how to loss factor program: 2013

Jumat, 06 September 2013

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.

Kamis, 05 September 2013

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:

Kamis, 29 Agustus 2013

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

Selasa, 13 Agustus 2013

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.

Selasa, 06 Agustus 2013

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

Rabu, 31 Juli 2013

Selasa, 30 Juli 2013

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.

Sabtu, 27 Juli 2013

Mick Jagger celebrates his 70th birthday

Here is the money quote at 1 min 54 sec : http://youtu.be/ATtTqdTEFa8?t=1m54s

Jumat, 26 Juli 2013

Goitre - patient information video by NHS

From NHS Choices YouTube channel:

In this video, a consultant endocrinologist describes possible causes of a goitre, an abnormal swelling of the thyroid gland that causes a lump in the neck. She also explains why it is important to get any lump in the neck or throat checked out by a GP and treatments available (the U.S. spelling is "goiter").

Kamis, 25 Juli 2013

Using “microlives” to communicate how your habits may kill you

A daily loss or gain of 30 minutes can be termed a microlife.

The loss of a single microlife can be associated with:

- smoking two cigarettes
- taking two extra alcoholic drinks
- eating a portion of red meat
- being 5 kg overweight
- watching 2 hours of television a day

Gains are associated with:

- taking a statin daily (1 microlife)
- taking just one alcoholic drink a day (1 microlife)
- 20 minutes of moderate exercise daily (2 microlives)
- a diet including fresh fruit and vegetables daily (4 microlives)

Demographic associations can also be expressed in these units:

- being female rather than male (4 microlives a day)
- Swedish rather than Russian (21 a day for men)
- living in 2010 rather than 1910 (15 a day)

This form of communication allows a general, non-academic audience to make rough but fair comparisons between the sizes of chronic risks, and is based on a metaphor of “speed of ageing,” which has been effective in encouraging cessation of smoking.

The metaphor of speed of ageing and use of the term microlife are intended for popular rather than scientific consumption, but they could also be useful for health professionals. They could perhaps best be communicated with phrases such as “When averaged over a lifetime habit of many people, it is as if each burger were taking 30 minutes off their life.”

References:

Using speed of ageing and “microlives” to communicate the effects of lifetime habits and environment. BMJ 2012;345:e8223.
Image source: OpenClipart.org, public domain.

Comments from Google Plus:

Allan Palmer: Heard this on one of our national radio programs - http://www.abc.net.au/radionational/programs/scienceshow/linking-lifestyle-choices-with-risk/4335556

Seems a really really elegant way of explaining things.

Rabu, 24 Juli 2013

WSJ insights on wine blogs - and blogging in general

What makes bloggers keep on writing?

Most of the bloggers write for "personal satisfaction" since the possibility of making money is quite small - WSJ.

What makes bloggers quit?

There are 1,450 wine blogs but only 18% have been blogging for more than 6 years. A lack of profit potential isn't necessarily the biggest blogger obstacle; time is in even shorter supply.
How do you know if a blogger is any good?

What makes a blogger credible? "Reputation and awards. Design and writing style". Most of all, a blog has to "be about something"

Define a good blogger: Impassioned amateur with genuine curiosity and interesting point of view (and current posts).

83% of wine bloggers cited "passion" as a reason for keeping a blog.

References:

Five Wine Blogs I Really Click With | On Wine by Lettie Teague - WSJ http://on.wsj.com/14HmDxg
Image source: Wikipedia, public domain.

Sabtu, 13 Juli 2013

Yoga for Gardeners

Celebrity gardener P Allen Smith shares what he has learned from a yoga teacher who suggests 3 specific yoga poses (asanas) for gardeners:

From the YouTube comments: "I can see how this will really help you get those tomato plants set out."

Here are some more conventional exercises for gardeners from the video blogger and California gardener "CaliKim29":

Rabu, 10 Juli 2013

RNA-only genes: ancient infections hide in human genome and get themselves passed from generation to generation

From the Economist:

Not so long ago, received wisdom was that most of the human genome—99% of it—was “junk”. If this junk had a role, it was just to space out the remaining 1%, the genes in which instructions about how to make proteins are encoded.

That, it now seems, was far from the truth. The decade since the completion of the Human Genome Project has shown that lots of the junk must indeed have a function. Almost two-thirds of human DNA, rather than just 1% of it, is being copied into molecules of RNA. As a consequence, rather than there being just 23,000 genes, there may be millions of them.

Human chromosomes (grey) capped by telomeres (white). Image source: Wikipedia, public domain.

One new genetic class is known as lincRNAs. Molecules of lincRNA are similar to the messenger-RNA molecules which carry protein blueprints. However, they do not encode proteins. More than 9,000 sorts are known, and their job is the regulation of other genes.

LincRNA is rather odd, though. It often contains members of a second class of weird genetic object. These are called transposable elements - “jumping genes” - because their DNA can hop from one place to another within the genome. Transposable elements come in several varieties, but one group of particular interest are known as endogenous retroviruses. These are the descendants of ancient infections that have managed to hide away in the genome and get themselves passed from generation to generation along with the rest of the genes.

This Nature video takes you on an audio-visual journey, diving into a cell to show how genes are transcribed to make messenger RNA (mRNA) and how RNAi can silence specific mRNAs to stop them from making proteins:

References:

RNA-only genes: The origin of species? The Economist.

Senin, 08 Juli 2013

Healthcare social media #HCSM - top articles

Here are my suggestions for some of the top articles related to healthcare social media (#HCSM) in the past 4-6 weeks:

An Introduction to Social Media for Scientists: In academia, there is often a stigma attached to online activities. http://buff.ly/17tGkKj

Twitter helps busy academics keep up with new research, and prepare teaching materials for graduate students. An Introduction to Social Media for Scientists: Online Visibility Helps Track and Improve Scientific Metrics. Researcher: Tweeting and blogging about papers leads to spikes in the number of article downloads http://buff.ly/10y1heu

Giving a TED presentation has no impact on the number of citations subsequently received by an academic http://buff.ly/12hQ75m

YouTube: A good source of information on pediatric tonsillectomy? Physician videos useful while many patient videos were "misleading" (study) http://buff.ly/1axVLOu

Parents of patients with rare diseases are active Internet users, engaged in search and online communities http://buff.ly/18tlnzu

"It would be weird to have that on Facebook": young people's opinion on use of social media for sexual health campaign http://buff.ly/1axXiEi

Workers in the emergency department (ED) spent 4-19 minutes per hour on Facebook? http://buff.ly/1axXKT9

How to Use Social Networks for "Toxicovigilance" http://buff.ly/141SAh5

Display of Alcohol Use on Facebook: 6.5% of pictures and 2.90% of status updates http://buff.ly/16oyulI

New Parents' Facebook Use: For mothers, more frequent visits were associated with higher levels of parenting stress http://buff.ly/157zhUb

Social media use among patients/caregivers: positive conclusions are often reported, despite non-significant findings http://buff.ly/1axMBSk

It’s not terribly surprising that American physicians adopt Twitter sooner that doctors in the rest of the world. Twitter, MD: the average US physician has 2,697 followers whereas the average European has 3,062. Europeans doctors tweet an average of 3 times per day, while their American colleagues only tweet once per day http://buff.ly/14j9QiN

Canadian Medical Association's 20-page report on health information technology mentions Twitter only once... (PDF) http://buff.ly/17LcHEL

"The use of social media within healthcare will become the norm" http://buff.ly/19XN700

Scientists who interacted with journalists had higher h-indices, as did those whose work was mentioned on Twitter http://buff.ly/15q21IG

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 an acknowledgement in the next edition of this publication.

Selasa, 02 Juli 2013

4% of oil supply is used to make plastic bags - each bag is in use for just 25 minutes

Senin, 01 Juli 2013

Video Pre-Op Guide to Bariatric Surgery from Cleveland Clinic

A 13-minute video from the official Cleveland Clinic channel on YouTube:

Jumat, 28 Juni 2013

Physician: "I think it's time to put the blogging down"

My good Twitter friend, and probably the most famous orthopedic surgeon using social media, @hjluks recently wrote: "Think it's time to put the blogging down...."

Is it time? Does blogging still have some place in the busy day of a practicing physician?

It really depends on what you use the blogging for. Here are just three examples:

- My blogs are my personal archive. I often post brief summaries of interesting articles with my personal comments. When I need to retrieve those during discussions with residents, students or patients, finding them is just a click away by using the custom search engine of the blog. Depending on the purpose of your blogs, the readership size and engagement often do not matter that much. For example, I have blogs that almost no one reads (my gardening blog) but I still post there and find them useful.

- Sometimes you need to point your Twitter/Facebook followers to a longer form explanation on a topic or a controversial issue. Blogs work well for that. A cardiologist was misunderstood by an e-patient recently. It took a 1,000-word blog post for him to explain what he really meant.

- You can create a practice website using blogging software. For example, FAQs for a physician practice can be hosted on a blog. Facebook and Twitter are disorganized and not easily searchable, and not everyone has the patience to watch videos to find (or miss) the answer to their question at the end.

Reasons to stop blogging

I know medical bloggers who stopped blogging or closed their Twitter accounts for similar reasons to those summarized below:

"He says in his final blog post that while he intended the personal blog to be a place where he could talk about ideas, his posts had started to “spark whole conversations that I never intended to start in the first place, conversations that leech precious time and energy while contributing precious little back.”

More related thoughts:

"So many things can go wrong (with social media) if you don’t do it right. You can get stampeded and lose the game. Playing on the sidelines is more appealing.

If you run a hospital and decide to establish a vast living presence on the Web, people will say bad things about your doctors, your nurses, your waiting times in the ER, your food. You’ll have to deal with HIPAA. There’s also a chance that you’ll say something you’ll regret. Playing on the sidelines is more appealing."

On the other hand, consider this:

Duty calls. Image source: Xkcd.com, Creative Commons license.

See a perfect example why you must read medical blogs in this post by a practicing electrophysiologist: The first 4 months of a new era - anticoagulation with dabigatran. You can't find this first-hand real-life experience in any textbook or medical journal.

6 Reasons Why Doctors Blog

Here are the 6 Reasons Why Doctors Blog, according to Dr. John M., a cardiologist and electrophysiologist:

Here are the top six reasons why I and other doctors choose to author medical blogs:

1. The Practice of Medicine inspires
2. To educate
3. To better mankind
4. To give a look behind the curtain
5. To archive useful information
6. To display our humanness

My comment is here:

Thank you for the wonderful post and sharing insights, John.

Blogging "To better mankind" is beyond reach for me, I think. However, I hope that my blogs helped "To educate" at least some of the readers who flipped through more than 8 million pages since 2005...

Doctors are highly-qualified experts who limit their impact only to patients they see - if they don't publish, give lectures - and blog. In most cases, benefits far outweigh the risk and doctors should be encouraged to at least give it a try.

I tried to describe a practical and time-efficient approach here:

Social media in medicine: How to be a Twitter superstar and help your patients and your practice
http://casesblog.blogspot.com/2011/10/social-media-in-medicine-how-to-be.html

Blogging also keeps you grounded and humble. Critical comments prompt you to back your clinical opinion, expressed in a blog post, with solid scientific references and that's a good thing.

This is a suggested Cycle of Patient Education (click here to enlarge the image):

A here is the suggested Cycle of Online Information and Physician Education (click here to enlarge the image):

The two cycles work together as two interlocking cogwheels. Here is how to facilitate the Rise of the ePhysican who works hand in hand with the ePatient:

Why you should start blogging

Quotes from an interview with Seth Godin and Tom Peters:

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

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

And it’s free."

Don't limit yourself to your blog - use Facebook and Twitter

Blogging can be great for personal growth but there is a lot more interaction on Twitter and Facebook nowadays as compared to blogs. If you have a blog, you must also have a Facebook "like" page (previously called "fan" page) and a Twitter account. These serve the dual purpose of distribution and commenting channels ("two-way street").

For example, Facebook pages get a lot more interaction than blogs for some medical journals - you can count the comments on the NEJM Facebook updates (the range is 9-180) vs. their blog (0). The blog has comments enabled, of course.

Facebook is the clear "winner" in terms of commenting activity, it is not even close:

NEJM Facebook page vs. NEJM blog

What is the oldest medical blog?

I have maintained medical blogs since 2004 but never thought about blog anniversaries - blogging seems such a mundane task of daily life.

What is the "life expectancy" of a medical blog?

The studies are ongoing but the current record is around 8-10 years... http://goo.gl/5LRx

In the medical blogging world, the physician bloggers who produce high volume of original content often quit after 1-2 years. There is too much to handle. Medical blogging is a difficult task that requires a lot of time and mental energy (scientific accuracy, HIPAA compliance, ethics, etc.), and the financial rewards are nonexistent or negligible.

As pointed out in the comments, the "oldest" medical blog probably is Family Medicine Notes, followed by GruntDoc.

Related reading and a lot of comments:

What is the oldest medical blog? http://bit.ly/1aSL3VY
Why you should start blogging in 2011 http://bit.ly/1aSKGdO
Doctors are natural communicators - social media is extension of what they do every day http://bit.ly/U2wB7O
6 Reasons Why Doctors Blog http://bit.ly/1aSL8c7
Who blogs? Personality predictors of blogging http://bit.ly/1aSLb7M

Selasa, 25 Juni 2013

Can hot peppers fight cancer? CBS video

Super hot peppers can make you sweat and tear up, but CBS News reports how they also may fight cancer:

Senin, 24 Juni 2013

12 tips for using Twitter as a learning tool in medical education - PubMed article

The suggested tips are organized into the following categories:

- mechanics of using Twitter
- suggestions and evidence for incorporating Twitter into many medical education contexts
- promoting research into the use of Twitter in medical education

However, you will need paid (or institutional) access to read the actual 12 tips for using Twitter as a learning tool in medical education, published at the Informa website:

http://informahealthcare.com/doi/abs/10.3109/0142159X.2012.746448

References:

Twelve tips for using Twitter as a learning tool in medical education. Forgie SE, Duff JP, Ross S. Med Teach. 2012 Dec 21.
http://www.ncbi.nlm.nih.gov/pubmed/23259608

Minggu, 23 Juni 2013

Synesthesia is the neurological trait that combines two or more senses: What color is Tuesday?

How does one experience synesthesia -- the neurological trait that combines two or more senses? Synesthetes (4% of the population) may taste the number 9 or attach a color to each day of the week. Richard E. Cytowic explains the fascinating world of entangled senses and why we may all have just a touch of synesthesia. Lesson by Richard E. Cytowic, animation by TED-Ed:

Comments from Twitter on "What color is Tuesday?":

Rann Patterson @RannPatterson: yellow

PilotHealthAdvocates @ClaudiaNichols Ruby?

Jenny Sprague @xFoodAllrgyhelp: tangerine... :)

Related:

TED Talks: "Daniel Tammet has linguistic, numerical and visual synesthesia -- meaning that his perception of words, numbers and colors are woven together into a new way of perceiving and understanding the world. The author of "Born on a Blue Day," Tammet shares his art and his passion for languages in this glimpse into his beautiful mind."

Sabtu, 22 Juni 2013

Healthcare social media #HCSM - top articles

Here are my suggestions for some of the top articles related to healthcare social media (#HCSM) in the past 4-5 weeks:

Twitter and Facebook: Potentially inappropriate attitudes towards professionalism were found among pharmacy students http://buff.ly/136KLJZ

Harnessing the cloud of patient experience: using social media to detect poor quality healthcare http://buff.ly/136KRkO

Social media and you: what every physician needs to know - J Med Pract Manage. http://buff.ly/ZFKvvw

How to Get RSS Feeds for Twitter http://bit.ly/Yp4VHq

Effectiveness of Mobile-Health Technologies to Improve Health Care Service: Not much benfit http://buff.ly/Y5wdWT

Blogosphere is crowded. Every minute of the day, 347 WordPress users publish a new blog post http://buff.ly/YpmOtt

"You’re either living your life or reading Facebook. FB would surely prefer those to be one and the same." http://buff.ly/YIW6eO

"Big Data" for Global Infectious Disease Surveillance - Free dynamic risk maps http://buff.ly/11j8Hq9

Medicine videos by Khan Academy http://bit.ly/XoQS9O -- including some detailed, system-based ones, e.g. Lungs http://bit.ly/XoQTL6

MCAT Video Competition - How to Make a Khan Academy Video http://bit.ly/XoQVCP

Has Twitter Changed? Remember when Twitter was a great place to have conversations? http://bit.ly/Z0ynE5

Practice Fusion Launches Doctors Appointment And Reviews Site: "Patient Fusion" http://buff.ly/Yi9O9R

How To Backup Your Online Content by @grahamwalker http://buff.ly/ZiD38k

How useful is YouTube in learning heart anatomy? Only 294 videos (out of 55,000) qualified for further analysis http://buff.ly/10XzoPW

Practical Guidance: The Use of Social Media In Oncology Practice (free full text) http://buff.ly/1554SZ9

Social Media Use in Medical Education: review of 14 studies: there was only 1 randomized controlled trial http://buff.ly/ZiMNzQ

So far this year, over 400 healthcare conferences have registered their hashtag with Symplur. It’s an amazing number. Healthcare Conferences on Twitter: more virtual participants than participants physically present at the location http://buff.ly/ZxZdHF

Predicting national suicide numbers with social media data http://buff.ly/141R8v5

52% of plastic surgeons feel that social media are an effective marketing tool for increased exposure and referrals http://buff.ly/10pghiG

Quantifying collective attention from tweet stream - PLoS study http://buff.ly/13wWgYM

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 an acknowledgement in the next edition of this publication.

Jumat, 21 Juni 2013

5 Tips to Stay Up-to-Date with Medical Literature

There is an old saying: "How do you eat in elephant? In small bites." The same rule probably applies to staying current with the ever expanding avalanche of medical literature. You can try the following approach:

1. RSS Feeds for Journals.

Subscribe to the RSS feeds of the "Big Five" medical journals (NEJM, JAMA, BMJ, Lancet and Annals) plus 2-3 subpecialty journals in your field of interest. Any of the many RSS readers would do. I use RSS Owl. PeRSSonalized Medicine by Webicina.com was one of the first services to arrange the medical journal feeds in a visually appealing way and make RSS consumption user-friendly. Feedly is one of the most popular online RSS readers.

Try to read the journal on the day it is published online, for example, NEJM and JAMA on Wednesdays, BMJ in Fridays, etc.

2. Podcasts.

Listen to journal podcasts. Many applications are available for desktop and smartphones. All major journals have weekly or monthly podcasts.

3. Persistent Searches.

Subscribe to RSS feeds for "persistent searches" in Pubmed and Google. For example, choose a search term in your field of interest, run the search in Pubmed, then subscribe to the feed for the search. The same process can be repeated with Google News and Google Alerts.

Image source: U.S. National Library of Medicine.

4. Text-to-speech (TTS).

Use text-to-speech to listen to articles you do not have time to read. For example, you can save your articles in the Pocket app for Android and listen to them later.

5. Blogs and Twitter accounts.

Subscribe to high-quality medical blogs and Twitter accounts in your field of interest -- they often review many of the important new articles.

Here is an example of the allergists on Twitter:

This is a list of the allergists who are planning to use Twitter to post updates from the 2013 #AAAAI meeting. The list is open for edit, please feel free to add your own info.

Related reading

How to stay up-to-date with RSS in medicine - presentation from the free Social MEDia Course http://j.mp/Hale12
Not a Medical Course, but a Life Course (somewhat vague advice) http://goo.gl/mDMsr - Here are 5 practical tips: http://goo.gl/n5rbw
Medical journals that use social media (spreadsheet). Body in Mind, 2011.
Image source: OpenClipArt, public domain.

Note: This is an update of a 2008 article.

Rabu, 19 Juni 2013

Apps help improve water quality (video)

Around the globe, more people have access to smartphones than to clean water and sanitary facilities. A competition for smartphone developers, sponsored by the World Bank, could change that. Numerous apps show how the internet can be used to help to improve water quality. Video from Deutsche Welle:

Senin, 10 Juni 2013

1 out of 6 doctors has been rated on a physician-rating website: are you one of them?

The current usage of physician-rating websites is still low but is increasing. International data show that 1 out of 6 physicians has been rated, and approximately 90% of all ratings on physician-rating websites were positive.

What Percentage of Physicians Has Been Rated?

Data for US physicians obtained from RateMDs showed that 16% of physicians were assessed by January 2010 (112,000 out of approx. 700,000).

What Is the Average Number of Ratings on Physician-Rating Websites?

Nearly half of the physicians had only a single rating on RateMDs in 2010, and the number of physicians with five or more ratings was 12.5%

Although often a concern, the authors of this meta-analysis could not find any evidence of "doctor-bashing".

How Should Physicians Deal With Physician-Rating Websites?

Physicians should not ignore these websites, but rather, monitor the information available and use it for internal and external purpose.

Physicians should perform “self-audits” on popular physician-rating websites to search for available information. It may be helpful if a staff member monitors these sites on a regular basis.

If nothing else, physician-rating websites often provide incorrect demographic information (eg, incorrect address, links to old practices, opening hours), which should be corrected.

Physicians should use the ratings in order to evaluate their patients’ satisfaction. Patients’ true thoughts on what makes a good doctor, what they value, etc., can be understood.

In the case of negative reviews, it is best not to respond online to try to refute the negative review point by point.

What Recommendations Can Be Made for Improvement of Physician-Rating Websites?

Some authors discuss whether a simple One Feedback Question containing a single question such as “Would you recommend Dr X to a loved one?” may be as useful as the multitude of specific questions.

Alemi et al suggest a 2-question survey: the “Minute Survey”. The first question asks patients to rate their overall experience. The second question asks: “Tell us what worked well and what needs improvement”.

References:

Eight Questions About Physician-Rating Websites - JMIR 2013 http://bit.ly/12ifjXA
Image source: RateMDs.com.

Jumat, 07 Juni 2013

Healthcare social media #HCSM - top articles

Here are my suggestions for some of the top articles related to healthcare social media (#HCSM) in the past 2-4 weeks:

Social media for health professionals at a glance http://buff.ly/10Gopxy

Online Professionalism Investigations by State Medical Boards: First, Do No Harm http://buff.ly/10GozFe

Social media in vascular surgery. [J Vasc Surg. 2013] http://buff.ly/10L5kdJ

Study finds rampant envy on Facebook http://buff.ly/10sCUzo

Eight Questions About Physician-Rating Websites - JMIR 2013 http://bit.ly/12ifjXA

Preserving Science News In An Online World - NPR discussion. How can journalists and bloggers avoid some of the pitfalls of communicating science in an online world? http://buff.ly/UMNSAN

Dr Mike Cadogan takes the medical world beyond social media (PDF) http://buff.ly/X8RTOD

Don't Call It Social Media: FOAM and the Future of Medical Education http://buff.ly/UQQ6PD

Misleading Health-Related Information Promoted Through Video-Based Social Media: Anorexia on YouTube. Pro-anorexia information was identified in 29.3% of anorexia-related videos. http://bit.ly/12joxD6

“While the vast majority of journalists are honest, some believe the facts shouldn't get in the way of a salacious story” http://bit.ly/VhPC59

Feasibility study of using social networks for learning support: Facebook (PDF) http://buff.ly/Y07ouE

Tesla, the New York Times and the leveling of the media playing field http://buff.ly/XeHT5y - This will soon apply to medicine too.

The Geography of Happiness According to 10 Million Tweets http://buff.ly/12ILWOy - Source PDF: http://buff.ly/12JmhW2

Twitter has the potential to enhance professional collegiality, advocacy, and scientific research - for ophthalmologists http://buff.ly/ZB0cUF

The researcher of the future…makes the most of social media - The Lancet discovers Twitter (comment) http://buff.ly/133cB9O (free full text after registration)

Show Us You Are Real: Human vs. Organizational Presence and Online Relationship Building Through Social Networks http://buff.ly/ZFJZxr

Twitter may be a promising mechanism to spread brief exercise behaviors http://buff.ly/136KpD2

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 an acknowledgement in the next edition of this publication.

Kamis, 30 Mei 2013

Risk of diabetes and stroke may be influenced by what we experienced in the womb

The risk of suffering diabetes or a stroke in later years may be influenced by what we experience in the womb. Medical researchers at Jena's University Hospital are investigating the long-term effects of prenatal stress on children now 8-10 years old.

Source: Research on Aging - Stress in the Womb | Tomorrow Today - YouTube http://bit.ly/15DQTtm

Rabu, 29 Mei 2013

Analysis of Rafael Nadal's Knee Injury - Computer Animation from NYTimes

Rafael Nadal missed seven months last year with a knee injury. Nadal, an 11-time Grand Slam champion, returned to the tour at a small clay-court event in Vina del Mar, Chile, in February after recovering from a partially torn patella tendon and inflammation in his left knee. That knee will face its toughest test when he plays in the French Open, his first Grand Slam event since his return.

The 26-year-old Spaniard is favored to win and become the only player with eight French Open titles, even though he said his knee is still “not 100 percent.” Although he can practice less than an hour a day, he’s made the final in each of the eight tournaments he’s played since he returned to the men’s tennis circuit in February.

References:

Even at Half Speed, Nadal Still the Man to Beat in Paris - Bloomberg http://bloom.bg/111VzBK

Rabu, 22 Mei 2013

Senin, 20 Mei 2013

How and when do we learn to talk: Why German and French babies cry differently

Prof. Angela D. Friederici, of the Max Planck Institute for Human Cognitive and Brain Sciences in Leipzig talks about Language Acquisition. She asserts that babies learn language right from birth, even cry with the intonations of their mother tongue.

Source: How and when do we learn to talk? | Tomorrow Today - Interview - YouTube http://bit.ly/15DQJSQ

Rabu, 15 Mei 2013

Every single hour of television watched after the age of 25 reduces the viewer’s life expectancy by 22 minutes

By comparison, smoking a single cigarette reduces life expectancy by about 11 minutes.

An adult who spends an average of six hours a day watching TV over the course of a lifetime can expect to live 4.8 years fewer than a person who does not watch TV.

References:

Get Up. Get Out. Don't Sit. - NYTimes, 2012 http://nyti.ms/10oXBQd

Comments from Twitter and Google Plus:

Humera Naqvi, MD @nayab78: hmmm that means we ppl should be dying early taking the amount of tv watched but life expectancy has increased.

K Dillon, RDMS,CPC-A @comalliwrites: Confounders & confirmation bias not accounted for...

@ShadolooDoll: Misleading. It isn't TV itself, but the lack of activity. A person who is dedicated to exercise can still watch TV, right?

Timothy Cook: Great, since I stopped watching TV. I can start smoking again! ;-)

Davíð Þórisson: Phew - no mention of watching Youtube! :-)

Jimena Yosara Aguilar Jimenez: I'll never watch tv again

Dimiter Stanev: Does that mean that disabled people suffer from this too?

Image source: Wikipedia, Creative Commons Attribution ShareAlike 2.5 License.

Selasa, 14 Mei 2013

What is HDL? Videos for patient education by Cleveland Clinic

Watch and learn how high-density lipoprotein (HDL) cholesterol can protect the body from heart disease in this whiteboard session lead by Cleveland Clinic Cardiologist Michael Rocco, MD.

Here are more videos from the same series:

What is LDL? - YouTube http://bit.ly/18cuEay

What is a lipid profile? - YouTube http://bit.ly/18cuFLE

What is cholesterol? - YouTube http://bit.ly/18cuHmX

What are the types of cholesterol? - YouTube http://bit.ly/18cuKPA

Time to treat your cholesterol numbers - YouTube http://bit.ly/18cuLmD

Know your cholesterol numbers - YouTube http://bit.ly/18cuMa7

Senin, 13 Mei 2013

"Attention span halved in a decade, from 12 to 5 minutes, spelling trouble for doctors and patients"

From the WSJ:

Our average attention span halved in a decade, from 12 to five minutes. To combat this, a "museum intervention" is now mandatory at Yale's School of Medicine for all first-year medical students. Called Enhancing Observational Skills, the program asks students to look at and then describe paintings—not Pollocks and Picassos but Victorian pieces, with whole people in them. The aim? To improve diagnostic knack.

The Waterseller of Seville, 1618-1622, Oil on canvas. This is not considered an example of the "Victorian pieces" mentioned in the WSJ article. Image source: Wikipedia, public domain.

Each student is assigned a painting which they examine for 15 minutes, recording all they see. Then the group discusses its observations.

"We are trying to slow down the students. They have an urge to come up with a diagnosis immediately and get the right answer."

The study did not provide a huge improvement in the diagnostic acumen though. After the completion of the study project, the medical students were 10% more effective at diagnosis. Nonetheless, the program has now expanded to more than 20 U.S. medical schools. The evidence behind this intervention is not very convincing.

References:

Reviving the Art of Observation | Marvels - WSJ, 2012 http://goo.gl/iOhAV

Comments from Google Plus and Twitter:

Dr John Weiner @AllergyNet: Soon to become 140 characters? MT @DrVes: "Attention span halved in a decade, from 12 to 5 minutes” goo.gl/fb/818DN

andrew murphy, md @PAallergy: @DrVes took to long for me to read that story : )

Mike Moore: Interesting. What's the reference for "Attention span halved in a decade, from 12 to 5 minutes"

Ves Dimov, M.D.: The reference is the text: "Our average attention span halved in a decade, from 12 to five minutes, according to a study commissioned by Lloyds TSB Insurance. (And that was in 2008.)" I haven't checked the source beyond the referenced WSJ article in this case.

Mike Moore: Sorry, that was a bit of a rhetorical question. This is the best I could find, it doesn't appear to be an actual published study... http://www.insurance.lloydstsb.com/personal/general/mediacentre/homehazards_pr.asp

Mike Moore: Even better, here is an analysis of when the "data" was initially released in 2008. http://neuroskeptic.blogspot.com/2008/11/spooky-case-of-disappearing-crap.html [The link to David Moxon, the "researcher" who was commissioned by Lloyds to do the study is now dead, replaced with a generic landing page. I guess he doesn't do "Psychological Research" anymore.]

CMDoran @TheFebrileMuse: Yes, phones may be a part of this? very distracting..

Senin, 06 Mei 2013

"The happiest people in the world" live in Denmark and the happiness is lowest in middle age

According to the "World Happiness Report", the happiest people in the world live in Denmark, Finland and Norway. The report is published by the United Nations (the first edition was in 2012).

According to one of the people interviewed, it's all an expectations game: "We don't expect much from life in Denmark, and we are happily surprised when something goods happens." (quote from memory). I doubt that it is that simple. Here is the Deutsche Welle video:

The top 10 happiest nations on the planet are:

1. Denmark
2. Finland
3. Norway
4. Netherlands
5. Canada
6. Switzerland
7. Sweden
8. New Zealand
9. Australia
10. Ireland

Happier countries tend to be richer countries. Over time as living standards have risen, happiness has increased in some countries, but not in others (like for example, the United States). On average, the world has become a little happier in the last 30 years (by 0.14 times the standard deviation of happiness around the world).

Stable family life and enduring marriages are important for the happiness of parents and children. In advanced countries, women are happier than men, while the position in poorer countries is mixed.

Happiness is lowest in middle age.

References:

First World Happiness Report Launched at the United Nations - The Earth Institute - Columbia University http://bit.ly/ZdgyAr

Jumat, 03 Mei 2013

Healthcare social media #HCSM - top articles

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

Cardiologist: Physicians Beware on the Twittersphere http://buff.ly/YWDE3x -- William Dillon, MD: "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."

"Smartphone will evolve to become a 'soulmate' device that knows your body better than you know it yourself" http://buff.ly/Rz6PaK

70% of Americans sleep with their cell phone within arm’s reach. 61% check their phones every hour. http://buff.ly/WX3UoT

10 reputation management tips for doctors http://buff.ly/S04bea

The Rise of Patient Communities on Twitter http://buff.ly/X2oXqa

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

Increased Use of Twitter at a Medical Conference: A Report and a Review of the Educational Opportunities http://buff.ly/ZdwhVi

Online portal leads patients back to doctors' offices - amednews http://buff.ly/VPXTt8

Tweets, Google searches help solve migraine mysteries - Harvard Health blog http://buff.ly/VNLNB4 - Migraine Tweets – What can online behavior tell us about disease? http://buff.ly/R625Z5 -- We did a similar study for allergies.

Using Social Media to Improve Continuing Medical Education: A Survey of Course Participants http://buff.ly/Uh0u37

Internet-based self-management improved asthma control after 3 months - however, all benefits were lost after 12 mo http://buff.ly/Uh25G0

Online urologist ratings usually positive: study http://buff.ly/UZBf2U -- Online Reviews Of 500 Urologists http://buff.ly/UmXcv7

The interaction between the medical profession and the media is becoming increasingly complex http://buff.ly/UZChfb

What were the top Nature papers according to social media in 2012? Nobody is quite sure, apparently http://buff.ly/UhJPMP

94% of high school students accessed social media on their phones during class http://buff.ly/V6Yqbx

How to Supercharge Google RSS Reader with Styles and Extensions http://buff.ly/HT8L8a

Share, Discuss and Learn, Socially - Disrupting Medical Education by Redefining “Social Media” http://buff.ly/UpUkvD

Lessons from 12 Years of Blogging http://buff.ly/Wrzry8

Most STD educational apps have failed to attract user attention and positive reviews http://buff.ly/11aAryf

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 an acknowledgement in the next edition of this publication.

Senin, 29 April 2013

140-character Resume: How Twitter is Changing the Job Hunt

How Twitter is Changing the Job Hunt. Some recruiters say Twitter has transformed their prospecting and hiring, helping them identify candidates they wouldn't have found otherwise, but others say the messaging platform has some way to go before it can replace LinkedIn, Facebook or other job-hunting tools. Lauren Weber from the WSJ reports:

Rabu, 24 April 2013

What are the 6 Most Germ-infested Places in Your Office?

A study by the producer of Kleenex, Kimberly-Clark, found that the 6 "Dirtiest Places" in Your Office are:

- break room sink-faucet handles
- microwave door handles
- keyboards
- refrigerator door handles
- water fountain buttons
- vending machine buttons

And don't forget that the "Five Second Rule" doesn't work, says Dr. Susan Rhem, an infectious disease specialist from the Cleveland Clinic:

A common superstition, the five-second rule states that food dropped on the ground will not be contaminated with bacteria if it is picked up within five seconds of being dropped (Wikipedia).

References:

Office Germs: The 6 Dirtiest Work Places. WebMD, 2012.
Image source: Wikipedia, CDC.

Selasa, 23 April 2013

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.

Logic is not good enough. We need evidence. Why should performance measures receive a pass on evaluation?

We once thought it was logical to give antiarrythmic drugs to patients after they had a myocardial infarction. We once thought that beta blockers were contraindicated in systolic dysfunction. We consistently follow logic and conventional wisdom, yet find out that we were wrong. Why should performance measures receive a pass on evaluation? From db's Medical Rants: http://buff.ly/16uF3j7

Has Twitter Changed? Remember when Twitter was a great place to have conversations?

When people now want to have a little bit deeper discussion, they send me an e-mail, or even a text to my phone - and the conversation takes place off the "public" airwaves. But why?

In my opinion, here are reasons why "rich engagement" has gone private: Political Correctness prevents deep analysis; This hyper-partisian world leaves little room for the "middle of the road" opinion; Being taken "out of context" is no longer the exception, it is the rule. From Family Medicine Rocks: http://bit.ly/Z0ynE5

Dr. Wes: Maintaining Board Certification Every Two Years http://bit.ly/17gFAU9

We need more “old fashioned” doctors. Spending time with patients should not be considered “old fashioned”. Using technology sparingly should not be considered “old fashioned”. Technology is a tool not an answer. http://www.medrants.com/archives/7249

Work Life Balance - from Life in the Fast Lane medical education blog http://bit.ly/XoPZ12

Times have changed… we might break free from the self-flagellating oppression of yesteryear to forge a fitter and more fulfilling future

Senin, 22 April 2013

Brain networking among musicians

From Deutsche Welle:

When musicians play, what is happening inside their brains? Scientists at Berlin's Max Planck Institute for Human Development have discovered that while performing together, their neurological activity goes into a kind of synchronization mode - almost as though they were connected by a wireless network.

Kamis, 18 April 2013

Industry breeds "superior" rodeo bulls. The result? A lot of cowboys with broken bones

Rodeo Bulls Kick Higher and Buck Harder. A great bucking bronco can be worth hundreds of thousands of dollars, and an entire industry has sprung up that's dedicated to breeding these superior bulls. The result? A lot of cowboys with broken bones. WSJ's Michael M. Phillips reports:

Senin, 15 April 2013

Healthcare social media #HCSM - top articles

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

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 an acknowledgement in the next edition of this publication.

How to use social media to supplement a novel curriculum in medical education. Twitter and Facebook are excellent applications of "push technology" as a means to deliver educational conten http://buff.ly/131Q8tW

Wiki as a Participatory Tool for Patients in Clinical Guideline Development http://buff.ly/SSA2cV

There are no definitive numbers on how many doctors prescribe apps but 10% of users have health apps on their phones http://buff.ly/QhKy0h

9% of medical school and residency program directors/coordinators search Facebook and Twitter to evaluate candidates http://buff.ly/UABZK4

Banned on Wall St.: Facebook, Twitter and Gmail. The number of global organizations blocking social media is declining 10 percent annually. By 2014, fewer than 30 percent of all large organizations are expected to be blocking employee access to social media. http://buff.ly/Ybn1Ay

59 Top Physician Blogs Worth Reading http://buff.ly/V37c91

Sign of the times: WSJ discontinues its health Blog http://buff.ly/YlouV8

How college students find and use information [Infographic] http://buff.ly/V2bXzx

Medical school applicants might want to rethink that last tweet http://buff.ly/YoTjZ5

“Human-powered discovery engine for interestingness” is what the NYTimes calls Maria Popova. The Web has a presentism bias, with Facebook updates, tweets and blog entries always appearing with the latest first http://buff.ly/VcDQFb

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

Social Media May Help Fight Childhood Obesity http://buff.ly/VjcIEx

Rabu, 10 April 2013

Concussions 101, a Primer for Kids and Parents (video)

Dr. Mike has put together a few resources on concussions at http://www.myfavouritemedicine.com/2012/03/07/concussions/

Dr. Mike Evans is founder of the Health Design Lab at the Li Ka Shing Knowledge Institute, an Associate Professor of Family Medicine and Public Health at the University of Toronto, and a staff physician at St. Michael's Hospital.

http://twitter.com/docmikeevans
http://www.facebook.com/docmikeevans

Conceived, written, and presented by Dr. Mike Evans, Illustrated by Liisa Sorsa, Produced, directed, and filmed by Nick De Pencier, Picture and sound edit by David Schmidt, Gaffer, Martin Wojtunik, Whiteboard construction by James Vanderkleyn, Production assistant, Chris Niesing, ©2011 Michael Evans and Mercury Films Inc.

Getting Strangled by a Boa Constrictor - BBC video

"Steve Backshall risks being strangled by a Boa Constrictor snake as he demonstrates their lethal killing technique - on himself! Incredible clip from Deadly 60 series 2."

Source: Strangled by a Boa Constrictor - Deadly 60 - BBC - YouTube http://bit.ly/XCfXhK

Selasa, 02 April 2013

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.

Choose Wisely when Choosing Wisely http://buff.ly/Wrjs4S

From NBC: "You don’t need an MRI for lower back pain. You don’t need antibiotics for a sinus infection. And you don’t need to be screened for osteoporosis, either, if you’re under 65. A list of 90 medical ‘don’ts.’"

Based on the headlines, one might think that these tests or treatments should never be done. However, this is not what the experts were saying. These are commonly overused tests and treatments, not useless.

Can computers replace physicians? http://buff.ly/WriSUx -- Why we need physicians rather than computers http://buff.ly/WriNAn

Computers might be great if we humans were identical. They might be great if our patients were accurate historians without unknown agendas. But none of those, and many other restrictions exist. We have to weigh each piece of evidence, especially the history. We use complex illness scripts and our experience.

Excellent doctoring requires knowledge (computers can provide) plus wisdom. How can we program wisdom?

“How safe is Z-pak?” With the medicalization of everything, patients and doctors need to better understand that taking medicine or having surgery means accepting trade-offs. http://buff.ly/16cMN76

Dr. Wes: The Generality of the FDA's Recommendations on Zithromax http://bit.ly/ZFKBDo

When 1A evidence is not 1A evidence - A quest to find the truth, via Twitter http://buff.ly/XCrV8s

Answering the critics of atrial fibrillation (AFib) ablation http://buff.ly/ZF6iDp

Dr. Wes: The Importance of Recess in our Era of Sequestration http://bit.ly/ZFKGqp

"In the 11th year of this blog, we just reached the 3 million visit bar" - medrants http://buff.ly/16cMysL

Senin, 25 Maret 2013

Americans "addicted" to salt - CNN interviews author of "Salt Sugar Fat: How the Food Giants Hooked Us"

Americans overdosing on salt - Author Michael Moss talks about our addiction to salt, and how the food industry develops our taste for it.

From Amazon:

"From a Pulitzer Prize–winning investigative reporter at The New York Times comes the explosive story of the rise of the processed food industry and its link to the emerging obesity epidemic. Michael Moss reveals how companies use salt, sugar, and fat to addict us and, more important, how we can fight back.

Every year, the average American eats 33 pounds of cheese (triple what we ate in 1970) and 70 pounds of sugar (about twenty-two teaspoons a day). We ingest 8,500 milligrams of salt a day, double the recommended amount, and almost none of that comes from the shakers on our table. It comes from processed food. It’s no wonder, then, that one in three adults, and one in five kids, is clinically obese. It’s no wonder that twenty-six million Americans have diabetes, the processed food industry in the U.S. accounts for $1 trillion a year in sales, and the total economic cost of this health crisis is approaching $300 billion a year.

In Salt Sugar Fat, Pulitzer Prize–winning investigative reporter Michael Moss shows how we got here. Featuring examples from some of the most recognizable (and profitable) companies and brands of the last half century—including Kraft, Coca-Cola, Lunchables, Kellogg, Nestlé, Oreos, Cargill, Capri Sun, and many more—Moss’s explosive, empowering narrative is grounded in meticulous, often eye-opening research.

Moss takes us inside the labs where food scientists use cutting-edge technology to calculate the “bliss point” of sugary beverages or enhance the “mouthfeel” of fat by manipulating its chemical structure. He unearths marketing campaigns designed—in a technique adapted from tobacco companies—to redirect concerns about the health risks of their products: Dial back on one ingredient, pump up the other two, and tout the new line as “fat-free” or “low-salt.” He talks to concerned executives who confess that they could never produce truly healthy alternatives to their products even if serious regulation became a reality. Simply put: The industry itself would cease to exist without salt, sugar, and fat. Just as millions of “heavy users”—as the companies refer to their most ardent customers—are addicted to this seductive trio, so too are the companies that peddle them. You will never look at a nutrition label the same way again."

Minggu, 24 Maret 2013

Cleveland Clinic - Past and Present (video)

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

Sabtu, 23 Maret 2013

Match Day 2013 at the Pritzker School of Medicine (video)

Holly J. Humphrey, MD'83, and James N. Woodruff, MD, describe the Match Day experience at the University of Chicago Pritzker School of Medicine as the medical students discover where they will be placed for their residencies. Look at the pure joy in their faces:

The most popular specialties chosen this year by Pritzker students were Internal Medicine (21), Pediatrics (11), Family Medicine (6), Obstetrics-Gynecology (6), and General Surgery (5).

For more information, see the Match Results at http://bit.ly/Yz681a

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

Kamis, 21 Maret 2013

Acute otitis externa

What is Acute otitis externa?

Acute otitis externa is a common condition involving inflammation of the ear canal. It is caused by bacteria such as Pseudomonas aeruginosa and Staphylococcus aureus. Acute otitis externa often occurs following swimming or minor trauma from inappropriate cleaning.

What are the symptoms of Acute otitis externa?

The rapid onset of ear canal inflammation leads to otalgia (earache), itching, canal edema, erythema, and otorrhea. Tenderness with movement of the tragus or pinna is a classic finding.

What is the treatment for Acute otitis externa?

For uncomplicated cases, use topical antimicrobials or antibiotics such as acetic acid, aminoglycosides, polymyxin B, and quinolones. Some of these agents come in preparations with topical corticosteroids which may help resolve symptoms more quickly.

There is no evidence that any one antimicrobial or antibiotic preparation is clinically superior to another. Here two suggested approaches:

- Neomycin/polymyxin B/hydrocortisone preparations are a reasonable first-line therapy when the tympanic membrane is intact.

- Oral antibiotics are used when the infection has spread beyond the ear canal or in patients at risk of a rapidly progressing infection.

References:

Acute otitis externa: an update. Schaefer P, Baugh RF. Am Fam Physician. 2012 Dec 1;86(11):1055-61.
Image source: Wikipedia, a GNU Free Documentation License.

Rabu, 20 Maret 2013

Calorie Detective: The Real Math Behind Food Labels

With the help of a science lab, the filmmaker Casey Neistat found that calorie listings on food labels can be highly inaccurate - mostly underestimating the amount of calories in food products such as muffins, sandwiches, burrito, etc.

He selected 5 items he might consume in an average day: a muffin, a tofu sandwich, a Subway sandwich, a Starbucks Frappuccino and a Chipotle burrito. Then, two food scientists tested the caloric content of each using a device called a calorimeter. It’s a precise but slow process — taking more than an hour per sample. The results were surprising.

Four out of the five items had more calories than their labels reported, adding up to 550 calories. If he unknowingly consumed those extra calories every day, in a week he would put on an extra pound of body weight.

References:

‘Calorie Detective’ - NYTimes.com http://nyti.ms/Yit3KO

Senin, 18 Maret 2013

What is the current best RSS reader?

After it was announced that Google Reader will be shut down in July, some of my Twitter buddies asked me what I plan to use in the future as a RSS reader.

I have already switched to RSS Owl.

Pros:

- faster and more powerful than Google Reader
- portable program that does not require installation (choose the version labeled "rssowl-2.1.6.windows.zip"). You can take it on a USB drive if you wish.
- keyboard shortcuts - you can either customize the existing shortcuts or create new ones
- social media sharing integration (Buffer, Twitter, Facebook, etc.)
- Easy export and import of your RSS subscriptions as an OPML file
- open source (just like WordPress, Firefox, WebKit, etc.)
- free

Cons:

- it is a downloadable program, not a website

For an online RSS reader, I would recommend Feedly in "Google Reader view". However, I prefer RSS Owl because it is faster and more customizable.

You can make Feedly look like Reader by going to preferences and changing "Default View" to "Condensed".

Why use RSS reader?

RSS is the most efficient way to collect information from multiple websites in one location. If you need to do that, that's the way to do it.

From Rex Hammock:

"I used to attempt to get my friends to use a newsreader. For whatever reason, most never quite got it. It’s one of the few things I use that I consider a competitive advantage and a tool I couldn’t operate professionally without. I decided to stop wasting time trying to give that secret away."

Please share your opinion via Twitter or in the comments section below.

References:

Google Reader was a Google Pigpen product | Rex Hammock's RexBlog.com http://bit.ly/XMB5A0
Which is the Best Alternative to Google Reader http://bit.ly/ZFKLKT

Comments from Twitter:

What is the current best RSS reader? http://bit.ly/WzPXST - I prefer the portable RSS Owl over online Feedly (quicker/custom kb shortcuts)

Sabtu, 16 Maret 2013

How to Dispose of Medications (video)

Watch this About.com video to learn how to properly dispose of your medications, and protect the environment at the same time.

For more information, check the selected references below:

FDA Consumer Updates > How to Dispose of Unused Medicines http://1.usa.gov/16yTnIf

Safe Disposal of Medicines > Disposal of Unused Medicines: What You Should Know http://1.usa.gov/16yTqnh

Kamis, 14 Maret 2013

Senior Living - technology for the elderly from Germany (video)

In Germany, as the number of seniors is increasing, the number of younger people is decreasing, and there are not enough caregivers. Scientists are examining a possible role for robots in the care for the elderly.

Rabu, 13 Maret 2013

Low-income urban youth are high users of technology but still prefer face-to-face meetings with doctor

From This survey included urban youth (aged 14-24 years) to asses the Use of Technology with Health Care Providers.

Eight focus groups including 82 primarily low-income urban African-American adolescents and young adults were completed.

Low-income urban adolescents and young adults (mean age, 18.5 years) reported high access to and use of technology. However, they still preferred face-to-face meetings with a healthcare provider because they felt that the information provided would be better tailored to their individual needs and more credible. Many worried about the confidentiality of conversations conducted using technology.

In conclusion, although low-income urban youth are high users of technology, they still prefer face-to-face meetings with a healthcare provider.

References:

Use of Technology with Health Care Providers: Perspectives from Urban Youth. Sarah Lindstrom Johnson et al. The Journal of Pediatrics, Volume 160, Issue 6 , Pages 997-1002, June 2012.

Jumat, 08 Maret 2013

What Will Social Media Look Like in 2020? (WSJ video)

The end of social networking? "Social, Inc." author Bob Zukis discusses his predictions on what the future holds for social media.

Kamis, 07 Maret 2013

Common rashes - 2-minute video overview by a dermatologist for About.com

The whole playlist is here: Does it Itch? | Common Rashes & Skin Conditions - YouTube http://bit.ly/12k3vFB

Here are some helpful resources:

Rash diagnosis algorithm - NCEMI eTools http://bit.ly/WvZ5IU

Academic Life in Emergency Medicine: Paucis Verbis: Approach to rashes http://bit.ly/WvZ3B1

Related:

Acne Treatments | Skin Care - YouTube http://bit.ly/12k3zVP

Rabu, 06 Maret 2013

Hepatitis A

Excerpts from a recent review in Am Fam Physician:

Hepatitis A is a common viral illness worldwide. It incidence in the U.S. has diminished as a result of immunization.

How is Hepatitis A transmitted?

Hepatitis A virus is transmitted through fecal-oral contamination, and there are occasional outbreaks through food sources.

What are the symptoms of Hepatitis A?

Young children are usually asymptomatic, although the likelihood of symptoms tends to increase with age.

What is the prognosis of Hepatitis A?

Most patients recover within 2 months of infection. However, 10-15% of patients will experience a relapse in the first 6 months. Hepatitis A virus does not usually result in chronic infection or chronic liver disease.

What is the treatment for Hepatitis A?

Supportive care is the mainstay of treatment, for example, PO and IV fluids if nausea and vomiting are severe, etc.

How to prevent Hepatitis A?

The CDC recommends routine vaccination of all children 12-23 months of age, as well as certain vulnerable populations.

What to do if you have just been exposed to Hepatitis A?

Hepatitis A vaccine is also recommended for most cases of postexposure prophylaxis. Immunoglobulin is an acceptable alternative.

References:

Hepatitis A. Matheny SC, Kingery JE. Am Fam Physician. 2012 Dec 1;86(11):1027-34.