Grand Rounds

Welcome to the debut of Grand Rounds, the weekly summary of the best of the medical blogosphere. It's our hope that this new feature will introduce a wider audience to the expanding array of talented doctors, nurses, techs and students writing online today.

This week, we've got a roundup of new medical reports, opinions on current health topics, and a look into several medical specialties. Plus, some stories from caregivers to make you laugh, cry, or spur the contemplation of your mortality. On to the links...

New Studies:

Code Blue Blog interprets the recent findings about MRIs and breast cancer screening. Sure, the expensive MRI is more sensitive than mammography, but it has more false positives. His recommendation (and you might notice this trend with medibloggers): let individuals decide! (And pay.)

Did you ever wonder why dogs sniff fire hydrants? Would you believe they're screening for disease amongst their canine friends. Well, probably not. But Rob Thomas at AlmostMD explains the news that dogs can smell bladder cancer in our urine, and the implications for more ... refined detection.

Mighty Medpundit casts a skeptical eye on the recent hype about the Mediterranean diet. Is it olive it's cracked up to be? You'd feta take a look! (Sorry. I'm Greek.)

There's new controversy regarding teens taking antidepressants. Dr. James Baker, child psychiatrist, weighs in on the comparative risks.

Health Care Views:

Grahamazon's been busy studying pharmacology. Maybe that's where he learned about this lifesaving but unprofitable drug, which was discontinued until it found a new application in cosmetics. Because sometimes, people can be ugly.

Kevin, MD brings up a medical conversation that doesn't happen enough: Patients don't like to admit they can't afford their meds, or are taking them inconsistently. So doctors don't inform them of their options. Bad outcomes result.

Also writing on drug costs, Dr. Bob at MedRants proposes a free-market solution to for pharmaceuticals: Make pricing and transparent, and consistent, so patients can weigh cost along with dosing regimens and side effects. Which should work great, until double coupon day on Monday.

For a Kerry / Edwards supporter, Rangel, MD sure has problems with tort lawyers. He examines how tort reform in Texas has lowered medical insurance rates, and compares it to the hurricanes in Florida (in the analogy, I think the doctors are represented by beachfront property).

Dr. Bard-Parker, the surgeon at Cut-to-cure, carves up the latest report on deaths caused by hospital errors. Analysis: The report doesn't disclose all its methods, and makes mistakes. Kind of like hospitals! So I must warn: reading it could kill you.

Notes from the Front Lines:

"How much longer do I have, doc?" Short answer: It's difficult to say! But whatever your prognosis, the time will just fly by when you read the Cheerful Oncologist.

One of the blogging docs at EchoJournal puts to rest many of the misconceptions about anesthesiology. Get it? Put to rest? Anesthesia? It's not going to get better than that, people.

Cameron over at ThreeMD draws on all his medical student knowledge to make a rare diagnosis... Can you guess how this extraordinary insight will alter the patient's outcome? (hint: doctors are very lucky the body often heals itself)

Computers are making their way into the psychiatrist's office. It's there to make things run faster, but will it disrupt the doctor / patient rapport? I suspect the answer is no, unless Shrinkette starts blogging while her patient's on the couch.

If a picture is worth a thousand words, these scrap paper doodlings from a manic patient are worth... several thousand words... jumbled together. And now, you can imagine what mania might be like. Via Grunt Doc.

The surgery student at Vertical Mattress dwells on his various symptoms, but somehow elevates it from hypochondriasis to... literature! The beautiful Proust quote helps.

In a somewhat related post at our group blog, the Lingual Nerve, spacefan notes that this tendency for medical students to over-interpret their own symptoms gives way to a doctor's stubborn refusal to acknowledge them. My own untreated pain -- something I can look forward to.

Galen's developed a choose-your-own-adventure hospitalist simulator. See what it's like to run around the hospital, at the mercy of the specialists. Keep an eye on the clock, and remember that you're always one move away from a jury of your peers.

Case Reports

Azygos has a moving post about his dying patient, Harry.

Top-of-my-head is an ER nurse who submitted an old but instructive tale about a heart attack in a young man. I thought readers might like a story a little more racy.

Of course, that doesn't compare to EMT Tom Reynolds' tale of madness, violence, and sex (ambiguous as the sex might be).

That wraps up this week's highlights of the medical blogosphere. If you liked any of these blogs, keep visiting them! Tell the authors! Bookmark them! Because, as others have noted, medical information doesn't translate well to TV spots and blurbs. Why not skip the media, and find what the practitioners in the field think?

Be sure to tune in next Tuesday, when Grand Rounds will be hosted at Galen's Log.