Top articles in medicine in May 2012

Here are my suggestions for some of the top articles in medicine in May 2012:

The primary care doctor is a rapidly evolving species - and in the future could become an endangered one - NEJM http://goo.gl/BPcVB

Japanese rail workers have to pass a daily smile scan. Even a faux smile may increase happiness - Lancet http://goo.gl/DKwD9

Mental Illness: "Checklist diagnoses" cost less in time and money but fail compared to comprehensive evaluation - NEJM http://goo.gl/uOmcd

Only 50% of people with major depression in the general population receive any treatment for depression http://goo.gl/IfCCq

Natalizumab-Associated Progressive Multifocal Leukoencephalopathy (PML) - NEJM lists the risk factors http://goo.gl/J71JA

Azithromycin and the Risk of Cardiovascular Death - NEJM: 7 additional cardiovascular deaths per 1 million courses; patients in the highest decile of risk for cardiovascular disease had an estimated 245 additional cardiovascular deaths per 1 million courses. http://goo.gl/QITcP

Coffee consumption was inversely associated with total and cause-specific mortality. Whether this was a causal or associational finding cannot be determined - NEJM http://goo.gl/0EMJF

The Right Way to Try to Buy Happiness: By using money to create memories with your family, build things with your hands or even sleep more, you stand a pretty good chance of being happier. http://goo.gl/FO2I5

Up to 21% of adults will develop tinnitus - 2% of population have severely impaired quality of life because of it http://goo.gl/q1Yuc

Aspirin Prevents the Recurrence of Venous Thromboembolism, with no increase in risk of major bleeding - NEJM http://goo.gl/3sqDu

Women who worked the night shift were 40% more likely to develop breast cancer http://goo.gl/VQPQt

Hyperglycemia on admission predicts death in patients with community acquired pneumonia without pre-existing diabetes http://goo.gl/edAwQ

How can I treat toenail fungus? Ask Doctor K from Harvard Medical School http://goo.gl/9pdj9

The articles were selected from my Twitter and Google Reader streams. Please feel free to send suggestions for articles to clinicalcases@gmail.com and you will receive acknowledgement in the next edition of this publication.

The evolution of a physician's blog

Dr. Smith presents his research poster, which charts the tremendous growth of his eponymous blog, Dr Smith’s ECG blog. The blog is practically free to maintain, hosted by Google's service, Blogger.com, and will break 1,000,000 page views this year. The site itself represents a living and breathing, dynamic textbook: http://hqmeded-ecg.blogspot.com



Dr. Stephen W. Smith is a faculty physician in the Emergency Medicine Residency at Hennepin County Medical Center (HCMC) in Minneapolis, MN, and Associate Professor of Emergency Medicine at the University of Minnesota.

Best of Medical Blogs - weekly review and blog carnival

The “Best of Medical Blogs - weekly review and blog carnival” is a weekly summary of the best posts from medical blogs. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best of Medical Blogs (BMB) is published every Tuesday, just like the old Grand Rounds.

Healthcare CIO: On Turning 50 

From John D. Halamka, MD: The difference between an expert and novice is not the detail they notice, but what they choose to ignore. For example, when I do a toxicology consult, I focus less on the exact subspecies of mushroom the patient has ingested, and more on ensuring it is not one of the few that kill humans. http://goo.gl/UXJe4

No one remembers the details of last year's urgencies. What really matters is happiness at home. Jobs may change but family is forever.

The End of House, MD.

Dr. Wes predicts bleak future: Yes, the image of Gregory House MD must end, because like Marcus Welby, MD, he no longer exists. That’s because instead of “House,” our medicine is now morphing into the “Office.” http://goo.gl/JxffI

A weekend with grandmaster

From ShadowFax ER blogger: He chose to dedicate his life to the study and preservation of the traditional Okinawan martial arts as a young man. He is, it seems, as old as the hills and as enduring. He is pushing 80, but still as tough as nails. Standing a diminutive 5'0", he can toss young men about like rag dolls, despite the fact that they have 12 inches of height, 60 lbs, and 50 less years of age on them. And his bones are so dense that blocking his punches feels like smashing your forearms into a cement wall. http://goo.gl/JixZ0

A Personal Rapid Learning System

From Social QI blog, here is how to assemble your Personal Rapid Learning System http://goo.gl/hPXuc:

1. Cast an information net. The tools include: saved Pubmed searches and Google alerts (and now RSS feeds and other channels).

2. Build a network of people in the know through LinkedIn and Twitter.

3. Narrate your learning and experiences. Share what you know and what you need to learn.

The pros/cons of using social media in biomedicine 

This is a presentation by one of the best thinkers about Web 2.0 use in medicine, Dean Giustini http://goo.gl/neenB:

Social media in health & medicine 2012 workshop

View more PowerPoint from Dean Giustini

Dean is UBC Biomedical Branch librarian at Vancouver hospital. He teaches at the School of Library, Archival and Information Studies, and the School of Population and Public Health.

ENT blog reaches 5 million web visits - their YouTube channel received 230 million views http://goo.gl/0nlFg

Is Acetaminophen Safe For Children With Asthma? Interpreting the Medical Literature Is Complex, says pediatric pulmonologist Dr. Canapari. The jury is still out on this topic. Hopefully large-scale trials will help answer the question conclusively. http://goo.gl/mxNpv

Comments from Twitter:

Mike Cadogan @sandnsurf: Reading: Best of Medical Blogs - weekly review and blog carnival. More fantastic links form @DrVes

Top articles in medicine in May 2012

Here are my suggestions for some of the top articles in medicine in May 2012:

Large numbers of very rare genetic mutations may underlie common human diseases like schizophrenia and cancer http://goo.gl/GttAQ

14 Ways Social Media May Soon Change Your Doctor's Visit http://goo.gl/muWK1

Drunk driving across the globe: many countries have “no tolerance” laws with 0.0% blood alcohol limit http://goo.gl/aIsRn

Top 10 Cloud-Based EHRs - CureMD and Practice Fusion (the only free EMR) scored best http://goo.gl/jWMuu

Pets at birth either decreased or had no effect on allergic disease up to age 12. No evidence that exposure to cats or dogs at birth increases the risk of allergic disease in high risk children http://goo.gl/MS4iW

Cleveland Clinic starts a blog called "Health Hub" http://goo.gl/66FF0 - competing with the aging consumer portal of MayoClinic.com

CT colonography is accurate in detecting adenomas 10 mm or larger but less so for smaller lesions http://goo.gl/gMTiX -- Laxative-free colonoscopy on the way? Virtual colonoscope digitally removes stool from the colon http://goo.gl/sJG6H

Do we need vacations? Vacations improve employee wellbeing but the positive effect is short-lived (study) http://goo.gl/jd3CH

NRMP to Implement “All-in” Policy for 2013 Match http://goo.gl/tn5Cs

New labeling will help you pick the best sunscreen - Consumer Reports http://goo.gl/Wtm3M

U.S. politicians invoke the “R word” - rationing for healthcare - NEJM http://goo.gl/Urhua

Pepsi and Competitors Scramble as Soda Sales Drop in the U.S. Average American drank less than 2 sodas/day in 2011, a drop in per capita consumption of 16% since the peak in 1998. Sugary soft drinks are the No. 1 source of calories in U.S. diets - NYTimes http://goo.gl/9tjdD

"Z-Pak Heart Attack" - sudden death may be a new (rare) risk linked to commonly prescribed antibiotic azithromycin http://goo.gl/3DeIh

Coffee Drinkers May Live Longer - there are 1,000 or more compounds in coffee - NYT and NEJM http://goo.gl/VSfbN

Using Internet Search Engines to Obtain Medical Information: users preferred Bing over Google in this study http://goo.gl/mJgpm

The articles were selected from my Twitter and Google Reader streams. Please feel free to send suggestions for articles to clinicalcases@gmail.com and you will receive acknowledgement in the next edition of this publication.

Comments from Twitter:

Mike Cadogan @sandnsurf: Reading: Top articles in medicine in May 2012 bit.ly/KUxEhs via @DrVes ...more great articles from the world of medicine

Karim Jessa @karimjessa: great stuff! thanks dr @DrVes

Healthcare social media #HCSM - top articles

Here are my suggestions for some of the top articles related to healthcare social media in the past 2 weeks:

Understanding Research Impact http://goo.gl/2ZHCK and 20 Strategies To Enhance The Impact Of Your Research http://goo.gl/49MLb

BMJ Learning gets social - British Medical Journal platform learns new tricks in this brave new social media world http://goo.gl/4vncy

Doctors' Use of iPads Becoming Mainstream (not my impression). Also, physician-only social networks remain stagnant http://goo.gl/9QfDf

Heart Rhythm Society 2012 Scientific Session in the Age of Twitter http://goo.gl/FGH10

"Healthcare Going To The Dogs" - a video for training hospital administrators http://goo.gl/hv40a and http://goo.gl/xsW4J

Cleveland Clinic starts a blog called "Health Hub" http://goo.gl/66FF0 - competing with the aging consumer portal of MayoClinic.com

JAMA will link 10 AMA journals like a group blog - all names will start with “JAMA”, for example, Archives of Surgery will become “JAMA Surgery” http://goo.gl/FJLL2

Cultivate followers on social media if you want to communicate science

From the blogs Soapbox Science http://goo.gl/cPQq1 and Medical Museion http://goo.gl/QmEU7 :

"Social media platforms can be very limiting. For example, can you define genotype and phenotype in 140 characters or less? If you want to use social media to communicate effectively, you need to drive readers somewhere.

Writing a blog gives substance to your social media presence. You have the opportunity to talk about science in a meaningful way, which ultimately helps people better understand the world around them. Answering those questions is probably why you got into science in the first place. Don’t be afraid to share what you’ve discovered."

The articles were selected from my Twitter and Google Reader streams. Please feel free to send suggestions for articles to allergycases@gmail.com and you will receive acknowledgement in the next edition of this publication.

Dr Topol to med students: "When I was in medical school, the term "digital" was reserved for the rectal examination"

Here are some excerpts from the Baylor College of Medicine commencement address by Dr. Eric Topol, director of the Scripps Translational Science Institute, delivered yesterday, May 22, 2012. This should be a required reading for everyone involved in healthcare, which is basically everybody because each and every one of us will be a patient one day.

Eric Topol to medical students: "When I was in medical school, the term "digital" was reserved for the rectal examination."

"You sleep with your cell phone and prize it right up there with food and water. We have evolved to a new species of man. We are Homo distractus!"

The benefits of digital medicine are clear to Dr. Topol who shares the story of a patient he saw last week: "I asked him to put his fingers on the 2 sensors on the back of my iPhone case so I could do his electrocardiogram—ECG—that was normal. And free, by the way. Then instead of using a stethoscope to listen to his heart, I used a portable pocket-sized high-resolution ultrasound device and within a minute I could see every heart structure—the heart muscle thickness and function, the valves, the size of the 4 chambers. Why would I ever listen for lub-dub when I can see everything? I haven't used a stethoscope for over 2 years to listen to a patient's heart."

From Baylor College of Medicine (BCM) YouTube channel: 2012 Commencement Speaker, Dr. Eric Topol, spoke on May 21, 2012:



Here is Eric Topol's presentation at Health at Google:



References:

Baylor College of Medicine commencement address by Dr. Eric Topol, director of the Scripps Translational Science Institute

Comments from Twitter

Quoc-Dien Trinh, MD @qdtrinh: Makes it sound cool. “@DrVes: Dr Topol to med studs: When I was in med school, the term "digital" was reserved for the rectal examination"

Hemophilia educational videos by CDC

Hemophilia belongs to a family of inherited lifelong bleeding conditions that prevent blood from clotting properly. Patients with these disorders bleed for longer than normal, either as a result of injury or spontaneously without an external cause.

The severity of bleeding depends on the amount of clotting factor that is missing or not functioning properly, which in hemophilia A and B - the most common types of hemophilia - is the coagulation factors VIII and IX, respectively.

In addition to external bleeding, patients more commonly have internal bleeding around the joints and muscles, which can be extremely painful and cause permanent disability. Bleeding into major organs such as the brain is especially difficult to manage and can be fatal.

Here are 2 hemophilia educational videos by CDC:  Playing it Safe With Hemophilia: Friends with hemophilia talk about playing sports growing up and the importance of making smart decisions.



Starting the Conversation: Hemophilia. How to talk to your friends about hemophilia. A group of friends ask their friend Billy questions about his hemophilia:



Hemophilia care has undergone substantial improvements during the past 40 - 50 years. Early clotting factor concentrates were not sufficiently refined to enable self-administered treatment at home until the 1970s.

Long-term substitution therapy (prophylaxis) of the missing clotting factor is the recommended treatment in severe hemophilia. The major side-effect of treatment, development of inhibitors to the infused concentrate, is the main threat to the health of patients.

Mnemonic: Differential Diagnosis of Bleeding Disorders: F-CAP

Fibrinolysis - tPA
Coagulopathy - hemophilia, vWD
Angiopathy - conditions affecting blood vessels, e.g. Osler-Weber-Rendu syndrome
Platelets - thrombocytopenia or thrombocytopathia

Initial diagnostic tests = 3P:

Platelets
PT - INR
PTT

References:

http://www.cdc.gov/NCBDDD/video/Hemophilia_sports/index.html

http://www.cdc.gov/NCBDDD/video/Hemophilia_Friends/index.html

Making haemophilia a global priority - The Lancet, 2012.

Modern haemophilia care - The Lancet, 2012.

Best of Medical Blogs - weekly review and blog carnival

The “Best of Medical Blogs - weekly review and blog carnival” is a weekly summary of the best posts from medical blogs. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best of Medical Blogs (BMB) is published every Tuesday, just like the old Grand Rounds.

Cultivate followers on social media if you want to communicate science

From the blogs Soapbox Science http://goo.gl/cPQq1 and Medical Museion http://goo.gl/QmEU7:

Social media platforms can be very limiting. For example, can you define genotype and phenotype in 140 characters or less? If you want to use social media to communicate effectively, you need to drive readers somewhere.

Writing a blog gives substance to your social media presence. You have the opportunity to talk about science in a meaningful way, which ultimately helps people better understand the world around them. Answering those questions is probably why you got into science in the first place. Don’t be afraid to share what you’ve discovered.

Are doctors afraid to be wrong?

From the surgeon blogging at Skeptical Scalpel: "I once did some expert witness work for a malpractice insurance company. There is rarely a case that does not have many opportunities for second-guessing. When you know the outcome, you can always find something in the medical record that could have been done differently.

The current medicolegal and patient safety climate creates a feeling among physicians that any error is going to be extensively scrutinized. This results in a situation analogous to an athlete trying not to lose a game instead of trying to win. For those of you not familiar with sports, that strategy usually fails. Fear of being wrong can lead to excessive testing too." http://goo.gl/FWTbC

When did we stop teaching the basics to medical students and residents?

Dr. Centor of the blog db's Medical Rants likes the ACGME 6 core competencies just fine, but also suggests a simpler list http://goo.gl/2sqip:

1. Take a complete, relevant, accurate history
2. Do an appropriate physical examination
3. Order the correct laboratory tests and interpret them fully and accurately
4. Order the correct images and interventions and interpret them

Happy 5th Blogiversary!

Former plastic surgeon and blogger extraordinaire Dr. Ramona Bates reflects on her 5 years of blogging and the medical blogging community. http://goo.gl/0EVJW

How blogging has helped me academically. According to Dr. Centor: Because I write most days, my writing has improved dramatically http://goo.gl/GLNsL

Social media and medicine - Stanford University Grand Rounds

Graham Walker was one of the first medical bloggers. He went on a hiatus during his emergency medicine (EM) residency, and has now found new reasons to blog as an EM attending at Stanford University medical center. This is his talk on social media and medicine at Stanford University Grand Rounds: http://youtu.be/qtkggenLmlE



Dr. Walker: "My talk on the dissemination of medical information over time, how the internet and social networking are changing medicine, and how to use digital tools to be a better clinician at the bedside."

Here is Graham's list of Digital Tools to Improve the Specialty.

Paper-based Charts: How Soon We Forget http://goo.gl/Vspmp - Dr. Wes: Suddenly, I don't miss paper charts anymore.

Dr. Wes: How Bad Is Azithromycin's Cardiovascular Risk? http://goo.gl/yVgfo - Are "Big Data" linked to "Big Error"?

Comments from Twitter:

Seth Trueger @MDaware: some great stuff in there

Skeptical Scalpel @Skepticscalpel: Thanks for including me.

Mayo Clinic now offers Patient App: access to personal medical record, appointment schedule and more

The Mayo Clinic Patient app allows access to the latest news, publications, and health information from Mayo Clinic. Mayo Clinic patients also have access to their personal medical record, appointment schedule and other services using their Patient Online Services account.

The Mayo Clinic Patient app provides local community information, including directions to local restaurants, entertainment, and more. http://youtu.be/UAymmf5ZUNo

Top articles in medicine in May 2012

Here are my suggestions for some of the top articles in medicine in May 2012:

For every hour of "social jet lag", the risk of being overweight or obese rises 33% http://goo.gl/fTlge

Lorcaserin (Lorqess) will be the first new prescription weight loss drug in more than a decade http://goo.gl/MexzC

Healthcare crushed by acronyms http://goo.gl/FqPX6

Pulmonary embolism and deep vein thrombosis - 2012 Lancet review http://goo.gl/SpbKg

Spanish health cuts could create “humanitarian problem” - The Lancet http://goo.gl/YA0OA

Doctors in China were once revered, but now face increasing threats to their personal safety at work - Lancet http://goo.gl/gf62Q

Cosmetic laser treatment for removal of hair and tattoos can cause burns, blistering, scarring, permanent blindness http://goo.gl/71gdx

Statins: Is It Really Time to Reassess Benefits and Risks? http://goo.gl/vnn9x -- NEJM: studies are needed assess statin-induced diabetes.

How To Do Medical Education Research? A step-by-step guide: http://goo.gl/bTnIh

Understanding Research Impact http://goo.gl/2ZHCK and 20 Strategies To Enhance The Impact Of Your Research http://goo.gl/49MLb

Knee osteoarthritis in former elite soccer players: 40-80% have osteoarthritis http://goo.gl/qLu4f

Former world record holder in the 100-meter sprint, ran it in 22.04 seconds -- when he was 95 years old http://goo.gl/9bu01

The articles were selected from my Twitter and Google Reader streams. Please feel free to send suggestions for articles to clinicalcases@gmail.com and you will receive acknowledgement in the next edition of this publication.

Healthcare social media #HCSM - top articles

Here are my suggestions for some of the top articles related to healthcare social media in the past 2 weeks:

Social media “likes” healthcare: From marketing to social business. Social media and health care: opportunities and obstacles - PWC 2012 report, free download http://goo.gl/GtSgE

8 Chrome Extensions that Make Blogging Easier http://goo.gl/fFKye

"News Squares" for Chrome is a new visual RSS reader http://goo.gl/ZgO7Z

CDC Social Media Guidelines and Best Practices http://goo.gl/Sw0n - Twitter guide updated in Feb 2012.

"20 Days to High-Quality, Engaged Twitter Following (in just 20 minutes a day)" http://goo.gl/8T0xL - Mixed bag of advice, some good tips

There is an allergy/immunology wiki: "AI notes" http://goo.gl/Qt1iE - Not sure who's behind it, looks useful.

Medicine, Social Media and Clinical Excellence. Let’s do it. http://goo.gl/WgRDw -- Here is one of my related blog posts: Doctors are natural communicators - social media is extension of what they do every day http://goo.gl/2FzQb

Study: There is a kernel of truth to the popular term "Facebook stalking". Introducing new terms (to me) such as: cyber obsessional pursuit (COP) and obsessive relational pursuit (ORI), which are categories of cyberstalking and stalking, resulting in three factors: Covert Provocation, Public Harassment, and Venting. http://goo.gl/sgVys

How to find RSS feeds for Twitter accounts, Facebook pages, YouTube, other SoMe sites http://goo.gl/Q6tNg

Fake tweet stops Nashville doctor's lecture, plans for cruise http://goo.gl/Lj0mO

How to Create Your Own Website using Blogger - Step-by-Step Guide for Physicians http://goo.gl/tCd37

Science blogging and self-promotion? http://goo.gl/yGUqS

How To Deal With Information Overload http://goo.gl/h4CmL and http://goo.gl/wDv5

The articles were selected from my Twitter and Google Reader streams. Please feel free to send suggestions for articles to allergycases@gmail.com and you will receive acknowledgement in the next edition of this publication.

Social media and medicine - Stanford University Grand Rounds

Graham Walker is one of the first medical bloggers. He went on a hiatus during his emergency medicine (EM) residency, and has now found new inspiration to blog as an EM attending at Stanford University medical center. This is his talk on social media and medicine at Stanford University Grand Rounds: http://youtu.be/qtkggenLmlE



Dr. Walker: This is my talk on the dissemination of medical information over time, how the internet and social networking are changing medicine, and how to use digital tools to be a better clinician at the bedside.

Here is Graham's list of Digital Tools to Improve the Specialty:
http://gmergency.tumblr.com/post/22727728700/stanford-grand-rounds-may-9-2012

Comments from Twitter:

Alice Ackerman, MD, @CloseToHomeMD: [You need to watch the video-Gr8 talk]

Top articles in medicine in May 2012

Here are my suggestions for some of the top articles in medicine in May 2012 so far:

Point-of-care genetic testing for personalisation of antiplatelet treatment is effective http://goo.gl/ZWLvz

Patient empowerment - who empowers whom? Virtually all people are patients at some point in their lives http://goo.gl/4YKjq

Doctors' love-hate relationship with EHRs http://goo.gl/wd74F

Why U.S. spends more on healthcare than other developed countries: Higher prices, readily accessible technology, obesity http://goo.gl/cid6S

Austerely law transforms Spain’s health system from universal access to one based on employment | BMJ http://goo.gl/36u4C

Bevacizumab (Avastin) is as effective as ranibizumab (Lucentis) for wet AMD and could save NHS millions - NHS http://goo.gl/JJ8uV

Having 'Type D' Personality - a distressed and pessimistic outlook on life - May Affect Your Health http://goo.gl/kFbpA

New Cautions About Bisphosphonate Use - NYTimes http://goo.gl/PYiKy

How to Create Your Own Website using Blogger - Step-by-Step Guide for Physicians http://goo.gl/tCd37

Truvada (Emtriva + Viread), first drug to prevent HIV infection in healthy people at high risk (MSM, partners of HIV+) http://goo.gl/e1MJM

Can mobile phones give you brain cancer? The verdict's still on hold http://goo.gl/gI6Ta

Drink Water to Improve Test Scores http://goo.gl/MNB6k and http://goo.gl/EO12p

The articles were selected from my Twitter and Google Reader streams.

What it's like to study medicine at Cambridge (video)

What is "the favorite" for medical students in the UK at the moment? Going into General Practice (at minute 2:45 of the video). They are also "very keen into going into a specialty such as pediatrics". This is a night and day difference compared to their counterparts in the U.S.



From Cambridge University YouTube channel: "At Cambridge, we offer two medicine courses - the Standard Course and the Graduate Course. With both, our aim is to educate students to become compassionate, thoughtful, skilled members - and leaders - of the medical profession.

Success in medicine requires application and hard work, both while studying and when in practice. However, it brings great rewards in terms of job satisfaction, involving as it does a combination of science and human interactions, and numerous career opportunities."

To find out more about Medicine at Cambridge, see http://study.cam.ac.uk/undergraduate/courses/medicine

Comments from Twitter:

Nick Bennett @peds_id_doc: Best medical school in the world. Seriously.

Medical School Life in Cambridge and Debrecen - @Berci compares the promotional videos http://goo.gl/BZm2w

Best of Medical Blogs - weekly review and blog carnival

The “Best of Medical Blogs - BMB weekly review and blog carnival” is a weekly summary of the best posts from medical blogs. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best of Medical Blogs (BMB) is published every Tuesday, just like the old Grand Rounds.

A Medical Educator Joins Social Media: One Year Later

Dr. Djuricich, Program Director in Medicine-Pediatrics at the Indiana University, shares what he has learned in one short year: If physicians and other health care professionals are not becoming involved in social media, they are missing out on a “place” where many of the patients already are. There is a lot of misinformation floating around on the internet. It is a duty of physicians to combat this and provide correct information. Do not let social media take over your life. The important things (family, friends, etc.) are still the important things, so don’t lose the priorities. http://goo.gl/zNfpe

What explains blogging longevity? It's easy: blog for yourself, and share with others

Dr. Centor explains his blogging longevity after 10-years of blogging. I've been blogging for 8 years, and I agreee with him: Why you should write a blog for yourself rather than for a shifting audience http://goo.gl/P8xtz

Here's Dr. Centor again: Explaining longevity is subjective. Mostly, I like blogging. Basically I blog with myself in mind, and am gratified that others find my comments interesting. Blogging is never a chore. One cannot last 10 years doing a chore. http://goo.gl/Jyl2o

Cardiologist Dr. Wes nominates the hardest to read Abstract of the Year at 2012 Heart Rhythm Society

What is the abstract that contributes the smallest amount to our field while demonstrating the worst grammar, the most bureaucratic lingo and, of course, verbosity. The sentence that clinched it? "Conclusions: The harmonization of endpoint definitions, terminology, and clinical trial design paradigms provides consistency across clinical trial studies that can facility (sic) clinician acceptance of results and the evaluation of safety and effectiveness of devices and medicines for atrial fibrillation." http://goo.gl/ZstA0

Harvard Medical School Q&A blog doctor reflects on his readers’ feedback

Dr. Komaroff from the blog Ask Doctor K.: “Since I began this column last September, I’ve received a lot of mail — both emails and “snail mail.” Mostly it’s been health questions. I can’t answer them all, but I try to answer as many as I can. However, I’ve also received complaints. Sometimes they represent an honest difference of perspective. On occasion, they reflect the fact that I’m a man.” http://goo.gl/XK3O1

A complete list of all academic medical journals available for the iPad

The omnipresent blog iMedicalApps makes a good use of Google Docs spreadsheet to list the apps of many academic medical journals available for the iPad. I still have personal preference for the open web rather than apps but that’s just me. http://goo.gl/13Gjz

What is postinfectious cough and how to treat it?

From Dr. Matthew Mintz' blog: While the cause of the postinfectious cough is not known, it has been thought to be due to the extensive damage of cells lining the lung and widespread airway inflammation of the upper and/or lower airways. The good news is that this usually goes away by itself, the bad news is that it can take weeks or even months, and can be quite disruptive to patients lives. Since symptoms are caused primarily by inflammation and hyperresponsiveness/bronchoconstriction in the lungs (which is what we see in asthma), then treatment is likely best with something that treats both inflammation and bronchoconstriction in the lungs, such as an inhaled corticosteroid/long-acting beta agonist like Advair (which is commonly used in asthma). Use of Advair for postinfectious cough may be the single most common off-label use of any prescription product. Since inflammation can persist for weeks, it is important that Advair be used for at least 4 weeks. If symptoms return, the patient should be brought back for pulmonary function testing as this may be a new presentation of asthma. http://goo.gl/RgxLb

Reality Social Media: Live Tweeting Brain Surgery. What is the downside of this marketing push? Dr. Wes explains: http://goo.gl/XbKwv

"Healthcare Going To The Dogs" - a video for training hospital administrators http://goo.gl/hv40a and http://goo.gl/xsW4J

Science blogging and self-promotion? http://goo.gl/yGUqS

Depression affects up to 9% of U.S. population - how to do effective screening?

From American Family Physician:

Depression affects up to 9% of U.S. population.

The U.S. Preventive Services Task Force recommends screening in adolescents and adults but it does not recommend screening for depression in children 7-11 years of age, or screening for suicide risk in the general population.

The Patient Health Questionnaire (PHQ)-2 and PHQ-9 are commonly used and validated screening tools.

The PHQ-2 has a 97% sensitivity and 67% specificity in adults. The PHQ-2 inquires about the frequency of depressed mood and anhedonia over the past 2 weeks, scoring each as 0 ("not at all") to 3 ("nearly every day").

PHQ-9 has a 61% sensitivity and 94% specificity in adults. The PHQ-9 depression module scores each of the 9 DSM-IV criteria as “0” (not at all) to “3” (nearly every day).

If the PHQ-2 is positive for depression, the PHQ-9 should be administered.

In older adults, the 15-item Geriatric Depression Scale is an appropriate follow-up test.

If these screening tests are positive for depression, further evaluation is needed to confirm that the patient's symptoms meet the Diagnostic and Statistical Manual of Mental Disorders' (DSM) criteria for diagnosis.

References:

Screening for depression. Maurer DM. Am Fam Physician. 2012 Jan 15;85(2):139-44.

Image source: Vincent van Gogh's 1890 painting At Eternity's Gate. Wikipedia, public domain.

Top articles in medicine in May 2012

Here are my suggestions for some of the top articles in medicine in May 2012 so far:

Is Geriatric Medicine Terminally Ill? asks Annals of Internal Medicine http://goo.gl/J4jMU

Low vitamin D (below 50 nmol/L (20 ng/mL) increases risk for clinical disease among older adults http://goo.gl/tBXS4

Senior physicians keep working, putting off the R-word - 20% of U.S. physicians are older than 65 http://goo.gl/Dxgip

Many young doctors worried about future of medicine - amednews http://goo.gl/r61lW

"One of the greatest risks of social media is ignoring social media" says chief integrity officer of Cleveland Clinic. Patients want to use social media tools to manage health care http://goo.gl/9SAry

Doctors can risk lawsuits when writing about patients - amednews points to books about patients as examples http://goo.gl/QhqFS

Coffee is the most complex food known to man. It has 1200 flavor components. The nearest comparison is red wine with 450 chemical compounds in the flavor make-up. In most commercial blends there are 10 to 12 different coffees, from different farms. http://goo.gl/m2LwD

Guidelines for social media use by Federation of State Medical Boards (FSMB) describe in detail what NOT to do: http://goo.gl/Raq2e

Prevention of acute knee injuries in adolescent female football (soccer) players: warm-up could help http://goo.gl/dBgSS

Is It Possible To Walk And Work At The Same Time? Kaiser Permanente tries walking meetings http://goo.gl/cRu8l

Corneal transplantation - 2012 state of the art review in The Lancet http://goo.gl/JBAag

Towards an optimum strategy in rheumatoid arthritis: For RA patients who fail initial methotrexate treatment, add-on disease-modifying antirheumatic drugs are appropriate http://goo.gl/ONq6u

Time Spent Behind the Wheel May Increase Heart Health Risks, linked to less time spent exercising http://goo.gl/NUYX7

Recipe For Safer Drinking Water (from bacteria)? Add Sun, Salt And Lime http://goo.gl/kU2ZK

The articles were selected from my Twitter and Google Reader streams.

Healthcare social media - top articles

Here are my suggestions for some of the top articles related to healthcare social media in the past 2 weeks:

Healthcare social media is a moral obligation

Healthcare social media is a 'moral obligation', says Farris Timimi, M.D., medical director for the Mayo Clinic Center for Social Media. Social media needs to be grown and nurtured for patients. "Our patients are there. Our moral obligation is to meet them where they're at and give them the information they need so they can seek recovery," Timimi said. "You've got to be ready for it. You build it for the patients; not for yourself. "This is not marketing," he added. "This is the right thing to do." http://goo.gl/BHzKf

The New World Of Medical Tweeting

300 million users generate 300 million messages every day, and doctor are part of it. 38% of tweets are conversational - transferring information and spreading content. Twitter can be a strong educational tool.

The American Medical Association has released a public statement about professionalism in social media:

“Participating in social networking and other similar internet opportunities can support physicians’ personal expression, enable individual physicians to have a professional presence online, foster collegiality and camaraderie within the profession, provide opportunity to widely disseminate public health messages and other health communication." http://goo.gl/K2QtK

Guidelines for social media use by Federation of State Medical Boards (FSMB) describe in detail what NOT to do: http://goo.gl/Raq2e

Digital Strategies for Healthcare Organisations http://goo.gl/PZtWl

Use of Social Media by Western European Hospitals: Longitudinal Study shows that SoMe awareness is growing http://goo.gl/l41tz

Doctors can risk lawsuits when writing about patients - amednews points to books about patients as examples http://goo.gl/QhqFS

GruntDoc: It’s my 10th Blogging Anniversary http://goo.gl/TkBc7 - Congratulations! A great reflection on a long journey.

The articles were selected from my Twitter and Google Reader streams.

Dermatology Art Contest by Mayo Clinic shows that art can be seen in every aspect of life

A Mayo Clinic dermatology art contest shows beauty really is skin deep. From Mayo Clinic News blog:

A hair follicle or skin specimen that doesn’t look like much of anything to the naked eye can become a complex, colorful work of art under a microscope. The winner of the Mayo dermatologists’ first art contest in 2011 was “Hair Follicle Triplet”. Alexander Meves, M.D., used fluorescent dyes to highlight proteins. The inaugural winners of the art contest appeared in the May issue of the Journal of Cutaneous Pathology.

“Every single day, dermatopathologists get to see beautiful images under the microscope, and most people never have the opportunity to see that. So I thought it would be a nice way to show not only the science of dermatopathology, but also the art,” says the contest’s creator, Dr. Lehman, a Mayo Clinic dermatopathologist.



Dr. Lehman hopes medical societies will run with the idea and hold similar competitions to highlight aesthetics in their specialties. People in other lines of work can also celebrate the beauty of what they do each day, she says.

Editor's note: Allergists should do something similar. We already highlight beautiful pollen allergens on the monthly covers of the ACAAI journal.

“Art can be seen in every aspect of life,” Dr. Lehman says. “You just have to have an open mind and be looking for it.”

References

Dermatology Art Shows Beauty Really Is Skin Deep. Mayo Clinic News.

Diary-Writing Has Psychological Benefits - Journal of Happiness Studies

Writing has long been used as a coping strategy and has been applied to improve psychological well-being. One study found that suicidal poets used more first-person singular pronouns (I, me, my) than the control group of poets.

This study from Taiwan, published in the Journal of Happiness Studies, investigated the psychological displacement paradigm in diary-writing (PDPD) and its supposed psychological benefits.

Study participants were randomly assigned to write about their recent negative life experiences two times a week for 2 weeks in PDPD group (diary-writing), or comparison group (no diary-writing).

The diary-writing group (PDPD) showed a decrease in negative emotion and an increase in positive emotion immediately after each writing session (short term effect).

They also had an increase in psychological well-being for at least 2 weeks (long term effect).

References:

The Psychological Displacement Paradigm in Diary-Writing (PDPD) and its Psychological Benefits. Jen-Ho Chang, Chin-Lan Huang and Yi-Cheng Lin. JOURNAL OF HAPPINESS STUDIES 2012, DOI: 10.1007/s10902-012-9321-y

Comments from Google Plus and Twitter:

Lin W: I guess blog writing might have the same effect?

Ves Dimov, M.D.: It depends on the type of blogging you do, but yes, blogging can be a positive experience too.

Dr. Amal Hasan @DrFloona: Diary-Writing Has Psychological Benefits bit.ly/wwMDmr” Until someone else reads it

Dean Giustini @giustini: Diary-Writing Has Psychological Benefits bit.ly/wwMDmr [Isn't this why we blog Ves?]

@DrVes: Well, I'm not sure. I don't blog about "negative experiences". Blog = archive for me

Best of Medical Blogs - weekly review, blog carnival

The “Best of Medical Blogs - weekly review, blog carnival” is a weekly summary of the best posts from medical blogs. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best of Medical Blogs is published every Tuesday, just like the old Grand Rounds.

Social Networks for Doctors: Are We There, Yet?

Twitter can be as inane, or as useful, as the accounts you follow. Sure, doctors use Facebook like everyone else, but – by and large – they haven’t tapped into the educational potential that online social networks offer. Once viewed as a trivial hobby by more eminent researchers and writers, blogs now serve as the elder statesmen of social media - and they can act as a base of operations for social networking. An excellent summary by Shiv Gaglani & Nicholas Genes: http://goo.gl/9DVbI

A Twitter Primer for Physicians (aka Twitter 101 for Docs)

Here are Dr. Ryan Madanick's suggestions: http://goo.gl/gNS5d. Dr. Madanick is a gastroenterologist at the University of North Carolina School of Medicine, as well as the Program Director for the GI & Hepatology Fellowship Program.

1. Consider starting with a private account.

2. Start following some accounts: Specialty societies and journals, let Twitter suggest some accounts, search for accounts with similar interests.

3. Listen to what others are saying.

4. Decide what to tweet.

5. Find a hashtag.

The incredible frailty of life

Realizing the incredible frailty of life and the battle to avoid irrational exuberance: a journey into the NICU as a Med-Peds uncle. This is a heartfelt article by Dr. Moises Auron from Cleveland Clinic: http://goo.gl/KvUbN

The NYTimes gets it wrong on ECG screening of young athletes

Dr. John Mandrola, a cardiac electrophysiologist, comments on a NYTimes article that included numerous inaccuracies and failed to tell important facts about the complexities of widespread screening of athletes. http://goo.gl/siEEp

How one patient uses Social Media

"Personally.. I don’t want to be a patient.. It’s totally the last thing I want to be…Before my diagnosis I shamefully has no idea what Rheumatoid arthritis (RA) was or what the consequences were of having a Chronic Illness. Patients and Doctors will find a solution together." A guest post at Dr. Ronan Kavanagh's blog. Dr. Kavanagh is rheumatologist from Ireland: http://goo.gl/daRfd

Krokodil is a devastating homemade opiate

Krokodil (or crocodile) refers to homemade batches of the opiate desomorphine (currently available without a prescription in Russia), and ingredients such as gasoline, paint thinner, hydrochloric acid, iodine, and red phosphorous. When injected, this highly impure mixture often causes skin to turn greenish grey and scaly, which may explain the drug’s name. Another explanation is that subsequent ischemia, gangrene and amputation has the same effect as a crocodile biting off a victim’s limb. From The Poison Review: http://goo.gl/VAq28

How to straighten a guidewire with one hand

The Australian blog Life in the Fast Lane is one of the best blogs focused on emergency medicine. Here is one of their shorter posts: How to straighten a guidewire with one hand http://goo.gl/mC9zY

GruntDoc: It’s my 10th Blogging Anniversary http://goo.gl/TkBc7 - Congratulations! A great reflection on a long journey.

10 Bad Assumptions Patients Make - a post by Dr. Rob http://goo.gl/EpmUO

All papers at PLoS Medicine now reflect the public Twitter debate | Medical Museion http://goo.gl/Xmu5Y

Caffeine and Sleep In Kids: It is a good rule of thumb to avoid soda entirely | Craig Canapari, MD http://goo.gl/W5HGS

Using fruit to improving anaphylaxis care - use your expired injectable epinephrine on an orange, an allergists suggest http://goo.gl/AQIxw

Are we too concerned with confidentiality? Former BMJ editor provides a personal example: http://goo.gl/0J3dp

Comments from Twitter:

John Mandrola, MD @drjohnm: Thx 4 shout out. Wow, lots of other great posts.

Mike Cadogan @sandnsurf: Concise, pithy and diverse - great read

Craig Canapari @DrCanapari:  Honored to be included

The Diet Factor in Attention-Deficit/Hyperactivity Disorder - State-of-the-Art Review Article in Pediatrics

Diets that were tried in attempt to reduce symptoms associated with attention-deficit/hyperactivity disorder (ADHD) include:

- sugar-restricted
- additive/preservative-free
- oligoantigenic/elimination
- fatty acid supplements

Omega−3 supplement is the latest dietary treatment with positive reports of efficacy. Interest in the additive-free diet of the 1970s is occasionally revived.

Provocative reports have drawn attention to the ADHD-associated “Western-style” diet, high in fat and refined sugars, and the ADHD-free “healthy” diet, containing fiber, folate, and omega-3 fatty acids.

Indications for dietary therapy include:

- medication failure
- parental or patient preference
- iron deficiency
- change from an ADHD-linked Western diet to an ADHD-free healthy diet, when appropriate

In practice, additive-free and oligoantigenic/elimination diets are time-consuming and disruptive to the household; they are indicated only in selected patients.

Iron and zinc are supplemented in patients with known deficiencies; they may also enhance the effectiveness of stimulant therapy.

In patients failing to respond or with parents opposed to medication, omega-3 supplements may warrant a trial.

References:

The Diet Factor in Attention-Deficit/Hyperactivity Disorder. J. Gordon Millichap, MD and Michelle M. Yee, CPNP. PEDIATRICS Vol. 129 No. 2 February 1, 2012, pp. 330 -337, (doi: 10.1542/peds.2011-2199)

Image source: Olive oil, Wikipedia

Healthcare social media - top articles

Here are my suggestions for some of the top articles related to healthcare social media in the past 2 weeks:

Doctors and social media: “How to Stop Worrying and Learn to Love the Internet” http://goo.gl/pIrgh

Consumer Expectations for Healthcare Social Media http://goo.gl/REXqV

Why all hospitals need Twitter accounts: Google ranking of a URL linked to number of Tweets about that URL http://goo.gl/AYf9t

Interviewee eliminated as a candidate because his Klout score was too low (34), “They hired a guy whose score was 67”. Even if you have no idea what your Klout score is, there’s a chance that it’s already affecting your life. People with formidable Klout will board planes earlier, get free access to VIP airport lounges, stay in better hotel rooms, and receive deep discounts from retail stores. A two-week vacation from social media might causes your Klout score to nose-dive. http://goo.gl/ABu2S

13 Things You Never Knew You Could Do On LinkedIn http://goo.gl/mh4da

100 Ways To Use Twitter In Education, By Degree Of Difficulty http://goo.gl/lAs5v

Pack the Right Gadgets for the Road - NYTimes http://goo.gl/SmQgA

A Review of Living Language and Rocket Languages - App Smart - NYTimes http://goo.gl/kpvJT

10 HTML Tags All New Bloggers Should Learn http://goo.gl/24FpW

Is this the future of Khan Academy? http://goo.gl/xtErX - Bozeman Biology on YouTube http://goo.gl/GUry5

Many consumers worldwide worry that technology is overtaking their lives http://goo.gl/cJj5e

The articles were selected from my Twitter and Google Reader streams.

Comments from Twitter:

Heidi Allen @dreamingspires: Healthcare social media - worth reading - Klout and Google rankings linked to tweets.

Top articles in medicine in April-May 2012

Here are my suggestions for some of the top articles in medicine in April-May 2012:

Always advocate for the patient. When in a bind, ask yourself, “Self, what's best for my patient?” You can only see ONE patient at a time. The patient in front of you is the only patient you have. http://bit.ly/HGJcU8

Adolescence is changing: age of onset of puberty is decreasing, age at which mature social roles are achieved is rising http://goo.gl/dshDG

Pilot sends plane into dive after mistaking Venus for oncoming plane http://bit.ly/INqXjw - "It's happened to most of us", starts CNN... North American-based pilots flying eastbound at night towards Europe are at increased risk of fatigue-related performance issues http://bit.ly/INqXjw

Are we ready to recommend aspirin for cancer prevention? Lancet http://goo.gl/WyRXY and http://goo.gl/oytIK

First described in 1967, Kawasaki disease is now a leading cause of acquired heart disease in developed countries http://goo.gl/ShL00 -- Addition of prednisolone to standard treatment with IVIG improves coronary artery outcomes in severe Kawasaki disease http://j.mp/JdUbTl

Bullying victimisation is associated with a myriad of emotional and behavioural problems throughout adolescence http://goo.gl/VzBrf

Thoughts for new medical students http://goo.gl/cr5k3 - Advice from the BMJ editor in 2003, still mostly relevant.

Consumer Expectations for Healthcare Social Media http://goo.gl/REXqV

Women are much more responsive than men to the weather, and life satisfaction decreases with rain (study) http://goo.gl/gp5KE

Use of Social Media by Western European Hospitals: Longitudinal Study shows that SoMe awareness is growing http://goo.gl/l41tz

Geriatrics update 2012: What parts of our practice to change, what to ‘think about’ - CCJM http://goo.gl/rvH9O

Family history: Still relevant in the genomics era - CCJM http://goo.gl/ty5vG

The articles were selected from my Twitter and Google Reader streams.

How to have a successful blog - with slow, steady growth

Tips from ProBlogger on how to have a successful blog:

- Regular useful content: Daily “how to” posts that solved problems and showed people how to achieve their goals, 90%

- Shareable content: inspirational posts, breaking news, humor, controversy, grand list posts, 5%

- Community: reader discussions, debates, polls, forum, 5%

- Email newsletter: collect people’s email addresses and send them weekly updates/newsletters

Here is a great quote from another blog: "Blogging is teaching, whether it’s yourself or others, and that’s the best feeling in the world" http://goo.gl/hCpF8

References:

2 Different Tales of Blog Growth. ProBlogger.

Memory loss - clinical focus on practical neurology

These are excerpts from a review in the Medical Journal of Australia (MJA):

Older people with mild cognitive impairment are at increased risk of progressing to dementia, but no tests are helpful in assessing this risk. Medications are not beneficial in mild cognitive impairment.

Physical activity and treatment of hypertension decrease the risk of dementia.

In people with Alzheimer’s disease, a cholinesterase inhibitor or memantine (an N-methyl- D-aspartate receptor antagonist) provides symptomatic relief. Medications do not change progression of the illness.

Behavioural and psychological symptoms are common in Alzheimer’s disease.

Atypical antipsychotics reduce agitation and psychosis but increase the risk of cardiovascular events.

Antidepressant role in managing depression with mild cognitive impairment is uncertain but they may increase the risk of delirium and falls.

References:

Memory loss. Leon A Flicker, Andrew H Ford, Christopher D Beer and Osvaldo P Almeida. Med J Aust 2012; 196 (2): 114-117.

Image source: Hippocampus, from Wikipedia, public domain.

Best of Medical Blogs - weekly review, blog carnival

What happened to "Grand Rounds" medblog carnival?

It's sad to see the demise of "Grand Rounds" medblog carnival. The weekly summary of the best medical blog posts has been published since 2004, with only few breaks. There have not been any editions for more than a month, and no new ones are scheduled. A new initiative by Health Care SoMedia Review could replace some of it http://goo.gl/73RpE

This blog post is a part of a project to recreate a weekly review, or blog carnival, of the best medical blog posts. Feel free to send your suggestions to my email at clinicalcases@gmail.com. The “Best of Medical Blogs - weekly review, blog carnival” will be published on Tuesdays, just like the old Grand Rounds. The last organizers of the Grand Rounds blog carnival. @DrVal and @NickGenes, are aware of this project.

How Doctors Manage Their Social Media Profiles

Personal vs. Professional: How Doctors Manage Their Social Media Profiles is a blog post by Matt Wood of the University of Chicago Medicine blog http://goo.gl/JNyu1. Matt has published a series of great blog posts recently about physicians’ use social media. The doctors at University of Chicago are clearly the leaders in social media use in a city with a rich history of great medical centers such as UChicago Medicine, Northwestern, Childrens’ Memorial, Rush, Loyola and Northshore. Matt tries to find out what makes the UChicago doctors more comfortable using social media that their peers at other institutions: http://goo.gl/JNyu1

Consumers use social media to make medical decisions

Consumer Expectations for Healthcare Social Media - this is a succinct summary by Ed Bennett, “a maker of lists” of healtchare oragnizations that use social media http://goo.gl/REXqV

Digital Strategies for Healthcare Organisations - a good overview by the Australian blog IV line http://goo.gl/PZtWl

Doctors’ salaries

Dr. Mandrola quotes an experienced colleague on doctors' salaries: “We are all happy with what we make. What upsets us most is seeing what others make.” Since then, I try not to dwell on what others make. http://goo.gl/WBnJq

Healthcare social media is a “moral obligation” for doctors

Healthcare social media is a 'moral obligation', says Farris Timimi, M.D., medical director for the Mayo Clinic Center for Social Media, quoted by “Fierce Health IT” . Social media needs to be grown and nurtured for patients. "Our patients are there. Our moral obligation is to meet them where they're at and give them the information they need so they can seek recovery," Dr. Timimi said. "You've got to be ready for it. You build it for the patients; not for yourself. "This is not marketing," he added. "This is the right thing to do." http://goo.gl/BHzKf

Social media is no more a moral obligation for doctors than it is to appear on TV and radio shows, and to write newspaper columns. It is great if you have the time and aptitude to do it, but the most important things is to focus on what matters most - providing correct diagnosis and best possible treatment to your patients.

Comments from Twitter:

Westby Fisher, MD @doctorwes: Best of Medical Blogs - weekly review, RIP blog carnival bit.ly/KsBSLJ

Laika (Jacqueline) @laikas: After the demise of THE Grand Rounds @DrVes starts his own weekly blog review bit.ly/Iqgcmx Gr8 initiative; but still miss the OLD GR

WB Medical Education @WBmeded: Hope to check out some of these later, looks interesting RT @DrVes: Best of Medical Blogs: weekly review, blog carnival goo.gl/fb/d870P

Mike Cadogan @sandnsurf: Another great way to control the information overload with the Best of Medical Blogs - weekly review bit.ly/K1stxo