Check Up

August 11, 2010
MDNG Psychiatry, June 2010, Volume 12, Issue 2

Editors' picks for this month's best websites, news, resources, and online information for physicians.

Editors’ picks for this month’s best websites, news, resources, and online information for physicians.

Brain Beat

A Breakthrough in Neurosurgical Retraction Technology

Michael W. Weaver, MD, assistant professor of Neurosurgery, Temple University, explains the Vycor Medical’s ViewSite Brain Access System (VBAS).

Vycor (www.vycormedical.com)didn’t come up with the idea for a minimally invasive brain access system, but they definitely made it a lot better than what it had been. Taktell was sort of the pioneer in using this tubular retraction system, which is a way of accessing the brain’s deep structures by a small surgical corridor. And it’s a retractor system that actually gives you a good visualization of the deep structures but minimizes the amount of damage and retraction to the transient cerebral cortex, or the brain itself.

For brain tumor surgery, you are either relegated to using little ribbons that sort of retract out the normal brain so you can get to the deep-seated abnormality, or you can use a cylindrical system, which actually gives you a more uniform pressure on the brain. Some of the injuries and damage during brain surgery are not related to the pathology itself, but getting to it. This retractor system minimizes that and still gives you a pretty good surgical corridor to get down there and get the job done.

Any kind of deep-seated pathology in the brain could theoretically be utilized with this retractor system. It has applicability in most of the things we do intercranially. The biggest applicability, though, is for deep tumor resection.

Any kind of technology or technique or therapy that you can use that minimizes collateral damage or injury to the surrounding organ is in the patient’s best interest. For their mental health, it’s a safer way of taking out a tumor that’s going to hurt them.

Recovery times are slightly less. The steroid dependency and steroid taper, some of the medications you use for brain swelling, can be relatively less because there’s less traction injury.

This is a sort of see-through, polyethylene kind of device that’s very easy to use. It allows you to use modern tools and really does allow for a minimally invasive surgical corridor to reach deep-seated tumors that would normally require a lot of retraction and a lot more brain dissection. It’s reduced the amount of surgical time, so you can do these tumors quicker, you probably can do them as safely, if not safer, and I think it should be utilized for every deep-seated tumor.

Straight from the Combat Zone

Jerald Block, MD, a major in the Army Reserves who just finished serving a three-month deployment as a psychiatrist for a combat stress control (CSC) team, wrote us from western Iraq to explain his role in this position, the conditions he treats, how technology has impacted his practice in both military and civilian roles, and what other psychiatrists can learn from his experiences.

Check out the full interview with Block at http://hcp.lv/dzyWM9 to see why he said, “We are tasked with providing care to troops that can be quite distantly located. Transporting the patient or therapist is time consuming, and involves expensive and potentially dangerous travel. But, for unclear reasons, telepsychiatry has never been implemented” and “I saw many cases in which the connection to home [allowed via the Internet] could be quite destructive. The soldier would essentially find themselves in two places at once: in Iraq, facing a dangerous enemy who wanted us dead, and at home trying to help their spouse with their own depression or daily issues. This happened daily, for months, and the distraction exacted a toll. Sleep disturbances, anger, frustration, anxiety, powerlessness, etc.”

Social Media Notebook

Long Tails, Short Tails, and Secret Recipes

Search Engine Optimization is key for any business. Unfortunately, all businesses are, to some extent, at the mercy of search giant Google. Complicating matters is the fact that Google has some very secretive recipes for success for those who are trying to get better rankings organically (ie, not paying for them). Complicating matters even further is the fact that Google is constantly changing the variables within their secret equation for success. Even the savviest SEO strategists aren’t privy to Google’s algorithms, although there are certain sources that can at least offer some perspective into the constant change.

http://hcp.lv/bopRMG

Social Mention Might Be the Best Tool You Aren’t Using

In our social media-driven world, it can be hard to keep track of the endless tools and applications that are being created every day. There’s literally something for everything and everyone, and there are plenty of tools out there that are completely useless. One social media tool that seems to have flown under the radar so far is Social Mention, which makes it easy for users to track any kind of social media mention for any search term.

http://hcp.lv/aATOHM

Are We Too Complacent about Cloud Computing?

Think of this as a sidebar to this issue’s cover story.

http://hcp.lv/ajr0l7

Loose-lipped Facebook Nurses Sink Own Ship

Another cautionary tale about Facebook and patient privacy laws: six registered nurses at Tri-City Medical Center of Oceanside, CA, “were put on administration leave by hospital administrators” for using “social media to post their personal discussions concerning hospital patients.” Max Carbuccia, a labor representative for the California Nurses Association “discussed how to handle different types of patients, but only in an educational context.” Regardless, Tri-City CEO Larry Anderson is pursuing termination.

http://hcp.lv/9YEgxK