Jarrod Shapiro, DPM PRESENT Practice Perfect Editor Mountain View Medical & Surgical Associates, Madras, Oregon

Keeping Current –
Impossible?

Keeping updated with the latest in medical and surgical techniques and technologies has become increasingly difficult.  Medicine seems to be changing every day, whether it’s the H1N1 flu issue or the most recent medication for diabetes.  As time goes by, I find myself inundated with more and more journals to review, whether online or paper versions: The Journal of the American Podiatric Medical Association, Journal of Foot and Ankle Surgery, Clinics in Podiatric Medicine and Surgery, Podiatry Management Magazine, Podiatry Today, Wounds, Foot and Ankle Journal, Foot and Ankle International, Journal of Bone and Joint Surgery just to name a few.

	Tonight's Premier Lecture is Emergency Care in the Practice of Podiatry by Adam Thau, MD

As I try to keep up with the podiatric literature, I also find I’m increasingly accessing the general medical literature.  For example, we’ve been having a discussion on PRESENT’s eTalk on preoperative MRSA screening. This has become an important issue in infectious disease circles with significant potential consequences for our patients.  Did you know two recent conflicting articles have been published in high profile journals about screening patients for MRSA?  For those interested, here are the articles: New England Journal of Medicine study, Annals of Internal Medicine study.  Do you screen your elective surgical patients for MRSA?  If so do you attempt decolonization?  Do you prophylax? 

How about the new IDSA/ASHSP/SIDP guidelines for Vancomycin monitoring released in January 2009?  Do you still order peaks and troughs?  Did you know you only need to order troughs?  Did you know monitoring for ototoxicity is only necessary when Vanco is combined with certain other drugs like aminoglycosides?  Follow this link for the guidelines.

What about diabetes screening?  Did you know the American Diabetes Association recently published a consensus statement about the use of HbA1c for screening and diagnosis of diabetes?  Our colleague Ryan Fitzgerald, DPM was kind enough to educate us in this eTalk on podiatry.com.  

Did you know about the first new gout medication to be available in 40 years?  Febuxostat (Uloric ®) is a new antihyperuricemic agent released in March 2009 by Takeda Pharmaceuticals.  Here’s a study from 2005 published in the New England Journal of Medicine comparing this medication to Allopurinol. According to the study, Uloric was more effective at reducing hyperuricemia than Allopurinol with a similar reduction in the number of gout flares.

Feel overwhelmed yet?  I’m not trying to make anyone feel inadequate or poorly educated.  Doctors are required to stay abreast of current medical trends and changes in treatments, but it’s actually impossible to do so.  When I was a medical school student I was once advised caution in how much I give to Medicine.  The more I give, the more Medicine would take, I was told.  Nothing truer has been said.  It’s hard enough keeping current on the podiatric literature much less general medicine.

So, how do you remain current — and sane?  The newest PRESENT ezine,  Journal Club, is a great service. Twice a month, newest PRESENT Editor Andrew Meyr, DPM from Temple shares his review of podiatric and medical literature with us.  In effect, he does our screening work for us.  He scans the literature and presents just a few articles that he considers most noteworthy.  It's like having a smart teacher working for us ! I've also found increasing utility in PRESENT’s eTalk site.  In essence other doctors are doing the scanning for us and bringing up these important topics.  It’s very effective; contribute a comment if you haven’t yet.  We’re all improved by participating in our online community. 

Do you scan websites?  Do you receive email updates from some medical website?  Do you subscribe to certain journals?  What methods do you employ to stay up to date?  Write in with your thoughts.  Best wishes.

What do you think?
Join in on any number of eTalk Topics taking place on PRESENT Podiatry, or create one of your own.

Keep writing in with your thoughts and comments or visit eTalk on PRESENT Podiatry and start or get in on the discussion. We'll see you next week. Best wishes!

Jarrod Shapiro, DPM
PRESENT Practice Perfect Editor
[email protected]

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