Top medicine articles for June-July 2013

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Best of Medical Blogs - weekly review and blog carnival

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

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

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

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

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

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

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

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

Video by Jason Headley:



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

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

Mick Jagger celebrates his 70th birthday

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

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").

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.

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.

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":

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.

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.

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

Video Pre-Op Guide to Bariatric Surgery from Cleveland Clinic

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