Top medicine articles for August 2012

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

Sanofi Announces FDA Approval for Auvi-Q, First Voice-guided Epinephrine Auto-injector http://goo.gl/4GfPr

Medical Journal of Australia: "Clearly, we overestimate our ability to correctly deploy tests and interpret results" http://goo.gl/q8da8

Drug Resistance Claims Another Gonorrhea Treatment: the oral cephalosporin cefixime http://goo.gl/tR2LW

Social media continues to excel at reaching patients and medical peers http://goo.gl/odKGo

New drugs, procedures, and devices for hypertension : The Lancet http://goo.gl/IbwbL

Data challenge the concept that raising of plasma HDL cholesterol will reduce risk of myocardial infarction http://goo.gl/67eZF

10 Ways to Make EMR Meaningful and Useful http://goo.gl/KimDJ

Tiger snake (Notechis spp) envenoming: Australian Snakebite Project (ASP-13) | Medical Journal of Australia http://goo.gl/YCzRg

Bias in clinical history significantly influenced the accuracy of ECG interpretation http://goo.gl/JjRd6

9 Smartphone Apps to Improve Your Medical Practice http://goo.gl/nUjNP -- 15 Smartphone Apps to Improve Your Practice http://goo.gl/s3dnR

How to Raise Successful (and Happier) Children - NYTimes http://buff.ly/MT4BRr

When metformin alone is insufficient, consider adding a dipeptidyl peptidase-4 inhibitor, linagliptin - Lancet http://goo.gl/bdMkG

Ciprofloxacin for 7 days versus 14 d. in women with acute pyelonephritis: Short courses should be favored - Lancet http://goo.gl/oU3uC

Radiation exposure from CT scans in childhood increases subsequent risk of leukemia and brain tumors - Lancet http://goo.gl/44feV

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.

Rosacea - NHS Choices video

From NHS Choices YouTube channel: Rosacea is a common but poorly understood long-term skin condition that mainly affects the face. It most commonly affects fair-skinned people from northern Europe and is estimated to affect up to 1 in 10 people. In this video, an expert explains what rosacea is, the symptoms to look out for and the various treatments.



Cathelicidin dysfunction may be a central factor in the pathogenesis of several cutaneous diseases, including rosacea.

Cathelicidins are antimicrobial peptides (AMPs) that protect the skin through 2 pathways:

- antimicrobial activity
- cytokine release, inflammation, angiogenesis, and reepithelialization

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.

Are Twitter friends real friends? A rheumatologists' tweetup proves they're real, and yes, they're friends http://goo.gl/6oE93

Searchable database of Clinical Examination Videos at Life in the FastLane EM blog http://goo.gl/VEf1

Physician blogger on assignment: Getting ready for the European Society of Cardiology Congress http://goo.gl/fGtpY

Life as a Healthcare CIO blog calls the Meaningful EHR Use Stage 2 "the most exciting time to be in healthcare IT" http://goo.gl/I6oNN

3 Things Medical Conferences Can Learn From Tech Events | MedCrunch http://bit.ly/RiefZk

Tweets for Credit: Social Media’s Role in CME | The Doctor's Tablet http://goo.gl/QToLQ

“Many faculty members have a keen interest in learning how to better use Twitter. They are attracted to Twitter’s quick pace, easy learning opportunities and ability to help them control more carefully what they share publicly in social media.”

Twitter and Medical Education: Information and Inspiration from Albert Einstein College of Medicine

Comments from Twitter:

Mike Cadogan @sandnsurf: More great stuff from @DrVes with “Best of Medical Blogs - weekly review and blog carnival” litfl.com/NwEUq1

Best of Medical Blogs http://goo.gl/kxLHa with @RonanTKavanagh @sandnsurf @medcrunch @EinsteinMed @drjohnm

Einstein Coll of Med @EinsteinMed: Honored. Thank you!

Carolyn Hastie @Thinkbirth: Awesome list

Dr. Ronan Kavanagh @RonanTKavanagh: Thanks @DrVes I'm in good company!

What are the New Risk Markers for Coronary Heart Disease?

Traditional CHD risk factors used in the Framingham risk score (FRS) predictions include:

- age
- gender
- systolic blood pressure
- treatment of hypertension
- total and high-density lipoprotein cholesterol levels
- smoking
- diabetes

The newer CHD risk factors include:

- N-terminal fragment of prohormone B-type natriuretic peptide levels
- von Willebrand factor antigen levels
- fibrinogen levels
- chronic kidney disease
- leukocyte count
- C-reactive protein levels
- homocysteine levels
- uric acid levels
- coronary artery calcium [CAC] scores
- carotid intima–media thickness
- peripheral arterial disease
- pulse wave velocity

Adding coronary artery calcium [CAC] scores to the FRS improved the accuracy of risk predictions.

Levels of N-terminal fragment of prohormone B-type natriuretic peptide also improved risk predictions but to a lesser extent.

Improvements in predictions with other newer markers were marginal.

References:

Evaluation of Newer Risk Markers for Coronary Heart Disease Risk Classification: A Cohort Study. Maryam Kavousi et al. Ann Intern Med. 20 March 2012;156(6):438-444.
Image source: Gray's Anatomy, 1918, public domain.

Comments from Twitter:

Michael Mirochna, MD @DocRockne:  unfortunately, no evidence they help with OUTCOMES

Bunions animation

From NHS Choices YouTube channel: A bunion is a bony deformity of the joint at the base of the big toe. This animation shows how a bunion forms and explains what could cause it. Find out how bunions are treated: http://nhs.uk/Conditions/Bunion/Pages/Treatment.aspx