PFO and Cryptogenic Stroke

I read this with interest, having seen more and more PFOs closed in the absence of trial evidence, I am glad to see such an editorial hammer home the key point -- not without more study.

http://www.nejm.org/doi/full/10.1056/NEJMe1201173

An interesting concept... The "nocebo" effect

jama.ama-assn.org/content/307/6/567.full

or for McGill people here.

A rethink on supplimental oxygen by rote...

Or -- why the "Harvard oxygen saturation" (i.e. 100%) is not required and potentially dangerous...

The death of the statin in primary prevention...

Will this change practice?  It should (for low risk patients)...

Don't order a test if you don't know how to act on the result...

Nice editorial of providing high quality cost-conscious care...

Harnessing the placebo effect...

Sounds like medicine is beginning to embrace it again... take that, homeopathy.

We are in an outbreak of RSV

1) Isolation recommended - CDC guidelines
https://webvpn.mcgill.ca/http/www.cdc.gov/mmwr/preview/mmwrhtml/rr5303a1.htm

"Patient placement in acute-care facilities

1) Place a patient with diagnosed RSV, parainfluenza, adenovirus, or other viral respiratory tract infection in a private room when possible or in a room with other patients with the same infection and no other infection (IB) (37,367--369, 376,377).
2) Place a patient with suspected RSV, parainfluenza, adenovirus, or other viral respiratory tract infection in a private room (II).

a) Promptly perform rapid diagnostic laboratory tests on patients who are admitted with or who have symptoms of RSV infection after admission to the health-care facility to facilitate early downgrading of infection-control precautions to the minimum required for each patient's specific viral infection (IB) (364,376).
b) Promptly perform rapid diagnostic laboratory tests on patients who are admitted with or who have symptoms of parainfluenza or adenovirus infection after admission to the health-care facility to facilitate early downgrading of infection-control precautions to the minimum required for each patient's specific viral infection and early initiation of treatment when indicated (II)."

So -- I personally would isolate all RSV (or cohort).

2)Disease outcome of RSV in elderly is similar to that of non pandemic influenza (NEJM 2005)
https://webvpn.mcgill.ca/http/www.ncbi.nlm.nih.gov/pubmed/15858184