Using an iPhone for capturing urine microscopy

From the NEJM:

The authors describe their technique:

When microscopy revealed a field of interest, the camera was placed about 0.5 to 1.0 cm over one of the eyepieces, allowing optimization of the image and light intensity by means of the camera's digital display. The auto-focus and exposure features generally produced a circular image surrounded by a black rim...

Can't wait to try this.

Hat tip Pediatric Nephrology

Article on aging I want to spend some time looking at

From the American Scientist: Aging: to Treat or Not to Treat?

Patient called me with a blood pressure of 170

He has resistant hypertension that has been well controlled since we added spironolactone. He reported that his systolic blood pressures were between 170 and 205 over the last three hours. In the morning his blood pressure was 120 and for the last week he had been getting blood pressures of 115 to 135, trending toward the lower end of that range.

I told him that I wasn't worried about the isolated spike in blood pressure. The goal of therapy is to get the average blood pressure down and that chasing individual isolated episodes of hypertension becomes a hopeless game of whack-a-mole.

The treatment of hypertension is like trying to change the climate, not control the weather.

What do you do when they get this phone call? Do you chase after elevated blood pressures with prn clonidine? Is there an evidence based approach to this?

How many cancers have you caused from ordering CT scans

It feels like if a patient coughs they get a CT angiogram to rule-out pulmonary embolism. How many patients would defere that test if they had to sign off on the following chart:

Makes you think twice regarding the CT for stone-profile that some patients get yearly "just to make sure the Urocit-K is working."

Hat tip to Academic Life in Emergency Medicine blog.