Put down your phone - "Disconnect to connect" (video)

Here is a widely shared commercial from Thailand that is a part of a series of related videos on YouTube http://buff.ly/T8EoO8:

Top medicine articles for December 2012

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

Unlock the value of medical case reports: Search 17,507 cases from 167 journals http://buff.ly/RVN3qb

Routine Antibiotics Before Dental Procedures Not Recommended for Those with Implants (new ortho guidelines) http://buff.ly/UZBJ93

Stand-Up Desks (and recumbent bikes) Gaining Favor in the Workplace http://buff.ly/VdpYdY

Adderall, a Drug of Increased Focus for N.F.L. Players http://buff.ly/VdqecV

A color-coded map of the world’s most and least emotional countries http://bit.ly/Ytxx6B

Is There a Relationship Between Chronic Periodontitis and Erectile Dysfunction? http://buff.ly/YNgYCH

Internal Medicine Residents Are Reluctant to Pursue Primary Care Careers - JAMA http://buff.ly/Vjm6YV

Life expectancy rises as fine particle air pollution drops http://buff.ly/YNhsZD

Within 2 years of retiring, 3 out of 4 NFL players will be one or more of the following: alcohol or drug addicted; divorced; financially distressed/bankrupt. Suicide rate for men who have played in the N.F.L. is nearly 6 times the national average. http://buff.ly/YNhDUH

Not only are men more likely to be diagnosed with cancer, they have a higher chance of dying from the disease http://buff.ly/VpbDuU

As doctors grow older, hospitals begin requiring them to prove they’re still fit - Wa Post http://buff.ly/S3uobS

50% of UK's white population, up to 90% of black and Asian population may have vitamin D deficiency - BBC http://buff.ly/ZnMck0

Only 10% of a person's recommended daily vitamind D amount is found naturally in food. Eating more fish and getting out in the sun a bit more won't make much of a difference to your vitamin D levels - BBC http://buff.ly/12oF71C

Cleveland Clinic Diagnoses Health-Care Act - WSJ http://buff.ly/Ucs8hQ

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.

"We had a very simple idea, that's to see the warmth"

This ad was created for a Belgian natural gas company. The purpose was to show the TV audience what "warm looks like", says director Olivier Babinet.

"The idea of the film is simple. How to visualize the warmth of natural gas? By the use of the stop motion technic, we see how warmth spreads through the house as knitted wool."

Here is how they did it, carefully attaching yards of yarn to walls, radiators, and pipes, 40 people working 4 days and nights:



References:

It's December. Brrrr. Is My House Shivering? Krulwich Wonders. NPR http://n.pr/Y97YmJ
A house that knits itself | Colossal http://bit.ly/Y98xNl

Top medicine articles for December 2012

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

50- 75% of human pathogens, including the modern day scourges malaria and HIV, are zoonotic in origin http://buff.ly/VbEQJO -- Prediction and prevention of the next pandemic zoonosis http://buff.ly/YzMIek -- More than 60% of human infectious diseases are caused by pathogens shared with wild or domestic animals http://buff.ly/YzMOmn -- A journey of zoonotic discovery http://buff.ly/YzMZxX

Ticks and Turkey - Crimean-Congo haemorrhagic fever (CCHF) http://buff.ly/YzN5pe

New treatment for head lice effective with one dose and no combing (ivermectin) http://buff.ly/SMb8hG -- Topical 0.5% Ivermectin Lotion for Treatment of Head Lice — NEJM http://buff.ly/SMdOvE -- Topical Ivermectin Lotion for Head Lice - NEJM blog http://buff.ly/SL40PS

Hunting Down Huntingtin - first disease with gene mapped to a chromosome, and yet 30 yrs later, treatments don't exist http://buff.ly/SMdZHb

The Most Important Article in NEJM History - “Insensibility during Surgical Operations Produced by Inhalation” http://buff.ly/SMewcj

Sugary drinks linked to higher stroke risk in women - 83% higher risk, according to Reuters http://buff.ly/SPWAO6

Retail clinics may cut into primary care - convenient, but may take a bite out of the traditional Dr-Pt relationship http://buff.ly/SRSrqr

Eating in restaurants tied to higher calorie intake | Reuters http://buff.ly/SPX3zH

Multivitamin Use Does Not Reduce Cardiovascular Risk in Men http://buff.ly/SPX6vm

Patients beginning diabetes treatment with sulfonylureas carry 20% greater risk for cardiovascular events vs. metformin http://buff.ly/SRT3fC

With the new PCSK9 inhibitors and statin, "you can get virtually everyone to the cholesterol goal” - NYTimes http://buff.ly/SSB6NO

Dealing With Doctors Who Accept Only Cash - NYTimes http://buff.ly/UYEZQv

Where a baby might be luckiest to be born in 2013? After crunching numbers, Switzerland is comfortably in the top spot http://buff.ly/V0Yat8

Natural family planning - effectiveness of typical use is 76%, according to AFP http://buff.ly/V9mtoS

Diagnosis and management of gonococcal infections - 2012 AFP update http://buff.ly/YvJUyW

Diagnosis of deep venous thrombosis and pulmonary embolism - 2012 AFP update http://buff.ly/V9mzN3

Antibiotic use in acute upper respiratory tract infections. http://buff.ly/YvKixg

'Chemo Brain' Real, Not Just Patient’s Imagination (study) http://buff.ly/V9n6P5

US children (8 months to 8 years) are exposed to nearly 4 hours of background television on a typical day http://buff.ly/V9oxx8

Doctors describe growing pressure to meet the financial goals of their new hospital employers by performing unnecessary tests and procedures. Today, 39% of doctors nationwide are independent, down from 57% in 2000 http://buff.ly/YBjbRy

Role of the QuantiFERON-TB Gold In-Tube assay in screening new immigrants for tuberculosis infection http://buff.ly/VcF0Rc

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.

A Best Friend Will Always Wait for You

Julian Burrett: "Watson the dog stands by while the boy does a quick assessment of the puddle situation. Could this be the cutest video ever? FAQs: Watson is a 12 year old Shar Pei." http://buff.ly/X2Jpr9

Long Live Rock 'n' Roll? Study Shows Risk to Stars (video)

A new study from the United Kingdom (BMJ) reveals just how risky rock-and-roll can be - WSJ:



The WSJ summarized the findings of the study published in BMJ:

The research examined 1,489 stars of pop, rock, hip-hop and punk, of whom 137, or 9.2%, died during the five-decade period covered by the study. Nearly 39% of those deaths were caused by factors related to violence or alcohol and drug intake.

North American pop stars were 87.6% as likely to be alive as normal people of the same age and ethnicity—the lowest survival rate of any group identified in the study.

In North America, 23% of solo performers died, versus 10% of band-only stars, the study found. The comparable figures for Europe were 10% versus 5%.

The study doesn't address a widely held belief that drummers are more prone to early death than other musicians.

References:

Long Live Rock 'n' Roll? Study Shows Risk to Stars - WSJ.com http://on.wsj.com/V8O79a

Credit Card Germs: 1 of 10 of cards has fecal bacteria

Here is what a Cleveland Clinic ID specialist has to say: "You know all that money you're spending over the holidays? It's jam-packed with germs. So keep your hands clean and your credit cards wiped down. Avoid touching your eyes and mouth when out shopping."



What are the 8 germiest places in the mall?

The 8 germiest places in the mall, according to CNN, are:

1. Restroom sinks
2. Food court tables
3. Escalator handrails
4. ATM keypads
5. Toy stores
6. Fitting rooms
7. Gadget shops
8. Makeup samples

The filthiest area in a restroom (and therefore in the whole mall) isn't the toilet handle or the doorknob - it's the sink. The sink area is a moist environment, so bacteria can survive longer there.

Researchers found food, E. coli, urine, mucus, feces, and blood on escalator handrails. Where there is mucus, you may also find cold and flu viruses.

Each key on an ATM contains, on average, 1,200 germs. Protect yourself: "Knuckle" ATM buttons.

References:

The 8 germiest places in the mall. CNN.
12 Germiest Places in America According to Health Magazine
Dirty Money and Credit Card Germs - Health Hub from Cleveland Clinic http://bit.ly/TRLSoQ

Top medicine articles for December 2012

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

How doctors on social media are changing the face of medicine - Twitter takes the debate worldwide http://buff.ly/PSRmBv

"The Family Doctor, Minus the M.D." - NYTimes keeps pushing the idea of "The Nurse as Family Doctor" http://buff.ly/R1rbn9

Air travel and chronic obstructive pulmonary disease: a new algorithm for pre-flight evaluation http://buff.ly/RMN37n

Long-term natural history of chronic obstructive pulmonary disease (COPD) http://buff.ly/RMNa2C

Among patients with CAD, CHF or HTN, continuing selective beta blockers during COPD hospitalisation appears to be safe http://buff.ly/RMOJO5

Hepatitis—Do you “C” it? Many infected adults do not know they have HCV http://bit.ly/URgBFx

Do Mentors Know Who They Are Mentoring? Columbia University Medical Center reviews the evidence http://bit.ly/URgVUC

Discovery of “vitamin” D began with childhood rickets. Nonskeletal effects of this hormone are now recognized http://bit.ly/URhdLk

The prevalence of eating breakfast daily was low in boys (47%) and girls (45%). Skipping meals, mainly breakfast, is associated with worse glucose and lipid levels in obese children and adolescents. http://bit.ly/URhGgF

Prevalence of erectile dysfunction in U.S. is 34%, 47% in Middle East. Risk factors: diabetes mellitus, HTN, CAD, obesity, stress, depression http://bit.ly/URjVAC

Phosphodiesterase Inhibitors use for ED in U.S.: 16% of men buy PDEi over the Internet (68% without prescription) http://bit.ly/URkvON

The Cost of Living Longer: The average rent at assisted-living facilities in U.S. is now $3,486 per month. The price of a private room at a nursing home is now $248 a day http://on.wsj.com/VSQ3Fs

Certain phrases in Latin carry both historic and modern significance. Top 10 Latin phrases for hospitalists: http://buff.ly/S2dCpa

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.

Physician Communication PEARLS from Cleveland Clinic

The video features my former colleagues and hospital medicine stars Drs. Moises Auron and Vj Velez:



Some key messages:

- Establish rapport and plan an encounter with the patient

- Elicit the patient perspective using FIFE (function, ideas, fears and
expectations)

- Apply PEARLS (partnership, empathy, acknowledgment, respect,
legitimation and support) to convey empathy

- Incorporate the patient into decision making and education using ART
(ask, respond, tell)

References:

Relationship-Centered Communication for Physicians (PDF) from Cleveland Clinic Academy

The #FOAMed revolution (Free Open Access Medical education)

From Mike Cadogan:

"The net effect of #FOAM has taken me quite by surprise (editor's note: #FOAMed is Free Open Access Medical education). Despite a complete lack of evidence, peer review, mission statements OR Big Pharma backing – the FOAMed revolution continues to infiltrate the psyche of the everyday healthcare professional. The ability to intelligently review, discuss and develop hypotheses, guidelines and issues; the sense of community; the sense of rebellious augmented learning and the joy of independence is rife…and contagious.

There are now an amazing 180 emergency medicine and critical care blogs. Bloggers write from 21 different countries. GMEP – ‘the Facebook of Medicine’ has just welcomed it’s 800th new member, 2 weeks after launch." http://buff.ly/12lzWzs

Here is my comment: Congratulations, Mike! These are amazing stats that illustrate an inspiring success! "Facebook of medicine", indeed. Let's keep it growing.

Solving the puzzle of the periodic table - TED Education video

Solving the puzzle of the periodic table - TED Education video. View the full lesson here: http://ed.ted.com/lessons/solving-the-puzzle-of-the-periodic-table-eric-rosado

New additions to Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

From TIME:

Doctors use the the Diagnostic and Statistical Manual of Mental Disorders (DSM)'s definitions to diagnose more 300 other conditions. Insurance companies use it to justify reimbursements; without a DSM code, mental-health patients and doctors usually don't get paid. DSM-5 is already so famous that it has its own website: http://dsm5.org

On Dec. 1, the American Psychiatric Association approved the fifth edition of the DSM which took 13 years and 1,500 mental-health experts to complete. They tried to approach mental disorders less as discrete illnesses, like leukemia, and more as problems on a continuum, like hypertension.

Here are a few of the new additions in DSM-5:

- Hoarding is included as a diagnosis, meaning those who can't get rid of ephemera can now seek reimbursement for therapy

- Binge eating was in the appendix for more than a decade, but now it's an official diagnosis

- Bereavement. The previous DSM said those in mourning don't necessarily qualify for depression therapy or medication. DSM-5 eliminates that exclusion.

- Excoriation, or skin picking, should be considered a mental illness according to DSM-5

References:

Redefining Mental Illness. TIME, 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. 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.

Is robotic surgery the “laser” of the 21st century? http://buff.ly/Vpbt6W

A Low-tech Solution to Keep Immunosuppressed Patients Safe: a green ball http://buff.ly/VjcoFM

Cardiologist: Physicians Beware on the Twittersphere: "I was left at a conversational disadvantage because of the loss of context that is inherent to 140-character interactions on Twitter. This is a complex issue, and surely not suitable for Twitter. Engaging on this medium on this topic was a mistake. I learned from it." http://buff.ly/YWDE3x

Best article first-author, maybe ever: Taco Monster http://buff.ly/YMVUfq

Celebrity Actors Who Have Received a Tracheostomy (Catherine Zeta Jones Included) | Fauquier ENT Blog http://buff.ly/YNhXmo

Productivity tips: TalkTyper and more http://buff.ly/VjmdUc

Epocrates finally fights back - a review of their iPad app http://buff.ly/Rz9AZs

Here is my PhD thesis, by Dr. Bertalan Meskó: “Two weeks ago, my childhood dream became true and I finished PhD therefore becoming a medical geneticist.” http://buff.ly/YWAmx7

If you’re going to purchase a medical ebook, go through the Kindle app (more flexibility and less buyers remorse) http://buff.ly/S01xFq

Chronic Disease and Social Networks http://buff.ly/REhcKp

There are patients with "gluten sensitivity" in whom neither allergic nor autoimmune mechanisms can be identified

There are 3 main forms of gluten reactions:

- allergic (wheat allergy)
- autoimmune (celiac disease, dermatitis herpetiformis and gluten ataxia)
- possibly immune-mediated (gluten sensitivity)

From BMJ:

It is now becoming clear that, besides those with celiac disease or wheat allergy, there are patients with gluten sensitivity in whom neither allergic nor autoimmune mechanisms can be identified. It has been estimated that, for every person with celiac disease, there should be at least six or seven people with non-celiac gluten sensitivity. Gluten sensitivity may therefore affect 6-10% of the general population.

Patients with gluten sensitivity have negative immuno-allergy tests to wheat and negative celiac disease serology; normal endoscopy and biopsy; clinical symptoms that can overlap with those of celiac disease, irritable bowel syndrome, and wheat allergy; and they show a resolution of symptoms when started on a gluten-free diet.

Currently there are no laboratory biomarkers specific for gluten sensitivity, and the diagnosis is based on exclusion criteria; elimination of gluten-containing foods from the diet followed by an open challenge is most often used to establish whether health improves with the elimination or reduction of gluten from the patient’s diet.

New nomenclature and classifications are proposed (see the figures below).



"Fibromyalgia of the gut"

Some physician have labeled "gluten sensitivity" "fibromyalgia of the gut" to reflect the presence of symptoms in the absence of pathological findings. The BMJ editor-in-chief reflected on these doubts in an editorial: Gluten sensitivity: real or not?.

Since there are no biomarkers, gluten sensitivity is the ultimate diagnosis of exclusion. The worldwide shift to the Mediterranean diet may explain the rising prevalence of gluten sensitivity. The has been an “explosion of requests” for serological testing for celiac disease since 2007.

3 million Americans are living with celiac disease

Celiac disease, an immune system reaction to gluten in the diet, is four times as common today as it was 50 years ago. Lack of awareness of celiac could be contributing to a delay of up to 11 years in diagnosis of adults in North America (http://goo.gl/sy778).

This is an informative and beautifully designed video by the University of Chicago Celiac Disease Center. It looks like an infographic made into video - have a look:



New classification is being proposed for gluten-related disorders: celiac disease; dermatitis herpetiformis; gluten ataxia; wheat allergy; gluten sensitivity. WSJ, 2012.

Recent studies support the existence of the new condition nonceliac gluten sensitivity which is defined as symptoms with negative celiac antibodies and biopsy (http://goo.gl/57IlB).

References:

Non-coeliac gluten sensitivity | BMJ, 2012.

Gluten sensitivity: real or not? | BMJ http://buff.ly/ZgKgK1

Does gluten sensitivity in the absence of coeliac disease exist? | BMJ http://buff.ly/RvC7zg

New nomenclature and classification of gluten-related disorders - http://www.biomedcentral.com/1741-7015/10/13/figure/F1

Algorithm for the differential diagnosis of gluten-related disorders, including celiac disease, gluten sensitivity and wheat allergy - http://www.biomedcentral.com/1741-7015/10/13/figure/F4

Spectrum of gluten-related disorders: consensus on new nomenclature and classification. Anna Sapone et al. BMC Medicine 2012, 10:13 doi:10.1186/1741-7015-10-13.

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

Disclaimer: I am an Assistant Professor of Medicine and Pediatrics at University of Chicago.

Comments from Google Plus:

Neil Mehta: thanks for sharing this. Besides the content itself, Really like this type of articles where a patient can write about medical lessons learned. 


Howard Luks: That's me :-) thanks for sharing this! My GI guy will see it in the AM 

Bell's palsy - NHS video

Bell’s palsy is the abrupt paralysis of the facial nerve (cranial nerve 7, CN7), resulting in an inability to control facial muscles on the affected side. A common condition, Bell’s palsy has an annual incidence of 11-40 cases per 100 ,000 population. Many patients recover without intervention; however, up to 30% have poor recovery of facial muscle control and experience facial disfigurement, psychological trauma, and facial pain.

From the NHS Choices YouTube channel: Bell's palsy is the temporary weakness or paralysis of the muscles in one side of the face. In this video, a speech therapist explains who is most at risk and describes common causes and treatment options available. Helen explains how she dealt with the condition and recovered from it:



Remember:

U MN damage
U pper face is OK (the patient is able to wrinkle his forehead)

LMN damage = patient is unable to wrinkle his forehead (our patient)

The examination of CN 7 palsy can be remembered by the mnemonic COWS:

C lose your eyes
O pen (the examining physician tries to open the patient's eyes)
W rinkle your forehead
S mile

Two main types of pharmacological treatment have been used to improve outcomes from Bell’s palsy:

- steroids
- antivirals.

The rationale for these treatments is based on the presumed pathophysiology of Bell’s palsy, namely inflammation and viral infection.

In a 2009 study published in the BMJ antivirals did not provide an added benefit in achieving at least partial facial muscle recovery compared with steroids alone in patients with Bell’s palsy.

References:

The benefits of steroids versus steroids plus antivirals for treatment of Bell’s palsy: a meta-analysis | BMJ http://bit.ly/YD3iLG

Top medicine articles for November/December 2012

Here are my suggestions for some of the top articles in medicine for November/December 2012:

The Smartphone in Medicine: A Review of Current and Potential Use Among Physicians and Students http://buff.ly/THrvOA

Shocking News: Intraaortic Balloon Pumps May Not Help in Myocardial Infarction with Cardiogenic Shock http://buff.ly/QVzggF

What Your Breath Reveals: Each Patient Has a Unique Breath 'Fingerprint' That Doctors Could Use to Diagnose http://buff.ly/Ravmkd

Rilonacept for Colchicine-Resistant or -Intolerant Familial Mediterranean Fever http://buff.ly/QWJV76

Lowering LDL levels with statin reduces major vascular events regardless of baseline risk http://buff.ly/QWKuxU

Radical prostatectomy and observation did not differ for mortality in localized prostate cancer http://buff.ly/QWLbqM

The Mini-Cog had sensitivity similar to the longer 3MS for detecting cognitive impairment or dementia http://buff.ly/PQkDwL

Risk stratification schemes predict ischemic stroke and bleeding in AF - CHA2DS2-VASc score had 100% sensitivity but only 6% specificty http://buff.ly/QWLu4Z

Deep-Brain Stimulation for Parkinson’s Disease - NEJM summary http://buff.ly/QWNIkR

Update on the management of chronic kidney disease - AFP 2012 http://buff.ly/PQlEol

Chronic fatigue syndrome: diagnosis and treatment - 2012 update from AFP http://buff.ly/QWOePV

Diagnosis and treatment of acne - 2012 AFP update http://buff.ly/QWOmit

Why Some Physician Practices Are Wildly Successful - Medscape http://buff.ly/RFD3Nc

"End-run" lawsuits can blindside physicians. Administrative claims against doctors are likely to rise under the Affordable Care Act - amednews http://buff.ly/S6KU9a

Patients who read doctor notes feel more in control of their health http://buff.ly/RgGPPg

Older patients join crowd consulting "Dr. Internet" http://buff.ly/PNeD7Y

Doctors follow own advice for healthy living http://buff.ly/QYHPDY

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.

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.

Medical care is not the same as customer service

From the cardiologist Dr. John M: “Just say no to linking patient satisfaction with dollars. On a list of well-meaning but really dumb reform ideas, linking compensation of hospitals (or doctors) to patient satisfaction scores ranks near the top. Let me tell you why I think this way. It involves an important baddie—overtreatment. Medical care is not the same as customer service.” http://buff.ly/Vbyjig

Dr. Wes: Like food, we need a slow movement in medicine: Basic. Organic. Local. Personal. Real. http://buff.ly/V0XHXP

Every day is an adventure at Unity Farm

From a Boston hospital CIO who has branched out into farming: "Every day is an adventure at Unity Farm. You never know what interpersonal dynamics will develop with the alpacas, llama, guineas, chickens, and dogs. You never know who will squabble, who will have an injury/illness, and who will develop new behaviors. If it wasn't for the rigors of being a CIO, I could spent the day watching the events of the barnyard - far more interesting than Fox News or CNN." http://bit.ly/UllxPp

The message might be disturbing to you. Maybe we aren't born to run? From the cardiologist Dr. John M: http://buff.ly/YvIu7B

Green tea may be a 'brain booster' - NHS blog reviews the evidence http://buff.ly/YzA6nq

Dr. Wes: Politics in Major Medical Journals http://buff.ly/V58IHB

Recipe for health: cheap, nutritious beans - from Harvard health blog: http://buff.ly/Yyj216

The longevity of a rock singer

Here is Ian Gillan (age 67) from Deep Purple in a recent interview:

You have been screaming rock music for over 40 years. How do you do it?

I think it’s quite natural, I do a lot of it, and so I keep myself fairly fit. My mates who were singers they quit to enjoy their success or raise families and they didn’t continue. Then they tried to come back years later but it was very difficult because vocal cords, unlike guitar strings, are unforgiving, you can’t change them. So I think I’ve been singing all my life, and therefore I’m pretty much fit, so to speak. Most things are within my scope, I sing pretty naturally so it’s not a strain, never has been.

Here is Deep Purple with Maybe I'm a Leo, Mainz, Germany, July 2011:



This is the same band 40 years ago, in 1972:



I have been to two concerts of Deep Purple, the last one was in June 2011 and it was quite impressive. The audience age ranged from 5 to 75 and everyone rose to their feet to the sound of Smoke on the Water.

Here is Mick Jagger on staying fit: "You watch what you eat, you exercise, you have a bit of fun. You keep on going forward. Don’t stop. Do what makes you happy. Don’t look at the clouds of tomorrow through the sunshine of today. That’s it."

References:

Deep Purple but no blues: US legends top Dubai jazz festival line-up | Al Bawaba http://buff.ly/V520RZ

Mick Jagger's new supergroup with Joss Stone and Dave Stewart. DailyMail.

Redefining age 65 - when your job description is "rockstar"

Top medicine articles for November 2012

Here are my suggestions for some of the top articles in medicine for October-November 2012:

Medical licensure: State lines pose daunting barriers - amednews. 20% of U.S. physicians hold medical licenses in multiple states http://buff.ly/T90VNP

“There is a much better opportunity to find a smoking gun" through EMR, says malpractice attorney http://buff.ly/PZP8hT

Avocado Sales Are Rising, as Consumers Buy Into the Fruit as a Source of 'Healthy Fats' - WSJ http://buff.ly/P4Cvz3

Will meaningful use spur growth of patient portals? Stage 2 of meaningful use rules require that 5% of a physician’s patients access their records online http://buff.ly/NxtVvs

In New York, Poor Smokers Spend 25% of Income on Cigarettes http://buff.ly/PZRCwN

Facing anti-malaria nets, mosquitoes alter habits by changing their hours of "peak aggression" http://buff.ly/PZRVrc

"Sonic Hedgehog Is Neuroprotective in the Cavernous Nerve with Crush Injury". Not your everyday headline http://buff.ly/PZTmpK

Monthly administration of 100 000 IU of vitamin D did not reduce the incidence or severity of URTIs in healthy adults http://buff.ly/PNdxo8

Venous leg ulcers can be healed with a spray formulation of allogeneic neonatal keratinocytes and fibroblasts http://buff.ly/PNdOaB

Social media is an efficient and effective method for physicians to keep up-to-date http://buff.ly/TEHaxW

The role of aldosterone receptor antagonists in the management of heart failure: An update http://buff.ly/PNgYv7

Immune thrombocytopenia in adults: An update http://buff.ly/PNh6Lb

Vitamin D supplements do not prevent or reduce the severity of colds in adults without a frank vitamin D deficiency http://buff.ly/QNdpIc

Gout Guidelines Issued http://buff.ly/PNkO7E

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.