Being Black in America is dangerous. We hear about the deaths by police shooting or white supremacist - and by gun violence generally, which disproportionately plagues Black communities. But we hardly ever discuss the persistent discrepancy in life expectancy between white and black. There are many ways to attack the latter through healthcare policy and practice -- if we are willing. That remains the question for America 48 years after King was killed.
<p>Why is a 12 hour erection a bad thing? How should we manage the patient with bloody urine? A curbside consult with urologist Brian Shaffer, MD. </p
<p>An unusual southern accent</p
<p>and much more...</p
<p><em><strong><span style="font-size: x-large; color: #0000ff;">Urology Primer</span></strong></em></p
<p><strong><span style="font-size: large;">Priapism<span style="font-size: 10px; font-weight: normal;"> a rare condition that causes a persistent, and often painful, penile erection.</span></span></strong></p
<p>Priapism is drug induced, injury related, or caused by disease, not sexual desire. As in a normal erection, the penis fills with blood and becomes erect. However, unlike a normal erection that dissipates after sexual activity ends, the persistent erection caused by priapism is maintained because the blood in the penile shaft does not drain. The shaft remains hard, while the tip of the penis is soft. If it is not relieved promptly, priapism can lead to permanent scarring of the penis and inability to have a normal erection.</p
<p><strong><span style="font-size: large;">Clot retention</span></strong></p
<p>blood clots in the bladder prevent urine emptying</p
<p><span style="font-size: large;"><strong>Coude Catheter</strong></span></p
<p>a semi-rigid catheter that has a curve or bend at the tip. The curved tip allows it to navigate over the curvature of the prostate or any other urethral obstruction it may encounter. A Coude catheter is specifically designed for this purpose. Coude catheters are available in size 8 French to size 26 French.</p
<p><strong><span style="font-size: large;">De Novo</span></strong></p
<p>The Latin expression de novo literally means something akin to "from the beginning" or "anew"</p
<p><strong><span style="font-size: large;">Interstitial cystitis</span></strong></p
<p>also called painful bladder syndrome — is a chronic condition characterized by a combination of uncomfortable bladder pressure, bladder pain and sometimes pain in your pelvis, which can range from mild burning or discomfort to severe pain.</p
<p><strong><span style="font-size: large;">Cystoscopy</span></strong></p
<p>the use of a scope (cystoscope) to examine the bladder. This is done either to look at the bladder for abnormalities or to help with surgery being performed on the inside of the urinary tract (transurethral surgery).</p
<p><strong><span style="font-size: large;">CT Urogram</span></strong></p
<p>A urogram is a radiograph, or X-ray image, of the urinary tract. </p
<p><strong><span style="font-size: large;">TURP</span></strong></p
<p>transurethral resection of the prostate</p
<p><strong><span style="font-size: large;">Foley catheter</span></strong></p
<p>a thin, sterile tube inserted into the bladder to drain urine. Because it can be left in place in the bladder for a period of time, it is also called an indwelling catheter. It is held in place with a balloon at the end, which is filled with sterile water to hold it in place. The urine drains into a bag and can then be taken from an outlet device to be drained</p
In the lead up to finals time our latest podcast could be really useful for your practical sessions
In it we discuss how you will get the best out of presenting findings to an examiner in a medical student final OSCE or VIVA situation
These situations can be stressful and if you dont think about your presentation [...]
I would like to say "well done, Mark Zuckerberg" as Facebook tops 1 billion active users! But all this is while 1 billion people in the world never see a health worker in their entire lives.
The internet is the most powerful tool of our generation and there is no doubt that its influence will increase further in the future. I think we can all recognise the success of an enterprise such as Facebook and it is certainly a commendable feat to bring 1 billion people closer together on a regular basis. Well done Mark Zuckerberg!
But does this not highlight some bigger questions? When will we see the internet making a real difference?
I don't mean to belittle any enterprise such as Facebook which excites and energises a huge community, but when will we see a movement that has such an impact to save and improve billions of lives every month?
The WHO Global Health Workforce Alliance estimates that there are a billion people alive today who will never see a health worker in their lives... Ever! We are not short of the tools to change this.
So, how will this movement come about? Will it be a political push? Will it be an established company that walks in the 'right' direction? Or could it come from the grassroots?
I believe this is one of the greatest challenges of our generation, and the most exciting challenge I can think of. As a doctor and co-founder of Meducation, we have started a movement in the right direction. Meducation aims to unite the medical community - yes all of it, but we know our limits.
You can not make such an impact in one step. Most of the charitable solutions and philanthropic activity takes us huge leaps in the right direction and these are of significant importance, but will we ever see the sort of impact possible if we can't maintain the ability to push forwards with the attrition needed to effectively get this right.
I would assume that most of those who have set up an innovative and successful solution to a problem would say that they could not achieve this with an element of freedom to experiment, try different methods and approaches before finding the formula that works. Is it not the same with this problem?
The solution is going to grow from the grassroots and for us at Meducation, although we are starting with health workers in the UK, we certainly see the hopeful future where the health workers in the developing countries can gain access to the educational material and support they need from the rest of the community. With the global medical community working closely together, we will be better placed to help the 1 billion people who would have never see a health worker in their lives.
So well done Mark.... but there are still bigger fish to fry.
If I had a penny, okay a pound, for every time a patient responded to the request to practice examining them said, 'Well, we all gotta learn', I would be a very rich medical student. (I'd like to add that this is said in a strong West-country accent, just so that you feel like you're really there.) I'm sure that the majority of my colleagues would agree.
Today has been no different except for the fact that one of the patients I met described themselves as a 'whistleblower'. It was like my subconscious slapping me around the face and telling me to stop procrastinating. Why, you ask? Well I'm starting to get a little nervous actually, in exactly two weeks I'll be presenting my thoughts on whistleblowing (you might remember me going on about this during dissertation season) to a load of academics and healthcare professionals. My sphincters loosen up at the thought of it*
Within five minutes of meeting this patient, they had imparted their wise words on me 'Chantal, just remember when you become a doctor - if you're absolutely sure that you're right about something then never be afraid to speak up about it.' Like music to my ears. Well, until he told me that he was convinced that 'cannabis cures all ills.'
Each to their own.
*I sincerely apologise, poor medic joke. Yuck.
Written by Chantal Cox-George,
3rd Year Med Student at University of Bristol
This is a teaching resource that aids the student in memorisation of the Cranial Nerves, their anatomical path and function.
Additionally, it stimulates a clinical approach to the functions of the Cranial Nerves, with some 'not to be missed' signs.
Cultural change could be just what's needed
All of us, at some time, will have experiences of being a patient. At such times we might feel vulnerable as we look to doctors, nurses and other healthcare professionals for help and advice.
While most of our experiences will be positive, a significant minority of us will experience difficulties in our interactions with healthcare professionals. For example last year, following a spate of similar reports across the UK, the Older People's Commissioner for Wales found consistent issues concerning the lack of dignity and respect patients received in hospital.
These situations can cause real distress for patients, undermine the effectiveness of clinical treatment and sometimes impacts on how fast we might recover.
I am interested in how this state of affairs comes about within an NHS that promotes respect, dignity and compassion for all. My research examines what happens to healthcare students during their training in clinical settings that means they sometimes have to be reminded that the person in front of them is a human who deserves compassion and respect.
Today's healthcare students are explicitly taught about what comprises professional values and behaviours. However, a large part of learning to become a healthcare professional occurs within the NHS as they observe their seniors – who act as powerful role models – interacting with patients. Sometimes these role models were trained many years ago and belong to a different culture of medicine with different ways of doing things.
People who belong to the same cultural group tend to embrace common characteristics such as language, customs and values. In doing this they embrace a common "cultural identity" and achieve a sense of belonging.
Likewise, healthcare students tend to embrace common characteristics of their chosen profession. They look to their seniors for guidance about how to behave. But what if their seniors belong to a different era where things that were acceptable then may no longer be acceptable now?
One strand of my research examines professionalism dilemma situations. These are situations in which healthcare students find themselves witnessing or participating in something unethical or unprofessional. These include witnessing, and sometimes participating in, breaches of patient safety and dignity.
Students often report experiencing distress in such situations as they know the right way to behave, but feel unable to do so for some reason. In their stories, students frequently report feeling unable to speak out for fear of receiving poor grades as their seniors are also their teachers, because they are low in the pecking order or because speaking out might hamper their future career.
So how can we support tomorrow's healthcare students to become ethical and compassionate professionals?
Revalidation for doctors is coming into force and involves patient and colleague feedback. But our research suggests that, by itself, this is insufficient to change behaviours.
We urge healthcare schools to provide students with a safe place to share their stories with each other and with ethical role models so they can begin to make sense of their experiences, share good practice and ways to resist bad practice. Most of all, we suggest that cultural change should occur from within. Patients, patient advocates, students and healthcare professionals should join together to examine how language, practices and values occurring within clinical settings can be developed to improve patient safety and dignity for all.