexa study, by far the largest, included 149 children with ASDs who were given either the SSRI or a placebo for three months. Roughly one-third of the children in each group showed improvements in repetitive behaviors during the study period, with no advantage from the antidepressant.

All of the other studies Williams and her colleagues found were quite small, with the largest including 39 children. None went beyond three months.

Overall, the five studies that focused on children and teenagers showed no benefits of SSRI treatment, according to the researchers; the trials tested the drugs fluoxetine, fluvoxamine, and, in the two oldest studies, fenfluramine -- a medication that has since been pulled from the U.S. market.

Two studies included adults, with one testing fluoxetine and the other fluvoxamine. The trials found improvements in SSRI users' obsessive behaviors, anxiety, depression and aggression versus placebo users. However, the studies were very small -- one included six participants, the other 30 -- and treatment lasted eight to 12 weeks.

Moreover, SSRIs can have side effects, and concerns about adverse effects are greater with children and teens. In the citalopram study, one child given the drug developed seizures that required hospitalization, and continued to have repeat seizures after being taken off the drug. Children on the drug were also more likely than placebo users to show impulsive behavior, sleep problems and difficulty concentrating.

No increased risk of side effects was seen in children given Prozac; the study that looked at Luvox provided little information on side effects, according to Williams' team.

Given the lack of effectiveness and potential for side effects, SSRIs cannot be recommended for children with autism, the researchers say.

For adults, Williams told Reuters Health in an email, there is "preliminary information that suggests effectiveness" for alleviating depression, anxiety, obsessive-compulsive behavior and aggression. Decisions on whether an adult with autism should try an SSRI should be made on a case-by-case basis, according to Williams.

That said, some people with autism currently on an SSRI may be doing well.

"If children or adults are on an SSRI or other antidepressant and it has improved the problem that it was prescribed for and is not causing side effects, they should continue on the medication," Williams said.

Larger, well-conducted trials of SSRIs in the treatment of autism are still needed, according to Williams. That includes studies of other SSRIs that have yet to be put to the test in clinical trials but are being prescribed to people with autism -- such as sertraline and paroxetine (Paxil).

Larger studies, Williams and her colleagues point out, might allow researchers to find out whether certain subgroups of people with autism respond better to SSRIs than others.

SOURCE: link.reuters.com/kat93n Cochrane Database of Systematic Reviews, August 8, 2010.


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Here is a nice study looking at utility of antidepressants for autism,

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Sunday, August 08, 2010

Social Media in Healthcare

Can social media be an occupational health hazard? It’s an important question to ask if organizations want to protect their most valuable resource: the healthy and happy employee.

As more organizations recognize and implement emerging media into their operations, they will need to hire and train and develop qualified employees who can perform customer service, corporate communications and other core processes of business in the 21st Century.

For social media to work, it has to flow naturally. It can’t be a job.


Social media can be fun. It can be informing. It can be utilitarian. It might even be profitable.

It can also be insidious. It can infiltrate into people’s lives. It can distract from what matters.

Social media blurs the personal and the professional.

It may even re-wire our brains and alter our levels of dopamine.

So: is it conceivable that social media could be an occupational hazard?


We will need more research and feedback and stories in order to have a deep understanding of social media’s effect on us.

In between the two extremes of Social Media is harmless to Social Media is the end of culture, is the truth of what social media is doing for (or to) us.

Until we gather the scientific evidence, it’s only responsible that organizations consider the consequences of how they integrate social media within the enterprise:

  • What to do when an employee is on the receiving end of abusive comments, tweets, etc.?
  • How do you handle online stalking? In what ways is management responsible for officially sanctioned Foursquare check-ins?
  • For employees who work at home, what opportunities will they have for routine face-to-face time with others?
  • Will governmental agencies get involved in occupational social media? (Reach for your Kafka.)
  • Will we see a new form of employee litigation over social media in the workplace?
  • If social media addiction is a true pathology, how do you monitor for it? How do you intervene? (Don’t be too quick to laugh this off.)

These are just some things to consider. They aren’t intended to scare away. But management has a responsibility to ensure that employees are safe, productive and healthy.


The responsable answer to the potential occupational hazards of social media isn’t: This is too much of a risky prospect, so let’s just pass on it.

No, that’s irresponsible and counter-productive given today’s technological conditions. It not only fails the customer: it fails the investor too.

No, the responsible answer is to explore the entire spectrum of possible benefits and costs of bringing social media into daily work life and developing a comprehensive and inclusive plan on balancing the pluses and minuses.


If employees are given the resources they need to do their work, are encouraged to enjoy what they do and are allowed to express their concerns, social media won’t pose the hazards they would if management doesn’t care.

Is Social Media truly Social? In a sense, yes: it can enhance existing relationships and help ignite new ones.

But it can also produce the illusion of social, replacing the deeper meanings that arise from the kinds of social interactions we were born to cultivate with the veneer of friendliness.

When you hear that someone you love has died, which will you want: a tweet about it, or a pair of arms to hold you in silence?

What organizations need more than social media are social business designs. Meaning: organizations need to create working conditions that pull people together while ensuring they have time and space to reflect and process and create.

Health is social. No doubt about. A social workplace is a healthy workplace – with or without social media.

Our upcoming Webinar Healthcare Social Media: Perspectives in Practice includes a presentation on professional development. Learn more and sign up here.


Found this nice blog on integrating social and digital media into Healthcare...

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Tuesday, August 03, 2010

Coxsackievirus Infections

Here is what is going around this week ... nice post on cocksackievirus and symptoms...

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Personal Medicine

Physicians we'd love to have your preferences on viewing of growth and immunizations, sign up for our email newsletter on the PM site and we'll send out some screen shots to get your feedback.

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Monday, August 02, 2010

imgur: The Simple Image Sharer

Nice Jailbreak Video...

Not that we condone hacking at Personal Medicine, but we are all for using technology to revolutionize care delivery...

To Your Best Health,
The Personal Medicine Team

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