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 levels under 50 nmol/L are "vitamin-D deficient"
- those with levels between 50 nmol/L and 72.5 nmol/L are "insufficient"

The society's guidelines also offer an 'ideal' level of 100–150 nmol/L which would require 1,500–2,000 IU daily. It advises physicians to monitor vitamin-D levels in healthy people.

Quest Lab already began to implement these deficiency and insufficiency standards over the IOM's. Many physicians are expected to follow suit.

References:

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.

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:

From the former BMJ Editor-in-Chief:

"I meet with young doctors all over the world, and I usually ask them what they read. I ask for a show of hands and find fairly consistently that half read the NEJM, the Lancet, a local journal, and a specialist journal, a third the BMJ, and most a local newspaper.

About half are reading a novel, and about a third have read a poem in the past week.

Almost all are on Facebook but very few on Twitter."

A lot of them also use Wikipedia as textbook replacement but they will not admit it unless asked directly.

BMJ medical innovations: During the swine flu pandemic, Google showed that it was able to track the spread using the searches that its 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.

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/vU2s

Here 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

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 ?1-adrenoceptor antagonist with a ?2-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 6 months by steps of 100 mg to a maximum of 400 mg twice daily. The primary endpoints were arterial events (rupture or dissection, fatal or not).

Mean duration of follow-up was 47 months, with the trial stopped early for treatment benefit.

The primary endpoints were reached by 20% in the celiprolol group and by 50% controls (hazard ratio [HR] 0·36).

Celiprolol might be the treatment of choice for physicians aiming to prevent major complications in patients with vascular Ehlers-Danlos syndrome.

References:

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 Clinic

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.ly/glMJE5

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."

Based on antioxidant content (polyphenols), here is how nuts stack up, from highest to lowest:

- walnuts
- Brazil nuts
- pistachios
- pecans
- almonds
- peanuts
- macadamia nuts

All ethnic groups said they missed work or family functions because they were too sleepy, with the percentage ranging up to 24%, according to a 2010 "Sleep in America" survey by the National Sleep Foundation (NSF).

Some distinct differences are listed below:

On weekdays or workdays, African Americans reported they slept the least - 6 hours, 14 minutes, compared to 6 hours, 34 minutes for Hispanics, 6 hours, 48 minutes for Asians, and 6 hours, 52 minutes for Caucasians.

10% of African Americans and Hispanics reported having sex every night or nearly every night in the hour before bedtime, compared to 4% of Caucasians and 1% of Asians.

African Americans had different pre-bedtime activities and tended to pray in the hour before bedtime - 71% of them said they prayed but only 18% of Asians did so.

Asians were least likely to drink alcohol an hour before bed - a practice that many mistakenly think will help sleep. Only 1% of Asians had a nightcap every night or nearly every night, compared to 7% of whites, 4% of African Americans and Hispanics.

Caucasians were most likely to sleep with their pets - as well as more likely to sleep with their spouse or significant others: 16% of them say they sleep with a pet, and 72% say they sleep with their partners. In comparison, only 4% of Asians, 4% of Hispanics, and 2% of African Americans let the pet on the bed.

References:

From CNN:

The microbiologist Philip Tierno doesn't feel comfortable staying in hotels. He knows too much. He travels with an impervious mattress and pillow cover to protect against the unseen debris that guests leave behind. When humans sleep they shed about 1.5 million cells an hour.

While the covers were developed for allergy sufferers, Tierno encourages everyone to use them at home and on the road.

And definitely ditch the bedspread, he advises. Hotel bedspreads became a hot topic when one featuring bodily fluids from several sources was introduced in boxer Mike Tyson's 1992 rape trial.

How hotels clean drinking glasses

An Atlanta TV station used hidden cameras to monitor how the drinking glasses in hotel rooms were cleaned. In one case, a housekeeper appeared to clean a toilet and the glasses wearing the same gloves. In multiple hotels, the glasses were rinsed in the sink and dried for the next guests, in violation of health codes.

The Health Magazine lists the 12 germiest places in America or the so called "dirty dozen":

"The Lord Privy Seal is neither a lord, nor a privy, nor a seal" and "‘seborrhoeic’ warts have no relationship to seborrhoea."

"The simultaneous occurrence of scabies in a doctor and a nurse may mean that they have shared nothing more exciting than a patient with Norwegian scabies."

Most people infected with HIV-1 are dually infected with herpes simplex virus type 2. Daily suppression of this herpes virus reduces plasma HIV-1 concentrations, but whether it delays HIV-1 disease progression is unknown.

In this study, the median CD4 cell count at enrollment was 462 cells per ?L and median HIV-1 plasma RNA was 4 log10 copies per ?L. 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:

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.

Comments from Twitter:

@scanman: Ha!! I do this ALL THE TIME!!!

Clinical medicine is disappearing fast as topic for blog posts

Something happened to medical blogs in the past 6-12 months. They now seem a lot less interesting, more industrialized and aggregated. They have also become "too safe", generic and detached for regular reading.

There seems to be a rise of group blogs, guest posts and semi-syndicated contents. Several "clinic-focused" health bloggers have retired due to a variety of professional and HIPAA-related concerns.

It looks like clinical medicine is disappearing fast as a topic for blog posts in the U.S., replaced by posts about social media itself. As a side note, "social media" is actually a plural noun (media vs. medium), but it seems to be used mostly in singular form nowadays.

The central part of medicine is patients - don't push them out of social media

The central part of medicine is patients. Yet, we tell doctors: "never, ever blog about patients". This somewhat misguided advice displaces the most important part of the equation - the patients themselves.

Some health bloggers claim that we have to "aim above HIPAA" to avoid privacy breaches and comply with the highest standard of professionalism required by our occupation as physicians. How high "above HIPAA" is good enough though? In most clinical scenarios, the compliance with omitting the 18 unique HIPAA identifiers strikes the right balance.

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.

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 Video

References:
Professor Tracks Ghastly Injuries in Hope of Prevention - NYTimes.com.

Adult or Child Laptop Use at Home, Work or Classroom.

Mobile or Smart Phone Use while Driving, Traveling or on the Move.

Link via Digital Inspiration.

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 style