DundeeChest 3.0

Archive for the ‘General Respiratory’ Category

In a bid to improve data collection on the use of inhalers in the community one American company has now developed Asthmapolis,  a GPS device to strap onto your inhaler and track usage on your iPhone.  Looks like it could be a useful piece of kit for piecing together asthmatic triggers, but I have some issues over the name. Clearly Asthmapolis is meant to sound like a futuristic and fresh approach to disease management, but there are an awful lot of scottish patients who might think they are being monitored by the Asthma Police.

The MDT sessions seem to be going well enough. There’s been subtle iterations through the week, and tomorrow I might even manage to fit everything in. A couple of you have given some positive feedback about the MDT sessions – I think they have gone well. Most of the decisions have been in line with what happened in real life, which must be a good thing.

I have been disappointed that so few people have read through the information I have provided on “What to tell patients with Lung Cancer” as provided by the BTS. This useful document gives data on what kind of life expectancy lung cancer patients can expect, with and without treatment. We don’t have this data locally, so I can’t really tell you what goes on in Tayside.

On a more positive note, the staff on the ward and in East Block have commented to me that the second years who have come down to the department, been on ward rounds, come to clinics, visited the MDT, have been keen, enthusiastic, and interested. This is a very positive reflection on those of you who have come down, so well done. Someone even came to the real MDT today, to see how it really happens.

Dr Lockhart has given me his 2010 update to his microbiology lecture, so this is now on the microbiology resource page. All the materials from last week’s ITA are now up on the Basic Sciences ITA page too. This week’s MDT materials will go up on line when I get the digital copies from Richard.

Next week I have timetabled a lecture on Respiratory Illness and Oxygen Therapy. This lecture is one I usually leave blank, to give you the choice of what I talk about – last year the choice was Respiratory Illness and Oxygen Therapy. So I’m open to suggestions – what would you like me to talk about on Thursday of next week? I will use some of the time to talk about the RoCE exam, I would quite like to talk about oxygen therapy at some point, but I’m in your hands.

Hello to the community pharmacists who attended Ninewells tonight for their protected learning, this time on Oxygen therapy.

The acute oxygen prescribing page is here. You can see the local implementation of the national guideline here.

Over the Summer Vacation David Smith, one of the new 3rd year medical students, spent 6 weeks working on an interactive tool to improve awareness of ionising radiation doses associated with commonly requested radiological investigations.

The tool is now viewable here. This is a fantastic resource – I wholly recommend it to medical students, junior doctors and even consultants as a refresher!

Well done to David, on a fantastic piece of work.

In preparation for the phase 2 respiratory block, more lecture material is being made available on a daily basis. Today you can visit the respiratory infection page to find Dr France’s 2010 updates to his ever popular infection lectures. Or head over to the lung cancer materials page to see his lung cancer lectures.

The new BTS pleural guidelines have been published – they can be viewed here

If you want a short instructional video on how to aspirate an effusion, or put in a drain, here’s the BTS ePOD video, or at least, a section of it.

Lifted (due to its genius) completely from the Onion website.

RICHMOND, VA—Executives at Philip Morris USA this week unveiled Marlboro Earth, a new eco-friendly cigarette that gradually eliminates the causes of global warming and environmental destruction at their source.

Light up, save the planet

“By killing off the No. 1 threat to the environment, new Marlboro Earths will have a long-term effect on the overall health of our planet,” Philip Morris spokesperson Janet Weiss said. “If everyone in America does their part and joins our new green-smoking movement, then together we can eradicate man’s destructive practices once and for all.”

According to a press release from Philip Morris, the new environmentally friendly cigarettes work by employing powerful carcinogens that accumulate in the lungs of smokers, slowly breaking down their vital organs and eliminating the danger posed to the overpopulated planet by the human race.

Because Marlboro Earths take decades to work, the company stresses that people should start using them as early as possible, ideally during childhood or adolescence, in order to maximize the product’s effectiveness.

“We’ve got to get everybody on board, the sooner the better,” said Weiss, stressing that nothing less than the fate of the planet was at stake. “It doesn’t take much. As few as two packs of Marlboro Earths a day can make all the difference in the world.”

“Go ahead,” Weiss continued. “Light up, breathe in, and help save Mother Earth.”

An environmentally conscious smoker does his part to make a difference about once every 20 minutes or so.

Although industry research indicates people do offer some secondary benefits to the planet, such as recycling programs and wind power generators, studies have concluded these efforts fail to offset the disastrous potential of humanity.

According to Philip Morris, Marlboro Earths are the first green product to address that threat head-on.

“Wildlife habitat encroachment, climate change, the exploitation of precious natural resources—they can all become a thing of the past,” said James Freedman, a member of the marketing team tasked with branding the new product. “Smoke these cool, clean Marlboro Earths every chance you get, and you’ll reduce your carbon footprint to zero in no time.”

Added Freedman, “Plus, you’ll look really sophisticated and glamorous while doing it.”

The new cigarettes, released in limited test-market cities over the past two months, will be ready for a national rollout in mid-June. An ad campaign with the slogan “Marlboro Earth: Saving the Environment One Customer at a Time” has already been launched, and the product’s iconic new packaging, which is similar to the traditional Marlboro design but also features a tree, is reportedly testing “through the roof” with consumers.

In initial product trials, the eco-cigarettes have proven popular among smokers.

“I leave work three to five times a day to stand outside and help the environment,” said longtime smoker Sam Davies, an office worker in Raleigh, NC. “And the best thing about them is they make saving the planet incredibly addictive. After only a few hours, I get the uncontrollable urge to go out and help the environment some more.”

Philip Morris executives stressed that the new cigarettes, which contain the same great taste smokers have come to expect from Marlboro, but with nearly three times the tar and carbon monoxide, could make a huge difference in as little as 40 to 50 years, cutting down on urban sprawl, overpopulation, and eventually helping to enrich the soil with powerful fertilizers.

Like those who sit outside Apple shops waiting for the latest flat shiny “Jabscreen”, respiratory physicians have long awaited the publication of the BTS Bronchiectasis Guideline. I would venture however that the online rumour mill was less frenetic, few will pose to be photographed unwrapping it from the cellophane, and as far as I am aware it will work if you hold it in your left hand. I’ll admit I haven’t read it yet, but I know from previous seminar sessions that it is likely to highlight the weight of evidence that is lacking as much as give sound guidelines. Now that is all a bit dry, and, you know – clinical. So here is an animation based on the medical illustrator Fritz Kahn which is much more entertaining….

Death in a bun. Tasty, tasty death....

No I’m not a militant vegetarian, I wouldn’t be able to cope with all the hemp and Tofu. I just love the eye-catching nature of this piece from a consumer health blog about choking hazards – “About 17 percent of food-related asphyxiations were caused by hot dogs.” Despite the original press release from the American Academy of Pediatrics mentioning nary a word about processed pig snouts being the biggest killer since smallpox, there has apparently been a move to redesign the hotdog. As one statement author Gary Smith put it, “If you were to take the best engineers in the world and try to design the perfect plug for a child’s airway, it would be a hot dog,” One could only assume they would be working for Dr. Evil in this task.

Perhaps we simply need to encourage increased use of condiment lubrication and practice  our skills at removing these pig fingers from the right main bronchus? If nothing else, I’m sure our great british press will be able to torture this information into assuring us that Cumberland rings are better for your health.

“If meat is murder, is Quorn just wasting police time?” Armando Iannucci

Dr McKinlay delivered her Asthma and COPD revision lecture this morning, and has asked me to put it somewhere useful for you! I’m in Englandshire at a conference, but by the wonder of the interwebs, here it is:

Asthma and COPD Revision

I’ll see you all tomorrow. I have to do a Trans-Bronchial Biopsy tomorrow morning before the lecture, so I might be a wee bit late. I shouldn’t be more than about 15 minutes late, if at all.

Remember to come to the revision lecture armed with questions to discuss. We’ll be talking about acid base balance, oxygenation, how to do EMI questions; and whatever else you want to talk about.