Weblog Hosting

When I moved the weblog from Radio to MovableType, I decided to move it off of my own server and into a web host. THe primary reason for this was that as the traffic to the oncalls.com server has increased, so has the traffic to the weblog.

While the weblog is interesting — it's not as important as oncalls – since people actually pay for the oncalls service. Time to move my little hobby off of the production server.

So I found Pure Energy after a little web search. They've been great. A + web hosting – and very inexpensive. Very helpful with inital setup and transition .. and today I've finaly got things squared away so that movabletype is emulating the old Userland Radio archive format – so the google links are no longer broken.

Neuroblastoma

I'm on a roll this morning … another one from The Lancet:

Neuroblastoma, the most common extracranial solid tumour in children, originates in cells of the neural crest and is found mainly in the adrenal gland but may also be found anywhere along the paravertebral sympathetic chain in the chest or retroperitoneum. It is the most common neoplasm in infants and the leading cause of cancer deaths in children aged 1-4 years

This paper is an excellent case report of a 2 year old with nonspecifi findings. It's a good reminder of the constellation of symptoms that should cause one to think of Neuroblastoma.

[No Title]

From The Lancet:(free registration required)

Treatment of asymptomatic abnormal vaginal flora and bacterial vaginosis with oral clindamycin early in the second trimester significantly reduces the rate of late miscarriage and spontaneous preterm birth in a general obstetric population.
Lancet 2003; 361: 983-88

? so should we start to screen at 18 weeks for BV? I'm not yet convinced.

PSA Screening

In this week's JAMA:

If practice were evidence-based, PSA screening would be less common among men than colorectal cancer screening, a preventive service of broad acceptance and proven efficacy.

The article is a review of data collected on men between 40 and 50. Since the evidence for PSA testing remains less than compelling, one would expect that colorectal cancer screening would be more common, since it's darn clear that it saves lives.

Not so. 75% of men had PSA tests vs 63% with colorectal screening.

Hmm .. after some struggle with our EMR, I can say that the practice in my office (3 physicians) reflects the evidence quite well. Greater than 70% colorectal screening .. and less than 50% PSA.

Having ths discussion about PSA testing is challenging. Here's a nice little handout from across the pond.

New Website

I've completed a few projects tonight.

a) A little programming project for work – a little coldfusion and WDDX.
b) The Weblog has now moved to MovableType – nearly all of the old posts are moved over, but URLs are different – so it will take Google a while to re-index things. The primary domain name is currently docnotes.com .. and docnotes.net redirects to the .com address. I'll get that fixed soon – I don't like the .com as much as the .net.

Snow finally melting …