Beyond a hearing aid - Cochlear implants - Mayo Clinic video

From Mayo Clinic YouTube channel: Imagine what life would be like if you lost your hearing. No music, no sounds of nature, no listening to the voices of your loved ones. But some people with profound hearing loss do have options. Cochlear implants, in the right patients, offer the chance to hear again.

New treatment for dry eyes: "LipiFlow" uses heat and pressure to open blocked eyelid oil glands

The Meibomian glands (or tarsal glands) are sebaceous glands at the rim of the eyelids, responsible for the supply of meibum, an oily substance that prevents evaporation of the eye's tear film. They prevent tear spillage onto the cheek, trapping tears between the oiled edge and eyeball, and make the closed lids airtight. There are approximately 50 glands on the upper eyelids and 25 glands on the lower eyelids. The glands are named after Heinrich Meibom (1638–1700), a German physician (source: Wikipedia).

The LipiFlow Thermal Pulsation System uses heat and pressure to open blockages of the eyelid (Meibomian) glands. The treatment was approved by the FDA in 2011. Here is more information: http://lipiflow.com

Here is a Mayo Clinic video about the procedure:

88-year-old George H.W. Bush: "Maybe they’ll come out with a new drug that makes memory come roaring back"

The former president George H.W. Bush wrote a poem for his grandkids:

"So I can add to the report on getting older. 

Who knows, maybe they’ll come out with a new drug that makes legs bend easier,
Joints hurt less, drives go further, memory come roaring back,
And all fears about falling off fishing rocks go away. 

Remember the old song: I’ll be there ready when you are.
Well I’ll be there ready when you are
There’s so much excitement ahead, so many grandkids to watch grow.
If you need me I’m here."

By the way, the 88-year-old former president said he was not done skydiving. His goal: to jump again when he is 90.

Visit msnbc.com for breaking news, world news, and news about the economy

References:

'If you need me I'll be there': George HW Bush moved to tears during interview with granddaughter Jenna about his family and growing old | Daily Mail Online http://goo.gl/noCt0

Surgeon Folds and Throws Paper Airplane Using da Vinci Robot (video)

From Swedish hospital YouTube channel: Dr. James Porter, medical director of robotic surgery at Swedish folds a small paper airplane with the da Vinci robot to demonstrate how this device gives surgeons greater surgical precision and dexterity over existing approaches.



With over 600,000 views, this video undoubtedly brings good publicity to the hospital.

However, the robot costs on average $1.3 million, in addition to several hundred thousand dollars of annual maintenance fees. Surgical procedures performed with the robot take longer than traditional ones. Critics say that hospitals have a hard time recovering the cost and that most clinical data does not support the claim of improved patient outcomes.

The manufacturer Intuitive Surgical has sold more than 1,000 units worldwide.

References:

Prepping Robots to Perform Surgery, The New York Times, 4 May 2008.
Wikipedia

Comments from Twitter:

Meenakshi Budhraja @gastromom: Cool !!

Westby Fisher, MD @doctorwes:  Surgeon Folds and Throws Paper Airplane Using da Vinci Robot (video) bit.ly/KG2EG6 - Manual faster, no?

PDara MD, FACP @JediPD:  da Vinci good for that

Skeptical Scalpel @Skepticscalpel:  Finally a use. Maybe the airplanes could have the hospital's logo on them. Folding a paper airplane. Amazing feat by a surgical robot? I think not. My blog. is.gd/6tBcZp -- Folding a paper airplane. Amazing feat by the surgical robot?  http://goo.gl/cz7lC

Ravi Pamnani @ravrav0: Surgical robots: Folding tiny paper airplanes - CHECK. Actually improving clinical outcomes - TBD. bit.ly/LEp3jg  #medtech

Jenaro Fdez-Valencia @JenaroFV_MD: after all ... it doesn't fly! If he did a boat instead, it would work. Can he try?

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.

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.

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

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]

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

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.

Mayo Clinic Offers Dietary Supplements, Stress Management, Massage and Acupuncture in the Mall of America

Cleveland Clinic has a Wellness Institute. In another push to the realm of wellness, Mayo Clinic now offers one-on-one consults with Complementary and Integrative Medicine physicians on campus and where the customers are - right in the Mall of the America. See this 3-part video series below:



Brent A. Bauer, M.D. Dr. Bauer is a physician in the Department of General Internal Medicine and supervisor of the Complementary and Integrative Medicine Research program at Mayo Clinic.



Nancy Drackley, a physical therapist, massage therapist, and supervisor of massage therapy at Mayo Clinic.



Tony Chon, M.D, a physician in the Department of General Internal Medicine and a member of the Complementary and Integrative Medicine team at Mayo Clinic, discusses acupuncture.

"You take what you need and you leave the rest, But they should never have taken the very best"

"You take what you need and you leave the rest, But they should never have taken the very best" is a refrain from The Night They Drove Old Dixie Down, one of the best known songs of The Band.



Levon Helm, the revered drummer and singer of group the Band who kept the band's heart for more than three decades, died "peacefully" on April 19.

From CNN:

Born in Elaine, Arkansas, in 1940, the son of a cotton farmer, Helm rose to fame in the late 1960s and 1970s as a member of The Band, a folk rock group.

His soulful, drawling vocals highlighted many of the group's hit recordings, such as "The Weight," "The Night They Drove Old Dixie Down," and "Up on Cripple Creek."

Helm, 71, was diagnosed with throat cancer in 1998. He fell on hard times as cancer took his voice and medical bills threatened his house.

"You got to pick one -- pay your medical bills or pay the mortgage. Most people can't do both, and I'm not different," he told CNN in 2010.

So The Barn, as the residence is known around Helm's adopted hometown of Woodstock, New York, became the setting for what he called a "last celebration." Not quite. Instead, The Barn became the center of an unlikely and unrivaled rock 'n' roll revival.

It was there that Helm regularly hosted the Midnight Ramble, weekly concerts that attracted sell-out crowds and all-star support. The result not only paid the bills but also led to a creative resurgence for Helm, with his collaborations producing back-to-back Grammy-winning albums: 2007's "Dirt Farmer" and 2009's "Electric Dirt."

"If I had my way about it, we'd probably do it every night," Helm said. "I never get tired of it."

From Wikipedia:

Helm remained with "The Band" until their 1976 farewell performance, The Last Waltz, which was recorded in a documentary film by director Martin Scorsese (an excerpt is embedded above). Many music enthusiasts know Helm through his appearance in the concert film, a performance remarkable for the fact that Helm's vocal tracks appear substantially as he sang them during a grueling concert.

In the late 1990s, Helm was diagnosed with throat cancer suffering hoarseness. Advised to undergo a laryngectomy, Helm instead underwent an arduous regimen of radiation treatments at Memorial Sloan–Kettering Cancer Center in New York City. Although the tumor was then successfully removed, Helm's vocal cords were damaged, and his clear, powerful tenor voice was replaced by a quiet rasp. Initially Helm only played drums and relied on guest vocalists at the Rambles, but Helm's singing voice grew stronger. On January 10, 2004, he sang again of his Ramble Sessions. In 2007, during production of Dirt Farmer, Helm estimated that his singing voice was 80% recovered.

The Midnight Ramble was an outgrowth of an idea Helm explained to Martin Scorsese in The Last Waltz. Earlier in the 20th century, Helm explained, traveling medicine shows and music shows such as F.S. Walcott Rabbit's Foot Minstrels, featuring African-American blues singers and dancers, would put on titillating performances in rural areas. This was also turned into a song by the Band, "The W.S. Walcott Medicine Show," with the name altered so the lyric was easier to sing.

"After the finale, they'd have the midnight ramble," Helm told Scorsese. With young children off the premises, the show resumed: "The songs would get a little bit juicier. The jokes would get a little funnier and the prettiest dancer would really get down and shake it a few times. A lot of the rock and roll duck walks and moves came from that."

Helm has refused to play The Night They Drove Old Dixie Down since 1976 even though he continued to hold "Midnight Rambles" concerts several times a month at his private residence in Woodstock, New York.



References:

Fans remember Levon Helm as he faces final stages of cancer. CNN.
Levon Helm, co-founder of The Band, dead at 71. CNN.
Levon Helm, icon of Americana music, 'in the final stages of cancer'. Guardian.
Fauquier ENT Blog: Levon Helm, Singer/Drummer for The Band, Dies of Throat Cancer  http://goo.gl/tDgxL
Levon Helm. Wikipedia.

Understanding Healthcare Power of Attorney - Cleveland Clinic video

This is very important: Advance directives are legal documents that provide instructions about who should oversee your medical treatment and what your end-of-life wishes are, in case you are unable to speak for yourself.

Advance directives include:

- Health Care Power of Attorney
- Living Will



Everyone over the age of 18 should consider assigning Health Care Power of Attorney to someone.

Battling depression with "battery-powered brains" - CNN report on deep brain stimulation (DBS)

CNN reports on treating severe depression with electrodes inside the brain:



The procedure -- called deep brain stimulation, or DBS -- targets a small brain structure known as Area 25, the "ringleader" for the brain circuits that control our moods.

Area 25 is relatively overactive in depressed patients. One hypothesis is that in patients who do not improve with treatments for depression, Area 25 is somehow stuck in overdrive.

DBS had been used since 1997 as a treatment for movement disorders, including essential tremor, Parkinson's disease and dystonia.

References:

Treating depression with electrodes inside the brain. CNN, 2012.

iPad App for Education of Heart Patients After Surgery - Mayo Clinic Video

From Mayo Clinic YouTube channel: "Being in the hospital after major surgery is no fun. On top of dealing with pain, patients have uncertainty. They also have to worry about getting all the information they need to support their recovery. That's not always easy in the hospital; things happen quickly and doctors and hospital staff are often really busy. Doctors at Mayo Clinic may have a solution to this issue. They're giving iPads to heart surgery patients to see if a new iPad app can make hospital stays easier and more satisfying."



Our research presented during the 2011 ACAAI meeting showed that 95% patients thought the iPad was helpful for coming to understanding of their condition:

PATIENT PERCEPTION OF A POINT-OF-CARE TABLET COMPUTER (IPAD™) BEING USED FOR PATIENT EDUCATION - P318

A. Nickels*, V. Dimov, V. Press, R.Wolf, Chicago, IL.

Background:

During the fall of 2010, the Internal Medicine/Pediatrics program at University of Chicago introduced Point-of-Care Tablet Computers (iPad™) for clinical use. iPads™ are intended to improve access to EMR, work flow, resident and patient education, and access to electronic clinical tools. The graphic display and ease of interface makes the iPad™ a potentially powerful tool to achieve these goals. This pilot study is designed to gauge the initial patient perception of the iPad™ when used for patient education.

Methods:

8 questions, physician administered, patient survey of Allergy Immunology patients or their parents. Preloaded iPads™ with education materials (“mind map” diagrams, clinical pictures) into the photo software were used to clinically education the patients. Simple percentages and Fisher’s exact non-parametric test were used for statistical analysis. Results: 20 patients surveyed (11 resident/9 attending). For those survey items without 100% agreement, there was no statistically significant difference in responses based on level of training (p≥0.45). 100% [0.861, 1] of participants liked the iPad™ being used to help explain their children’s condition, 95% [0.783, 0.997] of participants did not find it distracting. 100% [0.8601, 1] found it helpful. 100% [0.861, 1] would like it to be used again to help explain medical information. 95% [0.784, 0.9974386] thought the iPad™ was helpful for coming to understanding of their condition. Limitations of this study include a convenient sample, physician-administered survey, and observer bias.

Conclusion:

Patient perception was very positive toward the use of a Point-of-Care Tablet Computer (iPad™) in a clinical setting. While limited to only two operators, level of training did not have an effect on patient perception. Confirmation of the results may be required before wider implementation.

Source:  Patient Perception of a Point-of-Care Tablet Computer (iPad) Being Used for Patient Education. A. Nickels, V. Dimov, V. Press, R. Wolf. American College of Allergy, Asthma & Immunology (ACAAI) 2011 Annual Meeting.

http://www.annallergy.org/supplements

Virtual dissection table, stretcher-sized multi-touch screen, a powerful tool for training medical students

Onstage at TED2012, Jack Choi demonstrates a powerful tool for training medical students: a stretcher-sized multi-touch screen of the human body that lets you explore, dissect and understand the body's parts and systems.

Jack is the CEO of Anatomage, a company specializing in 3D medical technology. See the TED video embedded below:



Comments from Twitter:

Mike Cadogan @sandnsurf: NEED! ...Virtual dissection table, stretcher-sized multi-touch screen bit.ly/IIeko3

Handwritten Video Tutorials in Medicine

Please note: The information in the following videos has not been verified by me. The purpose of this post is just to present the idea of this approach to medical education, not to recommend the content of the videos.

Here is the third video tutorial on electrocardiogram (ECG): ECG 3 - Segments, Intervals & Diseases:



Here is what the completed PDF looks like at the end of the drawing:

http://www.handwrittentutorials.com/pdf/pdf_69.pdf

Topics of the videos

Anatomy
Endocrinology
Immunology
Mathematics
Neuroscience
Pharmacology
Physiology

References

Handwritten Video Tutorials in Medicine http://goo.gl/ZxFhb and http://goo.gl/R8xse

Mosquito biting activity increases 500 times during a full moon phase, and they prefer blondes with smelly feet

Mosquitoes appear to prefer blonde people with smelly feet. Did you see the moon last night? Got mosquito spray? Mosquito biting activity increases 500 times during a full moon phase! There are more striking facts in this video excerpt from National Geographic.

The video is part of the Amazing Animals YouTube playlist by National Geographic:



Medical Geek Humor on Twitter

The tweets below are part of the series Medical Geek Humor on Twitter - they recall a TED moment from 2009:

@loic Bill Gates released mosquitoes at #TED we're all leaving the room and getting sick about 4 hours ago from web


@stevewhitaker Don't worry about the buggy mosquitos Gates released at #ted. Microsoft's working on a patch that's due out next year. about 14 hours ago from twitterrific
AllergyNotes Releasing mosquitoes by Bill Gates into a startled crowd at TED described as "an amazing TED moment" http://is.gd/iu0o about 12 hours ago from web

AllergyNotes Gates spreads malaria message with mosquitoes http://tinyurl.com/cxwo2e 12 minutes ago from TweetDeck

pyknosis Nice to hear Bill Gates picked up a hobby during his retirement: entomology. http://is.gd/izJn (Not surprised he likes the blood-suckers.) 14 minutes ago from web

pyknosis Don't get me wrong. Not saying B Gates is a bad person. He's not. He just created and championed software that can suck the life out of you. 12 minutes ago from web
pyknosis BTW, now that I understand the context, I think this is a winner of a tweet: http://is.gd/izK5 11 minutes ago from web: "If Steve Jobs had released mosquitoes, everyone would be wanting one."

If you are included in this post but would like to have your tweet removed for any reason, please email me and will comply with your request the same day.



Comments from Twitter:

Vijay @scanman: Mosquitoes are mini-vampires

Tariq @ucisee: Mosquito biting activity increases 500 times during a full moon phase - "appear to pref blonde with smelly feet."

Kathy Mackey @mkmackey: Ha! No one likes full moon!

"Lifestyle 180": Cleveland Clinic 1-year program promises to reverse chronic disease through lifestyle modification

During the past 5 years, the Cleveland Clinic has moved aggressively to expand from illness management to wellness management. They even have a Wellness Institute. One example of its programs is Lifestyle 180 (R) which is "designed to reverse" the effects of chronic disease through lifestyle modification.

Here is a 5-minute video about the program from the Clinic YouTube channel:



The program focuses on nutrition, exercise, and stress management. The yearlong program is available at the Cleveland Clinic Wellness Institute campus located in Lyndhurst, Ohio.

References:

Lifestyle medicine

Interactive wellness guide by Cleveland Clinic

Lifestyle 180 (PDF)

Disclaimer: I was on faculty at Cleveland Clinic and Case Western Reserve University as Assistant Professor of Medicine until 2008.

Comments from Twitter:

Meenakshi Budhraja @gastromom: Like>>

Linda Pourmassina,MD @LindaP_MD: "the $3,000 fee for this program represents a fraction of the increasingly high co-pays for doctor visits and medications."

What are Yips? (Mayo Clinic video)

Yips are involuntary wrist spasms that occur most commonly when golfers are trying to putt. However, the yips can also affect people who play other sports - such as cricket, darts and baseball.

It was once thought that the yips were always associated with performance anxiety. However, it now appears that some people have yips that are caused by a focal dystonia, which is a neurological dysfunction affecting specific muscles.



Charles H. Adler, M.D., neurologist at Mayo Clinic in Arizona, discusses study findings related to the yips, a condition affecting a significant number of already anxious golfers during putting or chipping.

References:

Yips. Mayo Clinic.