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  hospitals dont save lives, people save lives.  2008-05-02, 07:48:57

  Breakfast Egg Sandwich with Avocado and Chipotle Mayo  2008-05-02, 05:50:00

  Only Slightly Bewildered  2008-04-05, 02:05:00

  No  2008-04-06, 07:57:00

  
Twenty minutes later, a girl collapses onto Jewell station as we leave the train carriage.
">Rarely
 2008-04-12, 11:31:00

  Sluggish  2008-04-15, 09:43:00

  
GLORIFIED THROUGHOUT THE WORLD NOW AND FOREVER

SACRED HEART OF JESUS PRAY FOR US

ST JUDE HELP OF THE HELPLESS, PRAY FOR US"

SAY 9 TIMES A DAY AND BY THE EIGHTH DAY YOUR PRAYERS WILL BE ANSWERED.

Scrap of paper lying in the gutter outside Como Primary School, New South Wales. ">Those in Need
 2008-04-16, 06:40:00

  
(Obviously getting me on the ground was the goal. Only then could the other three morons waiting patiently on the corner start their head kicking.)

You got a fucking problem? Do you mean, like, apart from the fact that you just punched me?

I ran to the centre of the road: standing on the tram tracks - two lanes of traffic between my secret admirers and I - it felt like the perfect place from which to yell abuse. Fuck you. At this point fuckwit and his morons seemed to be sorting through my souvlaki debris, looking for something valuable amongst the yoghurt and pita bread. Fucking morons. My provocation was enough to enrage fuckwit and get him running towards me.

Although seemingly awkward, giraffes can run extremely fast when pursued. Even faster when escaping tabloid scenarios (alcohol fueled violence on the rise in Melbourne's streets, duh...).
">Giraffe
 2008-04-21, 13:10:00

  

Parker was issued a patent for the technology in September last year and has refined the process to such an art he even used his digital army of PC-powered "authors" to compile answers to interview questions for this article, based on information he had already written about his creation.

"The goal was to create original titles (book, videos, games, etc.) on topics that would not be economically viable if published using traditional methods, or covering topics that might be of interest to a limited audience that would nevertheless find the titles useful (what some call the 'long tail')," he said.

The machines - up to 10 PCs for a single sub-sub-genre - then work on compiling thousands of individual titles around the topic, which take about an hour each to compile.

"These genres create wholly original content or conclusions ... much the way consultants draw original conclusions from data they analyse," Parker said.

"If data need to be collected online as on author would, then this process is fully automated - much the way bloggers 'read' things online and then create comments based on what they have read."

Basic English errors in Parker's computer-compiled responses to interview questions highlight the fact that his processes aren't infallible.

To be sure, Parker does not believe his technology will render all human authorship obsolete - only that which is "mundane" or uneconomical to otherwise produce.

(Excerpted from) Asher Moses - Automaton Author Writes up a Storm, The Age, 21 April 2008.

">Automatic Writing
 2008-04-23, 14:21:00

  Urchin Sampler  2008-04-25, 06:08:00

  Sunday Night  2008-04-28, 07:33:00

  Bluebird of Happiness  2008-05-01, 03:06:00

  Signs of myocardial ischaemia after injection of oxytocin: a  2008-04-11, 00:00:00

  Complications in Anesthesiology  2008-04-11, 00:00:00

  Modulation of AMPA receptor GluR1 subunit phosphorylation in  2008-04-11, 00:00:00

  Positron emission tomography study of regional cerebral bloo  2008-04-11, 00:00:00

  Role of routine chest radiography after percutaneous dilatat  2008-04-11, 00:00:00

  Predicting death and readmission after intensive care discha  2008-04-11, 00:00:00

  Persistent train-of-four fade in myasthenia gravis patients  2008-04-11, 00:00:00

  Laparoscopic cholecystectomy in a patient with an implantabl  2008-04-11, 00:00:00

  Pressure-controlled ventilation improves oxygenation during  2008-04-11, 00:00:00

  Implementation of outpatient preoperative evaluation clinics  2008-04-11, 00:00:00

  Analgesic effectiveness of caudal levobupivacaine and ketami  2008-04-11, 00:00:00

  Bispectral Index asymmetry and COMFORT score in paediatric i  2008-04-11, 00:00:00

  Plasma concentrations and sedation scores after nebulized an  2008-04-11, 00:00:00

  Reversal of rocuronium-induced neuromuscular block with suga  2008-04-11, 00:00:00

  Examination of the effect of procalcitonin on human leucocyt  2008-04-11, 00:00:00

  Xenon or propofol anaesthesia for patients at cardiovascular  2008-04-11, 00:00:00

  Unusually early onset of post-dural puncture headache after  2008-04-11, 00:00:00

  Perioperative anaemia management: consensus statement on the  2008-04-11, 00:00:00

  In the May 2008 BJA ...  2008-04-11, 00:00:00

  Postoperative catheter-related pain after radical retropubic  2008-04-11, 00:00:00

  Volume 100: basic sciences in the British Journal of Anaesth  2008-04-11, 00:00:00

  Pharmacokinetics of intravenous dexmedetomidine in children  2008-04-11, 00:00:00

  Different small-dose sufentanil blunting cardiovascular resp  2008-04-11, 00:00:00

  Pharmacology for Anaesthesia and Intensive Care  2008-04-11, 00:00:00

  Heidelberg Dentist has Become a Participating Dentist  2008-04-15, 11:32:50

  Fawkner Dentist has Become a Participating Dentist  2008-04-15, 12:28:50

  Girrawheen Dentist has Become a Participating Dentist  2008-04-16, 21:44:32

  East Perth Dentist has Become a Participating Dentist  2008-04-16, 22:14:43

  Murdoch Dentist has Become a Participating Dentist  2008-04-16, 22:44:38

  South Perth Dentist has Become a Participating Dentist  2008-04-16, 23:00:44

  East Melbourne Dentist has Become a Participating Dentist  2008-04-19, 13:38:38

  Caulfield Dentist has Become a Participating Dentist  2008-04-19, 13:53:21

  Boronia Dentist has Become a Participating Dentist  2008-04-24, 16:19:40

  Mulgrave Dentist has Become a Participating Dentist  2008-05-01, 11:07:56

  Death of G. David Low  2008-04-02, 08:13:37

  "How Can I Motivate My Wife?"  2008-04-06, 08:28:00

  Clinical Trial Opportunity: DAVANT and 5-FU  2008-04-09, 09:12:27

  How Long Should it be from Diagnosis to Surgery?  2008-04-12, 08:49:05

  Should an 86-Year-Old Give Chemo a Shot?  2008-04-19, 08:34:16

  What is Stage 0 Colon Cancer?  2008-04-23, 09:16:30

  "These Posts Have Given Me the Strength I Needed"  2008-04-27, 09:03:10

  How to Find a Colon Surgeon  2008-04-30, 09:25:40

  Ewan McGregor skin cancer?  2008-04-23, 19:44:45

  Weekend Eagle Blogging Week 1: Apple, Fennel, and Celery Sal  2008-04-04, 18:15:00

  Habaneros Are Hot  2008-04-08, 05:46:00

  A Fava Bean by Any Other Name Would Taste as Good  2008-04-11, 03:30:00

  Beautiful Bones: An Osteoporosis Food Event  2008-04-14, 05:20:00

  Mizuna and Broccoli Flower Salad: The Plasma HDTV of Salads  2008-04-17, 16:45:00

  How to Clean, Cook, and Eat an Artichoke  2008-04-20, 23:05:00

  Roasted Rainbow Carrots and String Beans with Citrus-Sage Gl  2008-04-24, 16:40:00

  Baby Artichoke and Asparagus Risotto  2008-04-28, 03:40:00

  People With Psoriasis May Be at Risk for Other Serious Medic  2008-04-09, 09:20:19

  Eating Indian Spice Tumeric Does Not Treat Psoriasis  2008-04-17, 22:16:15

  Bacteria in Babies May Help Prevent Atopic Dermatitis  2008-04-27, 11:33:48

  Recurrent Cheilitis in a 37 yo Woman  2008-04-02, 17:11:00

  
Questions:
1) What has been learned about this entity since 1982?
2) Should he be rechallenged with penicillin and kept on long-term antibiotic prophylaxis.
3) What role does "hypersensitivity" to bacterial exotoxins play in the dermatitis.
4) Does anyone have magic for cases such as this?
5) Allergic contact dermatitis will be ruled out by patch testing.

Comment: My plan at the moment is to "clean up" any residual infection, consider prophylactic antibiotics and work on the dermatitis. I will refer him to a lymphedema center, if possible, for evaluation. Aggressive management of his leg swelling will help. He was told not to bathe the leg and I think this sets him up for infection. Your thoughts will be greatly appreciated. This man's life revolves around his leg. He is a keen student, a political scientist and in his later years he must focus exclusively on a leg. Let's give him "a leg to stand on!"

Reference:
Recurrent cellulitis after saphenous venectomy for coronary bypass surgery.
Baddour LM, Bisno AL.
Ann Intern Med. 1982 Oct;97(4):493-6.

We describe a previously unreported complication of coronary artery bypass
grafting, recurrent cellulitis. Five patients had 20 episodes of acute
cellulitis, each occurring in the lower extremity in which saphenous venectomy
had been done. The cases were striking because the patients presented with high
fever and considerable systemic toxicity. The appearance of the lesions, presence
in one case of obvious associated lymphangitis, and prompt response in three
instances to therapy with penicillin alone all suggest group A streptococcal
infection. In one case, a beta-hemolytic, bacitracin-susceptible Streptococcus
strain was isolated from the lesion. The pathogenesis of this syndrome remains
obscure but, based on our understanding of postsurgical erysipelas, this
cellulitis likely results from the interplay of several factors, including local
compromise of lymphatic drainage, direct bacterial invasion, and acquired
hypersensitivity to streptococcal exotoxins.">A Leg to Stand On
 2008-04-04, 00:46:00

  
Diagnosis: Non-healing erosions etiology unclear. One always considers factitial disease in health care professionals with atypical skin lesions and this man also has free access to needles as a diabetic. In a year, the scalp lesion has shown no tendency to improve.

Further Treatment: He was treated with topical corticosteroids in case this was erosive pustular dermatitis of the scalp (no response) and imiquimod in case erosion might have been hypergranulation tissue. (no response) We ordered Duoderm dressings, but they were too expensive for the patient.

Questions: Where would you go from here? Diagnostic and therapeutic suggestions.">Stumped...
 2008-04-16, 12:14:00

  
Our Western civilization began in the Fertile Crescent. Iraq was at the epicenter. The strory told here diminishes all of us. Professor Sharquie bravely bears witness as he helps and serves his people.
">No Man is an Island
 2008-04-27, 02:24:00

  Nice seafood  2008-04-02, 18:20:00

  10 reasons why doctors should maintain the rights to dispens  2008-04-03, 06:18:00

  TGIF  2008-04-04, 18:33:00

  Land of the Merlion  2008-04-06, 17:03:00

  Broken  2008-04-08, 18:39:00

  ">Dinner treat  2008-04-09, 16:57:00

  Am I dreaming?  2008-04-12, 18:36:00

  New kids on the block  2008-04-14, 17:30:00

  Ridiculous  2008-04-16, 15:38:00

  False positive  2008-04-18, 18:06:00

  Lunch talk  2008-04-19, 17:56:00

  
These are the many medications I give out to patient with Psoriasis.

I usually diagnosed this disease in a glance. Most part of my consultation is to explain to the patient regarding the disease, as well as various types of medications the patient need to apply, including the various detail steps on how the medications are applied and their various expected side effects.

Am I in no better qualified position to do the explanation and counseling in regards to the medications used and their various side effects?

How much one be sure that the pharmacists could explain how exactly I want the patients to use the way I want them to use?

I can tell you, they have no ideas and that is why I kept a full range of medications on my table to show and teach the patients how to use them.

Here's some comment from one reader:

"My point is that if dispensing separation were to take place, a check and balance system will be in place. The doctors wins, the pharmacists win, the patients win. Win-win for all. Isn't that good?"

My question now is, how are we really be sure that what the doctor prescribes, is what the patient should get?


This was the third time I encountered this on the same day.

I wrote a prescription for the amount of 200 gm, and the patient only received 60 gm. Did the pharmacists understand how much 200 gm is? Did they see the patient and estimate how much the patient need it? NO, and I am so tired of writing new prescriptions again and again just to get the exact amount of cream I wanted the patient to get. I am just so fed up.
Here was another prescription I wrote for a patient.

I wanted to give out the 'cream' form and for 30 gm amount.
This was what the patient received, 'ointment' and only for 15gm.

When I called back to confirm, they admitted it was their mistake.

Therefore, if pharmacists are to check on the doctors' prescriptions, who are there to check if the pharmacists dispense the correct medications and amount or not?

So, does the separate dispensing system really work with the 'check and balance' concept that benefit patients.

I hope doctors would not get new role, that is, to check back on pharmacists.

Read more about my posting over Storyformydoctor 1.0.

">This dispensing stuff again
 2008-04-20, 06:59:00

  But for me, so so only lah.

So, what exactly so special about this bowl of bihun?

RM 7.00
">Water fish
 2008-04-21, 17:30:00

  Goodbye Vox populi  2008-04-23, 13:47:00

  ">Tasteless and Offensive  2008-04-24, 17:16:00

  Chedet.com  2008-05-01, 11:53:00

  Smudge and me.  2008-04-19, 09:44:23