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Crit.Cloud considered relevant for Critical Care Medicine Education by the Journal of Intensive Care Medicine

10/3/2019

Top Ten Websites in Critical Care Medicine Education

The Journal of Intensive Care Medicine has recently published a review of websites providing educational content that is part of the Free Open Access Meducation (FOAMed) movement. The authors have searched the web for critical care medicine education websites and have identified 97 sites they consider relevant for critical care.

These websites were then reviewed and evaluated using the Critical Care Medical Education Website Quality Evaluation Tool (CCMEWQET). They were then split up into three tertiles according to their score.

Congratulations to the Top Ten websites that indeed provide excellent educational information freely accessible.

Oh, and by the way we might mention that our small site Crit.Cloud has been considered among 96 other as relavant in this field and has ended up in the middle tertile with its ranking. 🙃

A big thank you to the authors of this paper for their excellent work and for providing us with an updated list of websites worth taking a closer look! We are delighted to follow their wish by sharing the table of these websites.

Wolbrink TA et al. J Intensive Care Med. 2018 Jan;34(1):3-16

Full List of all Website Reviewed (Click on a table enlarge)

Take a very, very, very Close Look at this Nature Publication - or- What a Presidential Portrait Has to Do with a Heap of Feces

17/12/2018

Updated 28/01/2019

While this website concentrates on finding relevant publications from the world of Critical Care, there are always papers from other fields that attract our attention.
Recently, a remarkable detail from a publication of an even more noteworthy journal has been brought to our notice. I admit I rarely read articles on 'Nature', but this article is worth a very close look after all.

Chiou L. et al. have published an article about a noninvasive genomic sequencing of populations from faeces in this years January issue of Scientific Reports of 'Nature'. In this article, they deal with the problem that it is difficult to obtain high-quality samples for genomic studies from wild animals. They, therefore, describe a cost-effective method for enriching host DNA from noninvasive faecal samples.

And in fact, it is worthwhile to have a closer look at the faeces sample in this article as Nature has placed a portrait of Mr Trump in a rather delicate position.

Finding the hidden Trump-Portrait, here's how:

Update 28/01/2019: The authors have reacted and changed the resolution of the image so that a closer zoom is no longer possible. Following instructions refers to the previous publication.

1. Open the article in pubmed (just to proof, it's no fake news):

Chiou KL et al. Scientific Reports, 2018 January 31: Methylation-based enrichement facilitates low-cost, noninvasive genomic scale sequencing of populations from feces

2. It's OPEN ACCESS! Open the article via the full text links on the top right.

3. Download the pdf version of the article.

4. Go to page 3, figure 1. Spot the heap of feces right behind the pavian?

5. Zoom in on that heap of feces... zoom in closer... even closer!

This publication impressively demonstrates the interdependence of science and politics.

Remember, sometimes the unexpected lies in the detail.

Did the editors of Nature actually realise this?

Update 28/01/2019: Well, obviously they now have!

OPEN ACCESS: Chiou KL et al. Scientific Reports 2018 January 31: Methylation-based enrichement facilitates low-cost, noninvasive genomic scale sequencing of populations from feces

Doctors Should Position their Name Tag on the Right Side of their Chest... It's Evidence Based!

23/3/2015

They're All WRONG!!!

Here it is finally, the study we all have been waiting for. 'THE question' that has never been answered... until now!

Every day we all do our best to establish the best patient-physician relation possible. The first impression counts and besides introducing ourselves verbally we ware name tags to visually inform about our name and position. But did anyone actually ever ask himself if it makes a difference wether you ware your name tag on the left or right side of your chest?

Well, an orthopaedic surgeon in Switzerland obviously has and conducted a 'blinded' study to answer this specific question. He made one hundred volunteers, blinded to the experimental setup, present for an orthopedic consultation in a standardized manner. The name tag of the physician was randomly positioned on the left chest side and presented to 50 individuals (age 35 years (range 17 to 83)) or the right chest side and then presented to 50 other individuals (35 years (range 16 to 59)). The time of the participant noticing the name tag was documented. Subsequently, the participant was questioned concerning the relevance of a name tag and verbal self-introduction of the physician.

38% of the participants noticed the nametag on the right as opposed to 20% who noticed it if placed on the left upper chest... hey, this turned out to be statistically significant, giving us a p-value of 0.0473!

The author concludes: Positioning the name tag on the right chest side results in better and faster visibility.

We conclude:
- Also orthopaedic surgeons seem to be interested in a close patient-physician relationship
- Orthopedic surgeons actually do talk to their patients!
- Orthopedic surgeons in Switzerland don't seem to be overstrained with their workload

Schmid SL et al. March 2015, PLOS One, DOI: 10.1371/journal.pone.0119042

One of the Big Mysteries Solved: How to Correctly Prescribe the Duration of Antibiotic Treatments

2/5/2014

Just this week the World Health Organisation WHO has issued a warning that resistance of organisms to antibiotics will become one of the biggest challenges of the upcoming decade. Indeed, the correct prescription of antibiotics is crucial for successful treatment and the WHO states that completing the full length of the treatment is just as important.

But what is actually the correct length of treatment for all the different antibiotics and diseases? How many ward rounds on ICU's have I spent with microbiologists (the maybe most important specialists on our sides!) wondering on how they always had a straight answer on the correct length of treatment. 7 days, 10 days or sometimes 21 days... a little mystery to most intensivists, until now!

Hitchhiking though the the wide space of the internet I finally found secret to this question. Back in the year 2010 Paul E. Sax, a Professor of Medicine at Harvard Medical School him self, posted an excellent blog for the NEJM Journal Watch website. Inspired by a New York Time article by Harvard Professor Daniel Gilbert he finally gave insight into one of the great mysteries of medicine:

To figure out how long antibiotics need to be given, use the following rules:

Choose a multiple of 5 (fingers of the hand) or 7 (days of the week).
Is it an outpatient problem that is relatively mild? If so, choose something less than 10 days. After application of our multiples rule, this should be 5 or 7 days.
Is it really mild, so much so that antibiotics probably aren’t needed at all but clinician or patient are insistent? Break the 5/7 rule and go with 3 days. Ditto uncomplicated cystitis in young women.
Is it a serious problem that occurs in the hospital or could end up leading to hospitalization? With the exception of community-acquired pneumonia (5 or 7 days), 10 days is the minimum.
Patient not doing better at the end of some course of therapy? Extend treatment, again using a multiple of 5 or 7 days.
Does the infection involve a bone or a heart valve? Four weeks (28 days) at least, often 6 weeks (42 days). Note that 5 weeks (35 days) is not an option — here the 5′s and 7′s cancel each other out, and chaos ensues.
The following lengths of therapy are inherently weird, and should generally be avoided: 2, 4, 6, 8, 9, 11, 12, 13 days. Also, 3.14159265 days.

In this highly data-driven exercise, it is imporant also to note the number of rules — seven, as in days of the week.

That did not occur by chance

Wow, not much more I can add!

Paul E. Sax, NEJM Journal Watch HIV/AIDS Clinical Care, October 22nd 2010

NYT article by Daniel Gilbert from October 2010

Fist Bumps Prevent Spread of Bacteria... And Why This Study Won’t Change Social Behaviour (Well, at least not in Ireland)

28/3/2014

Some studies are fascinating and disconcerting at the same time... but at least they’re good for a smile!

In this paper by Ghareeb et al. the authors addressed the question whether a handshake or a fist bump is more effective in preventing or reducing pathogen transmission in the setting of a hospital, where most of us work of course. Unsurprisingly they found that using the fist bump instead of handshakes made skin contact 2.7 times shorter and this reduced spread of bacteria. They concluded that the fist bump is an effective alternative to the handshake in the hospital setting and that bumping might lead to decreased transmission of bacteria and improved health and safety of patients and health care workers alike.

So shall we all start bumping around the hospital?

We performed an observational study in our medium sized ICU in Galway (without approval of any committee and of course without any statistical evidence to be presented, actually just out of interest and for fun). We might also mention beforehand that working atmosphere in our unit is very good and nurses and doctors work very closely together.

Interestingly, neither nursing staff nor doctors shake hands when they meet and greet each other in the ICU. The only occasions handshakes were observed are when relatives are met for a discussion or a representative of some company comes in for a visit.

In regards of the study mentioned above I have some serious concerns: I wonder how many health care professionals out there would welcome a family fist bumping that has come in to discuss an end-of-life issue for instance. Also when representing the unit towards someone outside of hospital a fist bump carries some substantial risk of giving a very unprofessional impression... at least in Europe! And in very few occasions also a warm hug will be irreplaceable by some awkward bump. Social behavior is also a way on communicating... and anyhow, who pays for such studies?

Ghareeb PA et al. J Hosp Infect. 2013 Dec;85(4):321-3

Picture displayed above is taken from the New York Times

Reviews and Summaries

Crit.Cloud considered relevant for Critical Care Medicine Education by the Journal of Intensive Care Medicine

Top Ten Websites in Critical Care Medicine Education

Full List of all Website Reviewed (Click on a table enlarge)

Take a very, very, very Close Look at this Nature Publication - or- What a Presidential Portrait Has to Do with a Heap of Feces

Doctors Should Position their Name Tag on the Right Side of their Chest... It's Evidence Based!

One of the Big Mysteries Solved: How to Correctly Prescribe the Duration of Antibiotic Treatments

Fist Bumps Prevent Spread of Bacteria... And Why This Study Won’t Change Social Behaviour (Well, at least not in Ireland)

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Reviews and Summaries

Crit.Cloud considered relevant for Critical Care Medicine Education by the Journal of Intensive Care Medicine

​Top Ten Websites in Critical Care Medicine Education

Full List of all Website Reviewed (Click on a table enlarge)

Take a very, very, very Close Look at this Nature Publication - or- What a Presidential Portrait Has to Do with a Heap of Feces

Doctors Should Position their Name Tag on the Right Side of their Chest... It's Evidence Based!

One of the Big Mysteries Solved: How to Correctly Prescribe the Duration of Antibiotic Treatments

Fist Bumps Prevent Spread of Bacteria... And Why This Study Won’t Change Social Behaviour (Well, at least not in Ireland)

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​Categories

Archives

Author

ABOUT US

SEARCH US

CONTACT US

FOLLOW US

TRUST US

TWEET US

Top Ten Websites in Critical Care Medicine Education

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