Wednesday, August 31, 2005

Tulane University's Website has Turned into an Emergency Blog

Via Boing Boing:
It seems that the Tulane University website has essentially turned into a blog that has been running since August 26th. As you will see their links to their "normal" homepage no longer work and the address is a replica of the homepage. Its incredible to see how affected "the grid" really is.
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No Link Between Mobile Phones and Brain Tumors

From DNC and the British Journal of Cancer:
Using a mobile phone for up to 10 years does not appear to increase the risk of brain cancer, scientists said last night. A team from The Institute of Cancer Research found no substantial risk of acoustic neuroma -- a rare type of brain cancer -- with mobile use up to a decade...
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Aggregated Carbon Nanorods are Forever

From New Scientist:

A material that is harder than diamond has been created in the lab, by packing together tiny "nanorods" of carbon.

The new material, known as aggregated carbon nanorods (ACNR), was created by compressing and heating super-strong carbon molecules called buckyballs or carbon-60. These molecules consist of 60 atoms that interlock in hexagonal or pentagonal shapes and resemble tiny soccer balls...

Technorati Tags: Aggregated Carbon Nanorods, Nanorods, New Scientist

Wednesday Recommendations: Nip/Tuck

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Tuesday, August 30, 2005

20 Most Cited Scientists in Clinical Medicine

From In-Cites:

This month, in-cites presents a listing of the top 20 scientists who, as of the latest bimonthly update of the ISI Essential Science Indicators Web product, attracted the highest total citations to their papers published in ISI-indexed journals of Clinical Medicine over the past 10 years. These names are the top 20 out of a pool of 14,101 scientists comprising the top 1% ranked by total citation count in this field.

Heading up this top 20 list is Dr. Meir Stampfer, with 376 papers cited a total of 30,739 times to date. Dr. Stampfer’s research interests are mainly focused on the etiology of chronic diseases, and his highly cited papers in Clinical Medicine provide ample evidence of this interest. His most-cited papers focus on the risk Dr. Walter Willett factors for cardiovascular disease, breast cancer, and prostate cancer. Dr. Stampfer is Professor of Nutrition and Epidemiology and the Chair of the Department of Epidemiology at the Harvard School of Public Health in Boston, Massachusetts...

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Male Pregnancy Secrets Revealed!

RYT Hospital-Dwayne Medical Center has the following description of the first successful male pregnancy on their website:

In the years since the first "test tube baby" was born in 1978, physicians and scientists from RYT Hospital have been working to develop a viable technique for the successful impregnation of male individuals. Illustrated to the right is a recent radiographic image of Mr. Lee, the first human subject to attempt this procedure, which shows the healthy fetus developing in his abdominal cavity...

In vitro fertilization (IVF) techniques were used to induce an ectopic pregnancy by implanting an embryo and placenta into the abdominal cavity, just under the peritoneum (the surrounding lining)...

I highly recommend the website.

Some folks at Snopes, naturally assuming that this must be a well-written hoax, figured out that is registered to, which in turn is registered to the PaperVeins Museum of Art in New York City. Their website is also well worth a visit. ("The PaperVeins Museum of Art is focused on the creation, curation, exhibition, and study of contemporary art about the human body in medicine and technology.") The latest exhibition was AbraCadaver.

(A detailed description of male pregnancy is here.)

Very clever.

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Spam for Generic Erythropoetin

I received the following spam about generic erythropoetin. I'm reprinting it for interest. This is *not* an endorsement.

Erythropetin patent is expiring in Europe in 2005.Amgen became the largest Biotech company with a single product-Epogen, and later Neupogen G-CSF.

If you missed the opportunity to purchase Amgen stock in 1985,now you have the opportunity to buy shares of a Biotech Company that manufactures generic recombinant Erythropoetin-EPO.The company that will benefit the most from EPO patent expiration is the one with the least expensive production cost.

DRAGON PHARMACEUTICAL with headquarters in Vancouver-Canada manufactures Recombinant Erythropoetin in China.

Currently it is selling EPO in Patent non protected countries (China,India,Brazil,Peru,Ecuador,Egypt and Eastern Europe)

Major increase in revenues and stock appreciation is expected with Erythropoetin Patent expiration in 2005 in Western Europe, Japan, Australia and New Zeland . After 2005, the generic Erythropoetin will not be restricted by any existing patents and will be eligible for marketing worldwide excluding North America(Expires in 2010)

Dragon also has generic Neupogen .G-CSF Patent expiration in western Europe is expected in year 2006.

Medical professionals have the advantage of knowing how widely Erythropoetin is being used and how essential it is for treatment of Anemia.Use your medical knowledge to your advantage to invest .Look for medical companies that are not discovered yet by Wall street analysts because when you find a winner the results can be spectacular.You may not know the latest technology breakthrough but you know what Erythropoetin means for Anemia of Kidney Disease,AIDS etc...
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Grand Rounds 49

Grand Rounds 49, this week's best posts of the medical blogosphere, is up at Healthy Concerns.

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New Antibiotics for Staph Aureus / MRSA

From Scientific American:

The misuse and overuse of antibiotics has led to the rise of so-called superbugs, bacteria that have developed a resistance to widely-used antibiotics and pose a threat to public health. Scientists have thus been investigating alternative treatment options. At a presentation given yesterday at a national meeting of the American Chemical Society in Washington, D.C. researchers unveiled one such candidate: a novel type of antibiotic that has shown promise against bacteria that survive in the face of conventional medications.

Doctors first identified methicillin-resistant Staphylococcus aureus (MRSA) bacteria in the 1960s and hospitals have been fighting to control their spread ever since. MRSA carry a unique protein called PBP 2a on the cell membrane that plays a key role in helping to defend against antibiotics. In February, Shahriar Mobashery of Notre Dame University and his colleagues identified specific components of the bacterial cell wall that interact with PBP 2a to form a chemical barricade. The team has now made three new synthetic antibiotics based on cephalosporin, a close relative of penicillin. The compounds contain protein components that mimic the crucial parts of the cell wall that cooperate with PBP 2a, which leads to its deactivation and forces the bacterium to succumb to the medication. "We are the first to demonstrate this unique strategy," Mobashery says, "which could provide a new line of defense against the growing problem of antibiotic resistance."

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World's Oldest Woman Dies

From Reuters India:
A Dutchwoman, the world's oldest person on record who swore by a daily helping of herring for a healthy life, died on Tuesday aged 115, the ANP news agency reported.
Technorati Tags: Longevity, Hendrikje van Andel-Schipper

Monday, August 29, 2005

Better Than a Brain Biopsy -- a New Test for Prions

From Reuters:

Scientists at the University of Texas Medical Branch in Galveston are developing a highly sensitive blood test for detecting prion particles, the infectious agents responsible for scrapie in sheep, mad cow disease, and the human form of the disease called variant Creutzfeldt-Jacob disease.

Prions are misfolded rogue proteins that can replicate and build up in the brain. Up until now, prions could only be detected biochemically in the brain and some lymph tissue, Dr. Claudio Soto and his associates explain in the online issue of Nature Medicine.

Technorati Tags: Prions, Mad Cow Disease, Creutzfeldt Jacob Disease

Starving Doesn't Work

From Reuters:

Starving -- officially known as caloric restriction -- may make worms and mice live up to 50 percent longer but it will not help humans live super-long lives, two biologists argued on Sunday.

They said their mathematical model showed that a lifetime of low-calorie dieting would only extend human life span by about 7 percent, unlike smaller animals, whose life spans are affected more by the effects of starvation.

This is because restricting calories only indirectly affects life span, said John Phelan of the University of California Lo Angeles and Michael Rose of the University of California Irvine.

Researchers at various universities and the national Institutes of Health are testing the theories but there are groups already cutting calories by up to a third in the hope they can live to be 120 or 125, while staying healthy...

Technorati Tags: Starvation, Starving, Caloric Restriction, Longevity

Case Presentation of Terrorism with Chemical Agent on Medscape

A case presentation from Medscape (registration required):

On a cold Saturday evening in winter, a pregnant woman wearing an overcoat buys a ticket at a large metropolitan multiplex for the second night of a highly anticipated movie featuring the newly introduced OlfacTree™ technology for allowing moviegoers "the ultimate scents of realism" by experiencing odors relating to the film. The film has also generated enormous controversy (and corresponding ticket sales) by its moments of sudden and graphic terror, and in fact two moviegoers in separate cities collapsed from apparent myocardial infarctions during a particularly gruesome and unexpected scene on the opening night.

The woman enters the large theater in plenty of time to take a seat in the middle of the room. She takes off her overcoat and places it underneath her seat. Eventually, the theater is packed. Near the middle of the showing, a few minutes before a scary scene set in a dim herbal shop, she excuses herself and walks to a women's rest room, leaving her overcoat underneath her seat. In the rest room, she pulls a canister from a package under her bulky sweater, forming the bulge that had made her look pregnant, and hides it just inside an inconspicuous but crucial ventilation duct that she had investigated on previous visits to the multiplex. After exiting the building through the crowded lobby, she walks out to her van and sends a radio signal to the canister in the vent and to a second canister hidden under her overcoat in the packed theater but connected to a hose and a nozzle slightly protruding from a buttonhole in the overcoat. She then drives away without attracting attention.

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Sunday, August 28, 2005

Hurricane Katrina Photos

Photo of Hurricane Katrina from Flickr sorted by "interestingness" are here.

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Google Developing Parallel Internet?

Via Slashdot:
KhanReaper writes "As reported on On the Media and Business 2.0, Google appears to be purchasing dark (unused) fiber optic cable across the United States with the intention of building its own alternative parallel internet that would presumably be called GoogleNet. Possessing such a thing could allow Google to offer internet access in the form of free wifi or other means and create a powerful captive marketing audience which Google could monopolize. Outside of these marketing opportunities, such a development in infrastructure could help reduce Google's long-term content delivery costs were it to take on more bandwidth-intensive activities in the future."
Technorati Tags: Google, Internet, Fiber Optics, GoogleNet

Hilarious Journal Articles #15: Health Benefits of Coffee

From USA Today:

[Dr. Vinson's] team analyzed the antioxidant content of more than 100 different food items, including vegetables, fruits, nuts, spices, oils and common beverages. They then used Agriculture Department data on typical food consumption patterns to calculate how much antioxidant each food contributes to a person's diet.

They concluded that the average adult consumes 1,299 milligrams of antioxidants daily from coffee. The closest competitor was tea at 294 milligrams. Rounding out the top five sources were bananas, 76 milligrams; dry beans, 72 milligrams; and corn, 48 milligrams. According to the Agriculture Department, the typical adult American drinks 1.64 cups of coffee daily.

That does not mean coffee is a substitute for fruit and vegetables...

Men who drank more than six 8-ounce cups of caffeinated coffee per day lowered their risk of type 2 diabetes by about half, and women reduced their risk by nearly 30%, compared with people who did not drink coffee, according to the study in the Annals of Internal Medicine...

Technorati Tags: Hilarious Journal Articles, Coffee, Antioxidants, Diabetes

Criticism of Baby Nurses in the NY Daily News

From the New York Daily News:

Noella Allick cared for newborn after newborn in an undisciplined, unregulated world filled with false promises, pumped-up references and worthless credentials.

The disturbing case against Allick, who has confessed to violently shaking and seriously injuring two babies in her care, illustrates a shockingly indifferent system that leaves parents and their infants vulnerable to alarming levels of abuse.

Experts interviewed by the Daily News agreed that in most cases, parents who hire a "baby nurse," whether from an employment agency or through word of mouth, generally have no idea what they're getting for their money...

Technorati Tags: News from New York, Baby Nurses, Newborns

Weekend Photos: Alison and Jack

Alison and Jack the Puppy French Bulldog

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Contaminated Mouthwash Causes Hospital-Acquired Pneumonia with Burkholderia Cepacia

Similar outbreaks occurred in 1999 and 1996. (Posts on Legionella pneumonia / Legionnaires' disease, another cause of hospital-acquired pneumonia, are here.) From the CDC:

The Centers for Disease Control and Prevention (CDC) has been notified by several states of clusters of pneumonia and other infections caused by Burkholderia cepacia. These cases had exposure to alcohol-free mouthwash manufactured by Carrington Labs (Irving, TX) for Medline Industries (Mundelein, IL). Cultures performed by a hospital laboratory where the first cases were detected indicate that multiple lots of Medline alcohol-free mouthwash are intrinsically contaminated with B. cepacia. In August 2005, the Texas Department of State Health Services was notified of a cluster of nosocomial pneumonia involving three patients hospitalized at a Texas health-care facility.

All three patients were intubated and in the intensive care unit for their underlying illnesses when they developed signs of pneumonia and respiratory cultures grew B. cepacia. All three patients had received oral care using 4 oz. bottles of Medline alcohol-free mouthwash prior to illness onset. One patient has recovered and has been discharged. The second and third remain hospitalized, one with a poor prognosis. Molecular typing is pending. An additional two clusters (2 cases and 5 cases), both associated with prior use of Medline alcohol-free mouthwash, are currently being investigated in two Florida health-care facilities.

CDC is working with state health departments and the Food and Drug Administration to determine the magnitude of this outbreak. Carrington Labs analysis of in-house retain samples has confirmed contamination in multiple lots of the product in both 4 oz. and 2 oz. bottles leading to a recall of all alcohol-free mouthwash manufactured by Carrington Labs for Medline.

The suspect product bears a 7 or 8 digit lot number on the bottom of the bottle; suspect lot numbers include numbers 0503*** through 0508*** and 0503**** through 0508**** (asterisks represent any digit). The product is available in 2 oz. bottles as well as 4 oz. bottles and was distributed only to hospitals and long term care facilities. The product is not distributed for direct retail sale to the consumer. However, the 2 oz. bottles are packaged with other items, such as toothbrushes, toothpaste, etc. by Medline into a 'personal hygiene hospital admission kit' so some mouthwash may be in the possession of the consumer within a residential setting. Medline alcohol-free mouthwash with the above lot numbers should not be used. Individuals who are aware of cases of B. cepacia colonization or infection occurring during or shortly after exposure to these products should contact their health department and CDC at 1-800-893-0485.

Technorati Tags: Mouthwash, Nosocomial Pneumonia, Hospital Acquired Pneumonia, Burkholderia Cepacia

California Files French Fry Lawsuit

Via CNN:

California Attorney General Bill Lockyer has filed a lawsuit to force top makers of potato chips and french fries to warn consumers about a potential cancer-causing chemical found in the popular snacks.

In a complaint filed Friday in Los Angeles Superior Court, Lockyer sought an injunction to stop restaurant chains such as McDonald's Corp. and Wendy's International Inc. from selling french fries without some form of warning.

Also named were producers of potato chips and other packaged potato products like PepsiCo's Frito-Lay Inc. and Procter & Gamble Co., makers of Pringles chips.

The suit asks manufacturers of these products to identify the dangers of high levels of acrylamide, a chemical that studies have found is created when starchy foods are cooked at high heat...

The lawsuit alleges that companies have violated a state law passed in 1986 requiring companies to provide warnings before exposing people to known carcinogens or reproductive toxins...

Technorati Tags: French Fry, French Fries, Lawsuit, CNN, Bill Lockyer, Acrylamide

One Patient's Visit to a Nephrologist

From the Blog of Leonid Mamchenkov:
I was surprised to see that there was no equipment in Dr.Avraam’s office what-so-ever. Not even a computer. No scanning devices. No testers nothing. He checked Maxim with his hands, looked all over him and said “It doesn’t look like anything serious.”. He said that it is probably an easy case of ectopic kidney. I was eased on one hand, but suspecious on the other. He added than “But you’ll have to make some more tests.” He made us an appointment for strghchojdzojdhzl-scopy in the 20s days of August. He said that this strghchojdzojdhzl-scopy test will show the exact positions of Maxim’s kidneys and how serious the whole situation is. Because of his poor English I didn’t understand the nature of the test. The only thing that I got was that it will happen in the Nuclear Medicine Laboratory. Sounds scary.
Technorati Tags: Nephrology, Nephrologist, Kidneys, Hospitals, Ectopic Kidney

Spinal Cement / Vertebroplasty Article in NYT

I've seen a few patients for whom vertebroplasty seems to have been helpful, though N is admittedly small. From the New York Times:

It used to be that a patient with osteoporosis who broke a vertebra was pretty much out of luck. The only recourse was wearing a back brace and waiting to heal. If the searing pain was unbearable, it could be blunted with powerful narcotics.

But in the past few years, doctors have been offering and patients demanding what some call a miraculous treatment: vertebroplasty (pronounced vur-TEE-bro-plasty), in which a form of cement is injected into the broken spinal bone.

No one is sure why it helps, or even if it does. The hot cement may be shoring up the spine or merely destroying the nerve endings that transmit pain. Or the procedure may simply have a placebo effect...

The two procedures are so common, said Dr. Ethel Siris, an osteoporosis researcher at Columbia University, that "if you have osteoporosis and come into an emergency room with back pain from a fractured vertebra, you are unlikely to leave without it." She said she was concerned about the procedures' widespread and largely uncritical acceptance...

Technorati Tags: New York Times, Vertebroplasty, Orthopedics, Vertebral Fracture

Saturday, August 27, 2005

British Family Protests Bizarre Death on Rhodes

In a tale that sounds like a lurid tabloid headline, the British family of Christopher Rochester, killed in an accidental fall from an apartment balcony in Rhodes last year, is threatening legal action against Greece because their son's body was returned minus a kidney...
Technorati Tags: Kidneys, Greece, Christopher Rochester

Weekend Photos: Time Warner Building

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Friday, August 26, 2005

Swapping Kidneys (Kidney Donor Exchange Program)

From Reuters:

Say you wanted to donate a kidney to a relative, but weren't a match. Would you donate your kidney to a stranger who could use it, in exchange for a kidney from one of their relatives that was a match to your kin?

A new Living Donor Kidney Exchange Program launched earlier this month by the New York Organ Donor Network will allow potential kidney donor-recipient pairs who are not suitable for reasons such as mismatched blood type to be matched with other willing donor-recipient pairs...

The new program will address this problem by allowing a type A individual, who is willing but unable to donate an organ to a type B family member or friend, to donate his or her organ to a type A individual on the kidney transplant list. In turn, a type B willing donor who was unable to help his or her type A loved one will now be able to donate a kidney to the family member or friend of the type A donor.

The two transplants would be performed simultaneously...

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"Metabolic Syndrome Doesn't Exist"

In USA Today:

The world's leading diabetes organizations Thursday challenged the value of labeling patients as having "metabolic syndrome," a diagnosis based on a cluster of risk factors known to be bad for the heart.

The American Diabetes Association (ADA) and the European Association for the Study of Diabetes said in a joint statement that the syndrome is ill defined, built on sketchy evidence and could distract doctors from focusing on more established heart-disease risks...

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Thursday, August 25, 2005

Smoking Cessation: Combining the Nicotrol Inhaler and Nicotine Patch

I've recently successfully helped patients quit smoking by using a combination of the nicotine patch and the Nicotrol inhaler. A Google Scholar search is here. A very readable paper on treating tobacco use and dependence in the journal Chest is here.
Combining the nicotine patch with a self-administered form of nicotine replacement therapy (NRT), utilizing the gum, the inhaler, or the nasal spray, is more efficacious than a single form of nicotine replacement. Patients should be encouraged to use such combined treatments if they are unable to quit using a single type of first-line pharmacotherapy.
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Wife Commits Suicide, Husband Blamed for Not Providing Medical Care

A husband sued a psychiatric clinic because they did not see his wife, who later committed suicide. However, the court decided the husband was partially responsible for her death by not bringing her to the emergency department, as advised. From the New York Daily News:

A Brooklyn man bears responsibility for his wife's suicide because he failed to take her to a shrink, a judge ruled in a potential landmark decision.

Alexander Sklyarsky had a "duty to provide medical aid to his wife" before she jumped to her death from the fire escape of their Brooklyn apartment five years ago, according to state Supreme Court Justice Gerard Rosenberg.

Legal experts told the New York Law Journal that the ruling could complicate caregiving decisions by opening the door to lawsuits between spouses.

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Belatacept in Renal Transplantation

(The drug's name sounds like "belated.") A press release is here. From the New England Journal of Medicine:

Background Renal transplantation is the standard of care for patients with end-stage renal disease. Although maintenance immunosuppression with calcineurin inhibitors yields excellent one-year survival, it is associated over the long term with high rates of death and graft loss, owing in part to the adverse renal, cardiovascular, and metabolic effects of these agents. The use of potentially less toxic agents, such as belatacept, a selective blocker of T-cell activation, may improve outcomes...

Results At six months, the incidence of acute rejection was similar among the groups: 7 percent for intensive belatacept, 6 percent for less-intensive belatacept, and 8 percent for cyclosporine. At 12 months, the glomerular filtration rate was significantly higher with both intensive and less-intensive belatacept than it was with cyclosporine (66.3, 62.1, and 53.5 ml per minute per 1.73 m2, respectively), and chronic allograft nephropathy was less common with both regimens of belatacept than with cyclosporine (29 percent, 20 percent, and 44 percent, respectively)...

Conclusions Belatacept, an investigational selective costimulation blocker, did not appear to be inferior to cyclosporine as a means of preventing acute rejection after renal transplantation. Belatacept may preserve the glomerular filtration rate and reduce the rate of chronic allograft nephropathy.

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Wednesday, August 24, 2005

Google's Gmail Accounts Are Now Available

This page allows you to sign up for a free account (if you don't already have one).

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A Patient's Thoughts on Xenotransplantation

Terie is a liver and kidney transplant recipient. From Terie and Ger's Transplant Adventure:
Before my bovine lung patch turned me into a chimera (much like all those heart patients with the porcine valves and the mice with inserted human genes) I never thought about xenotransplantation. Now that I am part cow, part generous stranger and part Ger, I have done a lot of thinking about the issues surrounding ethical allo- and xenotransplantation...
Technorati Tags: , Bookmarks

Each post may now be bookmarked in using a link in the footer. My bookmarks are here.

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Kidney Disease in the Washington Post

From the Washington Post:

Kidney disease in America has a ground zero, and it is located right here in Washington. Three District Zip codes -- 20002, 20011 and 20019 -- have the highest rates of end-stage kidney disease in the nation. Yet many people headed toward kidney failure have no idea there is anything wrong with them.

Kidney disease is a national epidemic, affecting about 20 million Americans, or one out of nine adults, according to the 2000 annual report of the U.S. Renal Data System (USRDS). This is double the number of a decade ago. Eight million of the 20 million have seriously reduced kidney function. Nearly 400,000 have practically no function and require a punishing regimen of dialysis or a kidney transplant to stay alive, according to the National Kidney Foundation of the National Capital Area.

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Tuesday, August 23, 2005

How to Use Google Talk (Now)

The folks over at Make:Blog have apparently figured out how to use Google Talk ahead of its formal release (possibly tomorrow):
Guess what? I'm using Google's "talk" IM service right now. It's pretty simple, just added the server in iChat, used my google username and pass and now I'm using google's jabber server (you can add me, [email protected]). Adding the account, I needed to try connect with and without SSL, and finally I'm online using their server...
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Grand Rounds 48

Grand Rounds 48, this week's best posts of the medical blogosphere, is up at Straight from the Doc.
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Monday, August 22, 2005

Profile of Mark Lanier, Plaintiff Lawyer for Vioxx Lawsuit

From the New York Times:

On Friday, the jury fulfilled Mr. Lanier's wishes, finding Merck liable for the death of Robert C. Ernst, who died in 2001 after taking Merck's painkiller Vioxx for eight months. The jury awarded $253.5 million to Carol Ernst, Mr. Ernst's widow and Mr. Lanier's client, in one of the largest damage awards ever to a single plaintiff...

Dr. Maria M. Araneta, the coroner who conducted Mr. Ernst's autopsy, had found that Mr. Ernst died of an arrhythmia, or irregular heartbeat, and no clinical trials have ever linked Vioxx to arrhythmias...

But with a combination of charm, carefully scripted PowerPoint presentations and crucial help from Dr. Araneta, Mr. Lanier overcame that hurdle. Mr. Lanier hired a private investigator to find Dr. Araneta, who had moved to Abu Dhabi, United Arab Emirates. He then persuaded her to return to Texas, where she gave a videotaped deposition in which she said she believed that Mr. Ernst had actually died of a heart attack, despite her autopsy finding...

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News from New York: Artist Creates Suitcase Bomb

From Gawker:

Hackett said the strength of the bomb would be equivalent to "about four pounds of TNT. It doesn’t sound like much," he allowed, "but it’s enough to kill everyone in the gallery."

Mr. Hackett’s bomb is designed to be triggered from "anywhere else in the world—you call a cell phone." He said that he had already purchased the cell-phone trigger. Only he knows the number—but, of course, he has no plans to explode it.

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Sunday, August 21, 2005

Weekend Photos: Cigarettes in Thailand

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Saturday, August 20, 2005

New England Journal of Medicine Audio Feed: Medical Marijuana

Until the New England Journal of Medicine creates an audio feed to keep track of their excellent MP3 interviews, I've created my own at (Technical details on turning a search into a feed are here.) The latest interview is on Medical Marijuana and the Supreme Court.

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Weekend Photos: Thailand


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Friday, August 19, 2005

Escher in Space

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Weekly World News / News from New York

The Weekly World News has a feed. From an article on things people leave in taxis:

IF YOU'VE ever forgotten your baby in the backseat of a taxi cab, you're not alone. In addition to the occasional infant, a new survey reveals harried, stressed-out passengers leave behind purses, briefcases, laptop computers, artificial legs, dentures and thousands of other possessions...

The professional motorists reported the top 10 objects most likely to be in their company's lost and found bin are:

  1. Cell Phones
  2. Snakes
  3. Children
  4. Dinosaur Bones
  5. Priceless Works of Art
  6. Purses and Wallets
  7. Breast Implants
  8. Mothers-in-law
  9. 72-Inch Plasma Screen TVs
  10. Wedding Rings

The survey also found that each major city had its own unique list.

"My biggest problem is the dead bodies," Guido Concepcion, a 30-year veteran of the New York City yellow cab fleet, wrote in response to the survey questionnaire...

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New Heart Failure Guidelines Released

The American Heart Association website on heart failure, with resources for clinicians and patients, is here. The pdf file of the new guidelines is here. From the press release:
Early diagnosis and new treatments can help battle heart failure — a growing national problem that causes 1 million hospital admissions each year, according to new guidelines released today by the American College of Cardiology (ACC) and the American Heart Association (AHA).
The guidelines describe four stages of heart failure:
  • Stages A and B are when patients lack early signs or symptoms of heart failure, but are at risk because of risk factors or heart abnormalities, which could include a change in the shape or structure of the heart.
  • Stage C denotes patients with current or past heart failure symptoms such as shortness of breath.
  • Stage D designates patients with refractory heart failure who might be eligible for specialized advanced treatment — including cardiac transplantation — or compassionate end-of-life care such as hospice.
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Beer Plus: Beer with Additives

Recently, new beers have been released containing nicotine, caffeine and vitamins (though not at all once). Take, for example, NicoShot:

NicoShot is not necessarily a cure for smoking, but it can help smokers make lifestyle changes "without having to walk out of the bar for a quick smoke to deal with sudden withdrawal symptoms."

NicoShot contains a shot of natural nicotine, equivalent to a few regular filtered cigarettes. One 250 ml can of NicoShot contains 6.3 percent alcohol by volume. The press release notes that three cans of the brew are comparable to an entire pack of cigarettes...

Anheuser-Busch has released BE, which stands for Beer with Extra, which is being "marketed at people aged 18 to 34 who like to drink in bars and clubs." From the BBC:

Each bottle of BE beer contains 5% alcohol and 60.4mg of caffeine, as well as guarana and ginseng and flavouring to give it a sweet, fruity taste.

Campaigners fear the caffeine will spur drinkers to consume more beer by keeping them awake...

And finally, for those who prefer a more natural alternative, there's Lady Bird Bio Beer, made with vitamins and Aloe Vera. From IndiaInfo:

Rao said results of human clinical trails have shown that aloe vera increases the bioavailability of Vitamins B1, B6, B12, C and E...

Years of research have also proved that with the long-term use of the beverage, there was no ulceration, gastric trouble or other harmful effects from drinking it, Dr. Amarnath said.

Apart from giving the pleasant feeling, this also protects the liver by improving its function, he said, claiming it reduces the blood cholesterol and also maintains the bilirubin to normal levels...

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Random Google Videos

A page of random Google Videos is here. Read more about Google Video here.

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Thursday, August 18, 2005

On the Bus.

A guy with cutoff fatigue pants just got on the downtown bus. He's carrying an official-looking cooler labelled "Human Blood."

What is the Definition of "Young?"

A nurse just casually referred to a 66 year-old patient of mine as "young."

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Unexplained Increased Deaths from Heart Disease in New York

I presume this is related to poverty and many unmeasured variables, but according to epidemiologists, the increased death rate is mysterious and unexplained. As an aside, I've personally noticed that there's an unusual incentive to put "Ischemic Coronary Disease" down on the death certificate as the cause of death at the New York hospitals at which I've worked and trained. Anything significantly more complicated or arcane is likely to get rejected by the hospital administration, which is a hassle for the residents, who have to then fill out a new death certificate. So if an unusual incentive in New York exists to put heart disease down on the death certificate (for whatever reason), this could also explain the data. From the New York Times:

Death rates from heart disease in New York City and its suburbs are among the highest recorded in the country, and no one quite knows why...

There is no obvious explanation. Some speculate about the potential role of stress. It is widely believed that life in New York is more difficult, and stress has been linked to higher heart disease mortality. A 1999 study showed that people were more likely to die of a heart attack in New York City than elsewhere. The authors suggested stress could play a role because the excess death rate affected both visitors and residents; they found no other explanation.

"There's an acute effect of being in New York," said Nicholas Christenfeld, a psychologist at the University of California at San Diego who did the study. "You're wired the whole time." But stress is difficult to measure, and there is no proof that life is more stressful in and around New York, despite the popular notions...

The role of lipids is very large in heart disease," he said, adding: "People think we eat badly in the South, but the worst meal I ever had was at a deli in New York. I'd never heard of schmaltz before that," referring to chicken fat.

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Wednesday, August 17, 2005

How to Turn a Search into a Feed

What if a site offers content that you wish was published to a feed but isn't? One solution is to turn a search of the site into a feed.

The New England Journal of Medicine Audio Feed is a simple example. The NEJM publishes excellent MP3 interviews on their site (recently, they interviewed physicians caring for victims of the London bombings) but these interviews are not offered on the NEJM feed and are difficult to find.

This problem was solved by using MSN Search, which offers a RSS feed for searches. (At this time, Google offers a RSS feed for Google News but not for searches.)

The search for the newest MP3 files offered on is contains:mp3 {frsh=100}
  • indicates the site to be searched
  • contains:mp3 displays results that link to MP3 files
  • {frsh=100} indicates that the latest links should be displayed first -- this is important because only the first ten links are included in the feed
(A detailed description of advanced search options is here.)

The RSS feed for any search may be found by clicking on the RSS icon at the bottom of the search page.

This feed can then be burned into a more user-friendly format using Feedburner and renamed. For example, in this case a new feed was burned called

(This feed is not a podcast, because the NEJM doesn't allow direct links to MP3 files from searches -- the Robots META tag is set to "no follow." The NEJM says that they are considering offering a podcast in the future. For those sites that do allow links to audio files, Feedburner offers the Smartcast feature, which can potentially convert any search containing audio files to a podcast.)

For sites not offering feeds, this is a very workable solution.

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Wednesday Recommendations: Espresso

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Tuesday, August 16, 2005

Grand Rounds 47

Grand Rounds 47, this week's best posts of the medical blogosphere, is up at Circadiana.

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Monday, August 15, 2005

Finding Recommendations for Medical Blogs & News

There are many recommendation systems which can help guide readers towards interesting medical news and blog postings. Here are a few, in no particular order:For an extensive discussion of social bookmarking, see the entry on Wikipedia. Also see this chart of 19 social bookmarking sites.

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Hilarious Journal Articles Part 14: Urine-powered Batteries

Thanks to MedGadget. The paper, "Urine-activated Paper Batteries for Biosystems," is from Journal of Micromechanics and Microengineering. The press release is -- seriously! -- titled "Scientists Harness the Power of Pee."
Physicists in Singapore have succeeded in creating the first paper battery that generates electricity from urine. This new battery will be the perfect power source for cheap, disposable healthcare test-kits for diseases such as diabetes. This research is published today in the Institute of Physics’ Journal of Micromechanics and Microengineering...
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New England Journal of Medicine Audio Feed: Improvising Emergency Care After the London Attacks

Until the New England Journal of Medicine creates an audio feed to keep track of their excellent MP3 interviews, I've created my own at The latest interview is "Improvising Emergency Care After the London Attacks."

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The ZOTOB Worm

Windows update is here. From Reuters:

The ZOTOB virus appeared shortly after the world's largest software maker warned of three newly found "critical" security flaws in its software, including one that could allow attackers to take complete control of a computer...

The latest worm exploits security holes in Microsoft's Windows 95, 98, ME, NE, 2000 and XP platforms and can give computer attackers remote access to affected systems, said Trend Micro Inc...

Last Tuesday, Microsoft issued patches to fix its security flaws as part of its monthly security bulletin. The problems affect the Windows operating system and Microsoft's Internet Explorer Web browser...

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Sunday, August 14, 2005

Lab-grown Meat

From the BBC:

Developments in tissue engineering mean that cells taken from animals could be grown directly into meat in a laboratory, the researchers say...

Scientists believe the technology already exists to directly grow processed meat like a chicken nugget...

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Christopher Walken is Running for President in 2008

This is almost certainly a joke, but a good one.

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Weekend Photos: Hong Kong Harbor

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Saturday, August 13, 2005

Comments Cleared

I switched comments from Haloscan to Blogger because it's simpler, but unfortunately they've all been cleared. Comment away.

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Weekend Photos: Jellyfish


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Friday, August 12, 2005

3 Wives Greet Man after Triple Bypass Surgery

From MSN News:

British police confirmed that after Melvyn Reed woke from his triple bypass heart operation earlier this year, his complicated marital affairs took a turn for a worse. All three of his spouses had turned up at the same time, despite his efforts to stagger their visits.

Media reports say that, upon realizing that something was amiss, the wives held a meeting in the parking lot, and learned that they were all married to the same man...

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Legionnaires' Disease at Legionnaires Convention

There's an old joke where someone remarks how coincidental it was that Lou Gherig developed Lou Gherig's disease. I previously wrote about Legionnaires' disease at Columbia University Medical Center here. From Newsday:
Two men tested positive for Legionnaires disease after they attended the Pennsylvania American Legion's annual convention in Montgomery County, not far from where 34 people died of the disease at a similar event in 1976, hotel officials said Thursday.
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News from New York: Oral Histories of 9/11

From the New York Times:
A rich vein of city records from Sept. 11, including more than 12,000 pages of oral histories rendered in the voices of 503 firefighters, paramedics, and emergency medical technicians, will be made public today.
Some of the records may be found here.

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Thursday, August 11, 2005

New England Journal of Medicine Audio Feed: The Ethics of Organ Donation by Living Donors

Until the New England Journal of Medicine creates an audio feed to keep track of their excellent MP3 interviews, I've created my own at The latest interview is "The Ethics of Organ Donation by Living Donors."

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Hilarious Journal Articles Part 13

From DNC:

For reasons that have yet to be understood, women with red hair appear to be more resistant to pain compared to women with other colors of hair, and men, a scientist said yesterday...

Work on red hair and pain was originally carried out by Professor Jeffrey Mogil at McGill University in Montreal, Canada. He identified a mutant version of a gene called melanocortin-1 (Mc1r), which is linked to ginger hair and fair skin, gives women a higher pain threshold, but does not appear to have the same effect on men...

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Wednesday, August 10, 2005

Wednesday Recommendations: Dog Training

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Tandem Heart

I recently saw a patient who had a percutaneous left ventricular assist device placed called a Tandem Heart. A catheter is threaded from the femoral vein into the left atrium (via interatrial puncture) and oxygenated blood is withdrawn and returned to the femoral artery. The official web site is here. A Google Scholar search is here. A large animation file (47 MB) is here. A smaller shockwave animation is here. From a paper in Circulation:
A newly developed VAD can be rapidly deployed in the catheterization laboratory setting. This device provides up to 4.0 L/min of assisted cardiac output, which may aid to revert cardiogenic shock. The left ventricle is unloaded by diverting blood from the left atrium to the systemic circulation, making recovery more likely after an ischemic event. The influence of this device on long-term prognosis warrants further investigation.
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Tuesday, August 9, 2005

Grand Rounds 46

Grand Rounds 46, this week's best posts of the medical blogosphere, is up at Parallel Universes.

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Monday, August 8, 2005

Brain Region of Regret

From Scientific American:

It's human nature to sometimes regret a decision. Now scientists have identified the brain region that mediates that feeling of remorse: the medial orbitofrontal cortex...

The findings support previous studies involving patients with damaged OFC areas who do not experience regret and are also unable to alter their behavior to avoid situations that would induce the feeling...

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Peter Jennings on Wikipedia

Peter Jennings is dead at age 67. The Wikipedia entry is here.

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Sunday, August 7, 2005

Avian Flu Vaccine Found Effective

A previous NYT editorial on the potential for a flu pandemic is here. From the New York Times:

Tens of millions of birds have died from infection with the virus and culling to prevent the spread of the virus. About 100 people have been infected, and about 50 have died from this strain of the avian influenza virus, called A(H5N1). So far there has been no sustained human-to-human transmission, but that is what health officials fear, because it could cause a pandemic. And that fear has driven the intense research to develop a vaccine.

The director of the National Institute of Allergy and Infectious Diseases, Dr. Anthony S. Fauci, said that although the vaccine that had undergone preliminary tests could be used on an emergency basis if a pandemic developed, it would still be several months before that vaccine was tested further and, if licensed, offered to the public.

"It's good news," Dr. Fauci said. "We have a vaccine."

But he cautioned: "We don't have all the vaccine we need to meet the possible demand. The critical issue now is, can we make enough vaccine, given the well-known inability of the vaccine industry to make enough vaccine?"

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Weekend Photos: Central Park


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What is a Kidney Worth?

From the Christian Science Monitor:

Every day, 17 Americans die of organ failure. In Israel, the average wait for a kidney transplant is four years. In response, a global gray market has bloomed. In India, for example, poor sellers are quickly matched with sick buyers from Taiwan. Critics call it "transplant tourism." Proponents say the market is meeting a need...

The case raises anew hard legal and ethical questions, such as: Who owns our bodies? Should it be illegal to sell an organ if it could save someone's life? What is the government's role in protecting two vulnerable groups - the poor, who are willingly exploited, and the sick, who are desperate for healing?

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Saturday, August 6, 2005

Weekend Photos: Hong Kong

Spiral incense burners in Hong Kong.

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Friday, August 5, 2005

Accelerando by Charles Stross

Currently reading Accelerando. Highly entertaining. Website along with various downloadable versions is here.
In IP geek circles, Manfred is legendary; he's the guy who patented the business practice of moving your e-business somewhere with a slack intellectual property regime in order to evade licensing encumbrances. He's the guy who patented using genetic algorithms to patent everything they can permutate from an initial description of a problem domain – not just a better mousetrap, but the set of all possible better mousetraps. Roughly a third of his inventions are legal, a third are illegal, and the remainder are legal but will become illegal as soon as the legislatosaurus wakes up, smells the coffee, and panics. There are patent attorneys in Reno who swear that Manfred Macx is a pseudo, a net alias fronting for a bunch of crazed anonymous hackers armed with the Genetic Algorithm That Ate Calcutta: a kind of Serdar Argic of intellectual property, or maybe another Bourbaki math borg. There are lawyers in San Diego and Redmond who swear blind that Macx is an economic saboteur bent on wrecking the underpinning of capitalism, and there are communists in Prague who think he's the bastard spawn of Bill Gates by way of the Pope...

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Thursday, August 4, 2005

Lisa in Iraq

My friend Lisa is a lawyer who is traveling to Iraq to work with the government. Her blog is here.

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Technorati's State of the Blogosphere Part 3: Tagging

The third part of Technorati's Report is here.
Tags are simply categories or topics. Most blog tools make it easy to categorize your posts, and working with the microformats community, Technorati implemented a simple way to track and aggregate blog posts, photos, and links that are all categorized, or "tagged" with the same name. Unlike rigid taxonomy schemes that many people dislike using, the ease of tagging for personal organization with social incentives leads to a rich and discoverable system, often called a folksonomy. Intelligence is provided by real people from the bottom-up to aid social discovery. And with the right tag search and navigation, folksonomy may outperform more structured approches to classification...
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Wednesday, August 3, 2005

Modafinil (Provigil) for Excessive Sleepiness Associated with Shift-Work Sleep Disorder

Having prescribed Provigil (Modafinil) and having taken it once myself after a 12 hour flight, I'm very impressed: it works extremely well. You stay up. Easily, for many hours, and without the jitters of coffee or caffeine pills. I expect that it's a drug that will be used and abused by college students, medical residents, and business travelers. The following is an abstract from the New England Journal of Medicine. (I was struck most by the significant reduction in accidents or near accidents while commuting home.)

Patients with shift-work sleep disorder chronically have excessive sleepiness during night work and insomnia when attempting to sleep during the day. We evaluated the use of modafinil for treating sleepiness in patients with this disorder.

In a three-month, double-blind trial, we randomly assigned 209 patients with shift-work sleep disorder to receive either 200 mg of modafinil or placebo before the start of each shift. Assessments were performed with the use of the nighttime Multiple Sleep Latency Test, the Clinical Global Impression of Change, the Psychomotor Vigilance Test, diaries of patients, and daytime polysomnography. After randomization, we conducted monthly assessments.

Treatment with modafinil, as compared with placebo, resulted in a modest improvement from baseline in mean (±SEM) nighttime sleep latency (the interval between the time a person attempts to fall asleep and the onset of sleep) (1.7±0.4 vs. 0.3±0.3 minutes, respectively; P=0.002), and more patients had improvement in their clinical symptoms (74 percent vs. 36 percent, respectively; P<0.001). Patients who were receiving modafinil also had a reduction in the frequency and duration of lapses of attention during nighttime testing of their performance on the Psychomotor Vigilance Test (change from baseline, a reduction in lapse frequency of 2.6 vs. an increase of 3.8, respectively; P<0.001), and proportionally fewer patients reported having had accidents or near accidents while commuting home (29 percent vs. 54 percent, respectively; P<0.001). Despite these benefits, patients treated with modafinil continued to have excessive sleepiness and impaired performance at night. Modafinil did not adversely affect daytime sleep as compared with placebo. Headache was the most common adverse event.

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Wednesday Recommendations: Richard Morgan

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Tuesday, August 2, 2005

More from Technorati's State of the Blogosphere: Posting Volume

Part 2 of the full report is here. (Click for full resolution graph.)

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New Flickr Features

Interestingness is Flickr automatic choice of interesting and popular photos. For example, the last 24 hours of interesting photos are here.

Clustering is a collection of related tags. For example, here are all tags related to summer.

Both these features are outstanding.

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Technorati's State of the Blogosphere

The full report is here.
As of the end of July 2005, Technorati was tracking over 14.2 million weblogs, and over 1.3 billion links. Interestingly, this is just about double the number of blogs that we were tracking 5 months ago. In March 2005 we were tracking 7.8 million blogs, which means the blogosphere has just about doubled again in the past 5 months, and that the blogosphere continues to double about every 5.5 months...
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Advice for Medical Bloggers

Clinical Cases and Images has an interesting discussion about medical blogging here.

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Deplanetizing Pluto?

A link to a previous discussion of Planet Xena is here. From the New York Times Editorial Page:
Our own preference is to take a cleaner way out by dropping Pluto from the planetary ranks. Scientists may well discover many more ice balls bigger than Pluto, and it's a safe bet that few in our culture want to memorize the names of 20 or more planets. Far better to downgrade Pluto to the status of an icy sphere that was once mistakenly deemed a planet because we had not yet discovered its compatriots on the dark fringes of the solar system.
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Emergency Shuttle Repairs

A previous NYT article about increased shuttle surveillance is here. Via CNN:
NASA will send astronaut Steve Robinson out on an unprecedented in-flight shuttle repair mission to remove two protruding tile gap fillers that could cause uneven heating during re-entry. Robinson will ride the space station's robot arm underneath Discovery and try to pull out the gap fillers. If he can't pull them out, he'll cut them flush, according to mission managers...
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Grand Rounds 45

Grand Rounds 45, this week's best posts of the medical blogosphere, is up at Alois MD.

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Monday, August 1, 2005

Faster DNA Sequencing

Via FuturePundit and Pharmalive:
454 Life Sciences Corporation, a majority-owned subsidiary of CuraGen Corporation , today announced the publication of a new genome sequencing technique 100 times faster than previous technologies. This is the first new technology for genome sequencing to be developed and commercialized since Sanger-based DNA sequencing. 454's proprietary technology is described in the paper "Genome sequencing in microfabricated high-density picoliter reactors," in the July 31, 2005, online issue of Nature, with the print edition of the paper to follow later in the year. The technique was demonstrated by repeatedly sequencing the bacterial genome Mycoplasma genitalium in four hours, with up to and exceeding 99.99% accuracy. With a 100-fold increase in throughput over current sequencing technology, 454 Life Sciences' instrument system opens up new uses for sequencing, including personalized medicine and diagnostics, oncology research, understanding third world diseases, and providing fast responses to bioterrorism threats and diagnostics...
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