MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Clinical Cases and Images' source. Wed, 08 Feb 2012 18:50:19 +0100 http://www.medworm.com/index.php?rid=5668451&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FzQ9He_a7yRM%2Fbest-tweets-selection-of-twitter.html Because of a tendency for hands to be near mouths, we recommend #glutenfree hand lotions for celiacs.— Celiac Disease Ctr (@CureCeliac) February 7, 2012 Btw, is it usual for the receptionist to read out the blood results of a patient in front of the entire waiting room? The poor man!— richard horton (@richardhorton1) February 7, 2012 When the receptionist read out the cholesterol and blood glucose, the man asked: "Are they normal?" To which she said "Probably."— richard horton (@richardhorton1) February 7, 2012 Researching a topic is much easier than writing about it...— Dr. Ronan Kavanagh (@RonanTKavanagh) February 7, 2012 A new paper looks to decipher the ailments tied to eating gluten. More importantly, there's a journal called "Gut" on.wsj.com/AorvDJ— ... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5668451 Wed, 08 Feb 2012 13:48:00 +0100 5668451 http://www.medworm.com/index.php?rid=5630280&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FIvoUh6ZRof4%2Fdoctors-make-mistakes-can-we-talk-about.html Dr. Goldman asks if you know your surgeon's "batting average" of operations with good outcomes. He mentions the three words you never want to hear: "Do you remember?" It's a good TED talk: Every doctor makes mistakes (just like everyone does). But, says Dr. Goldman, medicine's culture of denial (and shame) keeps doctors from ever talking about those mistakes, or using them to learn and improve. Telling stories from his own long practice, he calls on doctors to start talking about being wrong. Here are some simple steps to avoid medical errors from a patient's perspective (source: CNN): 1. Say: "My name is Mary Smith, my date of birth is October 21, 1965, and I'm here for an appendectomy." 2. Say: "Please check my ID bracelet." 3. Say: "Please look in my chart and tell me what procedur... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5630280 Thu, 26 Jan 2012 13:45:00 +0100 5630280 http://www.medworm.com/index.php?rid=5621092&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FhBlJmSmfQ-o%2Fhow-to-evaluate-patient-with-chronic.html Initial evaluation of chronic cough (defined as more than 8 weeks' duration in adults and 4 weeks in children) should include a chest radiography (CXR) in most adult patients. Patients who are taking an angiotensin-converting enzyme inhibitor (ACEi) should switch to a medication from another drug class. Differential diagnosis of cough, a simple mnemonic is BAD CAT TOM (Bronchitis or pneumonia, Asthma, Drugs, CF or Cardiogenic, Aspiration, TB, Thyroid enlargement, Other, e.g. GERD, Malignancy, e.g. lung cancer). Click here to enlarge the image. The most common causes of chronic cough in adults are: - upper airway cough syndrome (post-nasal drip) - asthma - gastroesophageal reflux disease (GERD) - any combination of the above If upper airway cough syndrome is suspected, a trial of ... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5621092 Mon, 23 Jan 2012 13:34:00 +0100 5621092 http://www.medworm.com/index.php?rid=5610699&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2Fr1wdbqS_MA0%2Flung-cancer-lancet-review.html Small-cell lung cancer Diagnosis relies on histology, with the use of immunohistochemical studies to confirm difficult cases. Typical patients are men older than 70 years who are current or past heavy smokers and who have pulmonary and cardiovascular comorbidities. Patients often present with rapid-onset symptoms due to: - local intrathoracic tumour growth - extrapulmonary distant spread - paraneoplastic syndromes - a combination of these features Staging aims ultimately to define disease as metastatic or non-metastatic: - Combination chemotherapy (platinum-based plus etoposide or irinotecan) is the mainstay first-line treatment for metastatic small-cell lung cancer. - For non-metastatic disease, early concurrent thoracic radiotherapy is indicated. Prophylactic cranial irradiati... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5610699 Fri, 20 Jan 2012 13:12:00 +0100 5610699 http://www.medworm.com/index.php?rid=5599126&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FGb8_NHIVkLU%2Fhow-to-investigate-mildly-elevated.html Mild elevations in the liver enzymes alanine transaminase (ALT) and aspartate transaminase (AST) are commonly found in asymptomatic patients. The most common cause is nonalcoholic fatty liver disease (sometimes called nonalcoholic steatohepatitis or NASH), which can affect up to 30% of the U.S. population. Other common liver causes include: - alcoholic liver disease - medication-associated liver injury - viral hepatitis (hepatitis B and C) - hemochromatosis Pale stool and dark urine (click to enlarge the images). This is an example of "obstructive" jaundice with the classic constellation of tea-colored urine and clay-colored stool. Less common liver causes include: - alpha-1-antitrypsin deficiency (AAT) - autoimmune hepatitis - Wilson disease Extrahepatic conditions can also caus... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5599126 Tue, 17 Jan 2012 13:39:00 +0100 5599126 http://www.medworm.com/index.php?rid=5599127&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2F1oDnq9NK4Xs%2Fevaluation-of-suspected-dementia-2.html Prevalence of dementia will increase as the U.S. and the world population ages. The text below is based on a recent review in the journal Am Fam Physician: Risk factors for dementia include: - age - family history of dementia - apolipoprotein E4 genotype - cardiovascular comorbidities - chronic anticholinergic use - lower educational level A two-visit approach is time-effective for primary care physicians. During the first visit, the physician should administer a screening test such as: - verbal fluency test - Mini-Cognitive Assessment Instrument - Sweet 16 The tests above have relatively high sensitivity and specificity for detecting dementia, and can be completed in as little as 60 seconds (Note by editor: this one-minute time estimate sounds too optimistic, it usua... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5599127 Mon, 16 Jan 2012 20:34:04 +0100 5599127 http://www.medworm.com/index.php?rid=5583865&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FKDyVSDulPPg%2Fpremenstrual-syndrome-and-premenstrual.html Premenstrual syndrome Premenstrual syndrome is defined as recurrent psychological and physical symptoms that occur during the luteal phase of menses and resolve with menstruation. It affects 20-30% of premenopausal women. Premenstrual dysphoric disorder Premenstrual dysphoric disorder includes affective or somatic symptoms that cause severe dysfunction in social or occupational activity. It affects 3-8% of premenopausal women. Proposed etiologies (causative factors) include: - increased sensitivity to normal cycling levels of estrogen and progesterone - increased aldosterone and plasma renin activity - neurotransmitter abnormalities, particularly serotonin The Daily Record of Severity of Problems is one tool with which women may self-report premenstrual symptoms. Symptom reli... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5583865 Fri, 13 Jan 2012 13:25:00 +0100 5583865 http://www.medworm.com/index.php?rid=5561657&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FZ62rL88suCU%2Fhands-only-cpr-videos-american-way-vs.html The American Heart Association (AHA) recruited Kendrick Kang-Joh Jeong, MD (a trained physician and an actor from the Hangover) to demonstrate ‘hands only CPR’ to the metronomic beat of the Bee Gees 1977 disco hit ‘Stayin’ Alive’: The British Heart Foundation recruited footballer-turned-actor Vinnie Jones to show how hard and fast hands-only CPR to Stayin' Alive by the Bee Gees can help save the life of someone who has had a cardiac arrest. The Hollywood hardman is starring in a TV advert urging more people to carry out CPR in a medical emergency: Ken Jeong Behind the Scenes - AHA CPR video: Comments from YouTube: Sure, the beat to "Staying Alive" works, but so does "Another One Bites The Dust" by Queen......... just saying! Related reading: Disco Still Saves Lives... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5561657 Thu, 05 Jan 2012 13:44:01 +0100 5561657 http://www.medworm.com/index.php?rid=5561658&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FwVUkCoLA254%2Fthird-component-of-genetic-blueprint.html The term epigenetics refers to changes in phenotype (appearance) or gene expression caused by mechanisms other than changes in the underlying DNA sequence, hence the name epi- (Greek: over; above) -genetics. There is no change in the underlying DNA sequence of the organism; the phenotype is expressed by activating some genes while inhibiting others. Epigenetics includes changes in gene function that occur without a change in the sequence of DNA. These changes occur as a result of the interaction of the environment with the genome. Epigenetic determinants activate or silence fetal genes through alterations in DNA, histone methylation and acetylation. DNA associates with histone proteins to form chromatin. Image source: Wikipedia, GNU Free Documentation License. From the Nationa... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5561658 Wed, 04 Jan 2012 17:04:04 +0100 5561658 http://www.medworm.com/index.php?rid=5553151&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FckWOrM-xaIM%2Frisk-of-heart-attack-and-stroke-goes-up.html From the Mayo Clinic YouTube channel: Are you at an increased risk of heart attack and stroke? Studies show the incidents rise during December and January, but particularly on Christmas Day and New Year's Day. Stay safe. Jon Lord (70), a Hammond organ player, and a founding member of Deep Purple, who is currently recovering from cancer, says it very well: "Party hearty but look after yourselves. I wish you success and happiness, and above all I wish you health." Jon Lord - Child In Time, 4 March, 2009, Palace of Arts (MÜPA), Budapest, Hungary. Happy New Year! References: Jon wishes you a Happy New Year Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5553151 Sat, 31 Dec 2011 16:44:15 +0100 5553151 http://www.medworm.com/index.php?rid=5545433&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FYRO6xG-LwQw%2Fhow-to-manage-your-online-reputation-as.html 1. Google yourself - repeat on a regular basis, at least once a month, and set up Google alerts to catch new mentions. 2. Correct mistakes and false information about you that is published online. Contact the site authors. 3. Create your own content - start a blog, Twitter account and Facebook page, use Google+ for draft posts. Send selected news to Twitter, try Facebook for updates from you practice. Link you own blog posts from Twitrter and Facebook. Setup professional profiles on Google+ and LinkedIn. Push irrelevant or non-reliable content down in the search results. The farther down the better, as 90% of people won't go past the first page of search results and 99% won't go past page 2. 4. Embrace constructive online criticism. Consider it a 360-degree evaluation. 5. Address ac... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5545433 Wed, 28 Dec 2011 13:57:00 +0100 5545433 http://www.medworm.com/index.php?rid=5545434&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2F4kD10SD22hM%2Fipad-app-tests-athletes-for-concussion.html An iPad app tests athletes for concussions (a Cleveland Clinic video). The players perform a series of balance, memory, vision, and reaction time experiments to obtain a baseline reading. If they receive a blow to the head during a game or practice, these tests can be redone to determine when it is safe for the athlete to return to action. References: Concussion Center - Cleveland Clinic. Cleveland Clinic Treats Concussions With iPad App. Fox News. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5545434 Tue, 27 Dec 2011 17:49:04 +0100 5545434 http://www.medworm.com/index.php?rid=5526681&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FaBBG875beb4%2F40-police-officers-have-sleep-disorder.html More than a third of police officers have a sleep disorder, and those who do are more likely to experience heart disease, problems with job performance and rage toward suspects and citizens, says the NYTimes, citing a study in the JAMA. That figure is at least double the estimated 15-20% rate of sleep disorders seen in the general population. Having a sleep disorder raised the odds of heart disease by 45%, and the odds of depression by 120%. It also raised the odds of being injured on the job by 22% and falling asleep while driving by 51%. The JAMA report video. The officers who had sleep disorders reported more instances of “uncontrolled anger” toward suspects and citizens and serious administrative errors. Sleep deprivation may affect the amygdala, a part of the brain where emot... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5526681 Wed, 21 Dec 2011 16:53:07 +0100 5526681 http://www.medworm.com/index.php?rid=5526682&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2Fz65EXdr_JmY%2Fbrand-identity.html The image source is xkcd, of course. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5526682 Wed, 21 Dec 2011 16:52:22 +0100 5526682 http://www.medworm.com/index.php?rid=5495756&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FlstzOyVYIsQ%2Facute-pyelonephritis-in-women-2011.html This is a 2011 review from the official journal of the AAFP, American Family Physician:Acute pyelonephritis is a bacterial infection of the renal pelvis and kidney most often seen in young women.Symptoms of acute pyelonephritisMost patients have fever, although it may be absent early in the illness. Flank pain is nearly universal.Tests for acute pyelonephritisA positive urinalysis confirms the diagnosis.Urine culture should be obtained in all patients to guide antibiotic therapy if the patient does not respond to initial empiric antibiotic regimens.Escherichia coli is the most common pathogen in acute pyelonephritis. In the past decade, there has been an increasing rate of E. coli resistance to extended-spectrum beta-lactam antibiotics.Imaging, usually with contrast-enhanced CT is not nece... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5495756 Mon, 12 Dec 2011 13:26:00 +0100 5495756 http://www.medworm.com/index.php?rid=5488230&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FhNbhwwzxDgM%2Fuptodate-is-most-read-medical-reference.html This the summary of my Twitter discussion with an academic nephrologist (by the way, the founding editor of UpToDate is also a nephrologist):@DrVes: UpToDate is likely the most read medical reference tool, at least in the U.S. - how did Harrison's, Cecil's, etc. manage to lose that war?@kidney_boy (Joel Topf): Reasons for UpToDate winning: Harrison's had no search, and an editorial style that told you about disease but not how to treat it@DrVes: Exactly. It's amazing that those publishing companies didn't realize that they shipped "malfunctioning" product for years, and never fixed it.@kidney_boy (Joel Topf): Harrison's is the great preclinical prof teaching pathophysiology, UpToDate is the smart clinician teaching you how to care for the patient with EBM.@DrVes: UpToDate now has sections ... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5488230 Fri, 09 Dec 2011 13:47:01 +0100 5488230 http://www.medworm.com/index.php?rid=5459232&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FoBr0n6MtDHg%2Fhirsutism-or-excess-hair.html From NHS Choices YouTube channel: Hirsutism causes excess hair growth in women, such as on the face and chest. An expert explains the causes or hirsutism, treatments such as hair-removal and cosmetic techniques, and where to go for help if you're worried about excess hair growth.The Cleveland Clinic Journal of Medicine published an Update on the management of hirsutism in 2010:Hirsutism is a source of significant anxiety in women. While polycystic ovary syndrome (PCOS) or other endocrine conditions are responsible for excess androgen in many patients, other patients have normal menses and normal androgen levels (“idiopathic” hirsutism).The finding of polycystic ovaries on ultrasound is not required for the diagnosis of polycystic ovary syndrome (PCOS). Gonadotropin-dependent ovarian hy... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5459232 Wed, 30 Nov 2011 13:03:00 +0100 5459232 http://www.medworm.com/index.php?rid=5442833&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2F4_gsOe05jgI%2Fholiday-time-can-be-really-stressful.html From Mayo Clinic YouTube channel:For people with eating disorders such as binge eating disorder, bulimia nervosa and anorexia nervosa, the holiday season can be a nightmare.People with eating disorders usually begin to worry about food consumption at holiday gatherings weeks sometimes even months - before the event, says Leslie Sim, Ph.D., clinical director of the Mayo Clinic Eating Disorders Program. "It's really a stressful time because there are large amounts of food around."Dr. Sim suggests a few tips to navigate through holiday gatherings:- Have a plan. People with eating disorders should eat like they would on a normal day and not skip any meals. Make sure to eat breakfast, lunch, and a light snack in addition to the meal. People who starve themselves are more likely to skip out on t... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5442833 Thu, 24 Nov 2011 14:38:00 +0100 5442833 http://www.medworm.com/index.php?rid=5432697&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2Fv7CpcUgS2Zg%2Ftinnitus-is-perception-of-sound-where.html Just a few days ago, British newspapers reported that a rock fan committed suicide to relieve tinnitus that he had for 3 months after a supergroup's gig. Tinnitus is characterized as perception of sound where there is none. Read more about tinnitus in this blog post. The Cleveland Clinic Journal of Medicine recently published a review on Tinnitus: Patients do not have to ‘just live with it’ and Tinnitus relief: Suggestions for patients.From NHS Choices YouTube channel: Tinnitus causes people to hear constant sounds in one ear, both ears or in their head. An audiologist explains the possible causes and effects it often has, such as stress and anxiety, plus how to deal with them. Ashleigh, who was diagnosed with tinnitus in 2005, describes how she copes with it.Lars Ulrich, the drummer f... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5432697 Mon, 21 Nov 2011 13:11:01 +0100 5432697 http://www.medworm.com/index.php?rid=5409987&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2FNEeiQA4Dbag%2FlivzJTIWlmY From Mike Cadogan, the founder of one the most popular medical blogs Life in The Fast Lane, based in Australia:I blog to vent, to educate, to converse, to cogitate, to archive thoughts and to stimulate discussion.I love the concept of a launching a thought, an image, a moment… into the inferno of the blogosphere, and observing the response.With the average blog-reader attention span being around 90 seconds, I find that most of my ‘good’ posts – thoroughly researched, with well constructed arguments and propositions… are lost on this ‘average‘ reader… Yet, strangely I feel better having taken the time to arrange my thoughts, review the evidence and archive the information.The advent of Facebook and Twitter has changed the way readers comment and share, and in many cases the ... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5409987 Wed, 16 Nov 2011 12:57:00 +0100 5409987 http://www.medworm.com/index.php?rid=5409988&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2FouNZewqCvv4%2F "New drug could cure nearly any viral infection", proclaimed the media. The drug works by targeting a type of RNA (dsRNA) produced only in cells that have been infected by viruses. “In theory, it should work against all viruses."Currently there are relatively few antiviral therapeutics, and most which do exist are highly pathogen-specific.The MIT researchers developed a new broad-spectrum antiviral approach, called Double-stranded RNA (dsRNA) Activated Caspase Oligomerizer (DRACO).DRACO selectively induces apoptosis in cells containing viral dsRNA, rapidly killing infected cells without harming uninfected cells.The drugs were nontoxic to mammalian cells and effective against 15 different viruses, including dengue flavivirus, arenaviruses, bunyavirus, and H1N1 influenza.DRACOs have the po... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5409988 Tue, 15 Nov 2011 13:41:00 +0100 5409988 http://www.medworm.com/index.php?rid=5389416&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FSO_aVRlmypQ%2Fany-difference-between-mac-and-pc.html Permanent link to this comic: http://xkcd.com/934 Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5389416 Wed, 09 Nov 2011 17:57:00 +0100 5389416 http://www.medworm.com/index.php?rid=5389418&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2F6UWMKnziLCA%2Fsocial-media-in-medical-education-video.html This is a video presentation and summary by one of the best medical bloggers, Mike Cadogan of Life in the Fast Lane:The Cycle Of Social Media In Medical Education he mentions is based in part on my concept of TIC, Two Interlocking Cycles for Physician and Patient Education.Dr. Cadogan asked me for feedback on a few questions that he used to prepare the presentations a few weeks ago. The answers are listed below:1) What are your TOP 3 TIPS for the intrepid doctors starting out on their social media crusade?1. Post 3 times a week. Schedule posts in advance. In reality, 95% of medical bloggers probably quit within one year.2. Use your blog to collect interesting ideas and share/comment on health news.3. Write some original content, if you can, but if you don't have time, that's OK. You have a... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5389418 Wed, 09 Nov 2011 15:15:05 +0100 5389418 http://www.medworm.com/index.php?rid=5389417&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FmLoED5GNVsk%2Fmedical-systems-are-made-of-holes-and.html From the NYtimes:"In 2000, the British psychologist James Reason wrote that medical systems are stacked like slices of Swiss cheese; there are holes in each system, but they don’t usually overlap. An exhausted intern writes the wrong dose of a drug, but an alert pharmacist or nurse catches the mistake. Every now and then, however, all the holes align, leading to a patient’s death or injury."We have to fix the systems.References:The Phantom Menace of Sleep Deprived Doctors. NYTimes, 2011.Image source: OpenClipArt.org, public domain. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5389417 Wed, 09 Nov 2011 13:00:02 +0100 5389417 http://www.medworm.com/index.php?rid=5363239&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FM0BuQATbqFA%2Fwhy-you-shouldnt-close-your-blog-and.html A few months ago, @Doctor_V and an anonymous doctor on Twitter had an argument, she closed her account and now DrV's blog is the only one left to tell the story: http://goo.gl/mIS3NI understand and appreciate the arguments of both parties. However, when she deleted her Twitter account, we lost one side of the story forever.All doctors should consider having online presence because they need to tell their side of the story.For example, if the majority of pediatricians had blogs, the false autism/immunization link would not have become accepted by celebrities and misled a large part of the general public.Comments from Google Plus:Arin Basu: Excellent point by Ves about how false findings spread (read the bit about immunization and autism). I think by the same stretch of logic, I'd strongly v... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5363239 Tue, 01 Nov 2011 13:21:00 +0100 5363239 http://www.medworm.com/index.php?rid=5363242&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2FNt8Ui2_-Mrs%2F2011_Sept_01_Preliminary_Program_Website_website.pdf This is the key concept of a series of talks that I am scheduled to present at several national and international meetings in 2011-2012 (CSACI, AAAAI and WAO) - TIC, Two Interlocking Cycles:- Cycle of Patient Education- Cycle of Online Information and Physician EducationThe two cycles work together as two interlocking cogwheels (TIC).Cycle of Patient Education (click here to enlarge the image). An editable copy for your presentation is available at Google Docs.Cycle of Online Information and Physician Education (click here to enlarge the image). An editable copy for your presentation is available at Google Docs.The first presentation was during the annual meeting of the Canadian Society of Allergy and Clinical Immunology (CSACI) and brought a lot of engaged, useful, and interesting questio... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5363242 Mon, 31 Oct 2011 22:13:55 +0100 5363242 http://www.medworm.com/index.php?rid=5363240&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2Fdz7gkVH4m3A%2Fmedical-apps-are-wonderful-thing-but.html From the NYTimes:Epocrates drug reference app has won over 50% of U.S. doctors. But like so much else on the Web, “free” comes with a price: doctors must wade through marketing messages on Epocrates that try to sway their choices of which drugs to prescribe.The marketing messages are difficult to ignore. For example, a psychiatrist who recently opened Epocrates on his iPhone said that before he could look up any drugs, he had to click past “DocAlert” messages on hypertension, bipolar disorder and migraines.Epocrates says drug makers get $3 in increased sales from every dollar spent on DocAlerts.One in five doctors will not see drug sales representatives at work, and Epocrates sees DocAlerts as a way to get a sales pitch in front of doctors.Pharmaceutical companies provide at 70% of... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5363240 Mon, 31 Oct 2011 14:18:04 +0100 5363240 http://www.medworm.com/index.php?rid=5363241&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2F-3BZN7Z0cXQ%2Froad-office-in-box-video.html An “office in a box briefcase, with a place for everything and everything in its place". Check it out, by ePatient Dave: Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5363241 Mon, 31 Oct 2011 14:10:00 +0100 5363241 http://www.medworm.com/index.php?rid=5349432&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2FqnPtcGXjqDE%2F42806370001 This article is horribly out of date (as in, it looks at WEST Germany), so take it for what it's worth, but the relationship between income and lifespan was least pronounced in Sweden and Norway, worst in the US and UK (and W. Germany, but let's ignore that all together). http://www.bmj.com/content/304/6820/165.full.pdfAre there more uninsured and under-insured than I would like? Absolutely. But I think you're looking at this upside down. Our ability to take care of the bottom of our society is undeniably poor. But the middle elements of society get good care. And I'm not even saying that this is the way things ought to be. But it's the way things are, and to say a minority of patients get good healthcare is inaccurate to me. I would fundamentally disagree that FEW people in the US get "go... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5349432 Wed, 26 Oct 2011 13:47:00 +0100 5349432 http://www.medworm.com/index.php?rid=5349433&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2F5vkIAewwUZs%2Fsocial-media-in-medicine-how-to-be.html This is the key concept of a series of talks that I am scheduled to present at several national and international meetings in 2011-2012 (AAAAI and WAO):- Cycle of Patient Education- Cycle of Online Information and Physician EducationThe two cycles work together as two interlocking cogwheels.Cycle of Patient Education (click here to enlarge the image).Cycle of Online Information and Physician Education (click here to enlarge the image).The first presentation was during the annual meeting of the Canadian Society of Allergy and Clinical Immunology (CSACI) and brought a lot of engaged, useful, and interesting questions. Feel free to use the images in your own presentations with credit to AllergyCases.org.Byproducts of the Cycle of Patient Education- Energy! (energized and engaged patients)- Im... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5349433 Wed, 26 Oct 2011 03:50:45 +0100 5349433 http://www.medworm.com/index.php?rid=5324856&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2F5cwqrDUNUEA%2Fstuttering-affects-1-of-schoolchildren.html Stuttering, also known as stammering, is a common speech disorder of neural speech processing that typically begins during the first 3-4 years of life. A review of 44 studies shows a prevalence of around 1% for schoolchildren.Stuttering is a movement disorder of speech, with effects on the:- jaw- mouth- facial muscles- sometimes upper limbsPeople who stutter are at risk of developing social anxiety or mental health problems. Educational, occupational, and social problems are common if chronic stuttering is not treated earlyIt is not possible to predict who will recover spontaneously. The window of opportunity is to treat children within one year of onset.Early intervention is recommended, preferably within one year of onset of stuttering. Speech restructuring can rehabilitate speech in peo... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5324856 Mon, 17 Oct 2011 12:03:00 +0100 5324856 http://www.medworm.com/index.php?rid=5316691&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2F-dPIjd1plT4%2Fstandard-american-diet-yes-its-sad.html The average American consumes 45 gallons of soft drinks annually. This does not include noncarbonated sweetened beverages, which add up 17 gallons a person per year. Chips and Coke are a common breakfast.Nearly a third of American children are overweight or obese. In our inner cities a prevalence of obesity of more than 50% is not uncommon. Too many calories in, too little energy out. An 18% tax on pizza and soda can decrease U.S. adults' weight by 5 pounds (2 kg) per year, according to some researchers.Here are some ideas how to promote healthy diet from from the NYTimes:- taxing unhealthy food would reduce consumption and generate billions of dollars annually. That money could be used to subsidize the purchase of staple foods like seasonal greens, vegetables, whole grains, dried legumes ... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5316691 Sat, 15 Oct 2011 02:14:58 +0100 5316691 http://www.medworm.com/index.php?rid=5305610&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FRnexFpcquCM%2Fsearch-for-male-contraceptive.html From the NYT:Steve Owens had always left birth control to his wife, who took the pill. Then Mr. Owens volunteered to test potential methods that lowered his sperm count so much that “I was not viably able to produce a child,” he said. His count rebounded weeks after stopping each method, and he fathered a daughter between research studies.Male contraceptives are attracting growing interest from scientists. The most studied approach uses hormones such as testosterone and progestin, which send the body signals to stop producing sperm. While effective and safe for most men, they have not worked for everyone (5% do not respond to treatment). Questions about long term side effects also remain.Scientists are testing several ways of interrupting sperm production, maturation or mobility:- horm... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5305610 Wed, 12 Oct 2011 00:46:14 +0100 5305610 http://www.medworm.com/index.php?rid=5305611&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2Fcf8qGxlbcG0%2Fpets-cause-many-er-visits-for-owners.html From Cleveland Clinic YouTube channel: Accidental falls are the leading cause of non fatal injuries in the United States according to the American Association of Neurological Surgeons, and a new study finds more than 86,000 of those falls are caused by cats and dogs. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5305611 Tue, 11 Oct 2011 15:52:00 +0100 5305611 http://www.medworm.com/index.php?rid=5287108&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FOF0Tq-A9i2I%2Fwebmd-symptom-checker-is-not-for-faint.html So, you feel some trembling and you decide to see what the options might be on WebMD Symptom Checker... After a couple of clicks, the computerized algorithm suggests that you may be a cannibal:This is exactly why you need to see a real doctor instead of relying on online symptom checks, Google and Facebook.Link via FailBlog and Berci. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5287108 Wed, 05 Oct 2011 13:31:22 +0100 5287108 http://www.medworm.com/index.php?rid=5262346&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2Fyogcfn7FmDo%2Fwidget.jsp Please feel free to grab and embed the free widgets below in your own practice website or blog:BMI calculator BMI For Adults.Flash Player 9 is required.Flu (Influenza)Electronic Preventive ServicesDid you know: U.S. Department of Health & Human Services has 40 blogs?!More social media resources:Flickr: The U.S. Food and Drug Administration's Photostream Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5262346 Wed, 28 Sep 2011 13:40:00 +0100 5262346 http://www.medworm.com/index.php?rid=5239520&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2F_OnfaPi6Gi4%2Falarming-new-stimulant-bath-salts.html Update 09/21/2011: DEA Moves to Make 'Bath Salts' Illegal as Overdoses RiseWhat are these “bath salts”?The abuse of psychoactive “bath salts” (PABS) has become commonplace, and patients with PABS overdoses are presenting to emergency departments with increasing frequency. The main ingredient of the synthetic designer drugs in these bath salts, which are not related to any hygiene product, is methylenedioxypyrovalerone (MDPV).What is the clinical presentation?From the NYTimes: "Doctors could not believe what he was seeing this spring in the emergency room: people arriving so agitated, violent and psychotic that a small army of medical workers was needed to hold them down.They had taken new stimulant drugs that people are calling “bath salts,” and sometimes even large doses of se... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5239520 Wed, 21 Sep 2011 16:29:19 +0100 5239520 http://www.medworm.com/index.php?rid=5239519&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2F99uL9uW9X8A%2Fcnn_416x234_embed.swf Source: CNN Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5239519 Wed, 21 Sep 2011 14:39:00 +0100 5239519 http://www.medworm.com/index.php?rid=5239521&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2Fy1AtlUlg1qM%2Fpacemaker-implantation-animation.html From NHS Choices YouTube channel: Pacemaker implantation involves surgically placing an electrical device into the chest to help your heart beat normally. This animation explains what causes an irregular heartbeat and how a pacemaker can correct it. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5239521 Tue, 20 Sep 2011 15:57:00 +0100 5239521 http://www.medworm.com/index.php?rid=5239522&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FIfp-KeScjLE%2Fpresentations-from-medicine-20-congress.html These are some selected presentations from the 2011 Medicine 2.0 Congress that took place on the Stanford University campus last weekend: 5-pln-1050-Aase View more presentations from med20su Lee Aase, manager of Syndication and Social Media for Mayo Clinic, has uploaded more than 100 of his presentations on SlideShare. 5-pln-1050-Swanson View more presentations from med20su 5-pln-1341-Sahai View more presentations from med20su Other presentations: Epocrates and medical apps. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5239522 Mon, 19 Sep 2011 13:32:00 +0100 5239522 http://www.medworm.com/index.php?rid=5227737&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2Fs9CZ7eArmpU%2Fsciatica-roberts-story.html From NHS Choices YouTube channel: Robert's sciatica caused him intense pain in his right leg. He describes how the condition affected his life and mobility and what treatment options were available to him. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5227737 Fri, 16 Sep 2011 15:29:00 +0100 5227737 http://www.medworm.com/index.php?rid=5210684&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FReGtAR-Tuno%2Foral-symptoms-of-systemic-diseases-what.html Examination of the oral cavity (mouth) may reveal findings pointing to an underlying systemic condition, and allow for early diagnosis and treatment. Oral examination should include evaluation for: - mucosal changes- periodontal inflammation and bleeding- condition of the teeth Examples of lesions: - Oral findings of anemia may include mucosal pallor, atrophic glossitis, and candidiasis. - Oral ulceration may be found in patients with lupus erythematosus (SLE), pemphigus vulgaris, or Crohn disease. Oral manifestations of lupus erythematosus may include honeycomb plaques (silvery white, scarred plaques); raised keratotic plaques (verrucous lupus erythematosus); erythema, purpura, petechiae, and cheilitis. Oral findings in patients with Crohn disease may include diffuse mucosal swelling, ... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5210684 Mon, 12 Sep 2011 13:37:00 +0100 5210684 http://www.medworm.com/index.php?rid=5197393&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2F_plDUOyXyZw%2Fmedical-problems-among-prisoners.html From a recent review in The Lancet: More than 10 million people are incarcerated worldwide, and this number has increased by one million in the past decade. Some of the major medical problems include: - Mental disorders and infectious diseases are more common in prisoners - High rates of suicide in prison - Increased mortality on release High risk groups among prisoners: - women - prisoners aged 55 years and older - juveniles References: The health of prisoners. The Lancet, Volume 377, Issue 9769, Pages 956 - 965, 12 March 2011. “A very severe physical trial”. The Lancet, Volume 377, Issue 9769, Page 876, 12 March 2011. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5197393 Wed, 07 Sep 2011 12:19:01 +0100 5197393 http://www.medworm.com/index.php?rid=5197394&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FyuFzkpqegw0%2Fshould-doctor-block-hisher-patients-on.html According to the Guardian newspaper, the current UK guidelines state that "Doctors must not "friend" their patients on Facebook." Should a doctor block his/her patients on Google+ then? What about Twitter? Social media platforms, their use, and the perception of the ways they are used are all changing. The ban of professional use of the most popular services is not the way forward. Doctors are natural communicators and should do very well on social media platforms. Patients, and society in general, would only benefit from physicians who share ideas and focus on education. Simple guidance for social media use The suggested guidance for social media use by health professionals is very simple and based on a recent book by a nurse and social media advocate: 1. Remember the basics: - your... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5197394 Tue, 06 Sep 2011 23:52:05 +0100 5197394 http://www.medworm.com/index.php?rid=5176351&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FEpW1BIdMEO4%2Fadult-stem-cell-infusion-to-treat-ms.html Cleveland Clinic, University Hospitals Seidman Cancer Center and Case Western Reserve University are collaborating on a clinical trial designed to treat the debilitating effects of multiple sclerosis by using a patient's own adult stem cells. Mesenchymal stem cells, or MSCs, are found in the bone marrow. More than 150 clinical trials are currently testing MSCs' ability to encourage tissue repair as a way to treat a variety of conditions such as osteoarthritis, diabetes, emphysema and stroke. In this trial, a patient's MSCs are harvested at Case's University Hospital, cultivated in a special laboratory and then injected intravenously back into the patient at the Cleveland Clinic. See the two videos below that describe the project - the first is from the Cleveland Clinic and shows one o... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5176351 Tue, 30 Aug 2011 14:04:00 +0100 5176351 http://www.medworm.com/index.php?rid=5171089&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2FcFx1rF4c6Q8%2FwfegFjOygC0 . Tunga penetrans is hyperendemic in East Asia, India, and South America, where it originated, and in Sub-Saharan Africa, where it was introduced from South America in the late 19th century. Tungiasis is caused by the penetration of the gravid female chigoe flea into the epidermis to feed on blood and tissue juices, usually on the feet and under the toenails or in the interdigital web spaces. Management strategies for tungiasis include extracting all embedded fleas immediately with sterile needles or curettes, administering tetanus prophylaxis, and treating secondary wound infections with appropriate antibiotics. For heavy infestations with multiple lesions, oral therapy for 3 days with either thiabendazole or a single oral dose of niridazole (30 mg/kg) has been recommended. References... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5171089 Mon, 29 Aug 2011 15:50:00 +0100 5171089 http://www.medworm.com/index.php?rid=5171090&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FzICS-kVjsGg%2Fama-guide-to-assessing-and-counseling.html Motor vehicle injuries are a leading cause of injury-related deaths in the older population (persons 65 years and older). Per mile driven, the fatality rate for drivers 85 years and older is 9 times higher than the rate for drivers 25 to 69 years old. Physicians play an important role in the safe mobility of their older patients. The AMA encourages physicians to make driver safety a routine part of their geriatric medical services and the guide is freely available as PDF documents here: AMA Physician's Guide to Assessing and Counseling Older Drivers For example, dementia is just one of the risks that older drivers face: Evaluation of driving risk in dementia (click to enlarge the image). For patients with dementia, the following characteristics are useful for identifying patients a... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5171090 Mon, 29 Aug 2011 12:44:00 +0100 5171090 http://www.medworm.com/index.php?rid=5164062&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FMu6UNaFJv_c%2Fvitiligo-roberts-story.html From NHS Choices YouTube channel: Robert, 19, was diagnosed with vitiligo (loss of skin colour) when he was eight. He describes how the condition spread, how it first affected his confidence, and his treatment. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5164062 Fri, 26 Aug 2011 15:47:00 +0100 5164062 http://www.medworm.com/index.php?rid=5145473&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FpzdC96h4rQg%2Fexercises-to-avoid-with-osteoarthritis.html include: - Running and jogging. The difference between how much force goes through your joints jogging or running, as opposed to with walking, is sometimes more than 10-fold your whole body weight - Jumping rope - High-impact aerobics - Any activity where, at any time, you have both feet off the ground at once, however briefly (basketball, jumping) Fortunately, that leaves a lot of activities that are OK for people with knee and hip osteoarthritis and that can help keep you mobile - see the list at WebMD. References:Knee and Hip Exercises for Osteoarthritis. WebMD.Image source: OpenClipart.org, public domain. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5145473 Fri, 19 Aug 2011 13:57:00 +0100 5145473 http://www.medworm.com/index.php?rid=5133271&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FAQL_82sBnyY%2Fhepatitis-c-teenager-jazzys-story.html NHS Choices: Teenager Jazzy was born with hepatitis C. This is her video diary about living with the condition. Comments from Twitter: @napernurse: Fortunate to live in UK where extensive med/psych prescriptions for HepatitisC covered by NHS. If liver transplant needed, that is covered too! Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5133271 Tue, 16 Aug 2011 16:23:59 +0100 5133271 http://www.medworm.com/index.php?rid=5133272&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FEQfE6TE_u_o%2Fnew-treatments-for-diabetes-type-2.html There is urgent need for new treatment strategies for diabetes type 2. Some new approaches include: - Long acting (eg, once weekly) agonists of the glucagon-like-peptide-1 receptor - they improve prandial insulin secretion, reduce excess glucagon production, and promote satiety - inhibitors of dipeptidyl peptidase 4 (DPP-4), which enhance the effect of endogenous incretin hormones - inhibitors of the sodium—glucose cotransporter 2, which increase renal glucose elimination - inhibitors of 11β-hydroxysteroid dehydrogenase 1, which reduce the glucocorticoid effects in liver and fat - Insulin-releasing glucokinase activators and pancreatic-G-protein-coupled fatty-acid-receptor agonists, glucagon-receptor antagonists, and metabolic inhibitors of hepatic glucose output are also being as... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5133272 Tue, 16 Aug 2011 13:31:00 +0100 5133272 http://www.medworm.com/index.php?rid=5120917&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FvjTWhmMfGv0%2Fsocial-media-tips-for-employees-of.html From Dartmouth Hitchcock YouTube channel: Social media is everywhere... and what you write is forever. A simple rule of thumb: if you wouldn't say something in a loud voice in the crowded cafeteria, you shouldn't say it on Facebook, Twitter, or other social media sites. When can I use social media? Even if you have your own phone and you're just sending a quick tweet, you may only use social media for personal reasons on your own time, such as during scheduled breaks or meals. What's not allowed? - Posting protected health information or patient identifiable information - Using information created by or for Dartmouth-Hitchcock - such as logos, pictures, and videos - without the approval of Public Affairs and Marketing department. It's copyrighted content. - Creating social media sit... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5120917 Fri, 12 Aug 2011 13:20:00 +0100 5120917 http://www.medworm.com/index.php?rid=5120918&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FMRfoqYuWLOo%2Fsecondhand-smoke-is-nothing-to-kid.html CDC: This 30-second TV ad features vignettes of children talking about when they're exposed to secondhand smoke. As the narrator points out, secondhand smoke is nothing to kid about. It can hurt lung growth and damage lung function in children. When smoking around your kids, it's like they're smoking. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5120918 Fri, 12 Aug 2011 00:55:12 +0100 5120918 http://www.medworm.com/index.php?rid=5111044&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FxyuWA9f9NMQ%2Fwhen-are-you-starting-journal-club-on.html One of the BMJ blogs recently asked if Twitter Journal Club is yet another ‘revolution’ in scientific communication. I think Twitter Journal Club is an incremental change in the way the scientists and physicians communicate. It is a good idea but limited by the medium of Twitter. Does anybody have plans for a Journal Club on the newly-launched Google Plus? It is the fastest growing social network in history (25 million members in month) and it seems like a natural platform for that. Comments from Google+: Arin Basu - Google + is a very natural medium for hosting journal clubs or say even grand rounds! I am more than happy to start giving it a shot! Ves Dimov - We first tried Journal Club on Twitter in 2008 but didn't like it that much: http://casesblog.blogspot.com/2011/06/first-... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5111044 Wed, 10 Aug 2011 14:14:59 +0100 5111044 http://www.medworm.com/index.php?rid=5089443&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FqSaXBfWYsT0%2Fhepatitis-delta-virus.html From a recent review in The Lancet:Hepatitis delta virus (HDV) is a small, defective RNA virus that can infect only individuals who have hepatitis B virus (HBV). More than 15 million people are co-infected worldwide.There are 8 genotypes of HDV. The hepatitis D virion is composed of a coat of HBV envelope proteins surrounding the nucleocapsid.The nucleocapsid consists of:- a single-stranded, circular RNA genome- delta antigen, viral proteinHDV suppresses HBV replication but also causes severe liver disease with rapid progression to cirrhosis and hepatic decompensation (liver failure).The range of clinical presentation is wide, varying from mild disease to fulminant liver failure.Treatment of HDV is with pegylated interferon alfa; however, response rates are poor.Better understanding of the... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5089443 Wed, 03 Aug 2011 13:12:01 +0100 5089443 http://www.medworm.com/index.php?rid=5089444&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2F5fSZGdIXtF4%2Fpost-splenectomy-and-hyposplenism.html The spleen links innate and adaptive immunity.The impairment of splenic function is defined as hyposplenism. The term asplenia refers to the absence of the spleen, a condition that is rarely congenital and mostly post-surgical.Spleen. Image source: National Cancer Institute and Wikipedia, public domain.Complications of hyposplenism and aspleniaHyposplenism and asplenia might predispose individuals to thromboembolic events. However, infectious complications are the most widely recognised consequences of these states.Splenectomy and hyposplenism are associated with infections by encapsulated bacteria with high mortality, fulminant course, and refractoriness to common treatment.Prevention through vaccination and antibiotic prophylaxis is the basis of management.References:Post-splenectomy and... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5089444 Tue, 02 Aug 2011 13:03:00 +0100 5089444 http://www.medworm.com/index.php?rid=5081192&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FYqLJbf6Aoa0%2Fmayo-clinic-on-procedure-competency-140_30.html Mayo Clinic: GI professional organizations have traditionally recommended that gastroenterology (GI) fellows perform 140 colonoscopies before assessing competency. Robert E. Sedlack, M.D., of the Department of Gastroenterology and Hepatology at Mayo Clinic, discusses findings that suggest it takes an average of 275 procedures to acquire the skills needed to perform safe and effective exams.The quote is from here:"The Social Network" tells the story of how Facebook went from a college startup to essentially the only way that old friends keep in touch. Napster founder-turned-Facebook president Sean Parker gives site creator Mark Zuckerberg, some shrewd financial advice. "A million dollars isn't cool. You know what's cool? A billion dollars," he says. Posted at Clinical Cases and Images. S... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5081192 Mon, 01 Aug 2011 17:33:43 +0100 5081192 http://www.medworm.com/index.php?rid=5081190&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2F3esIhq3Ujw0%2Fbeyond-good-job-how-to-give-effective.html Although too often used interchangeably, encouragement, evaluation, and feedback are quite distinct:- Encouragement (eg, "good job!") is supportive but does nothing to improve the learner's skills- Evaluation is summative and is the final judgment of the learner's performance- Feedback is designed to improve future performanceReferences:Getting Beyond "Good Job": How to Give Effective Feedback. PEDIATRICS Vol. 127 No. 2 February 2011, pp. 205-207 (doi:10.1542/peds.2010-3351).Image source: OpenClipArt.org, public domain. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5081190 Mon, 01 Aug 2011 13:42:00 +0100 5081190 http://www.medworm.com/index.php?rid=5081191&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FvUNO8uwxsuM%2Fredefining-age-65-when-your-job.html Deep Purple and Orchestra - Maybe I'm a Leo, Mainz, Germany, July 2011:Ian Gillan, 65, is best known as the lead singer and lyricist for Deep Purple. Roger Glover, 65, is the bassist and songwriter for the group. Ian Paice, 63, is the drummer. He is the only founding member of the band who never stopped performing with the group, and the only member to appear on every album the band has released during the last 43 years (Deep Purple was founded in 1968).This is the same group almost 40 years ago, in 1972:I have attended two concerts of Deep Purple, the last one was in June 2011 and it was quite impressive. The audience age ranged from 5 to 75 and everyone rose to their feet to the sound of Smoke on the Water.Related:Videos from Deep Purple at Ravinia Festival 2011, 3 part series. Posted... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5081191 Sun, 31 Jul 2011 15:53:51 +0100 5081191 http://www.medworm.com/index.php?rid=5070949&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2FgT8l20lr-yg%2F32545640 Even though he recently turned 100, Dr. Ephraim Engleman still sees arthritis patients regularly at the University of California San Francisco (UCSF). He has some rather unconventional longevity secrets to share:"I think exercise is mostly overrated. And the use of vitamins, forget it. And I don't encourage a lot of doctors.Fall in love and get married. Sex is to be encouraged. Children are a priority."His two sons are physicians. His daugher, a lawyer, is a married to a doctor, and their son is a physician.From NBC’s Nightly News:Visit msnbc.com for breaking news, world news, and news about the economyThe extended 17-minute version of the report is embedded below:Visit msnbc.com for breaking news, world news, and news about the economy Posted at Clinical Cases and Images. Stay update... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5070949 Thu, 28 Jul 2011 13:17:00 +0100 5070949 http://www.medworm.com/index.php?rid=5064716&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2FHxFSv7oVcSs%2F5201ms1.pdf was Emil von Behring (1854-1917). He was the discoverer of diphtheria antitoxin in 1890 and attained a great reputation in his lifetime but also was a subject of controversy:Behring’s unabashed pursuit of financial rewards for his efforts — unusual in that era—drew much criticism. One of the first modern medical entrepreneurs, he aggressively sought to patent his discoveries, and profited handsomely from their applications. This conflicted with the more genteel notions that prevailed at the time, which venerated physicians as selfless servants of mankind.For all his accomplishments, Behring was a deeply troubled man. He suffered from frequent bouts of profound depression, and was institutionalised several times.The great discoverer of serum therapy died of pneumonia in Marburg on Ma... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5064716 Tue, 26 Jul 2011 12:25:00 +0100 5064716 http://www.medworm.com/index.php?rid=5058476&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FpWn7aaGgAJo%2Fexercise-is-good-for-you-mr-bean-even.html Mr Bean attends a judo class but doesn't want to be thrown by the teacher. From Back to School Mr Bean.Mr. Bean now has an Official YouTube Channel. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5058476 Sun, 24 Jul 2011 20:33:22 +0100 5058476 http://www.medworm.com/index.php?rid=5041382&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FidJdjk4yR5A%2Fhow-much-vitamin-d-do-you-need.html From Nature News:Vitamin D has been lauded in the media for preventing or treating multiple disease but most evidence is circumstantial or weak.Despite this, some physicians recommend supplementation of up to 6,000 international units (IU) to compensate for the time that people spend indoors. This is less than what a fair-skinned person make in 30 minutes of exposure to the summer sun (without sunscreen).The amount spent on vitamin-D supplements in the United States had risen 10-fold in 10 years.Poor data is one reason that the IOM panel did not recommend higher doses for vitamin D supplementation in 2010. The IOM 1,000-page report recommended that people should aim for blood levels of 50 nanomoles per litre (nmol/L).However, according to the Endocrine Society's guidelines:- people with le... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5041382 Wed, 20 Jul 2011 12:41:00 +0100 5041382 http://www.medworm.com/index.php?rid=5041383&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FeKZyHGVXv1w%2Fneighborhood-determinants-of-quality-of.html This paper analyzed quality of life in Uruguay. Differences in overall happiness can be explained by access to public goods.Neighborhood Determinants of Quality of Life included:- access to electricity, running water, sewage system, drainage, waste disposal system- street lighting- sidewalks in good condition- trees in the street - "forest bathing" (exposure to parks and forests) may increase immunity- absence of air or noise pollutionDon't forget that happy people are 22% less likely to develop heart disease.Based on research, Mike Cadogan summarized happiness in just 4 ideas - repeat every morning: "I'm happy, I'm hopeful about the future, I enjoy life, and I feel I'm just as good as other people."References:Neighborhood Determinants of Quality of Life. Néstor Gandelman, Giorgina Piani ... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5041383 Tue, 19 Jul 2011 12:41:00 +0100 5041383 http://www.medworm.com/index.php?rid=5041384&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FpvIU22fk0uU%2Fsecure-web-messaging-between-patients_18.html Although e-mail may be an efficient clinician-patient communication tool, standard e-mail is not adequately secure to meet Health Insurance Portability and Accountability Act (HIPAA) guidelines. For this reason, firewall-secured electronic messaging systems have been developed for use in health care.The Kryptiq messaging system was implemented at an academic center and messages were monitored continuously and tracked.In the 8 months after implementation, only 5 messages were initiated by patients in contrast to 2,363 phone calls.Patients/families expressed strong interest in e-mailing but secure Web messaging was:- less convenient than using the phone- too technically cumbersome- lacked a personal touch- only by a handful of patientsOne pediatrician on Twitter wants a simpler solution:@Doc... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5041384 Tue, 19 Jul 2011 03:01:39 +0100 5041384 http://www.medworm.com/index.php?rid=5031628&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FXrm5Vphap48%2Fcirrhosis-phils-story.html From NHSChoices: Many people enjoy a drink in the pub after work without realising how social drinking can damage health. Phil didn't realise the harm his alcohol intake was doing until he was diagnosed with cirrhosis of the liver. He talks about his experience and the shock he felt at being diagnosed. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5031628 Sat, 16 Jul 2011 14:41:24 +0100 5031628 http://www.medworm.com/index.php?rid=5031629&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2F-yHP5GIew9o%2Ftwitter-epidemics-bmj-video.html BMJ medical innovations: During the swine flu pandemic, Google showed that it was able to track the spread using the searches that it's users were making. In this video Dr Patty Kostkova shows her work using twitter - and how the data from that could be used to track future epidemics. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5031629 Sat, 16 Jul 2011 14:34:00 +0100 5031629 http://www.medworm.com/index.php?rid=5022191&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2F4Uif9Ufjbx4%2Fcholesterol-numbers-mayo-clinic-video.html Mayo Clinic: You've heard the warnings before — high cholesterol increases your risk of heart disease. So how often should you get your cholesterol checked, what should your numbers be, and how do you get them there?Heart numbers to know, from Cleveland ClinicKnowing your risk for heart disease depends on knowing and understanding some important numbers:- Blood pressure should be less than 120/80 mm Hg- Fasting blood sugar should be less than 100 mg/dL- Total cholesterol less than 200 mg/dL- LDL (bad cholesterol) less than 100 mg/dL, HDL (good) greater than 40 mg/dL- Waist circumference should be less than 40 inches for men and less then 35 inches for women- Body Mass Index (BMI) should be between 18.5 and 25. Calculate your BMI here: http://bit.ly/glMJE5 Posted at Clinical Cases and ... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5022191 Wed, 13 Jul 2011 12:46:01 +0100 5022191 http://www.medworm.com/index.php?rid=5022192&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2F-Yp4MKS1vMg%2Ffirst-gunshot-victim-in-new-world.html Archaeologists in Peru have discovered the 500-year-old skeleton of a man who died from a gunshot wound. Experts believe he's the first shooting victim in the New World. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5022192 Tue, 12 Jul 2011 18:37:00 +0100 5022192 http://www.medworm.com/index.php?rid=5022193&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FBwz7Bnwf4_E%2Fceliprolol-as-treatment-of-choice-to.html Vascular Ehlers-Danlos syndrome is a rare hereditary connective tissue disorder caused by mutations in the collagen type III gene ( COL3A1 ), which leads to a loss of tissue integrity in many organ systems.Patients with vascular Ehlers-Danlos syndrome have weakened blood vessels and an increased risk of arterial dissection or rupture that can lead to early death.The researchers assessed the ability of celiprolol, a β1-adrenoceptor antagonist with a β2-adrenoceptor agonist action, to prevent arterial dissections and ruptures in vascular Ehlers-Danlos syndrome.Patients with clinical vascular Ehlers-Danlos syndrome were randomly assigned to 5 years of treatment with celiprolol or to no treatment.33 patients were positive for mutation of collagen 3A1 (COL3A1). Celiprolol was uptitrated every... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5022193 Tue, 12 Jul 2011 13:16:00 +0100 5022193 http://www.medworm.com/index.php?rid=5022194&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2F4Vo9EhjMotQ%2Fmedical-educators-around-world.html Medical education around the world, a map by Anne Marie Cunningham: Add yourself so we can find people interested in medical education from all around the world.Look at this short video for guidance on how to edit the map: http://www.screenr.com/vU2sHere is a list of Healthcare / HCSM / HIT Social Media-related accounts around the world.This is a list of the Top Twitter Doctors arranged by specialty in alphabetical order - feel free to add your own suggestions. The list is open to anybody to edit:Related:For doctors: How to be a Twitter superstar in two easy steps Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5022194 Mon, 11 Jul 2011 12:01:00 +0100 5022194 http://www.medworm.com/index.php?rid=5022195&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FoATctBX_LNs%2Fsinging-doctor.html From Cleveland Clinic YouTube chanel: Who knew doctors can sign? Hear the ENT doctor Paul Bryson sing the National Anthem sing at an Indians Game (Cleveland baseball team).Comments from Twitter:@scanman Wow!! Great voice!!@DrSnit this was a lovely singing voice.@faisal_q Working talent @ClevelandClinic@gastromom Ruled out GERD ;) Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5022195 Mon, 11 Jul 2011 00:09:33 +0100 5022195 http://www.medworm.com/index.php?rid=5000316&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FEtVCghZeMvY%2Fweight-lifters-turning-to-human-growth.html From WebMD and the American Journal on Addictions:In the study of 230 male weight lifters aged 18 to 40:- 12% reported use of human growth hormone (HGH) or a similar supplement known as insulin-like growth factor-1- all weight lifters reported use of anabolic steroids- 56% percent had a current or past dependence on opioids, cocaine, and/or EcstasyHGH was prohibitively expensive in the 1990s, but now pills, powders, and injections can be purchased at low cost on the Internet.Weight lifters who already take steroids add HGH as a "turbo boost". “You can always tell which elite athletes are on HGH because their bones are growing at a faster rate and their faces look distorted.”References:Weight Lifters Turning to Human Growth Hormone. WebMD.Image source: OpenClipart, public domain Post... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=5000316 Wed, 06 Jul 2011 12:58:00 +0100 5000316 http://www.medworm.com/index.php?rid=4971453&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2Fpa8NM4ZJurs%2Fstock-market-dips-linked-to-heart.html During the period of increased volatility in the stock market in 2006-2009, when stock market values decreased, heart attacks seemed to increase, and then decreased when stock trends improved.While earlier studies showed a link between traumatic events such Hurricane Katrina in 2005 and an increased risk of "cardiac events," there was limited data on the impact of financial markets.References:Stock market dips linked to heart attack surge: study - Yahoo! News.Image source: Gray's Anatomy, 1918, public domain. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4971453 Mon, 27 Jun 2011 13:49:00 +0100 4971453 http://www.medworm.com/index.php?rid=4962361&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2FfJhF2LwpOto%2Ffederated_f9 Based on antioxidant content (polyphenols), here is how nuts stack up, from highest to lowest:- walnuts- Brazil nuts- pistachios- pecans- almonds- peanuts- macadamia nutsReferences:The Supernut: Walnuts Pack a Powerful Dose of Antioxidants. TIME. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4962361 Thu, 23 Jun 2011 20:58:18 +0100 4962361 http://www.medworm.com/index.php?rid=4939344&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FIp7ProX2NbU%2Fdrug-companies-trying-to-create.html Ulcerative colitis, a type of inflammatory bowel disease (IBD), is less common in countries endemic for helminth infections, suggesting that helminth colonization may have the potential to regulate intestinal inflammation in IBD. Therapeutic effects of experimental helminth infection have been reported.According to a researcher: "What we found was that after worm infection, the regions of the colon that were previously not making mucus, were now making mucus again." "That's a key factor in healing, and it looked like the mucus came back because the worms were causing the body to produce IL-22. This is a molecule that promotes epithelial growth and healing." Studies suggest parasites can regulate the immune system in ways that prevent it from "going wild" and attacking healthy tissue, and p... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4939344 Fri, 17 Jun 2011 13:17:00 +0100 4939344 http://www.medworm.com/index.php?rid=4924447&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FKMi2Mt8VOm4%2Facyclovir-reduces-risk-of-hiv-1-disease.html In this study, the median CD4 cell count at enrollment was 462 cells per μL and median HIV-1 plasma RNA was 4 log10 copies per μL. Aciclovir reduced risk of HIV-1 disease progression by 16%.The role of suppression of herpes simplex virus type 2 in reduction of HIV-1 disease progression before initiation of antiretroviral therapy warrants consideration.References:Daily aciclovir for HIV-1 disease progression in people dually infected with HIV-1 and herpes simplex virus type 2: a randomised placebo-controlled trial. The Lancet, Volume 375, Issue 9717, Pages 824 - 833, 6 March 2010.Image source: Diagram of HIV. Image source: Wikipedia. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4924447 Mon, 13 Jun 2011 13:38:01 +0100 4924447 http://www.medworm.com/index.php?rid=4924448&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FRSpzdSN7Gls%2Fvideo-you-can-never-trust-doctors.html Video: "You can never Trust Doctors", linked by one of my Facebook friends.I'm sure some patients and doctors will not find this Eurosport commercial funny, and they probably have a point. Humor may be difficult to explain and interpret. Some social media "experts" even advise doctors not to use humor on Twitter, Facebook and blogs for fear of misinterpretation and legal repercussions. However, humor is what makes us human. It can also help with the healing process and provide some relief at a time when you need it the most. Don't be afraid to use it appropriately and as needed, PRN. The commercial above may not provide the best example for that particular purpose but I think you get the point. Comments from Twitter:@scanman: Ha!! I do this ALL THE TIME!!! Posted at Clinical Cases and I... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4924448 Sat, 11 Jun 2011 17:09:21 +0100 4924448 http://www.medworm.com/index.php?rid=4915092&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2FHSBDpTmVytg%2FKqQwFmW6Sac From the NYTimes:Prof. Mueller almost immediately noticed a previously hidden cluster in, of all things, pole-vaulting. Several high school and college athletes each year were killed or paralyzed simply by missing the pit with the pole, falling on their heads off the landing pad, or sliding down the pole and hitting their heads on hard surfaces. Pits were soon expanded and surrounded with softer padding.Mueller detected a strange number of paralytic accidents in organized swimming, all from relay-type dives into water that was too shallow — resulting in today’s minimum depths.Concussion Recovery - Mayo Clinic VideoReferences:Professor Tracks Ghastly Injuries in Hope of Prevention - NYTimes.com. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4915092 Fri, 10 Jun 2011 13:29:00 +0100 4915092 http://www.medworm.com/index.php?rid=4915093&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FVF65ztGiP08%2Fmedical-tourism-map.html Provided by Mint.com Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4915093 Fri, 10 Jun 2011 02:01:28 +0100 4915093 http://www.medworm.com/index.php?rid=4905187&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FwDB1SFMtvfI%2Fcpap-for-sleep-apnea-bmj-video.html BMJ: Sleep apnoea (apnea, in its American spelling) is a condition that causes a patient to stop breathing for short periods during their sleep. In this video researchers Joaquín Durán-Cantolla and Jose María Montserrat discuss their work into the use of CPAP (continuous positive airway pressure) to treat the condition.People with OSA may be twice as likely to develop a stroke.Did you know that obstructive sleep apnea (OSA) can reduce a child’s IQ by as many as 10 points, while treatment in children with OSA can improve school grades? Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4905187 Tue, 07 Jun 2011 12:33:00 +0100 4905187 http://www.medworm.com/index.php?rid=4886658&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FfaJYhveFyXc%2Fpromoting-women-in-science-and-medicine.html The University of Tromsø in Norway - the world's northernmost university - has adopted new recommendations designed to increase the number of female full professors from the current 23% to 30% by 2014.Women spend longer as Associate Professors than men, partly because “men apply as soon as they think they have a chance of promotion, while women tend to wait until they are very confident”.The panel developed 13 recommendations, among them:- re-advertising positions if there are no women in the applicant pool- ensuring that women receive training in salary negotiation- assessing research quality rather than quantity- improving the visibility of women within institutions- encouraging diversity in leadership styleReferences:Promoting women in science and medicine. The Lancet, Volume 376, ... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4886658 Wed, 01 Jun 2011 12:38:00 +0100 4886658 http://www.medworm.com/index.php?rid=4865500&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FXOvXAfgVuSg%2F10-year-rule-you-must-persevere-with.html From The Lancet:Hard work is required: “Genius is one per cent inspiration, ninety-nine per cent perspiration” - Thomas EdisonLate in life, Charles Darwin made the same point in a letter to his son: “I have been speculating last night what makes a man a discoverer of undiscovered things, and a most perplexing problem it is.—Many men who are very clever,—much cleverer than the discoverers—never originate anything. As far as I can conjecture, the art consists in habitually searching for causes or meaning of everything which occurs.” Darwin was a relentless student of nature from 1828 until the few weeks in late 1838 when he suddenly perceived the mechanism of evolution by natural selection.There can be no doubt that geniuses have worked habitually and continually. Darwin produc... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4865500 Thu, 26 May 2011 13:17:00 +0100 4865500 http://www.medworm.com/index.php?rid=4855306&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2F1aZCsbC-1Z0%2Fnov10choices.pdf How can you make sure future program directors find only the best “you” online? Follow these suggestions when using social media services such as Facebook, Twitter and blogs:- Consider carefully what you’re posting- Avoid posting patient stories- Periodically search yourself- Check the photos in which you’re “tagged”- Define funny - Humor can be hard to interpret- Choose your friends carefully- Restrict your privacy settingsReferences:Careers in Medicine. AAMC, 2010 (PDF).Image source: OpenClipArt.org, public domain. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4855306 Tue, 24 May 2011 16:06:34 +0100 4855306 http://www.medworm.com/index.php?rid=4848907&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FZb-k5P1fJkE%2Fnew-hepatitis-c-treatment-2-new.html Mayo Clinic: Four million people in the U.S., 100 million worldwide, are infected with Hepatitis C. It's a virus you can get from blood transfusions given before 1990, shared needles, unclean tattoo needles and sometimes sex.In many cases it leads to cirrhosis of the liver and eventually liver cancer. Standard treatment with interferon and ribavirin only cures about 45% of all patients. But thanks to two new medications, up to 70% of people with hepatitis C may be be cured. More than 40 medications are in development. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4848907 Sat, 21 May 2011 12:50:00 +0100 4848907 http://www.medworm.com/index.php?rid=4833158&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2Fer7lWMmiJQA%2F1-in-40-adults-older-than-40-years-has.html One in 40 adults older than 40 years has glaucoma with loss of visual function. Adults have one of the two forms of glaucoma: - open-angle glaucoma- angle-closure glaucomaDiagnosisAt least half of glaucoma cases are undiagnosed. Glaucoma is mostly asymptomatic until late in the disease when visual problems arise. Vision loss from glaucoma cannot be recovered.TreatmentGlaucoma is treated with daily eye-drop drugs, but adherence to treatment is often unsatisfactory. Similarities to the pathogenesis of common CNS diseases mean that common neuroprotective strategies might exist. Successful gene therapy has been used for some eye diseases and may be possible for the treatment of glaucoma in the future.References:Glaucoma. The Lancet, Volume 377, Issue 9774, Pages 1367 - 1377, 16 April 2011.Imag... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4833158 Wed, 18 May 2011 13:36:00 +0100 4833158 http://www.medworm.com/index.php?rid=4833159&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FRJSW4PSWoVw%2Fhow-to-keep-your-family-on-board-for.html Some tips from ProBlogger:- Create Healthy Boundaries. For example, I have established a “no computer time” rule for myself where I don’t use the laptop (or my smart phone) between the time I get home from work and when we get the kids to bed. By setting up this boundary, I free my time and my mind to enjoy my children, play outside or help my wife out with dinner each evening.- Communicate Your Reasons for Blogging. Why are you investing all this time and effort into blogging anyway? Take the time to tell your loved ones why your blog is important to you and how you see it as a benefit for your family.- Sacrifice Personal Time, Not Family Time- Seek Their InputReferences:7 Tips to Keep Your Family On-Board for Your Blogging Journey. ProBlogger.Image source: public domain. Posted ... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4833159 Tue, 17 May 2011 12:42:00 +0100 4833159 http://www.medworm.com/index.php?rid=4814918&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2FKoAnlTViwf8%2Fsocialmedia.pdf Here are a few suggested approaches for social media use in medical education:- Peer student groups can utilize a private blog to share clinical experiences- Course/program directors and staff can use a wiki to manage course/program materials and centralize frequently used documents- Longitudinal preceptors can use a microblog (e.g., Twitter) to share links to journal articles, medical news, and reminders- Admissions personnel can use social networks during the application, interview, and acceptance processes to build a community before students ever set foot on campus- A public affairs office could generate podcasts to share graduate news, campus information, celebrations, and research success storiesThe Networked Teacher - Diagram, Flickr http://goo.gl/CVddiReferences:Saarinen C, Arora V... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4814918 Thu, 12 May 2011 13:15:00 +0100 4814918 http://www.medworm.com/index.php?rid=4807247&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2FzSbe7p5X-H8%2FembeddedPlayer.swf The University of Illinois Medical Center has installed a system called HyGreen (Hand Hygiene Recording and Reminding System) which acts as a reminder to health care workers before they ever enter a patient's room.The provider begins by cleaning his hands, then placing them under a sensor that recognizes the cleaning, and transmits a signal to a badge the provider is wearing. When they walk into the patient's room, that badge transmits an "all clean" signal to a sensor above the bed.If a caregiver walks into a room without washing their hands, the sensor won't get that all clean signal and the badge will start buzzing.References:Tech Ensures Your Doc Washed Their Hands. NBC Chicago. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Face... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4807247 Wed, 11 May 2011 12:47:00 +0100 4807247 http://www.medworm.com/index.php?rid=4798895&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FFmQWylbVwPU%2Fnight-shift-workers-are-fighting.html From the National Geographic Magazine:We sleep 1.5 hour less a night than we did just 100 years agoWe sleep on average 1.5 hour less a night than we did just a century ago. Some of our epidemic of insomnia or sleeplessness is probably just our refusal to pay attention to our biology. The natural sleep rhythms of teenagers would call for a late morning wake-up—but there they are, starting high school at 8 a.m. The night shift worker sleeping in the morning is fighting ancient rhythms in his or her body that order him or her awake to hunt or forage when the sky is flooded with light. Yet he or she has no choice.We fight these forces at our peril. Harvard's researchers note that going without sleep for 24 hours or getting only 5 hours of sleep a night for a week is the equivalent of a blood... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4798895 Mon, 09 May 2011 13:53:00 +0100 4798895 http://www.medworm.com/index.php?rid=4795711&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2FfJhF2LwpOto%2Ffederated_f9 Medicare does not currently reimburse routine screening with virtual colonoscopy, but it does cover evaluations with "regular" colonoscopy.References:Virtual Colonoscopy Gains in Popularity. Is It Right for You? TIME. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4795711 Sat, 07 May 2011 13:37:00 +0100 4795711 http://www.medworm.com/index.php?rid=4783775&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2FPmTYPW8m10o%2FWKZXoj0SIpA%26amp%3Bhl%3Den_US%26amp%3Bfs%3D1%26amp%3B AssociatedPress — May 16, 2010 — Teenagers are driving through an obstacle course with their cell phones in hand to see why texting while driving is so dangerous.Related:Proposal: All cell phones sold in Chicago to allow parents to block their children from texting while driving. Chicago Tribune, 2011. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4783775 Wed, 04 May 2011 16:33:17 +0100 4783775 http://www.medworm.com/index.php?rid=4776758&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2Fim8tMZ_0g5A%2Ffor-doctors-how-to-be-twitter-star-in.html Warning: The purpose of this article is to inspire you to use Twitter, not to scare you. There are plenty of other blog posts and newspaper articles about doctors posting pictures of body parts on Facebook and getting fired. This is not it. Social media is amazingly useful for doctors and patients if you use the tools responsibly, have commons sense, and never share the 18 HIPAA identifiers online or offline with unauthorized parties. The advice below is derived from extensive personal experience. I have used social media for professional purposes, as a physician, for more than 7 years, while working at some of the leading institutions in the U.S. such as the Cleveland Clinic and the University of Chicago. My account @DrVes has just been ranked #6 on the list of the Most Influential People... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4776758 Tue, 03 May 2011 12:44:00 +0100 4776758 http://www.medworm.com/index.php?rid=4772192&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FV8JdNs8IKJI%2Fpots-syndrome-mayo-clinic-video.html Phil Fischer, M.D., discusses the latest research on Postural Orthostatic Tachycardia Syndrome (POTS). Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4772192 Mon, 02 May 2011 13:49:00 +0100 4772192 http://www.medworm.com/index.php?rid=4764433&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FweDfpKEDhh0%2Fchronic-pancreatitis-lancet-review.html There are two forms of chronic pancreatitisChronic pancreatitis is a progressive fibroinflammatory disease that exists in 2 forms:- large-duct forms (often with intraductal calculi)- small-duct formCauses of chronic pancreatitisChronic pancreatitis results from a complex mix of:- environmental factors - alcohol, cigarettes, and occupational chemicals- genetic factors - mutation in a trypsin-controlling gene or the cystic fibrosis transmembrane conductance regulator (CFTR)- a few patients have hereditary or autoimmune diseaseManagement of painPain is the main symptom that occurs in two forms:- recurrent attacks of pancreatitis (representing paralysis of apical exocytosis in acinar cells)- constant and disabling painManagement of the pain is mainly empirical, involving:- potent analgesics- d... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4764433 Fri, 29 Apr 2011 13:55:00 +0100 4764433 http://www.medworm.com/index.php?rid=4755537&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2FWhhwkhB7l7U%2FKTVHL69-sZg%26amp%3Bhl%3Den%26amp%3Bfs%3D1%26amp%3B Study participants were categorized into 4 groups according to their intensity of Internet use: - heavy Internet users (HIUs; >2 hours/day)- regular Internet users (RIUs; several days per week and 2 hours/day)- occasional users (1 hour/week)- and non-Internet users (NIUs; no use in the previous month)Health factors examined were:- perceived health- depression- overweight- headaches- back pain- insufficient sleepU-shaped link Heavy Internet users of both genders were more likely to report higher depressive scores.Only male users were found at increased risk of overweight and female users at increased risk of insufficient sleep.Non-Internet users (NIUs) and occasional users also were found at increased risk of higher depressive scores.Back-pain complaints were found predominantly among ma... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4755537 Wed, 27 Apr 2011 12:52:00 +0100 4755537 http://www.medworm.com/index.php?rid=4743039&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2Fw9HIjYulu0k%2Fhigh-cost-of-healthcare-in-america.html - click on the image to see the larger-size file. The site hosting the infographic, MedicalBillingandCoding.org, is one of the URL-grabbing portals that redirects to other sites, so be careful what you click there once you go beyond the image. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4743039 Sat, 23 Apr 2011 16:16:33 +0100 4743039 http://www.medworm.com/index.php?rid=4711069&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FU5nWjNZZkXU%2Feffect-of-deployment-on-mental-health.html This Lancet study examined the consequences of deployment to Iraq and Afghanistan on the mental health of UK armed forces from 2003 to 2009.9990 (56%) participants completed the study questionnaire (roughly 8000 regulars, 1700 reservists).The prevalence was:- 19·7% for symptoms of common mental disorders- 13% for alcohol misuse- 4% for post-traumatic stress disorder (PTSD)Deployment to Iraq or Afghanistan was significantly associated with alcohol misuse for regulars (odds ratio 1·22) and with post-traumatic stress disorder (PTSD) for reservists (2·83)Symptoms of common mental disorders and alcohol misuse remain the most frequently reported mental disorders in UK armed forces personnel, whereas the prevalence of post-traumatic stress disorder (PTSD) was low.References:What are the conseq... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4711069 Thu, 14 Apr 2011 13:03:00 +0100 4711069 http://www.medworm.com/index.php?rid=4705879&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2F3gE-Bt07aa0%2Fstatins-slightly-increase-risk-of.html ConclusionClaims of unintended benefits of statins, except for oesophageal cancer, remain unsubstantiated, although potential adverse effects at population level were confirmed and quantified.Interestingly, the BMJ abstract did not mention increased diabetes risk that was reported in a previous study published in The Lancet.References:Unintended effects of statins in men and women in England and Wales: population based cohort study using the QResearch database. BMJ 2010; 340:c2197 doi: 10.1136/bmj.c2197 (Published 20 May 2010).Balancing the intended and unintended effects of statins. BMJ 2010; 340:c2240 doi: 10.1136/bmj.c2240 (Published 20 May 2010).People on statins are 9% more likely to develop diabetes according to a meta-analysisCholesterol drug side effects need watching: study. Reute... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4705879 Wed, 13 Apr 2011 12:01:01 +0100 4705879 http://www.medworm.com/index.php?rid=4699378&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FDeXCZ74E1aE%2Fselected-videos-from-tedxmaastricht.html TEDxMaastricht is the European stage for bright ideas, bold thinkers and innovators in medicine and healthcare. The playlist embedded below includes 16 videos: Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4699378 Tue, 12 Apr 2011 13:47:00 +0100 4699378 http://www.medworm.com/index.php?rid=4699379&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FCaGUaZrTdaA%2Faspirin-75-mg-daily-reduces-incidence.html This study in The Lancet assessed the effects of aspirin on incidence and mortality due to colorectal cancer over 20 years.In the four trials of aspirin versus control (mean duration of treatment 6 years), 2·8% of 14,000 patients had colorectal cancer during a follow-up of 18 years.Aspirin reduced the 20-year risk of colon cancer (incidence hazard ratio [HR] 0·76, but not rectal cancer (0·90).Where subsite data were available, aspirin reduced risk of cancer of the proximal colon (0·45), but not the distal colon (1·10). Benefit increased with duration of treatment - aspirin taken for 5 years or longer reduced risk of proximal colon cancer by 70% and also reduced risk of rectal cancer (0·58).There was no increase in benefit at doses of aspirin greater than 75 mg daily. However, risk of... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4699379 Mon, 11 Apr 2011 15:28:10 +0100 4699379 http://www.medworm.com/index.php?rid=4678286&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FxvX_eFJr6Ho%2Fpositive-thinking-1-minute-video-advice.html Positive thinking. Stop thinking bad thoughts. One-minute video advice from a Cleveland Clinic psychologist http://www.twitvid.com/XUL8S Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4678286 Tue, 05 Apr 2011 19:13:00 +0100 4678286 http://www.medworm.com/index.php?rid=4678287&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FJhPCWQo9gBE%2Fgout-update-new-drugs-for-old-disease.html Febuxostat is a non-purine-analogue inhibitor of xanthine oxidase that opened a new era in the treatment of gout.Modified uricasesThe use of modified uricases to rapidly reduce serum urate concentrations in patients with otherwise untreatable gout is progressing. Pegloticase, a pegylated uricase, is in development.Drugs in developmentTransport of uric acid in the renal proximal tubule and the inflammatory response to monosodium urate crystals (shown above) are targets for potential new treatments.Several pipeline drugs for gout related to the targets above include:- selective uricosuric drug RDEA594- various interleukin-1 inhibitorsReferences:Gout therapeutics: new drugs for an old disease. The Lancet, Volume 377, Issue 9760, Pages 165 - 177, 8 January 2011.Image source: Spiked rods of uri... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4678287 Tue, 05 Apr 2011 13:23:00 +0100 4678287 http://www.medworm.com/index.php?rid=4672450&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2FWhhwkhB7l7U%2FKTVHL69-sZg%26amp%3Bhl%3Den%26amp%3Bfs%3D1%26amp%3B Some helpful tips from one of the PLoS blogs, Obesity Panacea:1. Take the stairs as often as possible.2. Drink plenty of water.3. Park as far from the front door as possible.4. Clean your home regularly.5. Gardening and yardwork.6. Disconnect your cable for the summer.7. Buy a pedometer.8. Use active transportation and public transit.9. Have “walk-meetings”.10. Go for a family walk after dinner."Health Promotion" video: Benefits of exercise:Exercise delays telomere shortening, and potential slows the aging process in humans. Telomeres are the chromosome tips which shorten each time a cell divides, making them a possible marker of aging. A study of 2400 twins showed that physically active people had longer telomeres than sedentary people. According to the authors, this provides a powerf... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4672450 Mon, 04 Apr 2011 16:34:45 +0100 4672450 http://www.medworm.com/index.php?rid=4672451&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FLNT5F_7v9aY%2Fvita-salute-san-raffaele-university-in.html I was asked to help to spread the word regarding the new International MD Program at Vita-Salute San Raffaele University located in Milan, Italy. The program was launched in 2010. The application deadline is on April 20th, 2011.The Vita-Salute San Raffaele University (http://bit.ly/unisr01) is part of the San Raffaele Foundation which includes Hospitals, Research Centers and the Vita-Salute San Raffaele University itself.The International MD Program builds on the institution’s solid presence on the international scene. It provides medical-scientific education and research opportunities in philosophy, communication skills, cognitive neurosciences and psychology. The San Raffaele Scientific Institute (http://bit.ly/scientificinstitute) is the largest private research institute in Italy. Un... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4672451 Sun, 03 Apr 2011 20:52:41 +0100 4672451 http://www.medworm.com/index.php?rid=4659896&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FQVLpuSPsR0Q%2Fwhat-to-look-for-when-buying-sunglasses.html From the NYTimes:Unprotected exposure to sunlight can cause significant damage to the eyesSunlight can burn the surface of the eye, causing a temporary and painful condition known as photokeratitis. Over time, unprotected exposure can contribute to cataracts, as well as cancer of the eyelids and the skin around the eyes.UV exposure also may increase the risk of macular degeneration, the leading cause of blindness in people over age 65.What to look for when buying sunglasses?Look for labels indicating at least “98 percent UV protection” or that it “blocks 98 percent of UVA and UVB rays.” If there is no label, or it says something vague like “UV absorbing” or “blocks most UV light,” don’t buy them.For the best defense, look for sunglasses that “block all UV radiation up t... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4659896 Thu, 31 Mar 2011 13:47:00 +0100 4659896 http://www.medworm.com/index.php?rid=4654920&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2F2jXbtbZ5gQE%2Faverage-time-patients-spend-waiting-to.html The average time patients spend waiting to see a health-care provider is 22 minutes. Orthopedists have the longest waits, at 29 minutes; dermatologists the shortest, at 20.Patient satisfaction dropped significantly with each 5 minutes of waiting time. Even the term "waiting room" has a bad connotation. Many offices prefer "reception area" instead."I live my life in seven-minute intervals," says Laurie Green, a obstetrician-gynecologist in San Francisco who delivers 400 to 500 babies a year and says she needs to bring in $70 every 15 minutes just to meet her office overhead.Measures the health-care industry is trying to minimize waiting time include:- "Open-access" scheduling- Minimize office visits- Advance preparation- Huddling up: "Mr. Jones is in a 15-minute slot, but we know he's a 45-... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4654920 Wed, 30 Mar 2011 14:42:16 +0100 4654920 http://www.medworm.com/index.php?rid=4645952&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FGJNOLgx9y88%2Fmanaging-fever-of-unknown-origin-in.html Few clinical problems generate such a wide differential diagnosis as pyrexia (fever) of unknown origin. The initial definition proposed by Petersdorf and Beeson in 1961 was later revised. Essentially the term refers to a prolonged febrile illness without an obvious cause despite reasonable evaluation and diagnostic testing.DefinitionClassic adult fever of unknown origin (FUO) is fever of 38.3°C (101°F) or greater for at least 3 weeks with no identified cause after 3 days of hospital evaluation or 3 outpatient visitsCauses of FUOCommon causes of FUO are infections, neoplasms, and connective tissue disorders.Investigations almost always include imaging studies. Serological tests may be indicatedTreatment of FUOEmpirical antibiotics are warranted only for individuals who are clinically unst... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4645952 Tue, 29 Mar 2011 13:03:00 +0100 4645952 http://www.medworm.com/index.php?rid=4632994&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FT-NpucDKNIk%2Fonly-62-of-referring-pcps-received.html Communication between primary care physicians (PCPs) and specialists regarding referrals and consultations is often inadequate, with negative consequences for patients.A study found that perceptions of communication regarding referrals and consultations differed. For example, 69% of PCPs reported "always" or "most of the time" sending notification of a patient's history and reason for consultation to specialists, but only 34.8% of specialists said they "always" or "most of the time" received such notification. Similarly, 80.6% of specialists said they "always" or "most of the time" send consultation results to the referring PCP, but only 62% of PCPs said they received such information. The 3 practice characteristics associated with PCPs and specialists reporting good communication regardin... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4632994 Fri, 25 Mar 2011 12:56:00 +0100 4632994 http://www.medworm.com/index.php?rid=4628207&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2FYSX49pEt77s%2FXghweotMrKE There are a lot more sports health-related video from Cleveland Clinic on YouTube. I find many of these useful but they often don't get the numbers of views they deserve, for example the video embedded above was watched only 20 times as of 03/23/2011 (it was posted on 01/10/2011). Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4628207 Thu, 24 Mar 2011 13:08:00 +0100 4628207 http://www.medworm.com/index.php?rid=4623657&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2Fvy5gkNSLUN8%2F86-of-australian-doctors-report-high.html More than 80% of Australian doctors are moderately or very satisfied with their jobs, a national survey has found.The survey, of 10 498 doctors, 19% of those who were contacted and eligible, found that 86% were moderately or very satisfied with their jobs, with no significant differences between GPs, specialists, and specialists in training. Hospital non-specialists were less satisfied.The predictors of high professional satisfaction included:- a good support network- a household with a high income- patients with realistic expectations w- being able to take time off- being younger or close to retirement- having good self reported health.Female GPs earn an average 25% less than their male counterparts and that GPs on average earn 32% less than specialists. The average annual pretax person... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4623657 Wed, 23 Mar 2011 12:49:00 +0100 4623657 http://www.medworm.com/index.php?rid=4617615&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2Fya9q8aZGUR4%2Fwhen-physicians-prescribe-new.html According to a 2006 study of physician-patient communication during primary care visits, when physicians prescribed a new medication they:- did not tell the patient the name of the new medication in 26% of the cases (the other way to look at the data is that the physicians stated the specific medication name for 74% of new prescriptions)- did not explain the purpose of the medication to patients in 13% of cases (explained the purpose of the medication for 87%)- did not tell patient about adverse side effects of the medication in 65% of cases- did not describe to patients how long to take the medication in 66% of cases- did not tell patients the number of pills to take in 45% of cases- did not tell patients about medication dosing and timing in 42% of casesReferences:Hospitals: Check doctor... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4617615 Tue, 22 Mar 2011 13:28:00 +0100 4617615 http://www.medworm.com/index.php?rid=4607299&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FL3qb3PfMsp8%2Fwhat-drug-to-add-to-maximal-metformin.html Metformin is the recommended initial drug therapy for patients with type 2 diabetes mellitus (DM). However, the optimal second-line drug when metformin monotherapy fails is unclear.All noninsulin antidiabetic drugs were associated with similar HbA1c reductions but differed in their associations with weight gain and risk of hypoglycemia.The different classes of drugs were associated with similar HbA1c reductions (range, 0.64%-0.97%) compared with placebo. Noninsulin antidiabetic drugs and their effect on body weight:- thiazolidinediones, sulfonylureas, and glinides were associated with weight gain (range, 1.77-2.08 kg)- glucagon-like peptide-1 analogs, alpha-glucosidase inhibitors, and dipeptidyl peptidase-4 inhibitors were associated with weight loss or no weight changeSulfonylureas and gl... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4607299 Fri, 18 Mar 2011 13:24:00 +0100 4607299 http://www.medworm.com/index.php?rid=4602232&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FtUGYxzJg1vE%2Fmicrosoft-software-to-replace.html Microsoft Research, Mar 8, 2011: InnerEye focuses on the analysis of patient scans using machine learning techniques for automatic detection and segmentation of healthy anatomy as well as anomalies:Antonio Criminisi is the the researcher shown in the video above.The InnerEye research project focuses on the automatic analysis of patients' scans by using machine learning techniques for:- Automatic detection and segmentation of healthy anatomy, as well as anomalies- Semantic navigation and visualizationMicrosoft Research methods aim to combine medical expertise and modern machine learning theory in the design of tools for computer-aided diagnosis, personalized medicine, and natural user interfaces for surgical intervention.The InnerEye project has a host of famous collaborators, including Joh... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4602232 Thu, 17 Mar 2011 14:20:01 +0100 4602232 http://www.medworm.com/index.php?rid=4596874&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FsZZL32tk9pA%2Foropharyngeal-carcinoma-increased-by-22.html Head and neck cancer is the sixth most common cancer. Despite an overall marginal decline in the incidence of most head and neck cancers in recent years, the incidence of oropharyngeal squamous cell carcinoma has increased greatly, especially in the developed world.In the United States, the incidence of oropharyngeal squamous cell carcinoma increased by 22% between 1999 and 2006.The increase in incidence of oropharyngeal squamous cell carcinoma seems to be accounted for by a rise in human papillomavirus (HPV) related oropharyngeal carcinoma.References:Oropharyngeal carcinoma related to human papillomavirus. BMJ 2010; 340:c1439 doi: 10.1136/bmj.c1439 (Published 25 March 2010).Image source: HPV types and associated diseases, Wikipedia, public domain.Twitter comments:@travispew (Travis Pew): ... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4596874 Wed, 16 Mar 2011 14:07:24 +0100 4596874 http://www.medworm.com/index.php?rid=4582988&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2Frt4xVRHQJYc%2Fcnn_416x234_embed.swf Related:Targeted student: 'It's hard not to say something'. CNNAnother CNN video. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4582988 Tue, 15 Mar 2011 13:37:00 +0100 4582988 http://www.medworm.com/index.php?rid=4582989&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FHcPKm3OJtes%2Fpromise-of-prevention-effects-of-4-risk.html This analysis included 4 preventable risk factors:- smoking- high blood pressure- elevated blood glucose- adiposity The researchers estimated the effects of these 4 preventable risk factors on national life expectancy and on disparities in life expectancy and disease-specific mortality among 8 subgroups of the US population (the “Eight Americas”). The groups were defined on the basis of race, location and socioeconomic characteristics of county of residence, in 2005.Who has the lowest number of risk factors?Asians had the lowest mean body mass index, fasting plasma glucose, and smoking; whites had the lowest systolic blood pressure (SBP).Who has the highest number of risk factors?Systolic blood pressure (SBP) was highest in blacks, especially in the rural South - 5-7 mmHg higher than w... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4582989 Mon, 14 Mar 2011 13:00:00 +0100 4582989 http://www.medworm.com/index.php?rid=4567441&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FJZRpN_6g5gE%2Finvestigating-easy-bruising-in-child.html From BMJ:In a child, unusual bruising or bleeding out of proportion to the injury sustained should be investigated.All children under investigation for easy bruising or a bleeding tendency should have:- full blood count- blood film (peripheral smear)- coagulation screen including a thrombin time, in addition to a Von Willebrand factor assay and assays of factors VIII and IXThis is to ensure that mild forms of haemophilia are excluded even if the activated partial thromboplastin time is normalIn 30% of cases of haemophilia, there is no family history: it arises secondary to new genetic mutationsThe coagulation cascade. Black arrow - conversion/activation of factor. Red arrows - action of inhibitors. Blue arrows - reactions catalysed by activated factor. Grey arrow - various functions of thr... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4567441 Thu, 10 Mar 2011 12:59:00 +0100 4567441 http://www.medworm.com/index.php?rid=4562428&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2FKDW9Jjaf1QQ%2F8dF9kfc2A6o , according to a recent study from the Cleveland Clinic: As you're sharing fond family memories, don't forget to bring up family health history -- it's the best gift you can give. Dr. Charis Eng comments on a study she led looking at the important role of family history in predicting future disease risk.Related readingBeware the fortune tellers peddling genetic tests - BMJ http://goo.gl/F0DQtFamily History and Personal Genetic Risk Assessments: A Perspective on the Cleveland Clinic Study. 23andMe.com.Comments from Twitter@23andMe: See our perspective of Cleveland Clinic study - http://bit.ly/c373aj - bottom line is 2 aren't the same, so can't compare h2h. Also, we agree that family history is a very important piece, and believe it complements detailed genetic info. Posted at Clinical Ca... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4562428 Wed, 09 Mar 2011 16:28:57 +0100 4562428 http://www.medworm.com/index.php?rid=4555943&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FnFMsUZ6u1JY%2Fthere-are-25400-scientific-journals-and.html More scientific and medical papers are being published now than ever before. Is it possible to be an expert nowadays, asks BMJ.Every doctor has an ethical duty to keep up to date. Is this just getting more difficult or has it already become impossible? Since Alvin Toffler coined the phrase “information overload” in 1970, the growth of scientific and medical information has been inexorable.There are now 25 400 journals in science, technology, and medicine, and their number is increasing by 3.5% a year; in 2009, they published 1.5 million articles. PubMed now cites more than 20 million papers.One response of the medical profession to the increasing scientific basis and clinical capacity of medicine has been to increase subspecialisation. This may restrict the breadth of knowledge of th... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4555943 Tue, 08 Mar 2011 13:14:00 +0100 4555943 http://www.medworm.com/index.php?rid=4555944&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FheURqUAhzHU%2Felectronic-medical-record-emr-review-of.html Some negatives regarding the use of EMR:- So far, electronic systems are not interconnectable- Do electronic records improve or worsen the quality of care?- Accuracy vs copying and pasting- A third party in the examination room- Devoid of real medical thoughtA contrasting view:- Connectivity will improve- Staying focused on the patient, even with a computer in the room- Doctor-doctor communication is enhancedReferences:The electronic medical record: Diving into a shallow pool? CCJM.The electronic medical record: Learning to swim. CCJM. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4555944 Mon, 07 Mar 2011 13:20:00 +0100 4555944 http://www.medworm.com/index.php?rid=4541857&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2F8MOhTX_GJ8Q%2Fblogs-read-by-20-of-uk-medical-students.html A wide range of social media tools has become readily available in recent years, to the extent that the use of Facebook in particular is perceived as "second nature" by many students. There is increasing interest in the possibilities of using this social media services for medical education - blogs, wikis, Twitter and Facebook.This UK study included a self-administered questionnaire survey of 212 first year medical students.Over 90% used instant messaging. Social networking sites were also highly used - by 70%. There was no significant difference between males and females. Blogs were read by 20% of students and a small number (8%) wrote their own blogs. 20% of males were users of media sharing and contributed to wikis. Social bookmarking was rarely used by either gender. Medical educators ... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4541857 Thu, 03 Mar 2011 13:27:00 +0100 4541857 http://www.medworm.com/index.php?rid=4528641&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FV72XAjsr7os%2F25-of-medical-students-use-facebook-for.html This Australian study aimed to evaluate how effectively medical students may be using Facebook for education. Researchers surveyed 759 medical students at one Melbourne university, and explored the design and conduct of 4 Facebook study groups. 25.5% of students reported using Facebook for education-related reasons and another 50.0% said they were open to doing so. The case studies showed conservative approaches in students' efforts to support their development of medical knowledge and mixed successes. The study authors concluded that Facebook as part of learning and teaching is as much of a challenge for many students as it may be for most educators.References:Medical students' use of Facebook to support learning: Insights from four case studies. Gray K, Annabell L, Kennedy G. Med Teach. ... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4528641 Mon, 28 Feb 2011 13:07:00 +0100 4528641 http://www.medworm.com/index.php?rid=4508728&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2FOkK-2Hd55XI%2Fcnn_416x234_embed.swf Mind map of differential diagnosis of cough. See more Allergy and Immunology mind maps here.Cough is the most common symptom bringing patients to the primary care physician's office. The most common diagnosis in these patients is acute bronchitis, according to a recent review in the official journal of AFP, American Family Physician.Acute bronchitis should be differentiated from other common causes of cough such as pneumonia and asthma - because the therapies are clearly different.Symptoms of acute bronchitis typically last 3 weeks. As we already know, the presence of colored (e.g., yellow or green) sputum does not reliably differentiate between bacterial and viral lower respiratory tract infections. Viruses cause more than 90% of acute bronchitis, and therefore, antibiotics are generally ... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4508728 Wed, 23 Feb 2011 13:32:00 +0100 4508728 http://www.medworm.com/index.php?rid=4503435&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2Fo6MWnMtMZOM%2Fshake-may-be-common-in-hospitals.html High-protein dietary supplements were started for 2 patients, who had a period of anorexia before hospital admission but no history of liver disease. Subsequent altered mental status with ataxia developed in both patients.Hyperammonemia was noted, while liver function test results remained normal.Removal of the high-protein dietary supplements led to reversal of symptoms and normalization of the ammonia level.With the ubiquity of nutrition supplement use, SHAKE (supplement-associated hyperammonemia after c[k]achetic episode) syndrome may be common in modern hospitals.References:Iatrogenic Hyperammonemia After Anorexia. Emily Welsh, BA; Jan Kucera, MD; Michael D. Perloff, MD, PhD. Arch Intern Med. 2010;170(5):486-488.Image source: sxc.hu. Posted at Clinical Cases and Images. Stay updated... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4503435 Tue, 22 Feb 2011 13:47:00 +0100 4503435 http://www.medworm.com/index.php?rid=4485147&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2F7XeH48LCvx8%2Fpeople-who-brushed-their-teeth-less.html A Scottish national population based survey examined if self reported toothbrushing behaviour is associated with cardiovascular disease and markers of inflammation (C reactive protein) and coagulation (fibrinogen).Participants were 12,000 men and women, mean age 50. Oral hygiene was assessed from self reported frequency of toothbrushing. There were a total of 555 cardiovascular disease events over an average of 8 years of follow-up, of which 170 were fatal.Participants who reported poor oral hygiene (never/rarely brushed their teeth) had an increased risk of a cardiovascular disease event (hazard ratio 1.7).They also had increased concentrations of both C reactive protein and fibrinogen.Poor oral hygiene is associated with higher levels of risk of cardiovascular disease and low grade infla... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4485147 Thu, 17 Feb 2011 13:34:00 +0100 4485147 http://www.medworm.com/index.php?rid=4473928&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2FfJhF2LwpOto%2Ffederated_f9 Dr. Paul Rychwalski of the Cole Eye Institute at the Cleveland Clinic talks to the local TV station WKYC about how you can protect your child's eyes from video games. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4473928 Mon, 14 Feb 2011 13:52:00 +0100 4473928 http://www.medworm.com/index.php?rid=4461374&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2FW0J1KYjTS_U%2FXluC2PPLAVo Mayo Clinic: Millions of people know what it's like to have to run for the antacids after a big pasta dinner. Most of the time heartburn is harmless, but people who suffer from chronic heartburn are at increased risk of a condition called Barrett's esophagus. And if you have it, your chances of getting esophageal cancer go up. Doctors at Mayo Clinic studied whether or not burning away the Barrett's cells with heat from radiofrequency ablation gets rid of the problem. What they found was encouraging. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4461374 Fri, 11 Feb 2011 13:16:00 +0100 4461374 http://www.medworm.com/index.php?rid=4456462&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FAEK0EAY0QZs%2Fheart-has-endured-67-stents-and-28.html A 56-year-old male with coronary artery disease (CAD) presented with angina, nonspecific electrocardiographic (ECG) changes, and elevated troponins.Coronary angiography revealed total occlusion of a stent in the circumflex artery, where another was deployed—his 67th stent. The patient had 28 catheterizations over 10 years, with stents placed in his native coronary arteries as well as in 3 bypass grafts. All stents were placed to relieve his angina, refractory to maximal medical treatment and transmyocardial laser revascularization. Stents can be a great tool to help revascularization and relieve symptoms; unfortunately, they are prone to thrombosis and restenosis. If they fail while medical management is maximized unsuccessfully, alternative tools are lacking.This case raises many questi... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4456462 Thu, 10 Feb 2011 13:21:00 +0100 4456462 http://www.medworm.com/index.php?rid=4451910&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2FaUpz9p1p7SM%2FEmbedPlayer.swf Neuropsychologist Kim Gorgens makes the case for better protecting our brains against the risk of concussion -- with a compelling pitch for putting helmets on kids: A $20-helmet is a good way to protect $100,000 education. "Mind your (brain) matter." Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4451910 Wed, 09 Feb 2011 13:19:00 +0100 4451910 http://www.medworm.com/index.php?rid=4443070&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FjtL0hT8_Gjc%2Fnew-us-diet-guidelines-no-more-than-15.html This is a summary of the Cleveland Clinic commentary on the new U.S. Diet Guidelines via their Twitter account, provided by the dietitian Kristin Kirkpatrick:Decrease in salt consumptionThe main recommendation is a decrease in salt consumption. New recommendation is below 1,500 mg/day for at-risk populations. At-risk populations include African-Americans, people with high blood pressure or kidney disease, and people over 51. Americans not at risk can consumer up to 2,300 mg of salt per day (for now, until the next update of the guidelines - commentary of the blog author). Kristin Kirkpatrick: I think the 1,500 mg/day recommendation should apply to the entire population for many reasons. There is strong scientific evidence that limiting salt can help prevent heart attacks and stroke. The pr... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4443070 Mon, 07 Feb 2011 15:20:00 +0100 4443070 http://www.medworm.com/index.php?rid=4443071&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FIo9cnWXSBLk%2Fsocial-media-in-medical-education-what.html The 2011 Association for the Study of Medical Education (ASME) conference will take place in Edinburgh in July.The conference organizers are asking all the right questions:- Is a WordPress blog more useful than a Blackboard module?- How social is social bookmarking?- How can social media help medical education researchers?- How can we manage and develop our own digital identity?The Networked Teacher - Diagram, Flickr http://goo.gl/CVddiReferences:Social Media and Networks in Medical Education: Workshop at ASME Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4443071 Mon, 07 Feb 2011 13:18:00 +0100 4443071 http://www.medworm.com/index.php?rid=4437279&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2F2jqU08mYOrM%2Fmain.swf Health Benefits of Coffee - MarketWatch video.Coffee is not usually thought of as health food, but some recent studies suggest that it can be beneficial.A 2005 JAMA meta-analysis concluded that habitual coffee consumption was consistently associated with a lower risk of Type 2 diabetes. However, caffeine, seems to have little to do with it. In fact, caffeine (C8H10N4O2) is the natural pesticide of coffee beans, paralyzing and killing insects that try to feed on them.A Norwegian study found that women who drank 1-3 cups a day reduced their risk of cardiovascular disease by 24% compared with those drinking no coffee at all.Antioxidants in coffee may decrease inflammation, reducing the risk of disorders related to it, like cardiovascular disease. A typical serving of coffee contains more anti... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4437279 Sat, 05 Feb 2011 15:18:47 +0100 4437279 http://www.medworm.com/index.php?rid=4434026&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2Fl_ASx7Ne1rw%2Fromiplostim-for-treatment-on-immune.html Romiplostim, a thrombopoietin mimetic, increases platelet counts in patients with immune thrombocytopenia, with few adverse effects.In this open-label, 52-week study (funded by Amgen), 234 adult patients with immune thrombocytopenia, who had not undergone splenectomy, were randomized to receive the standard of care or weekly subcutaneous injections of romiplostim.The rate of a platelet response in the romiplostim group was 2.3 times that in the standard-of-care group.Patients receiving romiplostim had a significantly lower incidence of treatment failure [11%] than those receiving the standard of care [30%].Splenectomy also was performed less frequently in patients receiving romiplostim [9%]) than in those receiving the standard of care [36%].The romiplostim group had a lower rate of bleedi... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4434026 Fri, 04 Feb 2011 13:31:00 +0100 4434026 http://www.medworm.com/index.php?rid=4430149&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FVZHeqBBqCDg%2Fheart-numbers-to-know-by-cleveland_03.html Cleveland Clinic has been ranked the number one hospital in the U.S. for heart disease and heart surgery for the last 19 years. They must know what they are talking about when selecting the "heart numbers to know". This is the list by the cardiologist Dr. Richard Krasuski and the Clinic Twitter account.Knowing your risk for heart disease depends on knowing and understanding some important numbers:- Blood pressure should be less than 120/80 mm Hg- Fasting blood sugar should be less than 100 mg/dL- Total cholesterol less than 200 mg/dL- LDL (bad cholesterol) less than 100 mg/dL, HDL (good) greater than 40 mg/dL- Waist circumference should be less than 40 inches for men and less then 35 inches for women- Body Mass Index (BMI) should be between 18.5 and 25. Calculate your BMI here: http://bit.... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4430149 Thu, 03 Feb 2011 14:32:28 +0100 4430149 http://www.medworm.com/index.php?rid=4425729&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FCWLh2OI58UU%2Fstrategies-for-increasing-recruitment.html Recruitment of participants into randomised controlled trials (RCTs) is critical for successful trial conduct.396 papers were retrieved and 37 studies were included in this review.Recruitment strategies that improved recruitment included:- increased people's awareness of the health problem being studied (e.g., an interactive computer program)- attendance at an education session- addition of a health questionnaire or a video about the health condition- monetary incentivesIncreasing patients' understanding of the trial process, recruiter differences, and various methods of randomisation and consent design did not show a difference in recruitment.References: Caldwell PHY, Hamilton S, Tan A, Craig JC (2010) Strategies for Increasing Recruitment to Randomised Controlled Trials: Systematic Revie... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4425729 Wed, 02 Feb 2011 13:31:00 +0100 4425729 http://www.medworm.com/index.php?rid=4420608&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FUSy4Xlhw5_o%2Fcars-decide-if-driver-is-drunk-video.html Associated Press: An alcohol-detection prototype that uses automatic sensors to instantly gauge a driver's fitness has the potential to save thousands of lives, but could be a decade away from everyday use in cars.Motorists under the influence of drugs are a growing threat on U.S. roads. If you think about driving on a Friday or Saturday evening about 16% of the vehicles - one in six of the cars - the driver will be under the influence of an illicit or licit drug."Drugged driving" hampers judgment, reaction time, driving skills and memory.Related:16% of motorists may be under the influence of drugs during weekends - one in six of the cars Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4420608 Tue, 01 Feb 2011 13:40:33 +0100 4420608 http://www.medworm.com/index.php?rid=4415972&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2Fq9TpIdK1KhY%2Fvitamin-d-receptor-activation-with.html Despite treatment with renin—angiotensin—aldosterone system (RAAS) inhibitors, patients with diabetes have increased risk of progressive renal failure that correlates with albuminuria.281 patients with type 2 diabetes and albuminuria who were receiving angiotensin-converting enzyme inhibitors or angiotensin receptor blockers were enrolled in this study.Patients were assigned to receive 24 weeks' treatment with:- placebo- 1 μg/day paricalcitol- 2 μg/day paricalcitolParicalcitol (trade name Zemplar, Abbott Laboratories) is an analog of calcitriol, the active form of vitamin D.The primary endpoint was the percentage change in mean urinary albumin-to-creatinine ratio (UACR).The change in urinary albumin-to-creatinine ratio (UACR) was: −14% in the 1 μg paricalcitol group, and −20% in... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4415972 Mon, 31 Jan 2011 13:25:00 +0100 4415972 http://www.medworm.com/index.php?rid=4407699&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2F9RDC5Bhg5gA%2Fcnn_416x234_embed.swf From CNN:You can use apps and other tools to turn your cell phone into a safety tool:1. Program your cell phone so people can find you2. Put your "in case of emergency" contact into your cell phone3. Put your medical information on your cell phone4. Get an app that teaches you first aid and CPR5. Find help nearbyReferences:Five ways your cell phone can save you. CNN. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4407699 Fri, 28 Jan 2011 13:24:00 +0100 4407699 http://www.medworm.com/index.php?rid=4401764&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2Fp6Q8dJhrcEY%2Fdiagnosis-treatment-and-prognosis-of.html 5 new ideas that are changing the management of brain tumor patients:1. Prognosis and glioma subtypes. The cell of origin of the glioblastoma has never been defined. In his pioneering work “Death Foretold,” Dr. Christakis says “prognosis gives diagnosis its affective component, striking fear in patients and physicians alike.” There has been a lot of therapeutic nihilism about the treatment of glioblastoma, but that is now changing. Image source: Sen. Ted Kennedy who died of glioma in 2009.2. Diagnosis and imaging mimics. Acute stroke in the luxury perfusion stage is probably the most common mimic of a brain tumor. Diffusion MRI sequences and perfusion CT scan are helpful in differentiating stroke from tumor by showing hypoperfusion as would be expected, rather than hyperperfusion s... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4401764 Thu, 27 Jan 2011 13:20:00 +0100 4401764 http://www.medworm.com/index.php?rid=4395739&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2FHSBDpTmVytg%2FKqQwFmW6Sac Mayo Clinic Video: The news has been filled with stories about the dangers of concussions in sports like high school football. Doctors at Mayo Clinic say that pulling kids off the field until they have completely recovered is key to keeping them healthy. But some players who've suffered concussions choose not to get back in the game. They don't want to risk possible consequences of repeat and serious head injury. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4395739 Tue, 25 Jan 2011 16:15:00 +0100 4395739 http://www.medworm.com/index.php?rid=4390631&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FwgJXyhz1M8U%2Fexercise-pioneer-jack-lalanne-died-at.html Jack LaLanne, the fitness pioneer who inspired TV viewers to trim down, eat well and pump iron for decades (34 years), died at 96 of respiratory failure due to pneumonia at his home in California.He ate healthy and exercised every day of his life up until the end. Just before he had heart valve surgery in 2009 at age 95, Jack Lalanne told his family that dying would wreck his image."The only way you can hurt the body is not use it," LaLanne said. "Inactivity is the killer and, remember, it's never too late."His workout show was a television staple from the 1950s to the '70s. LaLanne and his dog Happy encouraged kids to wake their mothers and drag them in front of the television set. He developed exercises that used no special equipment, just a chair and a towel.He said his own daily routin... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4390631 Mon, 24 Jan 2011 11:36:00 +0100 4390631 http://www.medworm.com/index.php?rid=4379210&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FefkgCO6X3os%2Fstop-bang-questionnaire-identifies.html What is preoperative STOP-BANG?This is a questionnaire that evaluates the following patient characteristics:Snoring, Tiredness during daytime, Observed apnea, high blood Pressure, Body mass index, Age, Neck circumference, GenderPatient population135 adult patients undergoing elective surgery at a tertiary care center were administered the STOP-BANG questionnaire. 41.5% of patients had high risk scores for OSAS.Patients at high risk of OSAS had a much higher rate of postoperative complications compared with patients at low risk (19.6% vs 1.3%).STOP-BANG questionnaire predicts high riskThe STOP-BANG questionnaire is useful for preoperative identification of patients at higher than normal risk for surgical complications, probably because it identifies patients with occult OSAS.ReferencesObstr... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4379210 Fri, 21 Jan 2011 13:15:01 +0100 4379210 http://www.medworm.com/index.php?rid=4374044&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2FScGwa4TbRHs%2FEPW6jP-Mpao Psychologist and addiction expert Dr John Marsden takes part in a radical experiment as he trials an non-addictive drug alternative to alcohol:A single injection reverses the 'drug' alternative to alcohol and Dr John Marsden is left to reflect on whether this is indeed be the way forward in reducing alcohol dependency in future generations: Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4374044 Thu, 20 Jan 2011 13:39:00 +0100 4374044 http://www.medworm.com/index.php?rid=4364333&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2FdpM4H8YHzv4%2FzvwQXwJyaj0 TED talks: "You'll never sing again, said her doctor. But in a story from the very edge of medical possibility, operatic soprano Charity Tillemann-Dick tells a double story of survival -- of her body, from a double lung transplant -- and of her spirit, fueled by an unwavering will to sing. A powerful story from TEDMED 2011."Tillemann-Dick was diagnosed in 2004 – at the age of 20 – with Idiopathic Pulmonary Hypertension, a disease that causes high blood pressure in the pulmonary artery, which connects the heart to the lungs. People with the disease typically have a two-to-five-year mortality rate after diagnosis.Her physicians at Johns Hopkins put her on the lung transplant list at Cleveland Clinic. In September 2009, organs became available, and she had a double lung transplant. After ... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4364333 Wed, 19 Jan 2011 13:28:00 +0100 4364333 http://www.medworm.com/index.php?rid=4357051&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FWfSfxkNj1ZQ%2Fparticipation-in-clean-up-of-oil-spill.html In 2002, the oil tanker Prestige spilled more than 67 000 tons of bunker oil, heavily contaminating the coast of northwestern Spain. The study population included local fishermen who were highly exposed (n = 501) or not exposed (n = 177) to oil. They were evaluated 2 years after the spill.Elevated markers of airway injuryPersons exposed to oil were at increased risk for lower respiratory tract symptoms (risk difference, 8.0). However, lung function did not significantly differ between the groups. Exposed participants also had higher levels of exhaled vascular endothelial growth factor (risk difference, 44.8) and basic fibroblast growth factor (risk difference, 16.0).Human chromosomes (grey) capped by telomeres (white). Image source: Wikipedia, public domain.Chromosomal damageA higher propo... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4357051 Tue, 18 Jan 2011 13:07:00 +0100 4357051 http://www.medworm.com/index.php?rid=4357052&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2FKqcj051tcX8%2FD1R-jKKp3NA%26amp%3Brel%3D1 From the WSJ:William Chapman, transplantation chief at Washington University in St. Louis, hasn't examined Mr. Jobs personally, but said there are two likely scenarios in the CEO's case.The first is that there was a transplant-related problem, though it would be unusual for that to happen a year and a half after the transplant.A more likely possibility would be that the neuroendocrine tumor metastasized again. "It's really difficult to cure the disease with a liver transplant," said Mr. Chapman, adding that it's common to have some degree of recurrence. "Most people hope they reset the clock, gained some time and gained a quality of life even if you don't cure the disease."Steve Jobs' speech at the 2005 Stanford graduation ceremony: “This is the closest I’ve ever gotten to a college gr... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4357052 Tue, 18 Jan 2011 00:13:08 +0100 4357052 http://www.medworm.com/index.php?rid=4357053&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FHmGGTWTQE2w%2Fgoogle-translate-in-medicine-video.html "Conversation Mode" is a new interface for Android Phones within Google Translate that’s optimized to allow you to communicate with a nearby person in another language.In conversation mode, simply press the microphone for your language and start speaking. Google Translate will translate your speech and read the translation out loud. Your conversation partner can then respond in their language, and you’ll hear the translation spoken back to you. See an example below.Google Translate in Medicine from Graham Walker on Vimeo.References:A new look for Google Translate for AndroidConversation Mode in Google Translate for Android Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4357053 Mon, 17 Jan 2011 16:05:00 +0100 4357053 http://www.medworm.com/index.php?rid=4357054&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E3%2FKO1r1Tfuk1o%2Finvasive-dental-treatment-associated.html This study included persons exposed to invasive dental treatment with a primary hospital discharge diagnosis of ischemic stroke or myocardial infarction from 2002 to 2006.The rate of vascular events significantly increased in the first 4 weeks after invasive dental treatment (incidence ratio, 1.50) and gradually returned to the baseline rate within 6 months.Invasive dental treatment may be associated with a transient increase in the risk for vascular events. However, the absolute risks are minimal, and the long-term benefits on vascular health will probably outweigh the short-lived adverse effects.References:Invasive Dental Treatment and Risk for Vascular Events: A Self-Controlled Case Series. October 19, 2010, vol. 153 no. 8 499-506.Image source: Cross-section of a tooth with visible gums... Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4357054 Mon, 17 Jan 2011 13:06:00 +0100 4357054 http://www.medworm.com/index.php?rid=4350551&cid=s_34681_22_f&fid=34681&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCasesBlog%2F%7E5%2FR51c2SYw6CY%2FWn2fKmsoARs NationalGeographic | January 14, 2011 | A bite from a rattlesnake can be lethal, but a majority of snakebite victims survival their encounter. Do you know what to do if are on the receiving end of a rattlesnake bite?See the other videos in the series Survival Guide. Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images) Clinical Cases and Images news http://www.medworm.com/rss/comments.php?id=4350551 Sat, 15 Jan 2011 16:21:00 +0100 4350551