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.

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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:

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Times have changed for physician practice websites.

Older sites included static content such as the practice name, location, hours of operation, fax and telephone number, procedure instructions, office policies, physician photos and bios, and mission statement.

New websites are dynamic, maintained by the physicians or the office manager, updated weekly, and often include the following:

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This victim of neurosurgery clearly has his moments!!

Read more:
Necropolis Neurology Patient Fright Fest 2011 Six Flags Great America 10-8-11

Visit http://MyHealthStory.me for more info. The basic idea is to share short video stories about your healthcare experiences as a patient, family member, or healthcare professional. This is done by uploading these into your own YouTube account and adding a little tag that makes the system find the videos.

The project is hosted by a team at Radboud University Nijmegen Medical Centre.

Here is a good example by ePatient Dave:

The project leader Lucien Engelen provides some background info:

Please have in mind that by recording your video story you voluntarily reveal elements of your (or your relative or friend) protected health information as defined by the HIPAA law in the U.S. This is similar to sharing your personal experience on a blog or any other website.

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From CNN:

The woman inserts the latex condom like a tampon. Jagged rows of teeth-like hooks line its inside and attach on a man's penis during penetration. Once it lodges, only a doctor can remove it. The doctor inventor says: "It hurts, he cannot pee and walk when it's on. If he tries to remove it, it will clasp even tighter. Yes, my device may be a medieval, but it's for a medieval deed that has been around for decades."

Critics say the female condom is not a long-term solution and makes women vulnerable to more violence from men trapped by the device.

References:

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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.

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Plasticity and functional recovery in neurology

More here:
Plasticity and functional recovery in neurology

From BMJ:

A case described 5 surgeons who were working in a hospital and using a similar technique to operate on their patients. Surgeon B left the academy after a while to work in the private sector. Surgeon A decided to write a manuscript about their experiences and was the first author. Surgeons C, D, and E were named in the byline of the manuscript, but surgeon B was excluded. The question is whether surgeon B can claim to be an author of the article as well.

Using the International Committee of Medical Journal Editors (ICMJE) guideline without considering the ethical aspects of people’s contributions may lead to this guideline being abused, which is worse than not having any guideline at all.

References:

Behrooz Astaneh: Authorship criteria – use or abuse

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As well know, the iPad contains a touchscreen liquid crystal display that, like computer screens and television sets, emits light. Exposure to such abnormal light sources inhibits the body's secretion of melatonin.

All light-emitting devices, including cellphones, "tell the brain to stay alert." Because users hold those devices so close to their face, staring directly into the light, the effect is amplified compared with, for example, a TV across the room or a bedside lamp.

Related products from Amazon:

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Blogging helps you grow and meet wonderful people all over the world

"What have I learned as a blogger?", a 79-year-old blogger counts the ways:

1. Blogging gives me a focus

2. Blogging helps me stay young

3. Blogging helps me meet wonderful people all over the world

4. Blogging gives me an opportunity to grow

5. Blogging has the potential to create an income

It doesn’t matter if anyone reads it

From an interview of Seth Godin and Tom Peters:

"Blogging is free. It doesn’t matter if anyone reads it. What matters is the humility that comes from writing it. What matters is the metacognition of thinking about what you’re going to say. No single thing in the last 15 years professionally has been more important to my life than blogging. It has changed my life, it has changed my perspective, it has changed my intellectual outlook, it’s changed my emotional outlook. And it’s free."

Doctor, you can be a Twitter superstar in two easy steps

Here is how to start a medical blog today: For doctors: How to start using social media. Indeed, you can be a Twitter superstar in two easy steps.

References

Is it Too Late to Start Blogging?

Why you should start blogging in 2011

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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 Services

Did 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

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From NHS Choices YouTube channel:

Tips for managing stress:

- Take a few deep breaths
- Get plenty of exercise
- Socialize - don't stress alone, talk to someone and have a laugh
- Get out - go to the park

If nothing else helps, consider this: Chewing gum may reduce stress and improve memory

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Helicobacter pylori is associated with benign and malignant diseases of the upper gastrointestinal tract. Increasing antibiotic resistance has made alternative treatments necessary.

Empirical triple therapy (proton-pump inhibitor, clarithromycin, amoxicillin) is currently the first choice for eradication of Helicobacter pylori. As antibiotic resistance to clarithromycin (which has a crucial role in eradication) has increased. The eradication rate with triple therapy has gradually decreased below 80%, and even less.

The aim of this study reported in The Lancet was to assess the efficacy and safety of a new, single-capsule treatment versus the gold standard for H. pylori eradication (triple therapy).

A randomised, open-label trial of adults with H. pylori infection compared the efficacy and safety of:

- quadruple therapy: 10 days of quadruple therapy with omeprazole plus a single three-in-one capsule containing bismuth, metronidazole, and tetracycline

- standard therapy: 7 days of omeprazole, amoxicillin, and clarithromycin (editor note: why not 14 days of therapy?)

H. pylori eradication was established by negative 13C urea breath tests at 28 and 56 days after the end of treatment.

The eradication rates were 80% in the quadruple therapy group versus 55% in the standard therapy group.

The study authors concluded that quadruple therapy should be considered for first-line treatment in view of the rising prevalence of clarithromycin-resistant H. pylori. Quadruple therapy provides superior eradication with similar safety and tolerability to standard therapy.

References:

Helicobacter pylori eradication with a capsule containing bismuth subcitrate potassium, metronidazole, and tetracycline given with omeprazole versus clarithromycin-based triple therapy: a randomised, open-label, non-inferiority, phase 3 trial. The Lancet, Volume 377, Issue 9769, Pages 905 - 913, 12 March 2011.

Quadruple or triple therapy to eradicate H pylori. The Lancet, Volume 377, Issue 9769, Pages 877 - 878, 12 March 2011.

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From NHS Choices YouTube channel: Alan was 55 when he was diagnosed with haemochromatosis or iron overload disorder, a condition where the body contains too much iron. In this video, he describes how he learned to manage the condition by changing is diet and having venesection treatment several times a year.

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From The Lancet:

Graham Hughes, who first described antiphospholipid syndrome (APS) in 1983, urged for more efforts to raise awareness of this disorder. APS often remains undiagnosed and untreated with catastrophic consequences, such as multiple miscarriages, or stroke at a young age.

The 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 thrombin. Image source: Wikipedia

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A 2001 survey by the Commonwealth Fund found that doctor-patient communication often fell short. One in 5 American adults had trouble communicating with their doctors, and 1 in 10 felt they had been treated disrespectfully during a recent health care visit.

Just funded through a generous $42-million grant, the University of Chicago aims to fix the communication errors and bring the patient-physician relationship back where it belongs.

Here is the example that started the whole process:

Kay Bucksbaum, whose husband made multi-billion fortune developing shopping centers around the world, said she was inspired by Dr. Mark Siegler, a medical ethicist at the University of Chicago who became the couple's internist when they moved to Chicago from Iowa 10 years ago.

In contrast, she recalled a doctor years ago who didn't listen to her when she told him what she thought was wrong with her -- and didn't apologize when she turned out to be right.

When her husband needed surgery, she said, Siegler "took my husband by the hand to meet the surgeon, introduced him, and told the surgeon something about my husband. He even scrubs up and watches his patients' surgeries when he can, she said. "And he encourages patients to call him "Mark."

The video below introduces the Bucksbaum Institute for Clinical Excellence which is funded through $42 million grant to the University of Chicago to create a unique initiative that aims to improve the doctor-patient relationship and communication in medicine:

Disclaimer: I am an Allergist/Immunologist and Assistant Professor of Medicine and Pediatrics at the University of Chicago.

NBC video:

References:

New Bucksbaum Institute fosters doctor-patient communication
Benefactor Gives U of Chicago $42 Million to Work on Bedside Manner
A $42 Million Gift Aims at Improving Bedside Manner

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More than 50% of U.S. adults are habitual coffee drinkers. Americans get more antioxidants from coffee than anywhere else (?!). Coffee drinkers may be at lower risk of liver and colon cancer, type 2 diabetes, and Parkinson's disease.

"Most people drink it for the caffeine but it's the Number 1 source of antioxidants in the U.S. diet. Polyphenols are the "the good guys in coffee." Is coffee a "health food" now?

70% of Americans with an annual household income of $150,000 or more drink coffee, compared with 54% of Americans in a household making less than $25,000 a year.

Can drinking coffee even help you live longer? Maybe (same with alcohol).

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These are some selected presentations from the 2011 Medicine 2.0 Congress that took place on the Stanford University campus last weekend:

Lee Aase, manager of Syndication and Social Media for Mayo Clinic, has uploaded more than 100 of his presentations on SlideShare.

Other presentations: Epocrates and medical apps.

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Update 09/21/2011: DEA Moves to Make 'Bath Salts' Illegal as Overdoses Rise

What 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 sedatives failed to quiet them. Director of Poison Center. “If you gave me a list of drugs that I wouldn’t want to touch, this would be at the top.”

Bath salts contain man-made chemicals like mephedrone and methylenedioxypyrovalerone, or MDPV, also known as substituted cathinones. Both drugs are related to khat, an organic stimulant found in Arab and East African countries that is illegal in the United States." These products are easily obtained over the Internet under such names as Ivory Wave or Vanilla Sky.

What to do when evaluating and treating a patient intoxicated with psychoactive “bath salts” (PABS)?

Clinicians need to be aware of several issues (source: NEJM):

- severity and potential lethality from overdoses often require admission to the intensive care unit (ICU)

- routine drug screens do not detect PABS

- PABS can be cut with other psychoactive substances, which can confound the clinical presentation

- patients may need physical restraints and high doses of sedatives to prevent self-harm or harm to others.

Treatment is largely supportive, with IV benzodiazepines (for sedation or to control seizures) and IV fluids, particularly if there is rhabdomyolysis

References:

An Alarming New Stimulant, Sold Legally in Many States. NYTimes.
“Bath Salts” Intoxication. NEJM.

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