#wiltw

There is a huge growth in research into the gut biome and it's implications in health and treatment options. I'm sure by now you've heard of the use of faecal transplant for treatment of C. Difficile infection. And more recently gastroenterologists have been using faecal transplants to successfully treat Irritable Bowel Syndrome. Some people are even doing it themselves at home.

A while ago I posted about Brimonidine being available for treatment of Rosacea in Australia. Since then, a patient has brought some research to my attention about the use of Rifaximin as a treatment option for Rosacea.

While the research is limited and has a lot of possible confounders (confirming Small Intestinal Bacterial Overgrowth with a non-sensitive breath test is one) there is some sense in the theory behind dysregulation of immunity and managing gut biota to address this. While not without risk, Rifaximin is only active in the gut and may be an option for those people whose Rosacea is not responsive to standard treatments.

I’ve always been keen on using ultrasound in primary care, but am yet to make it happen. From my time working in ED I was taught a few useful techniques such as FAST, guided peripheral IVCs, central lines and a little bit of joint diagnostics.

Earlier this week I watched an introduction to Lung ultrasound via Periscope given by JKB and filmed by Adrian Wong that unfortunately looks like is not available to watch again. In it there was basic discussion around the role of Lung Ultrasound, including understanding features of a normal image (localising through the ribs as batwings) with a sliding pleural surface, artefacts of A lines being a pleural reflection and B lines as vertical comet tails (up to 2 is ok). 

They then stepped through various diagnostic pathways and concluded with a live demonstration. Pneumothorax, pleural effusion, consolidation and the BLUE (Bedside Lung Ultrasound in Emergency) protocol were all covered. Given that lung ultrasound has excellent sensitivity for most applications - and probably outperforms CXR in certain settings I can see it would be a useful technique in primary care at point of care. Particularly where access to imaging is delayed or not available.

Time to start learning. Anyone got a spare machine?

http://www.ultrasoundpodcast.com/ http://www.sonomojo.org/foamed-ultrasound-curriculum-2/

Despite having followed Damian Roland, a paediatric emergency specialist, on twitter for some time, I had never visited his blog until recently when I stumbled onto his #WILTW with a post on Social Media Hygiene. The highlight of this post is about applying the CAGE questionnaire to social media use. Eye opener anyone?

The full list of his #WILTW posts (satisfyingly in reverse chronological order) is littered with gems about medicine, paediatrics, though process, systems, technology, communication and more. Well worth a browse if you've got time.

So I'm going to attempt my own #WILTW that I imagine will be a little more prosaic than Damian's but hopefully will be useful for reflection. It may also not happen weekly. In fact I'm sure it won't!

Gonna try a new hashtag out for my blog (#wiltw), or better defined as “What I’m Listening To Wednesdays”. I’ve been posting #whatimlisteningto hashtags on my instagram for a looooong time now (@ianofdoom) and figured I’d write about some of the artists I take the time to hashtag the internet with. I’m also trying to find some structure to posting on this blog again. So here is my official, first…