Docnotes

Medlogs Comments -- please!

Well the new version of medlogs has been very popular.  We had to increase our bandwidth .. setting me back another $14 a month ... so all of you owe me a nickle. 

Today's e-mail has an appropriate comment that has made me think a bit about how medlogs is organized. 

You\'ve been around for five years, and I have a lot of respect for the work and thought you\'ve put into your writing -- and  your aggregator. I\'ve been around for five months, but I\'ve come to rely on weblogs and hope it succeeds as a useful tool.

But on July 14th,  the Medlogs \"physician\" section had 37 new items. Six were from Mercola, who urges readers to drop their prescription statins in favor of his diet plan, and links to sites claiming HIV doesn\'t cause AIDS.

Another thirteen were from something called Waukesha Family Practice. Judging by the juveline posts, I\'m almost inclined to think the Waukesha family is planning to practice blogging on medlogs.

About 20 of the 37 posts had nothing to do with medicine.

Now, about half of what I write on blogborygmi isn\'t strictly medical, but then again, I don\'t claim to aggregate medical news.

Regardless of their quality, too many blogs are being listed in medlogs inappropriately. I actually like Faughnan, but don\'t think he\'s ever written about medicine. On the other extreme, I think mercola is a menace, yet he dominates your site with a half-dozen ads a day.

You seem wary of the google ads, (which are innocuous and fine) but where\'s the concern over Mercola\'s advertisment / posts? At least Google pays you for space.

I guess what I\'m suggesting is, to avoid more July 14ths, and to keep Medlogs from collapsing under its permissiveness, some kind of rules should exist.

-- indexed blogs should be 50% medical? I\'d hate to see Faughnan or Chai Tea Latte go, but it might be worth it to get rid of the Waukesha family.

-- indexed blogs shouldn\'t be selling stuff via their blog? If it means closing down my Storeborygmi, it might be worth it. At least I\'m not posting about how other people\'s T-shirts and coffee mugs are lethal.

I think we can both agree that medlogs can be a wonderful aid for bloggers and lay readers alike. It\'d be a shame for your site to go the way of email, and become a victim of bandwidth-wasting hucksterism and nonsense.

Frankly, I agree with him.  I e-mailed Dr Mercola a few weeks ago and asked him who writes his posts and expressed some concerns about the commercial nature of them .. selling the book, etc.

I don't want to be in the position of ccensoring feeds .. so I think the 1st method of handling this is to make a "More" category ... and we'll take a more active editorial role.  When I'm not finding interest in the top few posts .. that means you're not either .. so the value of medlogs falls away.  Comments or suggestions?

Antibiotic Prescribing - Still too much

This article from this month's  JABFP reminds us that oversee of antibiotics remains a terrible problem in primary care, and family medicine especially.  The rate of antibiotic prescription for URIs decreased from 52.1% in 1997 to 41.5% in 1999:

Conclusions: Despite a downward trend in antibiotic prescribing over the years, over-prescription of antibiotics for upper respiratory infections persists. General internal medicine physicians are less likely than general/family physicians to prescribe antibiotics, but this gap seems to be narrowing. Specific interventions must be designed to address these disparities.

Family physicians prescribed antibiotics 42.9% of the time for URI .. while Internists did so 36.2% of the time.  Neither of these numbers is even approaching a reasonable goal (0%) ... I think that it's obvious that family physicians need to be better educated on this perils of over-prescribing antibiotics and given the tools to treat patients appropriately.  Of course, the CDC has some great educational tools .. but many states are working on this as well ... and the google directory  on antibiotic resistance is a good place to start looking for more information on this important topic.

DDX of Pinna cellulitis

bedside.org: How can cellulitis of the pinna be distinguished from relapsing polychondritis? Carl discusses two presentations of a red ear. I'd add HSV. I have seen this more than a handful of times, and it is certainly high on my list of conditions that would cause a red pinna.

Firewall/Router

Our old Netgear router has been acting up recently and instead of buying a new one, I installed a free software router onto an old PC we weren't using.   Smoothwall is a great router and it also provides firewall, DMZ, etc. I have not gotten it working with DansGuardian yet, but hope to soon to protect my children from the Internet.

Installing Dansguardian into Smoothwall doesn't look too hard, but I am no linuxhead .. so this may take a bit. 1st attempt this morning didn't go so well.

Moblogging

This post is a test of the moblogging functioality of MO:Blog ..so far the only moblogging software I've been able to get to function on mt treo 600 ... Let's try making a url to Dave's new blog
not bad. we'll try a picture next time

Speech Recognition

Today, and I'm experimenting with speech recognition .. 

This post and the title of this post are all being done with the native Microsoft speech recognition package in service pack two of windows tablet X. P.

 

I've experimented some with dragon naturally speaking but don't have that yet on this computer.

I'm actually impressed to see that it works better than I had expected it to be based on my experiments several years ago.

One still needs to speak rather slowly and clearly than expected with more training the program will get better and better.

It works not very well for dictating progress notes in the office, but we will experiment with the sum over the course of the next week or two, to see if this gets any better.

 

Let's try saying some medical words and see how it works: bob is a 47 year old car Mechanic with chief complaint I've just a name for the last three days.  he smokes to win a tax per day and has a father with COPD.

I think he may have to Cema but it's very unlikely from and this age.  he has a history hypercholesterolemia.  last call a stroll was 7462.  that was the last call Lester all cholesterol got it that time.

his gall bladder was removed six years ago after pinch NBA, and he had a splendid to me too.

Sometimes when he's eating he gets a sensation of heartburn and reflex especially when he eats macaroni and cheese with asparagus.  It is why spare is causes his urine test of funny by Tyson sure him that this was entirely normal.

family history also significant four innings IDs order.  his wife has hypothyroidism.  His two children one with a retinoblastoma and the other has S. Parker center.

 

 

OK, so it didn't do the medical staff very well be paragraph will try to drag and later this weekend and I hope to have a trained with some of the medical terminology as well up. 

Law and medicine

Now there are nearly 100 medical weblogs aggregated on medlogs.com ... just added:  the law section ...