Hirsutism or Excess Hair

From NHS Choices YouTube channel: Hirsutism causes excess hair growth in women, such as on the face and chest. An expert explains the causes or hirsutism, treatments such as hair-removal and cosmetic techniques, and where to go for help if you're worried about excess hair growth.

The Cleveland Clinic Journal of Medicine published an Update on the management of hirsutism in 2010:

Hirsutism is a source of significant anxiety in women. While polycystic ovary syndrome (PCOS) or other endocrine conditions are responsible for excess androgen in many patients, other patients have normal menses and normal androgen levels (“idiopathic” hirsutism).

The finding of polycystic ovaries on ultrasound is not required for the diagnosis of polycystic ovary syndrome (PCOS). Gonadotropin-dependent ovarian hyperandrogenism is believed to cause PCOS. However, mild adrenocorticotropic-dependent adrenal hyperandrogenism also is a feature in many cases.

Even women with mild hirsutism can have elevated androgen levels, and thus, they may benefit from a laboratory evaluation.

Laser treatment does not result in complete, permanent hair reduction, but it is more effective than other methods such as shaving, waxing, and electrolysis. It produces hair reduction for up to 6 months. The effect is enhanced with multiple treatments. Interestingly, a portable laser hair removal device is currently available from Amazon (this post is not a recommendation or endorsement of the product).

References:

Update on the management of hirsutism. Cleveland Clinic Journal of Medicine June 2010 vol. 77 6 388-398.

A home hair removal laser device is available without prescription from Amazon.com (not a recommendation to buy any product, see the link below). A similar device is available from Costco.

Cleveland Clinic calls "Code Lavender" to improve patient satisfaction

From the WSJ:

How patients feel they were treated has always colored their opinions of a hospital. Now, those feelings are being factored into how hospitals get paid.

The Cleveland Clinic CEO, Dr. Cosgrove, says that in his own days as a top cardiac surgeon, he focused so intently on reducing complications from cardiac procedures that he gave little thought to the feelings or experiences of patients.

Times have changed dramatically since then. The Cleveland Clinic has launched a program known as HEART - for hear the concern, empathize, apologize, respond and thank—that empowers employees to handle patient concerns from the moment they arise.

It developed a Healing Services team to offer complimentary light massages, Reiki—a laying on of hands—aromatherapy, spiritual care from a clergy person or lay practitioner and other holistic services, and it will call a "Code Lavender" for patients or family members under stress who need immediate comfort.

Since 2008, the Cleveland Clinic's overall hospital ratings have increased by 89%.

"Code Lavender" has a Twitter account too (@CodeLavender), managed by the former Cleveland Clinic Chief Experience Officer who popularized the term.

From the Cleveland Clinic Twitter account: Efforts to improve patient satisfaction were featured in a NBC Nightly News story (see the video below).



References:

A Financial Incentive for Better Bedside Manner. WSJ.
Image source: Lavender Farm, Wikipedia, public domain.

Disclaimer: I was an Assistant Professor of Medicine at Cleveland Clinic from 2005 to 2008.

Comments from Twitter:

@TanyaPRpro (Tanya R. Walton): Clever and meaningful hospital care

@scottRcrawford: Brand medicine

@gruntdoc: How sad. Condolences. RT @DrVes: Cleveland Clinic calls "Code Lavender" to improve patient satisfaction goo.gl/X4Jtt

@MGastorf (Melissa Gastorf): concerns about satisfaction basis for payment- i.e. if you refuse to write narcotic and patient angry, physician payment suffers.

Acute altitude illnesses

This summary is based on a recent BMJ review:

Acute altitude illnesses include:

- high altitude headache
- acute mountain sickness
- high altitude cerebral edema
- high altitude pulmonary edema

Typical scenarios in which such illness occurs include:

- a family trek to Everest base camp in Nepal (5,360 m)
- a fund raising climb of Mount Kilimanjaro (5,895 m), shown in the map below
- a tourist visit to Machu Picchu (2,430 m)


View Larger Map

High altitude headache and acute mountain sickness often occur a few hours after arrival at altitudes over 3,000 meters.

Occurrence of acute mountain sickness is reduced by slow ascent. Severity can be modified by prophylactic acetazolamide.

Mild to moderate acute mountain sickness usually resolves with:

- rest
- hydration
- halting ascent
- analgesics

Occasionally people with acute mountain sickness develop high altitude cerebral oedema with confusion, ataxia, persistent headache, and vomiting.

Severe acute mountain sickness and high altitude cerebral edema require urgent treatment with:

- oxygen if available
- dexamethasone
- possibly acetazolamide
- rapid descent

High altitude pulmonary edema is a rare but potentially life threatening condition that occurs 1-4 days after arrival at altitudes above 2,500 meters. Treatment includes oxygen if available, nifedipine, and rapid descent to lower altitude.

What do extreme athletes who can summit the peaks of Mt. Everest have in common with people with heart failure? This Mayo Clinic video explains it:



References:

Clinical Review: Acute altitude illnesses. BMJ 2011; 343:d4943 doi: 10.1136/bmj.d4943

Linaclotide for treatment of constipation - minimally absorbed peptide agonist of guanylate cyclase C receptor

Linaclotide is a minimally absorbed peptide agonist of the guanylate cyclase C receptor. It consists of 14 amino acids. The sequence is:

H–Cys1–Cys2–Glu3–Tyr4–Cys5–Cys6–Asn7–Pro8–Ala9–Cys10–Thr11–Gly12–Cys13–Tyr14–OH

Two randomized, 12-week trials included 1,300 patients with chronic constipation (NEJM, 2011). Patients received either placebo or linaclotide once daily for 12 weeks.

The incidence of adverse events was similar among all study groups, with the exception of diarrhea, which led to discontinuation of treatment in 4.2% of patients in linaclotide groups.

Linaclotide reduced bowel and abdominal symptoms in patients with chronic constipation. Additional studies are needed to evaluate the potential long-term risks of linaclotide in chronic constipation.

References:

Two Randomized Trials of Linaclotide for Chronic Constipation. N Engl J Med 2011; 365:527-536August 11, 2011.

Image source: Colon (anatomy), Wikipedia, public domain.

Holiday time can be really stressful for patients with eating disorders - here is what to do

From Mayo Clinic YouTube channel:

For people with eating disorders such as binge eating disorder, bulimia nervosa and anorexia nervosa, the holiday season can be a nightmare.

People with eating disorders usually begin to worry about food consumption at holiday gatherings weeks sometimes even months - before the event, says Leslie Sim, Ph.D., clinical director of the Mayo Clinic Eating Disorders Program. "It's really a stressful time because there are large amounts of food around."

Dr. Sim suggests a few tips to navigate through holiday gatherings:

- Have a plan. People with eating disorders should eat like they would on a normal day and not skip any meals. Make sure to eat breakfast, lunch, and a light snack in addition to the meal. People who starve themselves are more likely to skip out on the meal entirely or engage in binge eating.

- If family or friends know someone is struggling with an eating disorder, it's not a good idea to comment on their weight during a holiday gathering. Even a compliment can be taken the wrong way.

- If you're hosting a holiday gathering with plenty of food, don't take offense if someone doesn't eat.

- People with eating disorders should have a coping strategy if they begin to feel stressed during a gathering. Such tactics include deep breathing, meditation and talking to a close friend of family member.

A blog can help your career - and even if it doesn't, it's still good for you

From CNN:

There is strong evidence that people who use their blog as a career tool do better. In 2005, a Pew survey found that people who blog are generally higher earners. People who use social media end up finding jobs that are a better fit.

Changing your career and skipping entry-level positions can be easier if you have a blog.

Most importantly, a blog is a great platform for networking. Just look at this picture from the annual CME meeting Essentials of EM 2011.

A blog is a good way to meet other people who think like you do and who are in your field. It helps you to make real connections with them based on ideas and passions.

Social media use allows you to focus your connections on other top performers, since blogging about career topics probably self-selects for engaged and motivated people.

Social media in medicine: How to be a Twitter superstar and help your patients and your practice

The key concept is TIC, Two Interlocking Cycles:

- Cycle of Patient Education
- Cycle of Online Information and Physician Education

The two cycles work together as two interlocking cogwheels (TIC).



Cycle of Patient Education (click here to enlarge the image). An editable copy for your presentation is available at Google Docs.



Cycle of Online Information and Physician Education (click here to enlarge the image). An editable copy for your presentation is available at Google Docs. Feel free to use the images in your own presentations with credit to AllergyCases.org.



References:

Blog your way to a better career. CNN.

Social media in medicine: How to be a Twitter superstar and help your patients and your practice

Patients directed to online tools don't necessarily use them: 25% checked website vs. 42% read same material on paper. Am Medical News, 2012.

Comments from Twitter:

Julie Meadows-Keefe @esq140: Challenge is finding time.

Tinnitus is perception of sound where there is none

Just a few days ago, British newspapers reported that a rock fan committed suicide to relieve tinnitus that he had for 3 months after a supergroup's gig. Tinnitus is characterized as perception of sound where there is none. Read more about tinnitus in this blog post. The Cleveland Clinic Journal of Medicine recently published a review on Tinnitus: Patients do not have to ‘just live with it’ and Tinnitus relief: Suggestions for patients.



From NHS Choices YouTube channel: Tinnitus causes people to hear constant sounds in one ear, both ears or in their head. An audiologist explains the possible causes and effects it often has, such as stress and anxiety, plus how to deal with them. Ashleigh, who was diagnosed with tinnitus in 2005, describes how she copes with it.

Lars Ulrich, the drummer for the heavy metal band Metallica, also struggles with tinnitus and warns his fans that "once your hearing is gone, it's gone. I've been playing loud rock music for the better part of 35 years," said Ulrich, 46. "I never used to play with any kind of protection."

Early in his career, without protection for his ears, the loud noise began to follow Ulrich off-stage. "It's this constant ringing in the ears," Ulrich said. "It never sort of goes away. It never just stops." This is a classic description of tinnitus, a perception of sound where there is none (phantom ear sounds).

The military is generating a tremendous number of tinnitus patients, according to a recent CNN report on the problem.

Tinnitus differential diagnosis: Q SALAMI mnemonic

Quinidine

Salicylates (aspirin)
Aminoglycoside antibiotics (ABx)

Labyrinthitis
Acoustic neuroma, CN VIII
Meniere’s disease
Increased blood pressure (BP) (HTN)

References:

Metallica drummer struggles with tinnitus: "Once your hearing is gone, it's gone"
Metallica drummer struggles with ringing in ears. CNN.

Tinnitus: Patients do not have to ‘just live with it’. CCJM, 2011.

Tinnitus relief: Suggestions for patients. CCJM, 2011.
Rock Fan Commits Suicide to Relieve Tinnitus From Supergroup's Gig: Daily Mail and Fox News.
Noise Chart as It Relates to Hearing Damage and Hearing Loss http://goo.gl/tjZh1

"Family practitioners in the US are facing extinction. In their place must come nurse-practitioners" - The Lancet

From the Lancet review of the University of Pennsylvania nursing school:

Family practitioners in the US are facing extinction. In their place must come nurse-practitioners. Nurses are better educated to navigate and refer patients to specialists. They don't have any illusions about managing complex illness. Their lower threshold for referral means less risk of missing diagnoses or delaying expert care.

This is one vision for nursing to be found at the University of Pennsylvania's extraordinary School of Nursing.

I'm not sure if this is the best model for primary care in the U.S. What do you think?

References:

Offline: Nursing, but not as you know it. The Lancet, Volume 378, Issue 9805, Page 1768, 19 November 2011.
Image source: OpenClipArt.org, public domain.

Comments from Twitter:

@scanman: Looks like doctors will be an endangered genus in the US within this century

@MGastorf: so disagree. I know that is being pushed but I can provide far more complete care than nurse practitioner.

@davisliumd: Umm, No -> RT @DrVes Family practitioners in the US are facing extinction. In their place must come nurse-practitioners

@davisliumd: Agree -> RT @drves: @davisliumd that was actually a quote from The Lancet, not my opinion: j.mp/w33Kvq.

Where citations come from

Source: http://xkcd.com/978

A doctor admits: "I love to blog but I still don’t really know why"

From Mike Cadogan, the founder of one the most popular medical blogs Life in The Fast Lane, based in Australia:

I blog to vent, to educate, to converse, to cogitate, to archive thoughts and to stimulate discussion.

I love the concept of a launching a thought, an image, a moment… into the inferno of the blogosphere, and observing the response.

With the average blog-reader attention span being around 90 seconds, I find that most of my ‘good’ posts – thoroughly researched, with well constructed arguments and propositions… are lost on this ‘average‘ reader… Yet, strangely I feel better having taken the time to arrange my thoughts, review the evidence and archive the information.

The advent of Facebook and Twitter has changed the way readers comment and share, and in many cases the promoted discussion continues out-with the confines of the original medium…

I love to blog but I still don’t really know why…

My reply is here:

You blog because you have to, Mike. And we are lucky to have you as a writer.

I have more prosaic and simple reasons to keep several blogs focused on different aspects of clinical practice: internal medicine, allergy and immunology, pediatrics, and IT.

I simply blog as a way to keep track of the new developments in medicine that are relevant to my practice and patients. The blog is a digital notebook and an archive accessible from any place and device with an internet connection.

A lot of people find it useful and that's great but this is an added bonus. If I don't find a blog post interesting and useful, I don't hit the "publish" button. A custom-made Google search engine makes it all searchable in 0.2 seconds. It just works.

Quotes from an interview with Seth Godin and Tom Peters:

"Blogging is free. It doesn’t matter if anyone reads it. What matters is the humility that comes from writing it. What matters is the metacognition of thinking about what you’re going to say.

No single thing in the last 15 years professionally has been more important to my life than blogging. It has changed my life, it has changed my perspective, it has changed my intellectual outlook, it’s changed my emotional outlook.

And it’s free."



Comments from Google Plus:

Neil Mehta - Loved your poetic post. I attempted to reflect on this earlier this year and came up with some reasons http://blogedutech.blogspot.com/2011/05/reflections-on-why-do-i-blog.html but find that it does not come close to your beautiful prose. Thanks for sharing.

References:

Why I Blog?
Why I Blog: Andrew Sullivan from The Atlantic Shares His Thoughts on Blogging
Why Do I Blog?
Why blog? Notes from Dr. RW. A perfectly reasonable list. All doctors should consider blogging. It's do-it-yourself CME.
"One of the best decisions I’ve made in my career was to start a blog and a wiki, leaving a paper trail of ideas" http://bit.ly/GX7Z6C

DRACO drug effective against most viruses (Double-stranded RNA Activated Caspase Oligomerizer)

"New drug could cure nearly any viral infection", proclaimed the media. The drug works by targeting a type of RNA (dsRNA) produced only in cells that have been infected by viruses. “In theory, it should work against all viruses."

Currently there are relatively few antiviral therapeutics, and most which do exist are highly pathogen-specific.

The MIT researchers developed a new broad-spectrum antiviral approach, called Double-stranded RNA (dsRNA) Activated Caspase Oligomerizer (DRACO).

DRACO selectively induces apoptosis in cells containing viral dsRNA, rapidly killing infected cells without harming uninfected cells.

The drugs were nontoxic to mammalian cells and effective against 15 different viruses, including dengue flavivirus, arenaviruses, bunyavirus, and H1N1 influenza. Dengue fever has invaded Florida and there are no effective antiviral agents to treat dengue infection at this time, according to a recent NEJM review (http://goo.gl/0gEXH).

DRACOs have the potential to be effective therapeutics or prophylactics for numerous clinical and priority viruses, due to:

- broad-spectrum sensitivity of the dsRNA detection domain
- potent activity of the apoptosis induction domain



NPR Video: How a Flu Virus Invades Your Body: "It starts very simply. A virus, just one, latches on to one of your cells and fools that cell into making lots more. Lots, lots more, like a million new viruses. This animation shows you how viruses trick healthy cells to join the dark side".

References:

New drug could cure nearly any viral infection. MIT News.

Rider TH, Zook CE, Boettcher TL, Wick ST, Pancoast JS, et al. (2011) Broad-Spectrum Antiviral Therapeutics. PLoS ONE 6(7): e22572. doi:10.1371/journal.pone.0022572

Library of the future - the new UChicago library has a stunning design and functionality

The University of Chicago’s new Mansueto Library is a futuristic bubble of a building that uses an automated retrieval systems that holds the books in steel cases 50 feet below ground.

While many academic libraries are digitizing and moving holdings off site, Manseuto is the largest and latest of about 24 libraries that use the system.



The $81 million Mansueto library (Mr. Mansueto founded Morningstar stock info service) has capacity for 3.5 million volumes.

The Mansueto library is also focused on digitizing its collection and has a lab for both digitization and conservation:

- it mends paper and rebinds the university’s books — some of them papyrus
- it also scans books for its partner, Google Books

It takes 5 minutes for a student to get a book after the request is placed electronically:

- 5 cranes run along parallel tracks; one is activated and locates materials using bar codes

- the crane removes one of the 24,000 containers, each weighing up to 200 pounds and transports it to an elevator, which lifts it to a librarian's desk

Some students apparently like the new library so much that they record poetic videos of "Rain in the Mansueto": "A quick capture of what I think was the first rain storm for the new Mansueto Library at the University of Chicago. My phone's mic really couldn't do justice to the sound, but it was a pretty exciting deep almost-rumble. You also can't capture the immersive fish-bowl-ness of it; it really is all around you. I can't wait for a storm during the day... or a blizzard."



References:

The Bibliotech: Library of the Future, Now. NYTimes.

The Joe and Rika Mansueto Library

Building the Joe and Rika Mansueto Library (video)

The loss of the centuries-old idea of a library building as the place to go to read and to look for information. Johns Hopkins Medical Library Is Closing Its Doors to Patrons and Moving to Digital Model (http://goo.gl/BWjjO and http://goo.gl/KN55o). According to the article, Johns Hopkins will transition the current medical librarians to "informaticians" embedded with the clinical teams.

Disclaimer: I am an Allergist/Immunologist and Assistant Professor of Medicine and Pediatrics at the University of Chicago.

Comments from Twitter:

@aptronym: Very impressive but what happens if there's a power outage, eh?

@BiteTheDust: they provide long ladders?

@DrVes: power outage at University of Chicago's Mansueto Library: http://t.co/fHbuIf2A

@aptronym: Ha! Two weeks after opening and a power outage meant #nobooksforanyone. I always ponder the effects of outages.

Myopia, the most common refractive error, has a prevalence of 10-30% in Western countries, but as high as 80% in Asia

Myopia (nearsightedness), the most common form of refractive error, has a prevalence of about 10-30% in most Western countries, but this figure is as high as 80% in parts of Asia. Furthermore, myopic refractive error is likely to progress during school years, and maintaining appropriate spectacle correction requires regular services for children in these age groups.

A study of self correction of refractive error among young people in rural China showed that although visual acuity was slightly worse with self refraction than automated or subjective refraction, acuity was excellent in nearly all these young people with inadequately corrected refractive error at baseline. Inaccurate power was less common with self refraction than automated refraction.

Self refraction could decrease the requirement for scarce trained personnel, expensive devices, and cycloplegia in children’s vision programs in rural China.

References:

Self correction of refractive error among young people in rural China: results of cross sectional investigation. BMJ 2011; 343 doi: 10.1136/bmj.d4767 (Published 9 August 2011).

Nearsightedness (myopia) becoming more frequent, affects 42% of Americans

Correcting refractive error in low income countries. BMJ 2011; 343 doi: 10.1136/bmj.d4793 (Published 9 August 2011).

20-20-20 rule: For every 20 minutes of reading a screen take a 20-second eye break, look at something beyond 20 feet. NYTimes, 2012.

Image source: OpenClipArt.org.

Any difference between a Mac and a PC?

Permanent link to this comic: http://xkcd.com/934

"Medical systems are made of holes and stacked like slices of Swiss cheese"

From the NYtimes:

"In 2000, the British psychologist James Reason wrote that medical systems are stacked like slices of Swiss cheese; there are holes in each system, but they don’t usually overlap. An exhausted intern writes the wrong dose of a drug, but an alert pharmacist or nurse catches the mistake. Every now and then, however, all the holes align, leading to a patient’s death or injury."

We have to fix the systems.

References:

The Phantom Menace of Sleep Deprived Doctors. NYTimes, 2011.
Image source: OpenClipArt.org, public domain.

Best Practices for Social Media Use in Medical Education

This is a video presentation and summary by one of the best medical bloggers, Mike Cadogan of Life in the Fast Lane:



The Cycle Of Social Media In Medical Education he mentions is based in part on my concept of TIC, Two Interlocking Cycles for Physician and Patient Education.

Dr. Cadogan asked me for feedback on a few questions that he used to prepare the presentations a few weeks ago. The answers are listed below:

1) What are your TOP 3 TIPS for the intrepid doctors starting out on their social media crusade?

1. Post 3 times a week. Schedule posts in advance. In reality, 95% of medical bloggers probably quit within one year.

2. Use your blog to collect interesting ideas and share/comment on health news.

3. Write some original content, if you can, but if you don't have time, that's OK. You have a more important job as a physician in real world.

2) What are your TOP 3 TIPS for WHAT NOT TO DO on this crusade?

1. Don't disclose patient information.

2. Don't offend people.

3. Don't be unprofessional. If you use your real name, it's better to let your employer know about your social media activities. It's OK to start an anonymous blog/Twitter account to test the waters.

3) What are the top 3 benefits YOU see for the role of social media in medicine?

1. Provide expert info on health news and diseases. You, as a doctor, are the one who actually knows what he is talking about - if you stick to your area of expertise.

2. Collaborate with like-minded people.

3. Gather feedback (including critical feedback) for your ideas.

4. Grow your practice by providing high-quality actionable info to patients.

4) What (in your opinion) are the MOST USEFUL 'platforms/apps' in the social media revolution (e.g. Twitter, G+, Slideshare, Facebook, etc.)?

1. Start a blog.

2. Get useful feeds in Google Reader.

3. Share ideas and communicate on Twitter and Facebook.

Speaking from personal experience, I've started more than 30 blogs and still keep around about 7. It's important to find a purpose for your blog and other social media activities. If you don't enjoy it, you will stop eventually. Set limits and respect other priorities. Your family and your patients come first, blogs and social media are a distant second - if you spend most of your time in clinical medicine, of course. Stay away from trolls and online personas looking to start a fight. Ask for help when you need it.

References:

The Social Media Conversation
Social Media In Medical Education

Why blog? Notes from Dr. RW. A perfectly reasonable list. All doctors should consider blogging. It's do-it-yourself CME.
Social media in medical education - Grand Rounds presentation by IUH Med/Peds residency program director http://goo.gl/Zw3lK

Diagnosis and Management of COPD - Current Guidelines

WHO estimates that 210 million people have COPD worldwide. COPD is the 4th leading cause of death in the world, but by 2030 it is expected to be the 3rd, behind CAD and stroke (http://bit.ly/X5nje). COPD mortality is inversely correlated to the forced expiratory volume (FEV1) in 1 second (http://bit.ly/ZYIR7).

Here are the key recommendations from the recently published Guidelines for management of stable chronic obstructive pulmonary disease (COPD):

1. Spirometry should be obtained to diagnose airflow obstruction in patients with respiratory symptoms. Spirometry should not be used to screen for airflow obstruction in individuals without respiratory symptoms.

2. For stable COPD patients with respiratory symptoms and FEV1 between 60% and 80% predicted, treatment with inhaled bronchodilators may be used.

3. For stable COPD patients with respiratory symptoms and FEV1 <60% predicted, inhaled bronchodilators should be used.

4. Clinicians should prescribe monotherapy using either long-acting inhaled anticholinergics (LAMA) or long-acting inhaled β-agonists (LABA) for symptomatic patients with COPD and FEV1 <60% predicted.

5. Clinicians may administer combination inhaled therapies (long-acting inhaled anticholinergics, long-acting inhaled β-agonists, or inhaled corticosteroids, LABA/ICS) for symptomatic patients with stable COPD and FEV1<60% predicted.

6. Clinicians should prescribe pulmonary rehabilitation for symptomatic patients with an FEV1 <50% predicted. Clinicians may consider pulmonary rehabilitation for symptomatic or exercise-limited patients with an FEV1 >50% predicted.

7. Clinicians should prescribe continuous oxygen therapy in patients with COPD who have severe resting hypoxemia (PaO2 ≤55 mm Hg or SpO2 ≤88%).

References:

Diagnosis and Management of Stable Chronic Obstructive Pulmonary Disease: A Clinical Practice Guideline Update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society. ACP, 08/2011. Annals of Int Medicine, 2011.

Image source: Enlarged view of lung tissue showing the difference between healthy lung and COPD, Wikipedia, public domain.

Glaucoma: Aruna's story (video)

From NHS Choices YouTube channel: Glaucoma is a group of eye conditions that affect vision. Aruna talks about her diagnosis and subsequent treatment.

A consultant ophthalmologist explains what glaucoma is, how it can affect your vision and how it can be treated:

Clinical Pearls in Gastroenterology from Mayo Clinic (video)

The social media department of Mayo Clinic combines journal articles and videos by the lead authors. This is a useful approach that should be followed by other journals, in addition to Mayo's own journal, Clinic Proceedings.



Dr. Amy Oxentenko, Assistant Professor of Medicine at Mayo Clinic, discusses "Clinical Pearls in Gastroenterology" (article abstract). Here is the 2009 edition of the same project.

References:

Clinical Pearls in Gastroenterology 2011. Amy S. Oxentenko, MD, John B. Bundrick, MD, and Scott C. Litin, MD

Why you shouldn't close your blog and Twitter account

A few months ago, @Doctor_V and an anonymous doctor on Twitter had an argument, she closed her account and now DrV's blog is the only one left to tell the story: http://goo.gl/mIS3N

I understand and appreciate the arguments of both parties. However, when she deleted her Twitter account, we lost one side of the story forever.

All doctors should consider having online presence because they need to tell their side of the story.

For example, if the majority of pediatricians had blogs, the false autism/immunization link would not have become accepted by celebrities and misled a large part of the general public.

Comments from Google Plus:

Arin Basu: Excellent point by Ves about how false findings spread (read the bit about immunization and autism). I think by the same stretch of logic, I'd strongly vouch for clinician-epidemiologists, and epidemiologists should have their own blogs, and take part in social media more often and raise awareness about findings and interpretation of studies. Well said, Ves.

Related reading:

Why blog? Notes from Dr. RW. A perfectly reasonable list. All doctors should consider blogging. It's do-it-yourself CME.

BMJ, the first medical journal to launch a website in 1996, shows a blog-like redesign

See the video here: Make the most of the new bmj.com. Editor-in-Chief Fiona Godlee and David Payne explain the redesigned bmj.com website, and some of the new features:



And, of course, you can follow BMJ on:

- Twitter
twitter.com/bmj_latest

- Facebook
facebook.com/bmjdotcom

- YouTube
youtube.com/user/BMJmedia

References:

Welcome to the new design. BMJ.