Simple English Words Transformed into Google Brands

Via Google Operating System:

Try typing the words below in the Google search box and see what you get:

images
video
maps
local
groups
desktop
earth
blog
blogger
scholar
talk
alerts
trends
labs
spreadsheets
notebook
pages
suggest
or even just "more"

All these searches will show synonymous Google services as a top result or within the top 5.

Google Operating System discusses this development: "It's really interesting to see simple English words transformed into Google brands. Google has become a word, after being just a brand and now simple words become brands. I don't know if that's a good thing or a bad thing, all I know is that if I type more in my address bar, I'll get the list of Google products and that's really cool. More to come."

Search has become a dominant Internet activity and it looks like we live more and more in a "Google world". If your business or website is not listed on the front page of the results, it is almost as if it does not exist.

I cannot complain though -- check out number 2 and 4 search results for "clinical cases" on Google among 49 million pages...



References:
Easy Way to Access Google Sites. Google Operating System.

BMJ Audio Pilot

BMJ just launched an audio pilot: "a magazine programme with the latest medical news, opinion, and issues that matter to doctors."

One by one, all journals in the elite club of the "Big Five" are offering a podcast/audio summary of contents.

The list of "Big Five" medical journals consists of NEJM, JAMA, BMJ, Lancet and Annals. Currently, only Annals does not have a podcast.

The editorial teams have a slightly different approach to their audio supplements:

  1. NEJM has a physician (male or female) reviewing the main stories
  2. JAMA features its own Editor-in-Chief, Catherine DeAngelis
  3. Lancet audio is also read by its editor
  4. BMJ chose a GP who also works as a medical correspondent for BBC

Most of the journal audio summaries are also available on iTunes.

If you want to listen to the full articles and have online access, you can use text-to-speech to convert text to mp3 files and transfer them to your mp3 player of choice.

Feel free to expand the list of medical podcasts/videocasts on UBC HealthLib-Wiki.


References:
JAMA Podcast: Audio Commentary by the Editor-in-Chief
The Lancet Features Weekly Audio Summary
The NEJM Audio Summary
Text-to-Speech Programs and Continuous Medical Education
Top 5 Medical Podcasts I Listen To
Image source: OpenClipArt.org, public domain

Injection of Stem Cells in Acute Myocardial Infarction

There are 3 articles on the subject in last week's NEJM :

Intracoronary Injection of Mononuclear Bone Marrow Cells in Acute Myocardial Infarction.
NEJM.
There was no effect on global left ventricular function.

Intracoronary Bone Marrow-–Derived Progenitor Cells in Acute Myocardial Infarction.
NEJM.
There was an improved recovery of left ventricular contractile function in patients with acute myocardial infarction.

Transcoronary Transplantation of Progenitor Cells after Myocardial Infarction.
NEJM.
There was a moderate but significant improvement in the left ventricular ejection fraction after 3 months.

The conclusion of all 3 studies was almost the same: no breakthrough results, more studies are needed.


Virtual endoscopy of coronary arteries.


Video: Replicating heart stem cells, source: Empowered Medical Media.

References:
Bone-Marrow Cell Injections May Aid Heart Patients. NPR.

Only 2 Men Have Survived a Stingray Injury to the Heart

The tragic death of the "Crocodile Hunter" Steve Irwin who was killed by a stingray brought a renewed interest in these somewhat shy sea creatures.

The Medical Journal of Australia describes the 2nd known case of a Survivor of a Stingray Injury to the Heart (PDF, published in 2001):

"Cardiac injuries from stingray barbs are rare, even worldwide, and all but one have been fatal.

Clinical Record

A 33-year-old man was snorkelling at Coogee, a popular Sydney swimming beach, when he was noticed to be in distress."

References:
"Crocodile Hunter" Steve Irwin Killed by Stingray
The Claim: Never Remove a Barb From a Stingray Injury. NYTimes.
Image source: Wikipedia, Creative Commons Attribution ShareAlike 1.0 license, by Dr. Tony Ayling.

Looking for a Job? Send a Video Resume

Communication Nation points out to a prototype of the resume of the future: a video clip on YouTube:

"This video thing is definitely the wave of the future. There used to be financial barriers to this kind of thing. Publishing is rapidly becoming the province of everyone who has a computer and internet access. The walls continue to crumble."

Medicine is a conservative field so I suggest you wait for video resumes to hit mainstream before flooding the email boxes of potential employers with your video.

Physician Assistant Blogs About "Bush Medicine" in Alaska

From Medscape Pre-Rounds:

"An experienced physician assistant moved to the land of the Yupik Eskimo, in southwestern Alaska 7 years ago. Under the pen name "The Tundra PA," she writes about her experiences living and practicing medicine in this unique environment on her blog Tundra Medicine Dreams:

The culture here, the "flavor of life," if you will, is so very different from the lower 48. In many ways it is very like living in a Third World country, right here in the US of A. Non-Natives are definitely the minority; our ways of thinking and speaking, our perceptions of time, our attitudes about what is important and how things should be done are often at odds with Yupik culture. The biggest adjustment for me, and for most Westerners (ie, those raised in Western culture/civilization — lower 48 US states, Europe, etc), has to do with pace. The metronome of life ticks at a rate of about 120 for East Coasters (130 for New Yorkers!), perhaps 80 for Californians, and something like 40 for Yupik Eskimos. When you ask a Yupik a question, you better be prepared to wait 10 to 20 seconds for an answer, maybe longer. They think slowly, consider carefully, and answer slowly. Words are not wasted. The worst mistake Westerners make is to interpret that slowness as lack of intelligence; far from it. The most common Yupik criticism of us is that we talk too much and don't listen enough. There is a reason, they say, that we have 2 ears and only 1 mouth: We should listen twice as much as we talk."

Tundra Medicine Dreams hosts Grand Rounds, Vol. 2 No. 52.

Images source: Wikipedia, free documentation license and public domain.

Does Avandia Prevent Diabetes?

As Medpundit points out, sometimes, unfortunately, the thought process with pharmaceutical company-sponsored studies is like that: "well, we did the study, how can we spin the results now?"

I am not saying that this is the case with the recently publicized research that Avandia "cut the risk of developing Type 2 diabetes by more than half" but at least one doctor has doubts: "It is giving the impression that it prevents diabetes, when really what it is doing is delaying the diagnosis for one year," said Dr. Jim Wright, managing director of the B.C. Therapeutics Initiative."

Update 05/21/2007:
Avandia (Rosiglitazone) May Increase Risk of Cardiovascular Death

References:
Let Us Now Praise Expensive Drugs. Medpundit.
The DREAM study, Are we preventing or just delaying diabetes? Retired doc's thoughts.
Image source: Rosiglitazone, from Wikipedia, the free encyclopedia.

Once-a-Year Drug to Treat Osteoporosis

The new once-yearly Aclasta manufactured by Novartis has been shown to be as effective as weekly Fosamax in reducing incidence of bone fracture in women with postmenopausal osteoporosis (PMO). One in two women with PMO will suffer an osteoporotic fracture, if untreated. Reportedly, patients treated with Aclasta had a 70 % risk reduction in new spine fractures and a 40 % risk reduction in hip fractures (compared to placebo). Both Fosamax and Aclasta belong to a medication class called bisphosphonates.

Aclasta (zoledronic acid) is actually not a new drug -- is has been used in the U.S. under the name Zometa for treatment of hypercalcemia in malignancy and osteolytic bone metastasis. It will be sold in the U.S. under the name Reclasta. Why do we need a new name for the same drug? It is probably for marketing purposes so that patients do not confuse Zometa (used in malignancy) with Reclasta.

Currently, Fosamax is the most prescribed osteoporosis drug with worldwide sales of $3 billion in 2005 (its patent will expire in 2008).

Boniva by Roche has the advantage of once-a-month dosing and it rapidly gained market share at the expense of Fosamax.

A few questions come to mind:

Why do we need once-a-year drug for osteoporosis? We already have effective medications for this condition...

Oral bisphosphonates are cumbersome to take which leads to low-compliance -- 60% of patients taking weekly bisphosphonates (Fosamax) stop treatment within a year.

Patients must take the drug on an empty stomach in the morning, stay upright and wait for 30 minutes before eating, drinking or taking any other medication.

A medication that needs to be taken only once per year may help alleviate the compliance problems.

Once-a-year treatment sounds great but what is the drawback?

Aclasta can only be given as IV infusion. There is no oral form of the medication (no pill). It also has a different safety profile (different side effects) than oral bisphosphonates.

Bottom line

Compared to IV infusion, the once-a-month Boniva should be OK in terms of compliance -- it is only 12 pills per year after all.

References:
Novartis: Once a year drug helps bones. CNN Money.
Study Shows New Once-a-Year Osteoporosis Shot Reduces Fractures. WSJ.com
Bisphosphonates. Susan Ott, Department of Medicine, University of Washington.
The World Health Organization has an online Fracture Risk Assessment Tool.
Links to medications by Epocrates, Inc.
Images source: Wikipedia, public domain.

Interesting Links

National Geographic Videos in the News.
This one is especially good: Leopard vs. Hyenas, Lion.

Young Doctors' Resource Center by Medical Economics magazine.
It covers the basics such as: Career, Technology, Malpractice, Personal Finance, Practice Management.

Casebook Case Reports by the UK Medical Protection Society.
The 150 case reports are used to alert doctors to medical malpractice pitfalls that have caught their colleagues unawares.

Podcasting/vodcasts
in UBC HealthLib-Wiki - A Knowledge-Base for Health Librarians.
The list has only 5 entries but you can expand it to as many as you want -- it's a wiki. Having a wiki is a huge advantage because anybody can contribute to it. Bloggers-made lists of podcast lists are "closed" no matter how comprehensive they are bacause only the blog author can expand them. For example, NMM's Medical Informatics Blog recently posted a good summary of Medical Podcasts. It is a great start but the only way to add a new podcast is to post a comment. The wikis work better.

MedPeek.com has a directory of medical podcasts listed by specialty.

Don't forget to add your blog to the list of Bloggers in health & medicine in UBC HealthLib-Wiki.

Who's the Best Looking Science Blogger?

After the journal Nature listed the Top five science blogs, it was time for a far more substantial classification - the list of "the hottest science bloggers." The voting took place on Flags and Lollipops blog.

There seems to be a connection between intellect and external beauty which is proven by the fact that 2 bloggers made it on both lists - the best and the beautiful: ScientificActivist and Pharyngula. The placement of ScientificActivist is understandable -- see his photo here, but Pharyngula beats the odds since voters generally disfavor bearded men in beauty contests.

Naturally, the list of most beautiful science bloggers is dominated by women and the beauty queen crown goes to... Retrospectacle who made the announcement on her blog in the category "Stupidity."

Science is hard work and the scientists just have to have some fun from time to time assembling lists like that, don't they?

I found the link via Aetiology whose readers are disappointed that she was not listed.

Considering that the moose of Corpus Callosum was also nominated, I gather that some other people were also disappointed.

Image source: Openclipart.org

Warfdocs Web Tool Predicts the Maintenance Warfarin Dose

From Warfdocs website:

"Warfdocs (warfdocs.ucdavis.edu) is a point of care tool developed at the University of California, Davis to aid in the dosing of warfarin. It is currently available for the PalmOS platform as well as a web-based format.

Warfdocs for Web predicts a patient's steady state warfarin dose, as well as the effect of modulating doses on the time to steady state.

It relies on drug kinetic modeling and a Bayesian prediction algorithm, predicting appropriate doses of warfarin based on general patient characteristics and data from daily lab (INR) tests. Its intended audience is clinicians (physicians, pharmacists) who are initiating warfarin therapy.

It was developed by Terence Lin, MD and James Lee, MS."

Image source: warfdocs.ucdavis.edu

Music in the OR? For Cleveland Clinic Surgeons, It's Not Just Mozart.


This edition of Cleveland Clinic's video podcast HealthEdge may rock your world a bit. Studies show that music in the operating room may help surgeons concentrate better. But what happens if the patient likes Bach and the surgeon prefers Rolling Stones?

One thing is for sure, Cleveland Clinic is doing a good job using Web 2.0 tools like Google Video to inform the public.

The HealthEdge videocast is not Rocketboom but is often both informative and entertaining which is an important feature of any good educational medium. You can subscribe to HealthEdge on iTunes or Bloglines. Videos are available to watch or download for free on Google Video.

References:
Music in the Operating Room: Harmony or Discord? American Society of Anesthesiologists.
iPOD, iSAW, iCONQUERED operating theatre--essential anaesthetic equipment? Anaesth Intensive Care. 2006 Feb;34(1):123-4.
Web 2.0 in Medicine

Google News Archives Searches Newspapers From 1799 Until Today

Google launched a News Archive Search which helps you explore historical archives of newspapers and magazines.

This is an example search for "myocardial infarction."

According to a 1969 article:

"A common symptom of myocardial infarction is an electrocardiogram which fails to show the emission of r-waves."

Image source: Google Blogoscoped, a creative commons license.

NEJM on the Future of Primary Care

Primary Care -- Will It Survive?
Thomas Bodenheimer, M.D.

vs.

Primary Care -- The Best Job in Medicine?
Beverly Woo, M.D.


(click to see the figure)
Figure 2. Proportions of 3rd-year Internal Medical Residents Choosing Careers as Generalists (dramatic downward trend), Subspecialists (upward trend), and Hospitalists (significant upward trend).

In many European countries there is a distinct division between the inpatient care provided by hospitalists and the outpatient care provided by general practitioners (GPs). Currently, our health system is moving in this direction and this is probably beneficial.

As a hospitalist at the Cleveland Clinic, I see clearly that patients are happy to have a physician available to see them and answer their questions during a full work day rather than during a rushed 10-minute "encounter." Outpatient doctors are almost always pressed by their busy schedules and have to leave the hospital and go back to their office as soon as possible. It is no surprise than many patients ask hospitalists if they can continue to follow them after discharge.

Further reading:
This attitude frustrates me. DB’s Medical Rants.
Image source: Openclipart.org, public domain.

A Tribute to Steve Irwin

I don't know about you but I always liked the guy and what he was doing. He looked like one big kid fascinated with living creatures. He was only 44. Rest in peace Steve Irwin, you will be missed.


Steve Irwin Tribute


Steve Irwin Tribute


A tribute to Steve Irwin, a great person and conservationist

Update 09/04/2007:
CNN: Your e-mails: Remembering the 'Croc Hunter' One Year Later.

References:
Highlight: Tributes to Steve Irwin, Crocodile Hunter. Google Video Blog.
"Crocodile Hunter" Steve Irwin Killed by Stingray
Irwin's death strikes a chord. CNN.com.
Web Exclusive: Irwin's Widow Talks About Living in the Camera's Eye. ABC News.
Steve Irwin. A fond farewell. Jay Leno. Time, 2006.

Grand Rounds, Volume 2, Number 50

Grand Rounds is a weekly summary of the best posts in the medical blogosphere. Pre-Rounds is an article series about the hosts of Grand Rounds on Medscape.com. Nick Genes of Blogborygmi, who writes the Medscape column, is the founder of Grand Rounds and he maintains the archive.

This week's Grand Rounds is loosely structured in a "medical journal format" using the table of contents of one of my favorites -- the British Medical Journal:

Editor's choice
Editorials
News
Research
Clinical review
Practice
Analysis and Comment
Letters
Reviews
Fillers
Career focus


EDITOR'S CHOICE

Should Sammy Go to Medical School?
NHS Blog Doctor answers the question of Sammy, one of his readers: "I still enjoy my job, when I am allowed to do it. But, knowing everything I know now, looking down the all powerful retrospectoscope, would I do it again?" Read the whole post to find the answer.

Nephrology Case: Refractory Orthostatic Hypotension
KidneyNotes presents the challenging clinical case of a 72-year-old man with severe, disabling, refractory orthostatic hypotension for two years. What is the cause and how to treat it?

Perfecting Social Graces
Dr. Wes: "He was the most respected man in our training program. The oldest cardiologist at our institution, gruff, never afraid to shy away from a four-letter word to make his point, and with the uncanny ability to diagnose critical aortic stenosis or insufficiency by placing his hands on his patient’s pulse. No echocardiogram was necessary..."

A Yoga Class That Leads to Hyponatremia
TBTAM shares her experience taking a hot yoga class, complete with video explanation of hyponatremic heat exhaustion.


EDITORIAL

It is fascinating to see how Grand Rounds has grown over the years and has become an amazingly diverse collection of the best posts in the medical blogosphere. The statistics at the end of this issue provide a snapshot of the Grand Rounds' participants. In conclusion, I would like to say just one thing: keep on blogging, you make the web a better place.

Editor of Grand Rounds, Vol. 2, No. 50.


NEWS

Global Survey of Healthcare Bloggers
As announced in a previous edition of Grand Rounds, The Medical Blog Network and Envision Solutions, LLC are running the first global survey of healthcare bloggers. The final survey results will be presented during Healthcare Blogging Summit 2006 in Washington, DC. Please take a few minutes to complete the survey before the deadline on 9/29/06.

Uninsured Children
Despite what one might read, fewer children are uninsured now as compared to 1994, writes InsureBlog. According to a new study, state-mandated initiatives seem to be picking up steam.


CLINICAL REVIEW

Huffing in Alaska
According to Tundra Medicine Dreams, huffing is the most common form of substance abuse in rural Alaska. Huffing and sniffing are forms of inhalant abuse, sometimes known as “solvent abuse” in other parts of the world.

Stung by a Bee
Medicine for the Outdoors reviews what to do in case of a bee sting.

Neuromuscular Blockade
Inside Surgery has a 3-part series on the neuromuscular blocking drugs that are used to paralyze patients during general anesthesia and surgery.


RESEARCH

Cervical Cancer, Vaccines, and Jackalopes
Aetiology discusses the strange route of discovery of the Human papilloma virus (HPV) and the vaccine against it.

NSAIDs Use in Pregnancy Linked to Cardiac Abnormalities in Babies
Straight From The Doc comments on a study which suggests that NSAIDs intake in the first trimester of pregnancy may lead to
congenital heart abnormalities, particularly septal defects.

Microstructural Damage in the Brains of Professional Boxers
Sumer Sethi links to a a diffusion MRI study which shows "previously unreported abnormalities in the brains of professional boxers assumed to reflect cumulative (chronic) brain injury resulting from non severe head trauma."

Biological Pacemakers Using Gene Therapy
The BioTech weblog: "Two independent groups of researchers are making progress in the use of gene therapy to develop biological pacemakers."

Meeting with DNA Direct
Many blogs are prominently featured in the search engine results and are consequently becoming a target for PR departments of different companies. Hsien Hsien Lei of Genetics and Health writes about her meeting with the representatives of DNA Direct, a direct-to-consumer genetic testing company. There is a much-needed disclaimer: DNA Direct picked up the tab for the cafe lunch.


PRACTICE

Perfecting Social Graces
Dr. Wes: "He was the most respected man in our training program. The oldest cardiologist at our institution, gruff, never afraid to shy away from a four-letter word to make his point, and with the uncanny ability to diagnose critical aortic stenosis or insufficiency by placing his hands on his patient’s pulse. No echocardiogram was necessary..."

Medical School "Pimping" and Silverback, MD
A medical student describes the "art of medical school pimping" which can degenerate into simple bullying: "So I'm standing in a jungle of knowing nothing when along comes Silverback, MD... The doctor started to ask questions, slapping me around with his paws. I made the mistake of answering correctly, which is like eye-contact to them. He batted me harder, asking about all sorts of random things to throw me off any balance I pretended to have until I fell, incorrect." NYTimes and Kevin, M.D. also commented on this social phenomenon.

Jerk Consultants and Telephone Etiquette
GruntDoc: "The consultant who generates an acrimonious relationship with the ED is not doing himself or his patients any favors. We need each other to take effective care of our patients. And boorish behavior is for boors, not Physician Colleagues."

Patient Noncompliance
Aggravated DocSurg discusses patient noncompliance and its dire consequences in Public Service Announcement #2.

There Is No Such Things As Bloodless Surgery
Robotic Surgery Blog: "Any surgery which involves any incision has the potential to lose blood. There is no such thing as bloodless surgery in the sense that blood will not be lost. I think the term should be transfusion-less surgery as a more accurate, but maybe less marketable term."

Nephrology Case: Refractory Orthostatic Hypotension
KidneyNotes presents the challenging clinical case of a 72-year-old man with severe, disabling, refractory orthostatic hypotension for two years. What is the cause and how to treat it?

A Yoga Class That Leads to Hyponatremia
TBTAM shares her experience taking a hot yoga class, complete with video explanation of hyponatremic heat exhaustion.

A Memorable Patient
Surgeon's Blog: "I talked about a Whipple in my book: it's every surgical resident's dream: the full-meal deal, the three-ring circus, the Superbowl of surgery. It involves about every trick up the sleeve of a general surgeon: removing some stomach, some bowel, some bile duct, some pancreas, the gallbladder."

Judge Not. Unless It's Your Job.
ImprobableOptimisms writes about the pitfalls of first impressions in the ED.

How to Choose a Primary Care Doctor
In My Humble Opinion blog has a long list of tips on how to pick a primary care doctor and get the most out of your appointment.

When a Patient Commits Suicide
Musings of a Distractible Mind shares his feelings about a patient who unexpectedly committed suicide: "It is something many of us have experienced. As a physician it is easy to get caught up in the "what if" game, second-guessing whether there was anything you could do. You must resist this temptation, while also not totally suppressing the real human emotions you feel." More from Pubmed.

Cotton Bud Addiction
Parallel Universes discusses a topic I have never thought about: "Cotton Bud Addiction. Are you one them? Do you often clean your ears with cotton buds? How often is too often?'"

Hanging On For Dear Life
Emergiblog writes about a memorable patient.


ANALYSIS AND COMMENT

Patient Records Up For Auction?
MSSP Nexus Blog comments on an ad that appeared in a local newspaper about a month ago: "Up for auction in Norton, Ohio: Physician's office furniture, patient files and records." It is of particular interest to physicians who are considering closing a practice.

Deconstructing Evidence-based Medicine
Respectful Insolence explains why he is annoyed by a journal article and dispels several myths about evidence-based medicine.

Electronic Medical Records Under Senate Scrutiny
Enoch Choi covers the NYT article "Smart Care via a Mouse, but What Will It Cost?" and considers the cost of EMR a good investment in our health.

Let's Help the Tobacco Companies!
California Medicine Man does not believe in conspiracy theories but he wonders why the level of nicotine in American cigarettes has increased by 10% over the 6-year period between 1998 and 2004 and the public was never informed.

Upstairs, Downstairs with First-Gen Continuous Glucose Monitors
Diabetes Mine takes a look at the "bipolar" consumer reaction to a long-awaited CGMS (Continuous Glucose Monitoring System) technology.

Fear of Developing Dementia
The Tangled Neuron takes the Lancet Neurology test which aims to predict to risk of developing dementia in 20 years among middle aged people.

Massachusetts Balancing Act
Health Business blog comments on the new Massachusetts health care law that aims for universal coverage.


LETTERS

ED Video
ImpactEDnurse: "People often ask me why I continue to work in the Emergency Department despite the ongoing hazards of overcrowding, access block and the high stress levels. Its a difficult question to answer in words. A while ago I tried to answer it in a video clip…."

Why I’m Not a Numbers Girl
A twenty-something writer's take on life with chronic illness: “You have a 75 percent chance of not being able to have children on your own,” the fertility specialist told me... When I look at such a sampling of numbers, I am reminded why I am not and never will be a numbers girl. I cannot add all those parts up and get a whole me..."

Manic Monday
When i grow up blog reminds us that no matter how bad we feel about ourselves, the things are often worse on the cold end of the stethoscope where the patient is.

Anne. Nurse Extraordinaire.
Malcolm's Lab Space: "This is a story about a nurse I met who practiced in a rural center that had infrequent doctor visits. I wrote this fictional account of what I imagined her first day would be like."

Frustration
Neonatal Doc shares his concern: "Last week I saw a 24 year old mother having her fifth child and ninth pregnancy, and today I talked to a 23 year old mother who just had her third baby after her ninth pregnancy. Nine pregnancies by age 23?..." Practice of medicine is never easy for both logical and emotional reasons. Neonatal Doc, who works an urban area of the Midwest, feels that the more he practices and studies medicine, the less he knows.


REVIEWS

Nursing Podcast
Nursing Studio features Nursing Podcast # 13 with ACLS quick review and interviews of nursing bloggers Jen, RN and Third Degree Nurse.

Art and Life
HealthyConcerns.com discusses genetic testing and selecting embryos which is is the subject of both the latest novel she read and a recent NY Times article.


FILLERS

Building
A poem by the author of the blog In My Humble Opinion.

Questions on Evidence-based Medicine
Naomi of TMBN is planning a radio show on the pros and cons of evidence-based medicine: "I plan to tape the show, so at some point it may get uplinked to the web. Answers from professionals and non-professionals are encouraged."


CAREER FOCUS

Should Sammy Go to Medical School?
NHS Blog Doctor answers the question of Sammy, one of his readers: "I still enjoy my job, when I am allowed to do it. But, knowing everything I know now, looking down the all powerful retrospectoscope, would I do it again?" Read the whole post to find the answer.

Miss Mallard and Medical School Interviews
A medical student gives advice on how to flunk the admission interview.


Statistics of Grand Rounds, Vol. 2, No. 50


(click on the image to enlarge)

This is a Google Spreadsheets summary of the bloggers/posts in Grand Rounds, Vol. 2, No. 50. Male bloggers, at 55%, were slightly more than female bloggers. Most of the posts were submitted by physicians (47%), nurses (7%) and medical students (7%). Among doctor bloggers, surgeons (26%) and internists (15%) were predominant. Most of the posts were original (65%) as compared to opinions/comments on medical news (30%) .


Check out Grand Rounds next week

The host of next week's Grand Rounds is Amy Tenderich of Diabetes Mine.

"Crocodile Hunter" Steve Irwin Killed by Stingray

From Wikipedia:

"Stephen Robert "Steve" Irwin (February 22, 1962 – September 4, 2006) was an Australian naturalist, wildlife expert and television personality.

Shortly after 11:00am local time on 4 September 2006, Irwin was fatally pierced in the chest by a Short-tail stingray barb while diving in Queensland's Batt Reef. According to his friend and colleague John Stainton, who was on board Irwin's boat at the time, "he came on top of the stingray and the stingray's barb went up and into his chest and put a hole into his heart."

This was only the third known fatality in Australian history from a stingray attack, and only 17 worldwide fatalities have taken place since 1996.

Crewmembers aboard his boat administered CPR as they rushed the boat to nearby Low Isle to meet a rescue helicopter. Medical staff pronounced Irwin dead when they arrived a short time later. Autopsy identified that the stingray had badly damaged both the left atrium of the heart and the left ventricle which caused a great deal of stress for the heart and caused him to go into cardiac arrest.

His wife Terri was informed of her husband's death while on a walking tour in the Cradle Mountain-Lake St Clair National Park in Tasmania, and returned via private plane from Devonport to the Sunshine Coast with their two children."


Giant Stingray

CNN Video

Update 09/04/2007:
CNN: Your e-mails: Remembering the 'Croc Hunter' One Year Later.

References:
Steve Irwin, from Wikipedia, the free encyclopedia.
Stingray from Wikipedia, the free encyclopedia.
Steve Irwin killed by stingray trauma. RangelMD.com.
Australia’s ‘Crocodile Hunter’ Killed by Stingray. NYTimes.
Images source: Wikipedia, GNU Free Documentation License.

Oktoberfest in Berea, Ohio

This movie from Labor Day Oktoberfest in Berea, Ohio (2006) shows some staples of German tradition like castles, Bavarian cuckoo clocks, beer steins and dachshunds.



Click here to read more and see the photos.

A Day in the Life of Google


Click on the image above.

Link via Communication Nation.

TECAB = Totally Endoscopic Coronary Artery Bypass Grafting

On 9/26/06 , OR-Live will feature a video showing Beating Heart Totally Endoscopic Coronary Artery Bypass (TECAB) using the da Vinci robotic system.

May be the days of the big open-heart-surgery-scars will be gone soon.

According to Dr. Srivastava who will demonstrate the surgery on OR-Live:

"The vision of ideal CABG performed through ports on a beating heart with the use of arterial grafts may become the standard for future revascularization approaches where sternotomy will be a historical marker in the distant past for many patients".

Conventional coronary bypass surgery is done by splitting the sternum, putting the patient on a heart lung machine, and doing the bypass on a stopped heart. It can take up to two months before the patient can go back to a normal lifestyle. Many patients who have undergone TECAB using the da Vinci system have gone home the next day. The majority leave the hospital in less than three days and are back to functional recovery in one to two weeks, with minimal or no pain."

References:
Beating Heart Totally Endoscopic Coronary Artery Bypass using the da Vinci robotic system. OR-Live.com.
Ongoing procedure development in robotically assisted totally endoscopic coronary artery bypass grafting (TECAB). Heart Surg Forum. 2005;8(4):E287-91.
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