Clinical Cases and Images - Blog

Health News of the Day, part 2

noreply@blogger.com (Ves Dimov, M.D.) — Mon, 13 Jul 2009 11:08:00 PDT

Health News of the Day is a daily summary made from the selected links I post on Twitter. It is in a bullet points format with links to the original sources which include 350 RSS feeds that produce about 2,500 items per day.

SpringerImages (biomedical) can be used for almost all noncommercial purposes, presentations, etc. http://bit.ly/9dZMh & http://bit.ly/cgHRJ
LA Times: "With demand outstripping supply, problem nurses stay on the job as patients suffer" http://bit.ly/8kg65 -- Los Angeles Times photography: "His body a prison - In the prime of life, rendered a quadriplegic" http://bit.ly/ft2jh
Medscape: "Are Nurses With a Doctor of Nursing Practice Degree Called "Doctor"? - Legally , yes." http://bit.ly/5domO
Patients, Doctors and Health 2.0 Tools, by Kent Bottles, MD (PDF) http://bit.ly/13nUea

Image source: OpenClipArt.org, public domain.

Medical bloggers are now media and have a first-hand look, experience and credibility

noreply@blogger.com (Ves Dimov, M.D.) — Mon, 13 Jul 2009 04:42:00 PDT

A few thought from my Twitter stream:

The editors of Emergency Medicine News decided to place the article "Do Physician Blogs Betray Patient Privacy?" just next to "Paramedics Accused of Molesting Patients" http://bit.ly/A29tT in the latest issue of the publication. Those 2 pieces are followed by "I Feel So Dirty and Used!" http://bit.ly/C4eK1. Quite depressing indeed.

Despite the first line from the Emergency Medicine News article that claims that "Everybody's blogging, it seems." http://bit.ly/gOivC , in fact, very few doctors blog compared to other professional fields.

Dr. Lagu recommends blogging guidelines by professional societies and training in medical school, not more formal policing, which is a reasonable stand.

It is also time for some medical journals and other publications to stop behaving like "medical blogger" is a dirty word.

A Nature editorial recently asked to "Stop blogging during scientific meetings" http://bit.ly/DdjPH - To quote from the editorial, "Most researchers, if they're aware of social-networking applications, are likely to regard them as distractions at best."

Blogging and microblogging via Twitter and Facebook are natural communication tools nowadays and part of the culture of the new generation. Conference organizers may need to talk to their kids more often.

Believe it or not, the medical bloggers are now media and have a first-hand look, experience and credibility.

For example, see who is representing the physicians in Washington, DC - at least half of them are proven and respected medical bloggers... http://bit.ly/QTzcM

A professional blog is also one of the best ways to establish your online identity in a search engined dominated online world.

Image source: OpenClipArt.org, public domain.

A Meal To Die For (8,000 cal) at the Heart Attack Grill

noreply@blogger.com (Ves Dimov, M.D.) — Mon, 13 Jul 2009 04:29:00 PDT

CBS: Bill Geist visits the Heart Attack Grill in Chandler, Ariz., where you can almost feel your arteries clogging.

Health News of the Day

noreply@blogger.com (Ves Dimov, M.D.) — Mon, 13 Jul 2009 04:02:00 PDT

Sales of “energy shots” are soaring in the middle of a recession - concentrated caffeine, B vitamins and amino acids. Students (ab)use energy drinks to cram for exams, take them in combination with Adderall http://bit.ly/15w7Qi
Dual peroxisome proliferator-activated receptor-alpha/gamma agonist aleglitazar in DM2 - early results are encouraging http://bit.ly/XDWZM
Study: Famotidine prevents gastric and duodenal ulcers, and erosive oesophagitis in patients taking low-dose aspirin http://bit.ly/hrKle
Stressful jobs: "strain on immigration judges similar to that on prison wardens and hospital physicians" - study http://bit.ly/I0dGP
Cut-Prone Professional Fighters Turn to Plastic Surgery to Limit Bleeding http://bit.ly/18Lqzs

More cash-strapped Americans resort to paying medical bills on credit cards http://bit.ly/13XJkF
Health Bill in House Relies on Wealth Tax with a package of surtaxes on families making $350,000 or more. Health bill to cost $1 trillion - half the cost will come from budget savings from payments to health care providers http://bit.ly/LHMwh
Simple Strategies to De-Stress a Recession-Riddled Life - Forbes.com http://bit.ly/4uRq56
U.S. National Library of Medicine tips on managing stress - interactive step-by-step tutorial http://bit.ly/EyZI9
Comprehensive List of Interactive Health Tutorials by the U.S. National Library of Medicine http://bit.ly/12A47s

Image source: OpenClipArt.org, public domain.

Study: "45% of medical schools are adopting Web 2.0 tools for teaching"

noreply@blogger.com (Ves Dimov, M.D.) — Mon, 13 Jul 2009 08:17:49 PDT

According to a 2009 study (submitted in 2008), 45% of medical schools are adopting Web 2.0 tools for teaching: http://bit.ly/7Rbf6. In the article titled "Specific Web 2.0 tools used in curriculum at nursing and medical schools", they didn't even ask about Twitter back in 2008. There are other shortcomings in the paper but it is worth noting that as of 2009, Twitter is the most widely adopted social media tool by the hospitals according to the statistics kept by Ed Bennett:

StudentBMJ offers tips how stay up to date online but the advice "Get rid of your text books and find the latest information from the internet" goes a bit too far: http://bit.ly/S6qnZ

"Do you need to declare competing interests?" asks BMJ before you can post a comment on their blogs/articles...

BMJ is an enormous publishing empire and some areas are very advanced while the other are lagging a bit behind. This is an example of old style "push-only" Twitter feed by BMJ that pushes headlines like a bot and it seems to never reply: http://bit.ly/QWoxx - No wonder I have double the number of followers on Twitter:

On the other hand, BMJ is the only one of the big 5 journals that has its own social network: doc2doc where international doctors recently commented that "US doctor salaries are out of this world!" http://bit.ly/2X4hJ5

Image source: OpenClipArt.org, public domain.

Updated: 07/13/2009

Health News of the Day

noreply@blogger.com (Ves Dimov, M.D.) — Sun, 12 Jul 2009 04:56:00 PDT

The Best- And Worst-Paying Jobs For Doctors - Forbes.com. Family practitioners earn $16,000 less than certified registered nurse anesthetists http://bit.ly/Un5rv
Teenagers who drink heavily are also more likely to have behavioral problems or symptoms of depression and anxiety http://bit.ly/4crX0A
Too clever: obese children in London, participating in an exercise research study, put pedometers on their dogs http://bit.ly/lWaEm
Amount of carbohydrates a woman eats and "glycemic load" of her diet impact her chances of developing breast cancer. Women in the highest category of "glycemic load" had an 81% increased risk of ER+/PR- breast cancer http://bit.ly/1aCSrp
"Time: Why does Blubber Belt wrap the South?" http://bit.ly/iEeCW
Reuters forbids quoting from Wikipedia: http://bit.ly/NfzYS - Yet, it may be the top reference for your doctor http://bit.ly/4FU8XZ
Back pain made simple: An approach based on principles and evidence. CCJM review. http://bit.ly/qD81z
"JAMA Conflicts Policy: Now You See It, Now You Don’t" - WSJ http://bit.ly/14wcFr
"Toddler too good at hide-and-seek, parents call police to help find her. Hide-and-seek is now banned in the household" http://bit.ly/dnpqD

Image source: OpenClipArt.org, public domain.

Social Media Thoughts

noreply@blogger.com (Ves Dimov, M.D.) — Sun, 12 Jul 2009 04:00:02 PDT

From my Twitter account:

There's A Fine Line Between Informing and Spamming Your Followers. The trick is finding out where it is http://bit.ly/SBfrn -- Twitter rule is "4-6 a day or you'll send your followers away"- I post 47 per day - you know what to expect http://bit.ly/WwmkY
"Twitter surgery: wouldn't it be great if the tweets were ACTUALLY what the doctor and staff were really thinking?" http://bit.ly/98pjw
How to Build Credibility as a Blogger http://bit.ly/vidZW - "knowledge is only 10% of a credibility score" - not for medical bloggers.
More than 50 Google corporate accounts on Twitter, they have a "Twiiter team" too http://bit.ly/19ra6P - Why just don't buy the service? :)
"We have gotten to the point where it is so easy to publish to the web, that most of it is ignored." http://bit.ly/H667a
Seesmic Web interface for Twitter is actually quite nice http://bit.ly/AOlVV - Needs support for multiple accounts (coming soon).
Average income for blogs in 2008 was $6,000 but that was influenced heavily by the top 1% of bloggers who earned $200k http://bit.ly/NvYu2
Snoop Dogg's Top 5 Fatherhood Tips on Martha Stewart show http://bit.ly/KHEJ3 and 5 Words to Learn http://bit.ly/oT799

Image source: OpenClipArt.org, public domain.

Social Media Thoughts

noreply@blogger.com (Ves Dimov, M.D.) — Sat, 11 Jul 2009 04:36:00 PDT

From my Twitter account:

How I tweet - a FAQ by @chrisbrogan http://bit.ly/NPCBx
FriendFeed Conversation of the Day: Is Twitter "Awful?" http://bit.ly/NyQU2
Find Creative Commons images with Google Image Search, for use on your blog, presentations, etc. http://bit.ly/CGdym
"United Breaks Guitars" video and The secret to avoiding a YouTube crisis http://bit.ly/FufjT -- Is Twitter the new customer service line? Look at the string of apologies from @UnitedAirlines...
Shortest URL shortener - three letter domain - l.pr http://bit.ly/4JNni
Google Translate added the option to upload the documents you want to translate: Word documents, PowerPoint, PDF, etc. http://bit.ly/bl4hq
Google Maps Location Finder Pinpoints Where You Are in Chrome and Firefox (Opt-in) http://bit.ly/OTyRb
Tip: If you want to embed a Google Spreadsheet in your website, use Google Web Elements http://is.gd/1slQA and http://is.gd/1slRl
Gmail Tip: Recover your password via text message http://bit.ly/15D07K

Image source: OpenClipArt.org, public domain.

Health News of the Day

noreply@blogger.com (Ves Dimov, M.D.) — Sat, 11 Jul 2009 04:34:00 PDT

CNN: It's very difficult for a night owl to become a morning person. "Night owls" difficult to change. Even single-celled organisms do different tasks at different times of the day. http://is.gd/1shBE
PubMed abstract: Sleep disturbances in Disney animated films http://bit.ly/vWHCg and http://bit.ly/Y1H6v
"Cleveland Clinic launches its own WebMD" - needs to compete with Mayo Clinic consumer website http://bit.ly/K1xJ2 and http://bit.ly/e6YYZ
Computer virus copied thousands of Alberta health records - captured anything that was on computer screens http://bit.ly/13ctsI
The Journal of Hospital Medicine’s debut impact factor is stronger-than-expected at 3.163 (NEJM is 50) http://bit.ly/Qg4jM
Happy that @kidneynotes found a way to put WolframAlpha to use: "I'm 47 and my uric acid is 8.4. Is this normal?" http://tinyurl.com/kpluyx
NYT: "Suddenly it seemed as if Ed, promising young surgeon, had disappeared into a vicious cycle of errors and mishaps" http://bit.ly/YGWqI
TED Talks: Kary Mullis' next-gen cure for killer infections http://bit.ly/z247T
TED Talks: Bonnie Bassler on how bacteria "talk" http://bit.ly/16rfBL
"Marriage Calculator - calculate your chances of getting divorced" http://bit.ly/170xOy - Use at your own risk... :)

Image source: OpenClipArt.org, public domain.

In One Study Physicians Missed Abnormal Test Results in 18-58% of the Patients

noreply@blogger.com (Ves Dimov, M.D.) — Fri, 10 Jul 2009 04:51:00 PDT

Studies show that physicians may not recognize up to 30 percent of abnormal test results in a timely manner. Missed test results can delay treatment, threaten patient safety, and lead to malpractice lawsuits.

Researchers studied the electronic health records of 91 patients with newly diagnosed abdominal aortic dilation observed on computed tomography (CT).

Abdominal aortic aneurysm (AAA) on a CT of the abdomen.

Using a comment on the medical record as evidence, the authors found that the clinical care team had not noticed the dilation in 58 percent of cases within three months of CT. In 18 percent of the cases, the dilations were never documented during an average follow-up of more than three years. Fortunately, these delays and failures did not lead to patient complications or mortalities.

References:
Annals of Internal Medicine Tip Sheet for 7 July 2009 Issue, www.annals.org.
Large AAA and Diverticulosis

Social Media Thoughts

noreply@blogger.com (Ves Dimov, M.D.) — Fri, 10 Jul 2009 04:24:00 PDT

From my Twitter account:

Twittorati by Technorati is only for top tweets and top 100 blogs http://twittorati.com - No medical blogger has made the list yet...
TweeterScore: a detailed Twitter report card http://bit.ly/11pLJl - See @DrVes card http://bit.ly/WwmkY - You can get your own too... :)
"Blogs are born, blogs die — it's a cycle as old as blogging itself" http://bit.ly/H94p7
"A stay-at-home Ohio mom becomes Web cooking guru" with http://5dollardinners.com and http://bit.ly/NUzCF
50 Useful Blogging Tools for Teachers http://bit.ly/LF8gL
Pandora to begin limiting listening to 40 hours per month on the web for "heavy users" http://bit.ly/yfBaA
Google is Introducing "Google Chrome OS" that is open-source and will initially be targeted at netbooks http://bit.ly/33ic7Z -- Google Chrome has always been more than a browser: optimized for running web apps, each tab runs as a separate process http://bit.ly/1rybxX

Image source: OpenClipArt.org, public domain.

Health News of the Day

noreply@blogger.com (Ves Dimov, M.D.) — Fri, 10 Jul 2009 04:01:00 PDT

Nature Editorial: "Stop blogging during scientific meetings" http://bit.ly/DdjPH -- "Most researchers, if they're aware of social-networking applications, are likely to regard them as distractions at best." Conference organizers need to talk to their kids more often :)
Severe COPD Linked to Cognitive Impairment, COPD affects nearly 14% of adults over age 75 in the U.S. http://bit.ly/11CaeD
Study: Rising unemployment rates seem to trigger more suicides and murders. For every 1% increase in unemployment, there was a 0.8% rise in suicide and murder rates in people younger than age 65 http://bit.ly/Qfdk6
More Americans than ever are obese: 26 percent of the population http://bit.ly/DUSwL
Reduced sleep duration predicted higher BP levels http://bit.ly/xyAmy
Monoclonal antibody Raxibacumab against anthrax toxin useful for Treatment of Inhalational Anthrax in animal trials http://bit.ly/Ig30N
Anti-VEGF monoclonal antibody Bevacizumab improved hearing in Patients with Neurofibromatosis Type 2 http://bit.ly/6NgBp
"Physician adopters say Twitter can help you promote your practice and communicate with colleagues" http://bit.ly/vxwTb
Social networking etiquette for doctors: Making virtual acquaintances http://bit.ly/3eIXFS -

Image source: OpenClipArt.org, public domain.

The Power of a Twitterer with 637,600 Followers

noreply@blogger.com (Ves Dimov, M.D.) — Thu, 09 Jul 2009 08:55:00 PDT

Stephen Fry is an English actor, writer, comedian, author, television presenter and film director. He also has more than 600,000 followers on Twitter @stephenfry.

See what happens when @stephenfry is unhappy with his HP printer one fine morning:

stephenfry Oh the power of Twitter. Moan about a product & their "communications" people are in touch offering to help. Feel like a big bully now. 23 minutes ago from Tweetie

stephenfry Yes deeply aware I'm in privileged position: a tweet for or against something, with so many followers... Use power wisely, young Skywalker 9 minutes ago from Tweetie

Travel Associated With 3-Fold Increase in Risk for Venous Thromboembolism

noreply@blogger.com (Ves Dimov, M.D.) — Thu, 09 Jul 2009 04:48:00 PDT

Hundreds of millions of people will embark on long-distance journeys this summer.

Researchers investigated the association between travel and VTE for subjects using any mode of transportation and having non-travelling subjects for comparison in 4,055 cases of VTE.

They found that travel is associated with a nearly three-fold higher risk of VTE, with a dose-response of 18 percent higher risk for each two-hour increase in travel duration.

Physicians should investigate the use of low-cost, low-risk interventions such as increased hydration and ambulation for all long-distance travelers.

References:
Annals of Internal Medicine Tip Sheet for 7 July 2009 Issue, www.annals.org.
Image source: Saphenous vein, Gray's Anatomy, 1918 (public domain).

Wikipedia used by 70% of junior physicians, dominates search results for health queries

noreply@blogger.com (Ves Dimov, M.D.) — Thu, 09 Jul 2009 06:04:20 PDT

Study: Junior physician's use of Web 2.0 for information seeking and medical education:
Google and Wikipedia used by 80% and 70% of physicians, respectively http://is.gd/1oQky

Wikipedia is a prominent source of online health information compared to the other online health info providers studied. Wikipedia ranked among first ten results in 71–85% of search engines and medical keywords tested. In search tests, "Wikipedia surpassed MedlinePlus and NHS Direct Online and ranked higher with quality articles" http://bit.ly/39Xq8k

I didn't understand why @Berci spent so much time editing medical articles in Wikipedia. Now I know and it has obviously made an impact.

Also, I have dismissed Wikipedia as a medical resource until so many residents reported using it during the NEJM Horizons conference in October 2008.

Observation: Just look around you in computer section of medical library of any university & see how many students check Wikipedia. Whether we like or not (and I haven't for a long time), medical students use Wikipedia (a lot) http://bit.ly/39Xq8k

Do you think any medical encyclopedia (@medpedia, AskDrWiki) has any sustainable future facing Wikipedia headstart?

Twitter opinions:

@chrisseper: "One way to lose confidence in a doc. Ask a medical question and see the doc go online & find the answer via Wikipedia."

@palmdoc: "Would anyone lose confidence in a Doc who looks up Google? I'd be worried if they don't know how to Google."

Related:
Web 2.0 for Emergency Physicians http://bit.ly/uFnA0 - A must read. Applies to all physicians. Recommended.
Image source: Doctors Using Google by Philipp Lenssen, used with permission.

Social Media Thoughts

noreply@blogger.com (Ves Dimov, M.D.) — Thu, 09 Jul 2009 04:34:00 PDT

From my Twitter account:

Mind Map: What is the Future of Blogging? http://bit.ly/dklVy - Too complicated. My suggestion: 1 Start a blog. 2. Use Twitter a little bit
"Blogs are born, blogs die — it's a cycle as old as blogging itself" http://bit.ly/H94p7

Survey: Half of Twitter's Never Tweeted, 56% are not following anyone http://is.gd/1oQV1
2009 State of the Twittersphere Report by HubSpot (PDF) http://is.gd/1oR00
"Tighter copyright law could save newspapers" by Connie Schultz/Plain Dealer Columnist http://bit.ly/WzclN - I'm not so sure... Did Cleveland Plain Dealer (newspaper) consider closing their website to get more people to buy the paper edition? http://bit.ly/ObY1S
Study: Social Security Numbers May Be Hackable. Information experts can predict most of a person's Social Security number if they know their name, place/date of birth http://bit.ly/X0sJR
How kids sometimes perceive summer camp: http://bit.ly/3MdW9u

Image source: OpenClipArt.org, public domain.

Health News of the Day

noreply@blogger.com (Ves Dimov, M.D.) — Thu, 09 Jul 2009 04:24:00 PDT

A truly Web 2.0 congress: IAGG World Congress of Gerontology & Geriatrics - see for yourself: http://bit.ly/rifmM
Poor Working Conditions for Docs (time pressures, unfavorable organizational culture) May Affect Quality of Care. Adverse working conditions for PCPs may lead to stress, burnout and ultimately to lower quality patient care. 53.1% of PCPs reported time pressure during physical examinations, while 48.1% reported chaotic working environment. 48.8% of PCPs described their jobs as moderately or highly stressful, while 26.5% reported burnout http://bit.ly/vq8Dv
Dogs are good for you: dog ownership in early childhood may protect against development of inhalant sensitisation http://bit.ly/wnY9E
BMJ 1996 review formula for Dr's info needs still valid today: "Info usefulness=relevance x validity / effort to get" http://tinyurl.com/7n3zf6
High proportion of trials published in Chinese medical journals are flawed, study shows - BMJ http://bit.ly/g2GMJ
Study: "Where do junior doctors look things up?" - @amcunningham finds the method and results section quite perplexing http://bit.ly/KzrDg
"Quacks and Cures" - BBC audio slideshow http://bit.ly/4jkv3C
Zurich Chamber Orchestra Ads: Music and Medicine http://bit.ly/FgP7g
"Sample Cover Letter for Journal Manuscript Resubmissions" http://bit.ly/2Q6Ne1 by Dr. Baumeister http://bit.ly/1iORe - Use at your own risk

Image source: OpenClipArt.org, public domain.

A conversation with a Web 2.0 skeptic

noreply@blogger.com (Ves Dimov, M.D.) — Sun, 12 Jul 2009 21:12:08 PDT

This is a conversation between AnneMarie Cunningham (@amcunningham), a GP and Clinical Lecturer, based in the UK and I (@DrVes). It took place on Twitter yesterday and is summarized below. The tweets were not edited for grammar or spelling.

@amcunningham: Web 2.0 for Emergency Physicians http://bit.ly/uFnA0 .... would love examples of how web2.0 has helped docs with work.

@DrVes: I have written several abstracts with academic physicians I met via my blog or their blog.

@amcunningham: OK... yes, I know about academic relevance. i find the same. But I want to know about clinical use. Ran out of space in tweet:) but have you ever found web 2.0 content useful in your clinical work? you still do clinical work?

@DrVes: This is trickier. It depends whether you trust the resource or not. Sometimes, I provide links of selected resources on my sites to my patients, for example, videos how to use nasal saline rinse. Web 2.0 has a lot of uses for physician/patient communication, it's a pity so (relatively) few physicians benefit from it.

@amcunningham: right!!! but if I am to start teaching students about this I need some real life examples of how useful. And not around yet.

@DrVes: Web 2.0: A blog website is one of the best ways to establish your online identity and educational credibility as a physician. I use my own websites to refer to links I collected, tips, experience pearls, etc. Web 2.0 allows you to create your own section of the web that you trust, e.g. your own blog, best medical links, etc.

@amcunningham: uhm maybe it is different for a generalist but I need to be good for searching for info all the time. saving stuff not so relevant.

@DrVes: Saving info allows you to search it... :) I have experience using Web 2.0 both as "generalist" and specialist - it helps either way... I also follow a few people in my specialty that often select what's relevant from med news and provide a critical view. This presentation aims at answering the question "Why a physician should use Web 2.0?" http://bit.ly/jsQSL (101 slides)

@amcunningham: Uhmmm, you don't follow me [on Twitter] so missed me tweeting this paper by Richard Smith from 1996- still VERY pertinent http://bit.ly/tHQ8L

@DrVes: A good 1996 BMJ review http://bit.ly/tHQ8L but it doesn't even mention UpToDate! KevinMD can't practice without it... :) Did you know that UpToDate was launched in 1992? http://bit.ly/Yf2zB - It wasn't even quoted in this 1996 BMJ review: http://bit.ly/tHQ8L

@amcunningham: was uptodate around in 1996???

@DrVes: You sound like you would like to explore the skeptic point of view of Web 2.0 in medicine - a blog post would be a good start.

@amcunningham: oh, I have blogged! http://bit.ly/el80o http://bit.ly/18xrUm and I am sure I will blog again! yes, I am a skeptic.

@DrVes: I knew from your first Twitter reply that you were a skeptic about Web 2.0 use in medicine. And that's perfectly fine. Reply to @Berci too... :)

@amcunningham: without real-life examples, of myself and others, to be anything other than sceptical in this point in time would be foolish. There is a place of web2.0... discussing how guidelines etc are implemented in practice... but I see next to none of this yet. i have tried to use forums like doc2doc to start these conversations without success. i have tried crowdsourcing for clinical info on twitter without success. i believe it could work and maybe i should blog about that! good point:)

Generally, I am a proponent of Web 2.0 use in medicine but I fully appreciate the validity of the arguments of the skeptics who doubt its usefulness. Also, I may have been the first who used the term "Web 2.0 in Medicine" in articles and presentations back in October 2005.

This is one of my presentations on Web 2.0 in Medicine, updated in 04/2009:

Web2 0 in Medicine - 2009 Update

View more documents from Ves Dimov.

Related:
The same conversation on Twitoaster.
Image source: OpenClipArt, public domain.

Health News of the Day

noreply@blogger.com (Ves Dimov, M.D.) — Wed, 08 Jul 2009 04:39:01 PDT

A Doctor by Choice, a Businessman by Necessity - NYT. A doctor compares himself to a friend who dropped out of medical school 20 years ago to pursue investment banking - NYT http://bit.ly/sOQ8s
A Culprit in Infertility, Overlooked Yet Treatable: nonclassical congenital adrenal hyperplasia http://bit.ly/dDMmY
Designer diagnosed with Wilson's disease made a T-shirt for people who have the same condition http://is.gd/1qeaC
French tennis player Mathieu Moncourt has died at the age of 24 of PE http://bit.ly/8xDkZ - Travel doubles the risk of VTE.
Web 2.0 for Emergency Physicians http://bit.ly/uFnA0 - A must read. Applies to all physicians. How can physicians deal with information overload? #1. Relax! #3. Build a one-stop shop #4. Search selectively. #5. Be smart, be social. #6. Follow the leaders. http://bit.ly/FwTSX
Scary: "Strapping Grandma to the Bed: The Unintended Consequences of “No Pay for Errors Medicare Policy” by Bob Wachter http://bit.ly/B9Jkb
Does the insulin Lantus (glargine) cause cancer? A medical librarian review of literature http://bit.ly/hmK8A
Step-by-step instructions: "How to extract your DNA at home" include "Observe your DNA jellyfish" http://bit.ly/qYc1x (not serious)

Image source: OpenClipArt.org, public domain.

Social Media Thoughts

noreply@blogger.com (Ves Dimov, M.D.) — Wed, 08 Jul 2009 04:02:00 PDT

From my Twitter account:

Spreadsheet: Top 30 Twitter doctors worth following: http://bit.ly/orKao - Open to anybody to edit. This is a "beginner reader" list...
All honest medical blogs (most of them) that run automatic or regular ads have issues with them http://bit.ly/3f1HY and http://bit.ly/z4CZQ -- PalMD is unhappy with ads served by his host ScienceBlogs http://bit.ly/i9LOc - Blogger.com by Google does not force anybody to run ads (yet).
NCBI ROFL features some PubMed abstracts that may send chills down your spine: http://bit.ly/3uqgt -- NCBI ROFL celebrates their success by including banner ads as big as the blog posts & "Beer Fund" donate button http://bit.ly/gwLUv - Hmm...
Tour de Twitter: Lance Armstrong Takes Microblogging to the Races. Twitter: Other cyclists won’t be the only people following Lance Armstrong at this year’s Tour de France http://bit.ly/xaBKD
Search Like an Expert: Google Offers Search Lessons http://bit.ly/L8OJS and http://bit.ly/17Wtev
TRIP Database set up a 70-member advisory board, uses Ning social networking site http://bit.ly/BgE45
Tips: How to Hire A Web Design Firm http://bit.ly/hgTQb

Image source: OpenClipArt.org, public domain.

Health News of the Day (part 2)

noreply@blogger.com (Ves Dimov, M.D.) — Tue, 07 Jul 2009 11:34:00 PDT

In adults with w/o macroalbuminuria, effects of telmisartan (ARB) on renal outcomes were similar to those of placebo http://bit.ly/1Q02U
Candesartan (ARB) daily for 4.7 years did not prevent microalbuminuria in normotensive patients with DM type 1 and 2 http://bit.ly/13IVPb
Sugar Substitute Xylitol (as oral syrup) Prevents Tooth Decay by Acting as an Antibacterial Agent http://bit.ly/7oVZd
Amino acid glutamate, found in greater amounts in vegetable protein, is associated with lower blood pressure http://bit.ly/4hruor
"Chinese food in the U.S. can be a hidden salt mine," a dietitian says http://bit.ly/Phw8Y
No surprise: Kids of Parents Who Value Exercise Are More Active http://is.gd/1oQA7
Former Congressional Insiders Lobby for Health-Care Industry http://is.gd/1oQDS - Who's lobbying for doctors? Is AMA's effort enough?
Cases From AHRQ WebM&M: EMR Entry Error -- Not So Benign, Medscape: http://bit.ly/Xm2lH
Visual search diagram: Visualizing Pubmed http://bit.ly/12mNy5 via ScienceRoll http://bit.ly/N9WaH

Image source: OpenClipArt.org, public domain.

Health News of the Day

noreply@blogger.com (Ves Dimov, M.D.) — Tue, 07 Jul 2009 05:00:30 PDT

Noise from public transportation, especially subways, may be loud enough to harm some passengers' hearing. Experts generally recommend that people average no more than 2.7 hours per day around 80-decibel noise levels http://bit.ly/lNQT1
Pregabalin (Lyrica) reduces stabbing facial pain and other symptoms stemming from trigeminal neuralgia http://bit.ly/sdWYr
Long-term methotrexate appears safe in arthritis - only 3.7% discontinued MTX due to liver toxicity http://bit.ly/sCSA4
"The AMA and Sermo break up, and how it’s getting ugly" by KevinMD: http://bit.ly/1CBhmn
Study: Even Cockroaches Get Fat From Bad Food http://bit.ly/NgWQP
Video: The care one would receive at an (imaginary) Homeopathic ED http://bit.ly/Seuj0

Image source: OpenClipArt.org, public domain.

How to make medical RSS aggregators better

noreply@blogger.com (Ves Dimov, M.D.) — Thu, 09 Jul 2009 08:29:16 PDT

The Problems with RSS

For some reason, RSS has not caught up with most physicians. My Google Reader is loaded with 350 RSS feeds that produce about 2,500 items per day, but I understand that this is not for everybody. We are too busy and it turns out that RSS concept is not that easy to grasp. Assembling RSS feeds in a reader takes time and effort.

Make Your Own "Medical Journal" with iGoogle Personalized Page.

Two years ago, I described how you can Make Your Own "Medical Journal" with iGoogle Personalized Page and provided easy links to the feeds of the "Big Five" medical journals.

Since then, several medical RSS aggregators have launched that make the process of utilizing RSS for staying up-to-date much easier and even enjoyable.

AllTop RSS-powered Magazine Concept

AllTop has condition-specific pages but most of them are geared toward the general public rather than health professionals, for example, see Alltop - Top Asthma News.

Alltop - Top Asthma News.

PeRSSonalized Medicine by Webicina

PeRSSonalized Medicine by Webicina.com was one of the first services (but not the first) to arrange the medical journal feeds in a visually appealing way and make RSS consumption user-friendly.

PeRSSonalized Medicine by Webicina.com.

Kudos to Berci for achieving a significant user adoption which is not an easy task. Webicina.com also includes a feature which I call "create your own feed from PubMed search." There are no specialty-specific pages yet.

ClinicalReader for RSS

ClinicalReader is a new medical RSS aggregator which just launched at the end of June 2009. The service has a simple and easy to understand interface which is attractive and showcases the great benefits of using RSS to gather medical information.

ClinicalReader.com.

One of the best features of ClinicalReader is the specialty-specific pages which are extremely useful and I highly recommend them, for example, see the Allergy and Immunology section.

Suggestions how to make medical RSS aggregators better

- Make a list of top 30 medical blogs. A top 10 or 15 list is too limiting and leaves many useful blogs out. A top 50 or a top 100 list is a "crowd" and few people will check all of them. Most of the leading blogs would be captured in a top 30 and the list would be manageable. This is really a "beginner reader" list which encourages them to explore further. There should also be lists of specialty-specific blogs (see more below).

- Make a list of top 30 medical Twitters.

- Make a list of the top blogs in each major specialty, for example, cardiology blogs, allergy blogs, etc. Be sure to separate physician/nurses blogs for those authored by patients. These multiple specialty-specific lists should be as inclusive as possible. See an example. Give a chance to everybody to be listed, even the A-bloggers were Z-bloggers when they first started. This way nobody should feel left out. Please include a list of medical librarians too - few people have contributed more to educating physicians about the benefits of Web 2.0 tools.

- Make a list of the top Twitters in each major specialty, for example, cardiology, nephrology, allergy, etc. The same considerations listed above apply here. See an example.

I was asked by the ClinicalReader team to assemble a list of the "Top 30 Twitter doctors worth following." The list below is a spreadsheet-wiki that is open to anybody to edit.

The suggestions how to make medical RSS aggregators better apply to all major medical journals. Users want a one-stop shop for medical information (see my notes from the NEJM Horizons conference for reference). BMJ already has a social network (doc-2-doc) albeit one that is scarcely populated. It would be easy to add a medical RSS aggregator as part of the social network. Lancet, NEJM, and JAMA should do the same.

It looks like "printed media" is going out of business fast and unless Kindle replaces it, not many people would be willing to visitto 7-10 different journal web pages to get the information the need. All major journals that are likely to survive, especially the ones funded by medical societies, will most likely have social networks or at least a medical RSS aggregator. The networks should be open, allowing easy export/import, and using Twitter/Google/Facebook Connect, etc. to avoid the need to remember more user names/passwords.

References:
Make Your Own "Medical Journal" with iGoogle Personalized Page
Lists of Medical Bloggers and Twitters Categorized by Specialty
NEJM Horizons Conference to Push Boundaries of Traditional Medical Publishing, Day 1

Selection of My Twitter Favorites, Edition 72

noreply@blogger.com (Ves Dimov, M.D.) — Tue, 07 Jul 2009 04:32:01 PDT

Twitter is a microblogging service where people answer the question "What are you doing?" via 140-character messages from their cellphone, laptop or desktop. You can select the messages (called "tweets") that you find interesting, useful, amusing, or disagreeable. Here is the 72nd edition of My Twitter Favorites.

Stammy "Happiness equals reality minus expectation." - Tom Magliozzi 3:01 AM Jun 25th from Tweetie
Stammy how am i supposed to make an educated decision about where to order my Chinese food if all 3 places nearby are "Best Food in Town" 10:32 AM Jun 24th from Tweetie
AllergyNotes When I use EMR (Cleveland Clinic, VA, etc.), I always try to engage the patient - "write the note together" - esp. assessment and plan. 12:21 AM Jun 24th from web
AllergyNotes Health Data Rights http://bit.ly/yWZXa - I'll say it again - if you use EMR, print your note for your patient - it's their note too. 12:08 AM Jun 24th from TweetDeck
davewiner My netbook costs as much as one night at a hotel in Berlin. To put things in perspective. 3:33 PM Jun 23rd from web
DrGSHenderson Drinking a cold beer on the deck of the ferry to Crete; watching the sun set over Piraeus and considering never coming back. 12:59 PM Jun 23rd from Tweetie
medpedshosp If you have surgery - the least thing you want is to bleed and be transfused - tell your doctor all the over-the-counter stuff you take! 12:32 PM Jun 23rd from TweetDeck
Zorg20 Wooot ; important question answered within 30 minutes by DM in Twitter in 4 different global timezones. Twitter rocks 11:05 AM Jun 23rd from Tweetie
colinsegovis and I am procrastinating from writing the grant by surfing the web (its research...right?) 10:00 PM Jun 22nd from Seesmic Desktop
colinsegovis I am procrastinating from studying by writing a grant.... 9:59 PM Jun 22nd from Seesmic Desktop

The inclusion of a Twitter update (tweet) in Selection of My Twitter Favorites does not represent endorsement or agreement of any kind.

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

Micro-blogging on Twitter is easy, fun and can be useful and educational if you follow/subscribe to interesting people. You can read more here: A Doctor's Opinion: Why I Started Microblogging on Twitter and visit my account at Twitter/AllergyNotes.

Health News of the Day (part 2)

noreply@blogger.com (Ves Dimov, M.D.) — Mon, 06 Jul 2009 11:39:00 PDT

Parkinson's drugs tolcapone and entacapone (COMT inhibitors) show promise in resistant TB http://bit.ly/5oKlW
American Academy of Allergy, Asthma, and Immunology (AAAAI ) is actually blogging on their Facebook fan page: http://bit.ly/88xdh
NPR: Young Doctors Weigh In On Health Care and Choosing a Specialty vs. Primary Care http://bit.ly/Z9QNp
Only survivor of 1971 plane crash fell more than 3km into jungle attached to a row of seats - CNN http://bit.ly/18DQiT
http://clinicalreader.com is a useful medical RSS aggregator but why is it anonymous? http://bit.ly/kOB4b
Jay Parkinson, MD is a photographer too - some amazing photos in his Flickr stream, viewed by almost 1 mln people http://bit.ly/Gs5jF
Radiology Assistant is the educational web site of the Radiological Society of the Netherlands http://bit.ly/1b0eJM
A Mindmap Containing All Major Topics in Biology, Chemistry, and Physics. http://bit.ly/ZHB2m

Image source: OpenClipArt.org, public domain.