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11
357

Heart Attack: Signs and Symptoms

Millions of people suffer heart attacks every year. A heart attack can damage the heart’s function, and even lead to death. Learn what happens during a heart...  
youtube.com
about 4 years ago
Foo20151013 2023 t4jn?1444773937
9
357

Death by Powerpoint.

Introduction Computerised presentations are a part of every medical student's / junior doctor's life. Sometimes we give them, often we sleep through them and occasionally we even listen to them. They are the backbone of medical education besides traditional bed-side teaching, having rapidly replaced the now extinct OHR (Over Head Projector) acetate-sheet presentations of years gone-by. The problem is that Doctors and medical students often struggle with creating and presenting coherent slides. This is most probably due to the general apathy most have for actually talking in front of an audience, or because those asked to present are often taken unawares, and therefore have little time to prepare. In these times of avolition or last-minute hurriedness, people often reach out for the industry standard of presentation production: PowerPoint. PowerPoint is the most commonly used tool for making presentations because it is simple to use and comes with a whole load of free templates. Unfortunately, most of these templates look disgusting. If a template doesn't look disgusting, then it is most certainly overused and you run the risk of having a presentation that looks identical to the student before you at the weekly seminar teaching - a scenario that can be easily likened to turning up to a lecture wearing exactly the same clothes as another person in the room, which would just be awkward. Another problem with PowerPoint is the phenomenon of 'Death By Powerpoint,' which refers to the general boredom and apathy experienced by those who have received way too much information in way too short a space of time via a series of over-cramped, poorly stylised slides. But why on earth do you care? People should care about 'Death By Powerpoint' because if your presentations cause people to zone out, then you are not getting your message across. And if you aren't getting your message across then you. are. not. presenting. at. all. (take a moment to reflect on that particularly Zen statement). Let me explain using a metaphor, if I am a sales person and I present my talk with well-designed slides, in an enthusiastic and well-rehersed manner to an appropriate audience I will make more sales than if I present using poorly designed slides at the last minute. Similarly, in Medicine if I present well designed, aesthetic slides I am more likely to convey accurate information to my colleagues that may very well be retained and enjoyed by all involved. Of course, this blog assumes a degree of presentation-related Altruism. The recommendations I am about to make require you to 'step out of the mould' and say 'no' to poor presentations. They require you to forgive others for the presentations they have inflicted on you in the past. You will 'lead by example'. Unfortunately I am not capable (or qualified) to make you an excellent designer, nor can I give you the motivation to feel as passionately about design aesthetics as i do when all you've got to do is slam some slides together for your monthly journal club. But what I can do is present to you a series of resources that might tempt you away from the horrific PowerPoint templates that currently infest medical student seminars and young doctors presentations. If you really couldn't care less, then I suggest using Prezi, a website where you can make quite eccentric looking presentations rapidly and for free. The only problem is that Prezi became cliched even before its debut and you risk inflicting travel sickness on your poor audience, what with all the funky zooming in and out of slides that occurs during a typical Prezi presentation (you will know what I mean if you've ever seen one). So, without further ado, here are my top 5 tips for making your presentations look smoother and more polished... Irrespective of whether the contents of your talk are any good. Step One: Typography Get yourself a good font. Typography is really important, when you speak to someone you use a variety of tones and gestures to convey the meaning of the words you are using. Fonts are effectively the printed version of your tone and gestures. Good font choice can help give 'umph' to a particular point in your presentation and help give character to what you are saying. Of course, it's important to remain professional so 'Wingbats' might not be your first choice, but anything that you could envisage on a nice business card is probably a good shout. Fonts are usually something you have to pay for if you want anything beyond the set given to you when you download Microsoft Word (for example). However, there are whole hosts of free fonts available from sites like [dafont])(http://www.dafont.com). The key is to be willing to trawl through these sites to find fonts that are actually useful! Beware those fancy fonts unless you know your audience can take it! If you are stuck on choosing a font, which is a common complaint, then maybe this flow diagram will help! Oh yeah, and never ever use Comic Sans. Ever. Step Two: Colour A good font isn't going to get you very far on its own. You need a solid colour scheme to bring your presentation alive. It seems blunt to say, but some people are not very good at picking colours that go well with one another. This is well evidenced in PowerPoint presentations where the yellow-text-on-blue-background is far too common. I mean yeah, in theory blue and yellow 'compliment' each other, but thats where the relationship between blue and yellow should stay... in theory. Luckily there are some useful colour palette websites available out there, which will match colours for you... Step Three: Structure After you've picked a sensible font and a suitable colour scheme, it's time to think about the structure or layout of your slides. It's absolutely crucial that you avoid putting too much information on your slides even if you are giving an academic presentation. An overloaded slide is about as useful as a dead cat. At this point, some of you may be tempted to resort to those dodgy PowerPoint default templates but there is another way! There are sites out there that have some pretty fresh templates you can use and they are completely free! They are sure to add a bit of spice to your slide's aesthetic. There will probably be a separate tutorial on this in the future, but basic principles apply. As a general rule stick to Left Alignment *and avoid *Central Alignment like the plague. Step Four: Imagery Images help to spice up a presentation, but try and keep them related to the topic. Google Images is a great resource but remember that most images will be a low resolution and will be poorly suited to being shown blown up full-size on a presentation screen. Low resolution images are a presentation killer and should be avoided at all costs. For high-quality images try sites like Flikr or ShutterStock. Step Five: Consider Software The interface of Powerpoint does not lend itself well to having images dropped in and played with to make nice looking layouts. I would recommend Adobe Photoshop for this kind of work, but not everyone will have access to such expensive software. Cheap alternatives include Photoshop Elements amongst others. Once you have created slides in Photoshop it is quick and easy to save them as JPEG files and drag and drop them into PowePoint. Perhaps that can be a tutorial for another time... Step 5: Additional Stuff Presentations typically lack significance, structure, simplicity and rehearsal. Always check over your presentation and ask 'is this significant to my audience?' Always structure your presentation in a logical manner and (it is recommended you) include a contents slide and summary slide to tie things together. Keep your verbal commentary simple and keep the slides themselves even more simple than that. Simplicity is crucial. Once you have produced your beautiful slides with wonderful content you will want to practice them. Practice, Practice, Practice. Rehearsing even just once can make a good presentation even better. Conclusion: This blog entry has covered some basic points on how to improve your medical presentations and has given a series of useful online resources. Putting effort into designing a presentation takes time and motivation, for those without these vital ingredients we recommend Prezi (whilst it is still relatively new and fresh). Perhaps the rest of you will only use these tips for the occasional important presentation. However, I hope that soon after you start approaching presentations with a little more respect for their importance and potential, you too will find a desire to produce high-quality, aesthetically pleasing talks. LARF - Mood: damn tired and feeling guilty that I just wrote this blog instead of revising haematology notes. Follow me on Twitter. Follow the Occipital Designs original blog. Check out my Arterial Schematic.  
Dr. Luke Farmery
over 7 years ago
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6
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Birth asphyxia and Hypoxic-Ischaemic Injury: Prognosis and Management

This presentation summarises mechanism of injury in HIE, and goes through current and future treatment potentials. It also communicates some of the potential medico-legal risks in this field of medicine.  
Charlotte Patterson
about 9 years ago
Foo20151013 2023 1ilnrlb?1444774017
6
176

Itraconazole Toxicity and Cardiac Health Problems

Itraconazole is an antifungal drug used widely to treat fungal infections and is active against Aspergillus, Candida and Cryptococcus. It is effective and now much cheaper as it has passed out of the period of time granted to its inventor to exclusively sell it - there are now several competing manufacturers. It seems to be an increasingly useful and used drug now it has become more accessible which is a good thing in the main but this makes it increasingly important that this drug is properly understood and its very severe potential side effects appreciated and guarded against. These are the warnings published by the World Health Organisation Risk of congestive heart failure The agency says that while the available evidence suggests that the risk of heart failure with short courses of itraconazole is low in healthy, young patients, prescribers should exercise caution when prescribing the drug to at-risk patients. Amendments to the product information of all itraconazole formulations have been made to reflect this information. Risk to pregnant women By April 2000 the UMC had received 43 case reports from 5 countries regarding the use of itraconazole by pregnant women. 25 of these pregnancies ended in embryonic or foetal death. The remaining 19 reports described a variety of congenital malformation or neonatal disorders. In the 38 reports in which the route of administration was specified the drug was taken orally. The data suggested that: inspite of the approved recommendations and warnings itraconazole is being taken by pregnant women for minor indications, reported human experience seems to lend support to the experimental evidence that itraconazole is teratogenic, there is a predominance of abortion, and more firm warnings may be needed in the product information.Although not apparent from the UMC reports, a further question of interest was if itraconazole might decrease the reliability of oral contraceptives and so lead to unintended exposure in pregnancy. Care thus needs to be taken about which patients are prescribed itraconazole, adequate monitoring needs to be put in place if needed and sufficient advice given with the drug to ensure the patient is aware of the risks involved and the signs & symptoms to look out for.  
Graham Atherton
about 7 years ago
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5
77

Renal replacement therapy in the ICU

Acute kidney injury increases the risk of poor outcome and death. This presentation looks at diagnostic criteria, impact on outcome, and reviews the features and characteristics of the main types of renal replacement therapy available.  
Andrew Ferguson
over 9 years ago
13
5
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Cell Injury and Death

Struggling with Pathology? Why not join Howard Reisner, co-author of the bestselling Rubin’s Pathology, and Essentials of Rubin's Pathology, about Cell Injury and death. In it, he covers a variety of essential topics. For more information, or to purchase your copy of one of Dr Reisner’s books, visit [www.lww.co.uk](http://lww.co.uk). Save 15% (and get free P&P) on this, and a whole host of other [LWW titles](http://lww.co.uk) when you use the code MEDUCATION when you check out!  
Lippincott Williams & Wilkins
about 7 years ago
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5
35

Death is 'core business' of Scottish hospitals, university study finds - BBC News

Almost one in three hospital patients in Scotland will die within a year, and nearly one in 10 will die during their time in hospital, a study has found.  
BBC News
over 6 years ago
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5
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Asthma death: Mother 'shattered' after ambulance delay - BBC News

A mother describes the pain of losing her daughter to asthma, when an ambulance went to the wrong address.  
BBC News
about 6 years ago
3b19c5d9 2bdd 450f a374 41199ce842ad 2060x1236
5
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The power of the story: teaching doctors to ‘feel’ patient-centred care

Following the death of her 21-year-old son, Margaret Murphy, external lead of the WHO’s Patients for Patient Safety programme, has been teaching doctors and students how an engaged, knowledgeable patient can be the key resource in his or her own care  
theguardian.com
almost 5 years ago
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5
115

A healthy environment can prevent heart disease

Cardiovascular diseases (CVD), including heart disease and stroke, are the n°1 killer worldwide and in Europe, where they cause the death of over 10 000 people daily, i.e. more than all cancers combined (1).  
escardio.org
almost 5 years ago
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5
64

Pressure Ulcers

A pressure ulcer is a sore that results from the death of the skin and its underlying tissue in areas of the body that receive pressure. This occurs when a p...  
youtube.com
about 4 years ago
Preview 300x225
4
169

Death verification

Poster to help with death verification  
Martin Wicks
about 11 years ago
Foo20151013 2023 2njk5o?1444774020
4
1327

LWW: Case Of The Month - April 2013

This month’s case is by David R Bell PhD, co-author of Medical Physiology: Principles for Clinical Medicine, 3e (ISBN: 9781451110395) For more information, or to purchase your copy, visit: http://tiny.cc/Rhoades4e, with 15% off using the discount code: MEDUCATION. The case below is followed by a quiz question, allowing you a choice of diagnoses. Select the one letter section that best describes the patient’s condition. The Case A 28-year old woman has an unremarkable pregnancy through her first 28 weeks of gestation, with normal weight gain and no serious complications. She has no previous history of diabetes, hypertension of other systemic disease before or during her current pregnancy. During her 30-week checkup, her blood pressure measures 128/85, and she complains about feeling slightly more “bloated” than usual with swelling in her legs that seems to get more uncomfortable as the day goes on. Her obsterician recommends that she get more bed rest, stay off her feet as much as possible and return for evaluation in one week. At the one-week follow-up, the patient presents with noticable”puffiness” in her face, and a blood pressure of 145/95. She complains she has been developing headaches, sporadic blurred vision, right-sided discomfort and some shortness of breath. She has gained more than 10 lb (4.5kg) in the past week. A urinalysis on the patient revelas no glucose but a 3+ reading for protein. Her obstetrician decides to admit her immediately to a local tertiary care hospital for further evaluation. Over the next 24 hours, the patient’s urine output is recorded as 500mL and contains 6.8 grams of protein. Her plasma albumin level is 3.1 g/dl, hemacrit 48%, indirect bilirubin 1.5mg/dl and blood platelets=77000/uL, respectively. Her blood pressure is now 190/100. It is decided to try to deliver the foetus. The expelled placenta is small and shows signs of widespread ischmic damage. Within a week of delivery, the mother’s blood pressure returns to normal, and her oedema subsides. One month later, the mother shows no ill effects of thos later-term syndrome. Question What is the clinical diagnosis of this patient’s condition and its underlying pathophysiology? A. Gestational Hypertension B. Preeclampsia C. Gestational Diabetes D. Compression of the Inferior Vena Cava Answer The correct answer is "B. Preeclampsia". The patient’s symptoms and laboratory findings are consistent with a diagnosis of Preeclampsia, which is a condition occurring in some pregnancies that causes life-threatening organ and whole body regulatory malfunctions. The patient’s negative urine glucose is inconsistent with gestational diabetes. Gestational hypertension or vena caval compression cannot explain all of the patient findings. The patient has three major abnormal findings- generalised oedema, hypertension and proteinuria which are all common in preeclampsia. Although sequalae of a normal pregnancy can include water and salt retention, bloating, modest hypertension and leg swelling (secondary to capillary fluid loss from increased lower limb capillary hydrostatic pressure due to compression of the inferior vena cava by the growing foetus/uterus), oedema in the head and upper extremities, a rapid 10 pound weight gain and shortness of breath suggests a generalized and serious oedematous state. The patient did not have hypertension before or within 20 weeks gestation (primary hypertension) and did not develop hypertension after the 20th week of pregnancy with no other abnormal findings (gestational hypertension). Hypertension with proteinuria occurring beyond the 20th week of pregnancy however is a hallmark of preeclampsia. In addition, the patient has hemolysis (elevated bilirubin and LDH levels), elevated liver enzyme levels and thrombocytopenia. This is called the HELLP syndrome (HELLP = Hemolysis, Elevated Liver enzymes and Low Platelets.), and is considered evidence of serious patient deterioration in preeclampsia. A urine output of 500 ml in 24 hours is 1/2 to 1/4 of normal output in a hydrated female and indicates renal insufficiency. Protein should never be found in the urine and indicates loss of capillaries integrity in glomeruli which normally are not permeable to proteins. The patient has substantial 24 urine protein loss and hypoalbuminemia. However, generally plasma albumin levels must drop below 2.5 gm/dl to decrease plasma oncotic pressure enough to cause general oedema. The patient’s total urinary protein loss was insufficient in this regard. Capillary hyperpermeability occurs with preeclampsia and, along with hypertension, could facilitate capillary water efflux and generalized oedema. However myogenic constriction of pre-capillary arterioles could reduce the effect of high blood pressure on capillary water efflux. An early increase in hematocrit in this patient suggests hemoconcentration which could be caused by capillary fluid loss but the patient’s value of 48 is unremarkable and of little diagnostic value because increased hematocrit occurs in both preeclampsia and normal pregnancy. PGI2, PGE2 and NO, produced during normal pregnancy, cause vasorelaxation and luminal expansion of uterine arteries, which supports placental blood flow and development. Current theory suggests that over production of endothelin, thromboxane and oxygen radicals in preeclampsia antagonize vasorelaxation while stimulating platelet aggregation, microthrombi formation and endothelial destruction. These could cause oedema, hypertension, renal/hepatic deterioration and placental ischemia with release of vasotoxic factors. The patient’s right-sided pain is consistent with liver pathology (secondary to hepatic DIC or oedematous distention). Severe hypertension in preeclampsia can lead to maternal end organ damage, stroke, and death. Oedematous distension of the liver can cause hepatic rupture and internal hemorrhagic shock. Having this patient carry the baby to term markedly risks the life of the mother and is not considered current acceptable clinical practice. Delivery of the foetus and termination of the pregnancy is the only certain way to end preeclampsia. Read more This case is by David R Bell PhD, co-author of Medical Physiology: Principles for Clinical Medicine, 3e (ISBN: 9781451110395) For more information, or to purchase your copy, visit: http://tiny.cc/Rhoades4e. Save 15% (and get free P&P) on this, and a whole host of other LWW titles at (lww.co.uk)[http://lww.co.uk] when you use the code MEDUCATION when you check out! About LWW/ Wolters Kluwer Health Lippincott Williams and Wilkins (LWW) is a leading publisher of high-quality content for students and practitioners in medical and related fields. Their text and review products, eBooks, mobile apps and online solutions support students, educators, and instiutions throughout the professional’s career. LWW are proud to partner with Meducation.  
Lippincott Williams & Wilkins
about 7 years ago
Foo20151013 2023 4ktnps?1444774050
4
189

Poo transplants

When is it medically advisable to eat some one else's poo? When you need a poo transplant. Poo transplants could be the solution to one of the biggest problems facing the NHS today- the bacterial infection Clostridium difficile. C.diff, as it's known to its friends, infects about 18,000 people in England and Wales every year and is involved in the deaths of about 2000 people. C.diff typically arises due to imbalances in the normal gut bacteria. The gut is like a city, a city with about 100 trillion bacterial residents happily munching away on a banquet of bowel contents. The average person has about 1000 different types of bacteria in their gut, and about 3% of healthy adults have C.diff in that mix. The C.diff doesn't cause them any problems because its numbers are kept in check by the other gut bacteria. However treatment with broad spectrum antibiotics such as clindamycin, cephalosporins, ciprofloxacin and co-amoxiclav, can disrupt this happy community- killing off vast swathes of bacteria but crucially not the C.diff. Given free rein the C.diff multiplies rapidly and produces toxins which damage the gut. In some people this causes mild diarrhoea and abdominal pain, in others it can lead to torrential diarrhoea, perforation of the colon and death. Traditional treatment includes stopping any broad spectrum antibiotics and possibly prescribing antibiotics which target the C.diff such as metronidazole or vancomycin. However with antibiotic use comes the risk of resistance. Moreover our current approach isn't entirely effective and about 22% of patients treated suffer a recurrence. This can result in a cycle of illness and hospital admission which is costly to the patient and the hospital. So it's time to start thinking outside of the box. Cue the poo transplant. The thinking goes like this- if the cause of the problem is disruption to the normal community of gut bacteria, why not just pop those bacteria back in to crowd out the C.diff? Simples. Practically, the first step is to identify a donor, usually a close relative of the patient, and screen them for a range of infectious diseases and parasites. It's also advisable to make sure they haven't recently consumed anything the intended recipient is allergic to, before asking them to make their "donation". You then pop it in a household blender and blitz it down, adding saline or milk to achieve a slurry consistency. Next you need to strain your concoction to remove large materials- one medic in the UK uses coffee filters. Top tip. Then you're ready to administer it- about 25ml from above (e.g. via nasogastric tube), or 250ml from below. Now, its important to note that poo transplants are still an experimental treatment. To date only small case studies have been carried out, but with 200 total reported cases, an average cure rate of 96% and no serious adverse events reported to date, it's worth carrying out a large trial to assess it thoroughly. Poo transplants- arguably the ideal treatment for a cash strapped NHS. It's cheap, plentiful and it seems to work. Now to convince people to consume someone else's poo... Bottoms up! FYI: This was first posted on my own blog. Image Courtesy of Marcus007 at de.wikipedia [Public domain], from Wikimedia Commons  
Dr Catherine Carver
about 7 years ago
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3
39

Booking, Screening & Antenatal Care

Much of the follow-up of pregnant women is carried out in the community, by midwifes at primary health care centres. The risk of death from pregnancy in the UK is roughly 1 in 20 000. Antenatal care is as much about educating women about pregnancy, childbirth and child care, as it is about providing for actual medical needs, particularly in the case of a first pregnancy. The exact measures will differ between NHS trusts, but below is a general outline of the type of care provided in pregnancy.    
almostadoctor.com - free medical student revision notes
over 6 years ago
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3
53

Inactivity, disability, and death are all interlinked

Physical activity has long been recognised as an important determinant of health and longevity, and many countries have explicit physical activity guidelines for promoting health.1 2 The corollary of this is that people who do not meet the guidelines, a substantial proportion of the population,3 are at risk of worse health. However, relatively little attention has been given to the question of how much activity is needed to make a difference. Although this is not explicitly their primary purpose, two new papers shed light on this question. Dunlop and colleagues (doi:10.1136/bmj.g2472) followed a cohort of people who had mild to moderate osteoarthritis or were at risk of osteoarthritis to look at the development of disability over two years.4 Cooper and colleagues (doi:10.1136/bmj.g2219) estimated the relation between physical capability in midlife—as indicated by grip strength, chair rise speed, and standing balance—and later mortality.5 Both showed that the relation between inactivity and risk of disability or death is not linear: people …  
bmj.com
about 6 years ago
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3
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Atherosclerotic Cardiovascular Disease Mnemonics | IMnotebook.com

> Myocardial infarct, complications ABCDE x2 Arrhythmias / AneurysmBradycardia / ↓BPCardiac failure / cardiac tamponadeDresslers / Death!Embolism / Extra (VSD, pap muscle rupture)   
imnotebook.com
about 5 years ago
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3
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Sudden Cardiac Arrest FAQs | Sudden Cardiac Arrest Foundation

The Sudden Cardiac Arrest Foundation is a Non-Profit organization dedicated toward increasing awareness about sudden cardiac arrest. Join the SCA Community for SCA News, participate in the discussion forum, community blogs, share advice and gain insight.  
sca-aware.org
almost 5 years ago
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2
40

Lung Cancer

When we talk about lung cancer, we are generally referring to tumour of the bronchus. 95% of lung cancers are carcinoma of the bronchus 2% are alveolar tumours 3% are benign or less invasive malignant tumours. Death normally occurs after 30 ‘cell doublings’ of malignant cells. In this document I will be referring to bronchial carcinoma unless otherwise stated    
almostadoctor.com - free medical student revision notes
over 6 years ago
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2
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Glaucoma

Definition – gradual death of the optic nerve often associated with high intraocular pressure   High intraocular pressure is usually due to aqueous humour production and drainage imbalance   The Aqueous pathway  
almostadoctor.com - free medical student revision notes
over 6 years ago