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October 6, 2011

YouTube Ranks Fauquier ENT as Most Viewed for Medical Videos

I was informed that our practice's YouTube channel has been ranked as one of the most viewed channels related to medicine in the world!

As of Oct 6, 2011, our channel which contains 52 videos has received 198,064,840 views. We currently average over 500,000 views a day!

We far surpass other more "prestigious" medical organizations with a YouTube channel.

Mayo Clinic Channel Channel
4,936,943 views

University of Maryland Medical Center Channel
2,047,260 views

CDC Channel 
4,173,563 views

Massachusetts General Hospital (Harvard) Channel 
33,994 views

Children's Medical Center Channel 
318,688 views

Duke Medical Center Channel 
1,571,694 views

Medical University of South Carolina Channel 
699,002 views

UVA Health System Channel 
29,922 views

Stanford Medical Center Channel 
132,303 views

British Medical Journal Channel 
216,331 views

Penn State Hershey Medical Center Channel 
46,688 views

Scripps Health – San Diego Channel 
212,848 views

October 4, 2011

Sedated Anesthesia for Kids Under 2 Years May Cause Learning Disability

There is mounting evidence in animals and in humans that general anesthesia might damage developing young brains.

Researchers at Mayo Clinic compared the learning skills of 350 kids who underwent 1 or more general anesthesia before age 2 to 700 kids who have never been under sedated (general) anesthesia. What they found was that before the age of 19 (after statistical normalization):
No significant difference in learning disability between kids who have been under anesthesia once (23 out of 100) with kids who have never been under anesthesia (21 out of 100).  
However, those kids who have been under anesthesia 2 or more times had increased rate of learning disability (36 out of 100). 
Based on animal studies, anesthetics are known to cause accelerated loss of brain cells during development which leads to learning and behavior problems later in life. Whether that's also true for humans has not been studied.

However, further study is required as the results were obtained based on observation and did not account for other variables (type of surgery for example).

This information, though not definitive, does warrant extra circumspection by parents and surgeons when deciding to pursue surgery in kids under age 2 years, no matter how minor the surgery including ear tubes, tonsillectomy, adenoidectomy, and turbinate reduction.

IF surgery pursued, one should perform as much as required to minimize need for a 2nd procedure at a later date. That means multiple procedures under one anesthesia would be preferable than multiple procedures at different times.

Of course, surgery should only be done if the benefits outweigh the risks including anesthetic risks.

Read the MSNBC report here.

Reference:
Cognitive and Behavioral Outcomes After Early Exposure to Anesthesia and Surgery. Published online in Pediatrics October 3, 2011. doi: 10.1542/peds.2011-0351

New Webpage on Facial Fractures and Nasal Fractures

Our office has created a new webpage describing the evaluation and management of not only nasal fractures, but also facial fractures.

Fracture types discussed include:
  • Nasal Fractures
  • Orbital Fractures (around the eye)
  • Maxillary Fractures (cheek)
  • Zygomatic Fractures (behind cheekbone)
  • Tripod Fractures (cheekbone)
  • Mandible (lower jawbone)
  • LeFort (upper jawbone)
Check it out here!

October 1, 2011

Are You Able to Use Expired EpiPens Safely?

Though one should always use an EpiPen that is not expired, it is better to use an expired EpiPen to treat anaphylaxis than to do nothing at all.

Some Canadian researchers studied expired EpiPen auto-injectors 1 to 90 months past the expiration date.

What they found was that the older the EpiPen, the less effective it was due to decreased epinephrine bioavailability. The inverse correlation was 0.63 (months past expiration and decreased epinephrine content).

As long as the solution is clear without precipitates or discoloration, it's fine to use the EpiPen. BUT, still better to use an EpiPen that is not expired!!!

Reference:
Outdated EpiPen and EpiPen Jr autoinjectors: past their prime? J Allergy Clin Immunol. 2000 May;105(5):1025-30.

New Webpage on Thyroid Mass (Evaluation and Management)

A new webpage has been uploaded to our practice website describing the evaluation and management of a thyroid mass. Surgical removal is discussed along with risks involved.

Click here to read more!


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