Top articles in medicine in May 2012

Here are my suggestions for some of the top articles in medicine in May 2012:

Large numbers of very rare genetic mutations may underlie common human diseases like schizophrenia and cancer http://goo.gl/GttAQ

14 Ways Social Media May Soon Change Your Doctor's Visit http://goo.gl/muWK1

Drunk driving across the globe: many countries have “no tolerance” laws with 0.0% blood alcohol limit http://goo.gl/aIsRn

Top 10 Cloud-Based EHRs - CureMD and Practice Fusion (the only free EMR) scored best http://goo.gl/jWMuu


Pets at birth either decreased or had no effect on allergic disease up to age 12. No evidence that exposure to cats or dogs at birth increases the risk of allergic disease in high risk children http://goo.gl/MS4iW

Cleveland Clinic starts a blog called "Health Hub" http://goo.gl/66FF0 - competing with the aging consumer portal of MayoClinic.com

CT colonography is accurate in detecting adenomas 10 mm or larger but less so for smaller lesions http://goo.gl/gMTiX -- Laxative-free colonoscopy on the way? Virtual colonoscope digitally removes stool from the colon http://goo.gl/sJG6H

Do we need vacations? Vacations improve employee wellbeing but the positive effect is short-lived (study) http://goo.gl/jd3CH

NRMP to Implement “All-in” Policy for 2013 Match http://goo.gl/tn5Cs

New labeling will help you pick the best sunscreen - Consumer Reports http://goo.gl/Wtm3M

U.S. politicians invoke the “R word” - rationing for healthcare - NEJM http://goo.gl/Urhua

Pepsi and Competitors Scramble as Soda Sales Drop in the U.S. Average American drank less than 2 sodas/day in 2011, a drop in per capita consumption of 16% since the peak in 1998. Sugary soft drinks are the No. 1 source of calories in U.S. diets - NYTimes http://goo.gl/9tjdD

"Z-Pak Heart Attack" - sudden death may be a new (rare) risk linked to commonly prescribed antibiotic azithromycin http://goo.gl/3DeIh

Coffee Drinkers May Live Longer - there are 1,000 or more compounds in coffee - NYT and NEJM http://goo.gl/VSfbN

Using Internet Search Engines to Obtain Medical Information: users preferred Bing over Google in this study http://goo.gl/mJgpm

The articles were selected from my Twitter and Google Reader streams. Please feel free to send suggestions for articles to clinicalcases@gmail.com and you will receive acknowledgement in the next edition of this publication.

Healthcare social media #HCSM - top articles

Here are my suggestions for some of the top articles related to healthcare social media in the past 2 weeks:

Understanding Research Impact http://goo.gl/2ZHCK and 20 Strategies To Enhance The Impact Of Your Research http://goo.gl/49MLb

BMJ Learning gets social - British Medical Journal platform learns new tricks in this brave new social media world http://goo.gl/4vncy

Doctors' Use of iPads Becoming Mainstream (not my impression). Also, physician-only social networks remain stagnant http://goo.gl/9QfDf

Heart Rhythm Society 2012 Scientific Session in the Age of Twitter http://goo.gl/FGH10

"Healthcare Going To The Dogs" - a video for training hospital administrators http://goo.gl/hv40a and http://goo.gl/xsW4J

Cleveland Clinic starts a blog called "Health Hub" http://goo.gl/66FF0 - competing with the aging consumer portal of MayoClinic.com

JAMA will link 10 AMA journals like a group blog - all names will start with “JAMA”, for example, Archives of Surgery will become “JAMA Surgery” http://goo.gl/FJLL2

Cultivate followers on social media if you want to communicate science

From the blogs Soapbox Science http://goo.gl/cPQq1 and Medical Museion http://goo.gl/QmEU7 :

"Social media platforms can be very limiting. For example, can you define genotype and phenotype in 140 characters or less? If you want to use social media to communicate effectively, you need to drive readers somewhere.

Writing a blog gives substance to your social media presence. You have the opportunity to talk about science in a meaningful way, which ultimately helps people better understand the world around them. Answering those questions is probably why you got into science in the first place. Don’t be afraid to share what you’ve discovered."

The articles were selected from my Twitter and Google Reader streams. Please feel free to send suggestions for articles to allergycases@gmail.com and you will receive acknowledgement in the next edition of this publication.

Dr Topol to med students: "When I was in medical school, the term "digital" was reserved for the rectal examination"

Here are some excerpts from the Baylor College of Medicine commencement address by Dr. Eric Topol, director of the Scripps Translational Science Institute, delivered yesterday, May 22, 2012. This should be a required reading for everyone involved in healthcare, which is basically everybody because each and every one of us will be a patient one day.

Eric Topol to medical students: "When I was in medical school, the term "digital" was reserved for the rectal examination."

"You sleep with your cell phone and prize it right up there with food and water. We have evolved to a new species of man. We are Homo distractus!"

The benefits of digital medicine are clear to Dr. Topol who shares the story of a patient he saw last week: "I asked him to put his fingers on the 2 sensors on the back of my iPhone case so I could do his electrocardiogram—ECG—that was normal. And free, by the way. Then instead of using a stethoscope to listen to his heart, I used a portable pocket-sized high-resolution ultrasound device and within a minute I could see every heart structure—the heart muscle thickness and function, the valves, the size of the 4 chambers. Why would I ever listen for lub-dub when I can see everything? I haven't used a stethoscope for over 2 years to listen to a patient's heart."

Here is Eric Topol's presentation at Health at Google:



References:

Baylor College of Medicine commencement address by Dr. Eric Topol, director of the Scripps Translational Science Institute

Comments from Twitter

Quoc-Dien Trinh, MD @qdtrinh: Makes it sound cool. “@DrVes: Dr Topol to med studs: When I was in med school, the term "digital" was reserved for the rectal examination"

Hemophilia educational videos by CDC

Hemophilia belongs to a family of inherited lifelong bleeding conditions that prevent blood from clotting properly. Patients with these disorders bleed for longer than normal, either as a result of injury or spontaneously without an external cause.

The severity of bleeding depends on the amount of clotting factor that is missing or not functioning properly, which in hemophilia A and B - the most common types of hemophilia - is the coagulation factors VIII and IX, respectively.

In addition to external bleeding, patients more commonly have internal bleeding around the joints and muscles, which can be extremely painful and cause permanent disability. Bleeding into major organs such as the brain is especially difficult to manage and can be fatal.

Here are 2 hemophilia educational videos by CDC:  Playing it Safe With Hemophilia: Friends with hemophilia talk about playing sports growing up and the importance of making smart decisions.



Starting the Conversation: Hemophilia. How to talk to your friends about hemophilia. A group of friends ask their friend Billy questions about his hemophilia:



Hemophilia care has undergone substantial improvements during the past 40 - 50 years. Early clotting factor concentrates were not sufficiently refined to enable self-administered treatment at home until the 1970s.

Long-term substitution therapy (prophylaxis) of the missing clotting factor is the recommended treatment in severe hemophilia. The major side-effect of treatment, development of inhibitors to the infused concentrate, is the main threat to the health of patients.

Mnemonic: Differential Diagnosis of Bleeding Disorders: F-CAP

Fibrinolysis - tPA
Coagulopathy - hemophilia, vWD
Angiopathy - conditions affecting blood vessels, e.g. Osler-Weber-Rendu syndrome
Platelets - thrombocytopenia or thrombocytopathia

Initial diagnostic tests = 3P:

Platelets
PT - INR
PTT

References:

http://www.cdc.gov/NCBDDD/video/Hemophilia_sports/index.html

http://www.cdc.gov/NCBDDD/video/Hemophilia_Friends/index.html

Making haemophilia a global priority - The Lancet, 2012.

Modern haemophilia care - The Lancet, 2012.

Best of Medical Blogs - weekly review and blog carnival

The “Best of Medical Blogs - weekly review and blog carnival” is a weekly summary of the best posts from medical blogs. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best of Medical Blogs (BMB) is published every Tuesday, just like the old Grand Rounds.

Cultivate followers on social media if you want to communicate science

From the blogs Soapbox Science http://goo.gl/cPQq1 and Medical Museion http://goo.gl/QmEU7:

Social media platforms can be very limiting. For example, can you define genotype and phenotype in 140 characters or less? If you want to use social media to communicate effectively, you need to drive readers somewhere.

Writing a blog gives substance to your social media presence. You have the opportunity to talk about science in a meaningful way, which ultimately helps people better understand the world around them. Answering those questions is probably why you got into science in the first place. Don’t be afraid to share what you’ve discovered.

Are doctors afraid to be wrong?

From the surgeon blogging at Skeptical Scalpel: "I once did some expert witness work for a malpractice insurance company. There is rarely a case that does not have many opportunities for second-guessing. When you know the outcome, you can always find something in the medical record that could have been done differently.

The current medicolegal and patient safety climate creates a feeling among physicians that any error is going to be extensively scrutinized. This results in a situation analogous to an athlete trying not to lose a game instead of trying to win. For those of you not familiar with sports, that strategy usually fails. Fear of being wrong can lead to excessive testing too." http://goo.gl/FWTbC

When did we stop teaching the basics to medical students and residents?

Dr. Centor of the blog db's Medical Rants likes the ACGME 6 core competencies just fine, but also suggests a simpler list http://goo.gl/2sqip:

1. Take a complete, relevant, accurate history
2. Do an appropriate physical examination
3. Order the correct laboratory tests and interpret them fully and accurately
4. Order the correct images and interventions and interpret them

Happy 5th Blogiversary!

Former plastic surgeon and blogger extraordinaire Dr. Ramona Bates reflects on her 5 years of blogging and the medical blogging community. http://goo.gl/0EVJW

How blogging has helped me academically. According to Dr. Centor: Because I write most days, my writing has improved dramatically http://goo.gl/GLNsL

Social media and medicine - Stanford University Grand Rounds

Graham Walker was one of the first medical bloggers. He went on a hiatus during his emergency medicine (EM) residency, and has now found new reasons to blog as an EM attending at Stanford University medical center. This is his talk on social media and medicine at Stanford University Grand Rounds: http://youtu.be/qtkggenLmlE



Dr. Walker: "My talk on the dissemination of medical information over time, how the internet and social networking are changing medicine, and how to use digital tools to be a better clinician at the bedside."

Here is Graham's list of Digital Tools to Improve the Specialty.

Paper-based Charts: How Soon We Forget http://goo.gl/Vspmp - Dr. Wes: Suddenly, I don't miss paper charts anymore.

Dr. Wes: How Bad Is Azithromycin's Cardiovascular Risk? http://goo.gl/yVgfo - Are "Big Data" linked to "Big Error"?

Comments from Twitter:

Seth Trueger @MDaware: some great stuff in there

Skeptical Scalpel @Skepticscalpel: Thanks for including me.