Dr. Brandon Webb
Brandon Webb, MD, is an infectious disease physician in the division of epidemiology and infectious diseases at Intermountain Healthcare in Utah. He has also served as an adjunct assistant professor at the University of Utah School of Medicine. Dr. Webb’s research interests include bacterial pneumonia, antimicrobial stewardship, and transplant infectious diseases.
Why did you develop the DRIP Score? Was there a particular clinical experience or patient encounter that inspired you to create this tool for clinicians? Continue reading “When Can Broad-Spectrum Antibiotics Be Avoided?”
Dr. Kate Rowland
Counseling patients with diabetes on lifestyle change during primary care office visits is motivated by good intentions. We as primary care doctors are interested in prevention, lifestyle changes can positively affect many patients with diabetes, and patients do best when engaged in managing their disease1. But it’s difficult to show with data that brief physician encounters are effective at producing any of these outcomes. Continue reading “Diabetes Management: Why Can’t We Do This with Lifestyle Alone?”
Prof. Simon Griffin
Simon J. Griffin, DM, is professor of general practice at the University of Cambridge, Group Leader in the MRC Epidemiology Unit and an assistant general practitioner at Lensfield Medical Practice in Cambridge, UK. He leads the Prevention of Diabetes and Related Metabolic Disorders Programme. Professor Griffin’s research interests include prevention and early detection of chronic conditions such as diabetes.
Continue reading “Interview with Cambridge Diabetes Risk Creator Prof. Simon Griffin”
Dr. Haywan Chiu
Haywan Chiu, DPM, is a practicing podiatrist in Albuquerque, New Mexico. He has a special interest in the diabetic foot. Haywan runs Diabetic Foot Guardian, an easily digestible resource for patients regarding feet and diabetes.
Callus Debridement Can Be Diagnostic
Calluses form when shear forces and pressure induce the epidermis to reinforce itself. In patients with diminished pain sensation such as in diabetic neuropathy, continued friction from shear forces and pressure evolves the callus into a blister, then a blood blister (figure 1). When I see a bloody foot callus, I know that at some point, there was a break in the dermis. I don’t know if it has healed on its own or if it has expanded into a full blown ulcer because I can’t see past the callus. In fact, some calluses can be so thick I can’t even see the blood underneath! The only way to find out what’s hiding is to debride the callus.
Continue reading “How I Do It: Callus Debridement and the Diabetic Foot”
Dr. Patrick S. Kamath
Patrick S. Kamath, MD, is a professor of gastroenterology and hepatology at the Mayo Clinic in Rochester, Minnesota. His research interests include acute-on-chronic liver failure, nonalcoholic fatty liver disease, polycystic liver disease, Budd-Chiari syndrome and hereditary hemorrhagic telangiectasia. Dr. Kamath is internationally renowned as a leading researcher in hepatology and has also won numerous awards as an educator.
Why did you develop the MELD Score? Was there a particular clinical experience or patient encounter that inspired you to create this tool for clinicians?
Following a trans-jugular intrahepatic portosystemic shunt (TIPS) procedure for complications of portal hypertension, some patients do well and others fare poorly. My colleague in statistics, Mike Malinchoc, and I studied laboratory variables prior to the procedure and identified INR, serum creatinine, serum bilirubin and etiology of cirrhosis being predictive of survival. We developed a score based on these variables and demonstrated it predicted survival in a wide variety of patients with cirrhosis not undergoing TIPS. The score was originally called the Mayo End-Stage Liver Disease (MELD) model and was shown to be superior to the Child-Turcotte-Pugh score. Continue reading “Interview with MELD Score Creator Dr. Patrick Kamath”
Dr. John Bedolla is the assistant director of research education and assistant professor of emergency medicine at the Dell Medical School at the University of Texas at Austin. He is also editor-in-chief of ED CLEAR, an evidence-based medical risk reduction program. Dr. Joe Habboushe is MDCalc’s co-founder and CEO. Earlier this year, the two sat down and talked about MDCalc’s content development process and future plans.
Dr. John Bedolla (JB): Hello, I’m Dr. John Bedolla. I am assistant professor of medicine and I’m also the director of risk management for a large EM group. Continue reading “Interview with MDCalc Co-Founder Dr. Joe Habboushe [VIDEO]”
Dr. Kim Medlej
Kamal (Kim) Medlej, MD, is an attending physician in the department of emergency medicine at Massachusetts General Hospital and fellowship-trained in critical care, and a longtime contributor to MDCalc. Here’s Dr. Medlej’s take on applying evidence on managing pain, agitation, and delirium to his patients in the ICU.
Pain, agitation, and delirium (the ICU triad) are common in critically ill patients, and can be challenging for clinicians to manage, both in (1) ruling out and treating potential underlying causes, and (2) choosing appropriate sedatives and analgesics in those patients who need them.
This is a fascinating area of critical care medicine, although it can also be difficult and frustrating. While our insight and screening tools have improved, the management of patients with pain, agitation, and/or delirium remains difficult. This is a large topic with a significant amount of literature and opinions. This brief overview is in no way comprehensive, but more a personal view, approach and practice.
Continue reading “From Evidence to Practice: Managing Pain, Agitation and Delirium in the ICU”
By Jeff Russ, MD, PhD – Pediatric/Child Neurology Resident, UCSF
Dr. Jeff Russ
A major task of any pediatric ward provider is to regularly assess a patient’s appearance, vital signs, labs, and risk factors, and integrate these data into a cohesive clinical picture to determine the patient’s acuity and potential need for intervention. This can be especially challenging on busy services or night shifts, where, for example, nurses may divide their time among up to four patients, and a single physician may care for 10–20 patients. Particularly with children, a lot can change between sporadic assessments, making it difficult to triage acuity.
Continue reading “The PEWS Score: Can an Algorithm Predict Worsening Illness in a Hospitalized Child?”
We’ve just hit 300 calculators on our website (and iPhone and Android apps), and we thought it might be a good time for reflection.
By the Numbers:
- The Los Angeles Motor Scale (LAMS) was our 300th calculator!
- We’ve added over 120 calculators in the past year alone.
- MDCalc has been around for 12 years.
- We estimate that we’ve helped with over 15 million patient decisions across the world through our calculators and content in 2016.
- We’re used in 210 countries.
- Despite only having been prospectively validated in 2013, the HEART Score is already our 6th most popular calculator.
- We receive about 5 new calculator requests per week.
- We have 46 featured interviews with calculator creators that give insight into their thinking about their own scores.
- We provide calculators for 50+ specialties.
- We are used by at least 75% of US medical students in their clinical rotations.
Continue reading “300”