Let's Make Our Day Harder - By Walking, Taking the Stairs, Parking Further Away, etc. (video)

From DocMikeEvans:

A review of some of the science around how our typical days have shifted with technology and culture and the impact on our health. It is also a call to action about how to "Tweak your Week" and make small changes to improve your health.

Don't forget to check the rest of the videos from DocMikeEvans' YouTube channel.

Marfan syndrome - Mayo Clinic video summary

In this video Juan Bowen, M.D., director of Mayo Clinic Marfan Clinic, discusses causes of Marfan syndrome and the importance of diagnosis and treatment:

Small Steps to a Healthy You: 5-2-1-0

Small steps can help you be healthy. 5-2-1-0 helps you remember to eat healthy, limit screen time, get physical activity and exercise, and avoid sugary drinks. This Mayo Clinic video is intended for children but applies to anyone.



Share the healthy habits of “5 2 1 0” everyday:

5 – fruits and veggies
2 – hours or less of recreational screen time*
1 – hour or more of physical activity
0 – sugary drinks, more water and low-fat milk

* Keep TV/computer out of bedroom. No screen time under the age of 2

Source: http://www.letsgo.org

Pulmonary Rehabilitation with a Harmonica (video)

From Mayo Clinic YouTube channel: Two-time lung transplant recipient shares the power of music in his harmonica class with a Heart and Lung Transplant Support Group. He teaches his peers how music can both mentally and physically impact a patient's healing process.

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. Please email your suggestions for inclusion to clinicalcases@gmail.com. Best of Medical Blogs (BMB) is published every Tuesday, just like the old Grand Rounds.

The reversal of recommendation on perioperative beta blockade: 27% increase in mortality instead of decrease

From Notes from Dr. RW: Guideline writers began narrowing their recommendations for perioperative beta blockade back in 2009, since which time the only remaining class I recommendation regarding perioperative beta blockers is that they be continued perioperatively for those patients already taking them for a class I indication. Initiation in various high risk situations has since 2009 carried a IIa recommendation. The class I indication will likely stay. The IIa ones will likely go away in view of the new meta-analysis. http://buff.ly/19ARaPS

Why scientists should be on social media

From Medical Museion: Social media among scientists is quickly growing and will eventually become more and more natural for scientists to use (if not sooner than as the younger generation whom have grown up with social media enter the research arena). But until then there is a need to train on researchers and scholars on the potential of social media in academic work. Both to address the many misconception and skepticism but also to avoid researchers use it inefficiently or inappropriately. http://buff.ly/13FQfW5

The difficult dilemma of trying to do the “right thing” for patients, while recognizing that the “right thing” may not be covered by the payer or insurer.

Cardiologist and electrophysiologist Dr. Wes brings the issue to life: http://buff.ly/13viOKA

What an ER doctor and CIO does in his free time
Building Unity Farm http://buff.ly/18VjoFx

Top medicine articles for June-July 2013

Here are my suggestions for some of the top articles in medicine for June-July 2013:

Does Cigarette Smoking Make You Ugly and Old? Am. J. Epidemiol. Association of smoking and facial wrinkling may convince young persons not to begin smoking & older smokers to quit http://buff.ly/16g6NJe

"I COUGH" mnemonic: Reducing Postoperative Pulmonary Complications http://buff.ly/1e7ln6J

Perioperative beta blockers linked to lower 30-day mortality in patients with 2 or more Revised Cardiac Risk Index http://buff.ly/14PlJQq

"Trimethylamine-N-oxide (TMAO) is the new enemy within. We make it in our bowels" http://buff.ly/ZiM7KA

An Exercise Plan for Middle Age: walking is, physiologically and logistically, the simplest exercise. Or just do push-ups and squats in your living room. Start with one push-up, if that’s all that you can do, and progress to 15 or 20. http://buff.ly/10Ro3Fd

Adenotonsillectomy for Childhood Sleep Apnea does not improve attention or executive function. However, as compared with the watchful-waiting group, the early-adenotonsillectomy group had significant improvement on polysomnographic, behavioral, symptomatic, and quality-of-life measures. However, 46% of the patients in the watchful-waiting group had a normalization of polysomnographic findings after 7 months - NEJM http://buff.ly/167Vndb and http://bit.ly/14xa1WZ

Short Stature - NEJM blog http://bit.ly/XoQ8Sj

Psychiatrist:“It’s not ‘doing nothing. It’s ‘doing no-thing" http://buff.ly/14A9WD3 -- Don't Do Something; Just Sit There - NYTimes.

Dog ownership is associated with decreased cardiovascular risk (AHA Scientific Statement) http://buff.ly/11zNHaZ

Don’t Take Your Vitamins - NYTimes: Supplemental vitamins A, C, E and beta carotene, taken to prevent cancers, actually increased mortality. What explains the connection between supplemental vitamins and increased rates of cancer and mortality? Antioxidants. Free radicals aren’t as evil as advertised. People need them to kill bacteria and eliminate new cancer cells http://buff.ly/11zO7OF

How to interpret surveys in medical research: A practical approach from the Cleveland Clinic Journal of Medicine http://buff.ly/13CGs7g

Electronic siloing: An unintended consequence of the electronic health record http://buff.ly/167i7Fh -- "We asked for the EHR to look like paper, and we got it, and that has truly affected the way we practice & interact" http://buff.ly/13CHf87 -- Physician and EMR: "Some patients offer to type in their information for me—a bonding experience I could do without" http://buff.ly/13CHq3g

Paget disease of bone: Diagnosis and drug therapy - free review from CCJM 2013 http://buff.ly/167idwF

Practical management of bleeding due to the anticoagulants dabigatran, rivaroxaban, and apixaban - free review, CCJM http://buff.ly/167iUpO

A Decade of Reversal: An Analysis of 146 Contradicted Medical Practices http://bit.ly/163NNf6 -- Blog comment: Every 10 years scientific evidence causes a reversal of established medical practice in 40% of reported studies http://buff.ly/16g6VIU

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

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. Please email your suggestions for inclusion to clinicalcases@gmail.com. Best of Medical Blogs (BMB) is published every Tuesday, just like the old Grand Rounds.

Every 10 years scientific evidence causes a reversal of established medical practice in 40% of reported studies http://buff.ly/16g6VIU

Doctors and the Means of Production | The Health Care Blog http://buff.ly/18XRCTa

Maybe we should build upon the model of doctor-ownership and turn over public hospitals to their workers. All of them. Let the nurses buy in. And the food handlers. And the “environmental services” folks (i.e. custodial crews). Let’s really let the workers own the means of production. Then we can see where incentives get us.

Dr. Wes: Our first quarter's pay this year compared to last year was recently disclosed and the results were striking http://buff.ly/15pALMW

Dr. Wes’ HRS2013 Pre-meeting Reflections: How I can spend the time upbeat knowing that the relative value of the work that heart rhythm specialists do was cut at least 30% on 1 January 2013, thanks to new billing codes that bundled multiple codes into one? Can I afford to be here?

I do not say this lightly. Our first quarter's pay this year compared to last year was recently disclosed and the results were striking. Guys like me who have devoted years to our training, stood at bedsides for countless hours, and endured training that finally ended at age 36 (counting a brief two-year hiatus for a general medical officer stint as an ER physician for the US Navy), got a whopping 30% cut from CMS for the much of the procedure work we do, stealthy cloaked in codes.

"It's not about the nail" - by the Irish rhematologist Dr. Ronan Kavanagh: http://buff.ly/124UZYu

Video by Jason Headley:



Texting at Night: Teens, Smartphones, and Sleep http://bit.ly/XoR2Os

1. Observe your teen’s sleep habits.
2. Take the texting device at night.
3. It is critical for us, as parents, to demonstrate the priority of sleep.