Wednesday, November 30, 2005

A New Way to Read UpToDate

For the last 8 years, I've been a fan of UpToDate, an extensive online resource for medical education. A mixed blessing of this service is that too many articles are interesting, which makes reading them on the screen or printing them out impractical.

One simple solution I've discovered is to email the articles to yourself directly through UpToDate. Then, if you have a PDA which can receive email, like the Treo or Blackberry, you're able to read the articles later at your leisure.

I tried this out today. While riding the elevator, I quickly reviewed the latest on inferior vena cava filters, screening for carotid stenosis, and Gitelman's syndrome.

This solution would also work for any large text file, like a newspaper article, that you could email to yourself.

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Patient Quote of the Day #6

"I feel like a new man. I just had a colonoscopy. Everything was perfect."

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The Mosquito, An Ultrasound Device That Drives Away Teenagers

Via The New York Times:
Now 39, Stapleton has taken the lesson he learned that day--that children can hear sounds at higher frequencies than adults can--to fashion a novel device that he hopes will provide a solution to the eternal problem of obstreperous teenagers who hang around outside stores and cause trouble.

The device, called the Mosquito ("It's small and annoying," Stapleton said), emits a high-frequency pulsing sound that, he said, can be heard by most people younger than 20 and almost no one older than 30. The sound is designed to so irritate young people that after several minutes, they cannot stand it and go away...

At first, members of the usual crowd tried to gather as normal, repeatedly going inside the store with their fingers in their ears and "begging me to turn it off," Gough said. But he held firm and neatly avoided possible aggressive confrontations: "I told them it was to keep birds away because of the bird flu epidemic."
Technorati Tags: Mosquito, Ultrasound

Hilarious Journal Articles #31: Creativity, Sexual Success, and Schizophrenia

From Scientific American:
Psychologist Daniel Nettle of the University of Newcastle upon Tyne in England and his colleagues recruited 425 British men and women through advertisements in a small town newsletter and various specialty lists for creative types. The researchers surveyed this group with questions designed to measure various schizophrenic behaviors, artistic output and sexual success, among other aspects of their personal history.

Results of that survey showed that people who displayed strong evidence of "unusual experiences" and "impulsive non-conformity"--two broad types of schizophrenic behavior--had more sexual partners than their peers and were more likely to be involved in artistic pursuits, either professionally or as a hobby. Those who professionally pursued the arts had the highest average number of partners--5.5--compared to just over four for the less creative study participants.

Of course, there are a number of possible reasons for the artists' mating success. "Creative people are often considered to be very attractive and get lots of attention as a result," Nettle explains. "It could also be that very creative types lead a bohemian lifestyle and tend to act on more sexual impulses and opportunities."
The paper, from the Proceedings of the Royal Society, is "Schizotypy, creativity and mating success in humans:"
There is an evolutionary puzzle surrounding the persistence of schizophrenia, since it is substantially heritable and associated with sharply reduced fitness. However, some of the personality traits which are predictive of schizophrenia are also associated with artistic creativity. Geoffrey Miller has proposed that artistic creativity functions to attract mates. Here, we investigate the relationship between schizotypal personality traits, creative activity, and mating success in a large sample of British poets, visual artists, and other adults. We show that two components of schizotypy are positively correlated with mating success. For one component, this relationship is mediated by creative activity. Results are discussed in terms of the evolution of human creativity and the genesis of schizophrenia.
Technorati Tags: Hilarious Journal Articles, Creativity, Schizophrenia

Tuesday, November 29, 2005

Transplanted Nose Cells May Heal Damaged Nerves

Via Guardian Unlimited:
Surgeons will attempt early next year to mend the severed nerves of young people who have suffered motorbike accidents in the first trial of a simple but potentially revolutionary technology that could one day allow the paralysed to walk again.

At least ten operations will be carried out to test in humans a technique pioneered in animals by the neuroscientist Geoffrey Raisman, who heads the spinal repair unit of University College, London. He discovered 20 years ago that cells from the lining of the nose constantly regenerate themselves. Professor Raisman's team believes that if those cells were implanted at the site of the damage they would build a bridge across the break, allowing the nerve fibres to knit back together.
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Is There a Link Between Stress and Cancer?

NYT: Probably not.

Technorati Tags: Stress, Cancer, Medicine

New Orleans's Citywide WiFi

From The Washington Post:
Hurricane-ravaged New Orleans will deploy the nation's first municipally owned wireless Internet system that will be free for all users, part of an effort to jump-start recovery by making living and doing business in the city as attractive as possible.
Technorati Tags: New Orleans, Hurricane Katrina, WiFi

ACR: Tom Cruise's Reported Unsupervised Use of Fetal Keepsake Ultrasound Raises Risk for Baby and Is Potentially Illegal

Via RedOrbit:
Actors Tom Cruise and Katie Holmes may be placing their unborn child at risk if they are performing fetal ultrasound on Ms. Holmes with no medical supervision and, if so, should not, in any way, view their fetal keepsake ultrasound images as a substitute for appropriate medical attention. Use of such medical equipment by unlicensed individuals may also be a violation of federal law.
Technorati Tags: Ultrasound, Tom Cruise, Katie Holmes

Outlook Brightens After a New Kidney (Patient Profile from the New York Times)

This is a profile of a patient I know well. From The New York Times:
Noemi Pinto and Frank Talavera shared an unusual honeymoon. Several hours after exchanging vows at City Hall in late September, Mr. Talavera held his wife's hand as she was wheeled into an operating room for a kidney transplant. He had asked her to marry him several times during their seven-year relationship, and Ms. Pinto had always refused, saying their relationship didn't need a piece of paper for validation. This time, it was she who popped not the question, but the answer.
Technorati Tags: Kidney Transplant, New York Times, Transplantation

Grand Rounds 2.10

Grand Rounds 2.10, this week's best posts of the medical blogosphere, is up at Over My Med Body.

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"Cut Me Before I Eat Again" -- Bariatric Surgery in Slate

Via Slate:
The government plans to subsidize more weight-loss surgery. Medicare spent about $13,000 on the surgery for each of 8,000 people last year (that's about $100 million), but the procedure might save money by averting other medical problems related to obesity. However, the program might stop subsidizing such surgery for seniors, because data suggest it's killing them.
Technorati Tags: Obesity, Bariatric Surgery, Surgery, Medicine

Monday, November 28, 2005

Cleveland Clinic Offers Second Opinions Via The Internet ("My Consult" from the "E-Cleveland Clinic")

From The Washington Post:
"My Consult" is a Web-based second opinion service offered by e-Cleveland Clinic, the facility's Internet service. Patients who have received a diagnosis of any of more than 600 life-threatening or life-altering conditions can request an electronic consultation with a Cleveland Clinic doctor. For $565, a physician provides a written second opinion and a treatment recommendation -- all within five to seven working days of receiving a completed request.
Technorati Tags: Emedicine, E-Cleveland Clinic, My Consult

Hilarious Journal Articles #30: Raised Plasma Nerve Growth Factor Levels Associated With Early-Stage Romantic Love

Researchers said raised levels of a protein was linked to feelings of euphoria and dependence experienced at the start of a relationship.

But after studying people in long and short relationships and single people, they found the levels receded in time.

The team analysed alterations in proteins known as neurotrophins in the bloodstreams of men and women aged 18 to 31, the Psychoneuroendocrinology journal reported.
The paper is "Raised plasma nerve growth factor levels associated with early-stage romantic love:"
Our current knowledge of the neurobiology of romantic love remains scanty. In view of the complexity of a sentiment like love, it would not be surprising that a diversity of biochemical mechanisms could be involved in the mood changes of the initial stage of a romance. In the present study, we have examined whether the early romantic phase of a loving relationship could be associated with alterations in circulating levels of neurotrophins (NTs). Plasma levels of NGF, BDNF, NT-3 and NT-4 were measured in a total of 58 subjects who had recently fallen in love and compared with those of two control groups, consisting of subjects who were either single or were already engaged in a long-lasting relationship. NGF level was significantly higher (p<0.001) in the subjects in love [mean (SEM): 227 (14) pg/ml] than in either the subjects with a long-lasting relationship [123 (10) pg/ml] or the subjects with no relationship [149 (12) pg/ml]. Notably, there was also a significant positive correlation between levels of NGF and the intensity of romantic love as assessed with the passionate love scale (r=0.34; p=0.007). No differences in the concentrations of other NTs were detected. In 39 subjects in love who—after 12–24 months—maintained the same relationship but were no longer in the same mental state to which they had referred during the initial evaluation, plasma NGF levels decreased and became indistinguishable from those of the control groups. Taken together, these findings suggest that some behavioural and/or psychological features associated with falling in love could be related to raised NGF levels in the bloodstream.
Technorati Tags: Hilarious Journal Articles, Love, Romance

Nanomedicine in

It's the not-too-distant future, say 2016. You have been diagnosed with Stage III melanoma. Cancer has metastasized throughout your body. Just 10 years ago, in 2006, the choice of treatment would have been based on the type of primary cancer, the size and location of the metastasis, your age, your general health and your treatment history. Your prognosis would have been gloomy. But that was back in 2006, before we entered the era of nanomedicine.

In 2016, your doctor will be capable of scanning your entire genome in a few minutes. She will do this because every cell has a different gene expression pattern or profile. When a cell becomes cancerous, this profile changes. Your Stage III melanoma has a unique, schizoid genetic signature reflecting both a skin cell heritage and a newly acquired outlaw metabolism. Your doctor will explain that while your cancer has a great deal in common with other Stage III melanomas, it is not exactly like any other. Your doctor knows this because for the past few years DNA from virtually every melanoma patient in the U.S. healthcare system has been routinely extracted, scanned and deposited in a national database. This population of sequences, fully analyzed and with a user-friendly graphic interface, is available in real time. Searching this database for any specific cancer sequence will be about as difficult in 2016 as finding Madonna's birthday on Google is today.
Technorati Tags: Nanotechnology, Nanomedicine

Poisonings From Tylenol (Acetaminophen) Are On The Rise

From The New York Times:
Despite more than a decade's worth of research showing that taking too much of a popular pain reliever can ruin the liver, the number of severe, unintentional poisonings from the drug is on the rise, a new study reports. The drug, acetaminophen, is best known under the brand name Tylenol. But many consumers don't realize that it is also found in widely varying doses in several hundred common cold remedies and combination pain relievers.
Technorati Tags: Acetaminophen, Tylenol, Poisoning

The 2005 Medical Weblog Awards at Medgadget

Medgadget is hosting the 2005 Medical Weblog Awards. Nominations are now open. (In case you were wondering, KidneyNotes was established in 2005.)
Welcome to the second annual Medical Weblog Awards! These awards are designed to honor the very best in the medical blogosphere, as decided by you--the readers of these fine medical blogs.

It's been another year filled with explosive growth, stirring debate, and excellent writing -- in a number of fields. Our categories reflect this diversity. The categories for this year's awards will be:

-- Best Medical Weblog

-- Best New Medical Weblog (established in 2005)

-- Best Literary Medical Weblog

-- Best Clinical Sciences Weblog

-- Best Health Policies/Ethics Weblog

-- Best Medical Technologies/Informatics Weblog

Coffee Notes #4: The Bullet Bag

In Starbucks, instead of taking a prepackaged bag of coffee from the display, ask for a one pound bag of whole bean espresso (for example) from the "bullet bag." This is the five pound silver bag the baristas use to make the coffee, and the beans from the bullet bag are fresher and taste dramatically better.

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Hilarious Journal Articles #29: Big Bottoms Can Weaken Effectiveness of Injected Drugs

Via DNC:
Too much "junk in the trunk" isn't just a cosmetic concern anymore. Excess buttocks fat, especially in women, can reduce the effectiveness of vaccines, painkillers, contraceptives and anti-nausea drugs that are typically injected into the buttocks' gluteal muscles, researchers report.

"We are the first to report that the majority of intramuscular injections into the buttocks are not effective in the Western adult population," said Victoria O. Chan, a researchers at The Adelaide and Meath Hospital in Dublin, Ireland, and the lead researcher on the study.
Technorati Tags: Hilarious Journal Articles, Obesity, Injections

The Misunderstanding of Metformin (Glucophage) and Intravenous Contrast

Today, I saw two people on metformin who had their iodinated contrast study cancelled because they had taken their morning dose of metformin. Based on an old recommendation, some people mistakenly believe that taking metformin prior to intravenous contrast is a bad thing.

The revised recommendation is that holding metformin before contrast studies is unnecessary; metformin should only be held for 48 hours after contrast studies to ensure that renal function remains normal. (Metformin given during acute renal failure can theoretically lead to lactic acidosis.)

In the future, if this point needs to be made, googling "metformin" and "contrast" leads to this page from the manufacturer:
The main new point is that there is not any need to stop Glucophage any significant time before contrast administration. The reasoning behind this is as follows:

a) presumably, Glucophage levels in the patient will be fine before the contrast study, so,

b) even if the patient goes into renal failure afterwards, and excretes no further Glucophage for awhile, those levels will simply remain fine unless the patient takes another dose. The important thing is to suspend Glucophage use after the contrast procedure until you are sure that contrast-induced renal failure will not occur. The reasonable time chosen for this observation period is 48 hours.
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Sunday, November 27, 2005

Kiss May Have Killed Quebec Teen With Peanut Allergy

Via The Globe and Mail:
A fifteen-year-old girl with a peanut allergy has died after being kissed by her boyfriend following his snack of peanut butter.
Technorati Tags: Anaphylaxis, Peanuts

"Just Try to Sleep Tight. The Bedbugs Are Back." (New York Times)

From The New York Times:
Bedbugs are back and spreading through New York City like a swarm of locusts on a lush field of wheat.

Infestations have been reported sporadically across the United States over the past few years. But in New York, bedbugs have gained a foothold all across the city.

"It's becoming an epidemic," said Jeffrey Eisenberg, the owner of Pest Away Exterminating, an Upper West Side business that receives about 125 bedbug calls a week, compared with just a handful five years ago. "People are being tortured, and so am I. I spend half my day talking to hysterical people about bedbugs."
Technorati Tags: Bedbugs, New York Times

Friday, November 25, 2005

Thanksgiving and Second Hand Smoke

Happy Thanksgiving. At a family gathering, a distant relative argued that second hand smoke protects against cancer. "The risk ratio is 0.70. If second hand smoke were a vitamin, everyone would buy it."

Wednesday, November 23, 2005

New England Journal of Medicine Audio Interview: Dr. Robert Belshe on the Origins of Pandemic Influenza

Dr. Belshe is a professor of medicine, pediatrics, and molecular microbiology in the Division of Infectious Diseases and Immunology, Department of Internal Medicine, Saint Louis University, St. Louis. The podcast feed is here.

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Mycophenolate Mofetil (CellCept) or Intravenous Cyclophosphamide (Cytoxan) for Lupus Nephritis

This is further evidence that CellCept -- a daily oral immunosuppressive medication -- is more effective with fewer side effects than Cytoxan -- a monthly intravenous immunosuppressive medication -- in the treatment of proliferative lupus nephritis. From The New England Journal of Medicine:
Background Since anecdotal series and small, prospective, controlled trials suggest that mycophenolate mofetil may be effective for treating lupus nephritis, larger trials are desirable.

Methods We conducted a 24-week randomized, open-label, noninferiority trial comparing oral mycophenolate mofetil (initial dose, 1000 mg per day, increased to 3000 mg per day) with monthly intravenous cyclophosphamide (0.5 g per square meter of body-surface area, increased to 1.0 g per square meter) as induction therapy for active lupus nephritis. A change to the alternative regimen was allowed at 12 weeks in patients who did not have an early response. The study protocol specified adjunctive care and the use and tapering of corticosteroids. The primary end point was complete remission at 24 weeks (normalization of abnormal renal measurements and maintenance of baseline normal measurements). A secondary end point was partial remission at 24 weeks.

Results Of 140 patients recruited, 71 were randomly assigned to receive mycophenolate mofetil and 69 were randomly assigned to receive cyclophosphamide. At 12 weeks, 56 patients receiving mycophenolate mofetil and 42 receiving cyclophosphamide had satisfactory early responses. In the intention-to-treat analysis, 16 of the 71 patients (22.5 percent) receiving mycophenolate mofetil and 4 of the 69 patients receiving cyclophosphamide (5.8 percent) had complete remission, for an absolute difference of 16.7 percentage points (95 percent confidence interval, 5.6 to 27.9 percentage points; P=0.005), meeting the prespecified criteria for noninferiority and demonstrating the superiority of mycophenolate mofetil to cyclophosphamide. Partial remission occurred in 21 of the 71 patients (29.6 percent) and 17 of the 69 patients (24.6 percent), respectively (P=0.51). Three patients assigned to cyclophosphamide died, two during protocol therapy. Fewer severe infections and hospitalizations but more diarrhea occurred among those receiving mycophenolate.

Conclusions In this 24-week trial, mycophenolate mofetil was more effective than intravenous cyclophosphamide in inducing remission of lupus nephritis and had a more favorable safety profile.
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Patient Quote of the Day #5: Abstinence

Health Care Provider: "What form of birth control do you use?"

Patient, touching the cross around her neck: "I don't use any. I'm abstinent."

Health Care Provider pauses.

Patient: "Can you give me any advice on how to maintain my abstinence?"

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"Calligraphies #80"

"last of an 80 image series..
view the whole set"

From Flickr. Uploaded by clickykbd on 22 Nov '05, 4.52am PST.

PT-141, An Aphrodisiac in Phase 3 Clinical Trials

Via New York Magazine:
Horn of rhinoceros. Penis of tiger. Root of sea holly. Husk of the emerald-green blister beetle known as the Spanish fly. So colorful and exotic is the list of substances that have been claimed to heighten sexual appetite that it's hard not to feel a twinge of disappointment on first beholding the latest entry -- a small white plastic nasal inhaler containing an odorless, colorless synthetic chemical called PT-141. Plain as it is, however, there is one thing that distinguishes PT-141 from the 4,000 years' worth of recorded medicinal aphrodisiacs that precede it: It actually works.

And it's coming to a medicine cabinet near you. The drug will soon enter Phase 3 clinical trials...
Technorati Tags: PT-141, PT141

Tuesday, November 22, 2005

Patient Quote of the Day #4: Miracle Man

A patient with bipolar disorder has a cardiac arrest outside the hospital and is successfully resuscitated with an automatic defibrillator. When I see him, he's manic. "I'm the miracle man!" he shouts. And I'm thinking, "Yes you are."

"St. Paul 4"

"St. Paul, north of Theresienwiese. Straight from the camera.

Canon EF 17-40/f4L USM"

From Flickr. Uploaded by Michael Nagel on 20 Nov '05, 11.23pm PST.

"An Internet Lifeline, in Search of a Kidney" (

From The New York Times:
On Dec. 23, 1954, a 24-year-old Coast Guard veteran, Richard Herrick, received from his identical twin a remarkable present, a kidney. On that day, doctors at Peter Bent Brigham Hospital in Boston performed the first successful kidney transplant on Mr. Herrick.

A painting commemorating the operating room scene hangs in the Countway Library of Medicine at Harvard.

I hope to receive the same gift. Mysteriously, my own kidneys retired early, a fact learned when I had routine lab tests in August 2004...
Technorati Tags: Kidney Transplantation, Matching Donors,

Grand Rounds 2.09

Grand Rounds 2.09, this week's best posts of the medical blogosphere, is up at Code Blog.

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Travelers Entering Japan From Bird Flu-Affected Areas To Be Asked To Disinfect Shoes

From Mainichi Daily News:
Japan starting Tuesday will ask travelers from bird flu-affected areas to have their shoes disinfected upon arrival at the country's four major airports, including Tokyo's international gateway at Narita, a government official said.
Technorati Tags: Avian Flu, Avian Influenza, Bird Flu

Monday, November 21, 2005

"Night Glow"


From Flickr. Uploaded by creativity+ on 21 Nov '05, 12.30pm PST.

Sunday, November 20, 2005

Fertility Treatments (Including IVF) May Not Increase Risks to Babies

From The Washington Post:
Research suggests that babies conceived with a little help from science are no more likely to have birth defects or chromosomal abnormalities than babies made the old-fashioned way.

But women who become pregnant through in vitro fertilization may experience more complications during their pregnancy, the scientists cautioned.
The paper is Assisted Reproductive Technology and Pregnancy Outcome.

Technorati Tags: IVF, Fertility, Pregnancy

Hello, I'm Your Sister. Our Father Is Donor 150.

From The New York Times:
Like most anonymous sperm donors, Donor 150 of the California Cryobank will probably never meet any of the offspring he fathered through sperm bank donations. There are at least four, according to the bank's records, and perhaps many more, since the dozens of women who have bought Donor 150's sperm are not required to report when they have a baby.

But two of his genetic daughters, born to different mothers and living in different states, have been e-mailing and talking on the phone regularly since learning of each other's existence last summer. They plan to meet over Thanksgiving.
Technorati Tags: Sperm Donation, California Cryobank, Donor 150, New York Times

Saturday, November 19, 2005

The Harry Potter Ecstasy Pill

Via The Smoking Gun:
In the latest attempt to distinctively brand their illegal products, New York City drug dealers have begun peddling Ecstasy pills bearing images from the popular Harry Potter books and movies. Federal prosecutors in Brooklyn this week charged 14 people with allegedly smuggling 400,000 pills of the popular club drug into the U.S. from Europe. Included in that large stash--which was intercepted by Drug Enforcement Administration and Customs Service agents--were the so-called Harry Potters, pills that retail in Gotham for about $25. Below you'll find an evidence photograph, provided to us by the DEA, of a seized Ecstasy pill bearing Harry's initials in the young wizard's distinctive lightning typeface.
Technorati Tags: Harry Potter, Ecstasy

"Hagase La Luz"

"Nunca tengo muy claro cuando aplicar un "cutout" y puede que en este caso tampoco sea acertado, pero no me disgusta.
He seguido los consejos de Manuel Boo para estos casos.

From Flickr. Uploaded by xip on 18 Nov '05, 12.05pm PST.

The Rootkit of All Evil

From the New York Times:
SONY BMG can take two lessons from its recent wayward attempt to fend off digital piracy: One, in a world of technology-astute bloggers, it's not easy to get away with secretly infecting your customers' computers with potentially malicious code. And two, as many a politician has learned, explaining your own screw-up badly is often worse than the screw-up itself.
Technorati Tags: Sony, Rootkit, DRM, Digital Rights management

Medical Blogosphere Tag Cloud Weekly Update

The following are the top 100 keywords from the Medical Blogosphere Tag Cloud, a way of seeing at a glance what people are talking about online. The full cloud with links to individual posts is here.
access ... american ... american medical association ... american society ... american society of nephrology ... avian flu ... bird flu ... blog ... blogosphere ... boston ... bush ... california ... canada ... case ... chronic kidney ... chronic kidney disease ... clinic ... cold ... consumers ... contact ... creationism ... death ... diagnosis ... doctors ... dover ... drugs ... eggs ... email ... evidence based ... family ... federal ... flu ... flu pandemic ... food and drug administration ... google ... grand rounds ... guess ... h5n1 ... hasn ... health care ... heart ... heart attack ... hilarious ... hospital impact ... hospitals ... hurricane katrina ... idea ... impact ... intelligent design ... internal medicine ... journal articles ... kent ... kidney disease ... lawyers ... london ... love ... mail ... medical center ... medical malpractice ... medical students ... medicare drug ... medicine ... merck ... money ... mssp ... nejm ... new orleans ... new york ... nexus ... nurses ... nyt ... ohio ... pandemic ... parents ... photo ... physicians ... podcast ... product ... pseudoscience ... quality ... reading ... reason ... science ... scientists ... search ... service ... spread ... state ... story ... tamiflu ... tests ... therapy ... united states ... vioxx ... virginia ... wake ... wall ... wall street journal ... washington ... west virginia
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Is the Earth in a Vortex of Space-Time?

Via Slashdot:
"Apparently, we'll soon know for sure.... NASA has announced in an article that 'A NASA/Stanford physics experiment called Gravity Probe B (GP-B) recently finished a year of gathering science data in Earth orbit. The results, which will take another year to analyze, should reveal the shape of space-time around Earth--and, possibly, the vortex.'" More from the article: "If Earth were stationary, that would be the end of the story. But Earth is not stationary. Our planet spins, and the spin should twist the dimple, slightly, pulling it around into a 4-dimensional swirl. This is what GP-B went to space to check."
Technorati Tags: NASA

Friday, November 18, 2005

Patient Quote of the Day #3

"Can I get the floozie shot?"

"Old News"

"Lead type on an antique Ostrander Seymour Co. press. The press is on permanent display in the lobby of the Bellingham Herald in Bellingham, Washington.

I've worked as a graphic designer at the Bellingham Herald since January 1998. Publishing and typesetting is the stuff of geeks today. In the days when this press was used, however, publishing certainly must have been for the strong. This hand-operated press is heavy. Operating it must have been a deeply exhausting and horribly tedious job.

It makes me glad I live in the age of digital publishing. I could not have made it back then.

I'll post a photo of the press itself later."

From Flickr. Uploaded by Smaragd  on 18 Nov '05, 12.07am PST.

"If you hold up your pee too long can your kidney burst?"

To the person who found this blog by searching for "If you hold up your pee too long can your kidney burst?" -- The short answer is "No."

Oral Sex Linked to Mouth Cancer

Via Yahoo:
Certain cases of mouth cancer appear to be caused by a virus that can be contracted during oral sex...

People who contract a high-risk variety of the human papilloma virus, HPV, during oral sex are more likely to fall ill with mouth cancer, according to a study conducted at the Malmo University Faculty of Odontology in southern Sweden.

"You should avoid having oral sex," dentist and researcher Kerstin Rosenquist, who headed the study, told Swedish news agency TT.
Technorati Tags: Oral Sex, Mouth Cancer

Thursday, November 17, 2005

Bodies The Exhibition at South Street Seaport

Via NewYorkology:
"BODIES ... The Exhibition" will open Saturday at the South Street Seaport, filling up the new Exhibition Centre with 22 whole bodies and 260 organs and partial body specimens.

The bodies -- all real -- have been preserved with liquid silicone rubber that is treated and hardened, creating rubberized specimens preserved to the cellular level.
Technorati Tags: Bodies, South Street Seaport

Living Unrelated Dog to Dog Kidney Donation

From The Auburn Plainsman:
Kidney transplants are common surgeries among humans, but now man’s best friend is able to have the complicated procedure.
Technorati Tags: Dogs, Kidney Transplantation

Roller Coasters May Cause Sudden Cardiac Death

From Reuters:
"The rising heart rate in riders with pre-existing heart disease could result in heart attack, irregular heart rhythms and possibly sudden cardiac death," said Dr Jurgen Kuschyk, who presented the findings of his study at the American Heart Association's annual scientific sessions.

The German study of 37 men and 18 women volunteers with no heart disease and average age of 28 found heart rates increased dramatically both during and after the ride to an extent that could cause arrhythmias, or a dangerous irregular heart beat, in some people.

Forty-four percent of the participants had marked heart rhythm irregularities that lasted up to five minutes after their ride on the Expedition GeForce roller coaster at Holiday Park in Hassioch, Germany, researchers said.
Technorati Tags: Roller Coasters, Heart Disease

Hospitals in New York City Facing Financial Pressure

From The New York Sun:
In the last few years, several private hospitals in the city have closed, filed for Chapter 11, had their bond status downgraded, or sold off major assets to raise cash.

While the financial status varies widely at the 73 hospitals in the city, those in the industry say fiscal pressures are mounting on the facilities, which are not generally known for their business acumen.

"There are a lot of hospitals in New York that are operating with no cushion," the director of health care ratings at Standard & Poor's, Liz Sweeney, said. "They're operating with enough cash to make maybe the next payroll."
Technorati Tags: Hospitals, News from New York, New York City, Hospital Finances

Google Purchasing Riya, Face Recognition Technology Company

Via Niall Kennedy's Weblog:
Photo service Riya has been acquired by Google for close to $40 million according to sources involved with the company. Riya uses face recognition technology to identify people in photos. The system can also recognize text such as street signs.
Technorati Tags: Google, Riya

"Excess Water Damages Kidneys" (the Walkerton Health Study)

The news media is suddenly reporting that drinking water is bad for you. This report is apparently a misinterpretation of the soon-to-be-released results of the Walkerton Health Study, which showed high levels of chronic kidney disease in a town years after an outbreak of E. Coli 0157:H7 in patients who drank the water but did not have clinical evidence of hemolytic uremic syndrome. More to follow.

Update (11/19/05): Here's an earlier paper, "Risk of hypertension and reduced kidney function after acute gastroenteritis from bacteria-contaminated drinking water." Here's the abstract:
Background: The long-term health consequences of acute bacterial gastroenteritis remain uncertain. We studied the risk of hypertension and reduced kidney function after an outbreak of acute gastroenteritis due to contamination of a regional drinking water supply with Escherichia coli O157:H7 and Campylobacter species.

Methods: A total of 1958 adults with no known history of hypertension or kidney disease before the outbreak participated in a long-term follow-up study. Of the participants, 675 had been asymptomatic during the outbreak, 909 had had moderate symptoms of acute self-limited gastroenteritis, and 374 had had severe symptoms that necessitated medical attention. The outcomes of interest were a diagnosis of hypertension or the presence of reduced kidney function and albuminuria during the follow-up period.

Results: After a mean follow-up of 3.7 years after the outbreak, hypertension was diagnosed in 27.0% of participants who had been asymptomatic during the outbreak and in 32.3% and 35.9% of those who had had moderate and severe symptoms of acute gastroenteritis respectively (trend p = 0.009). Compared with the asymptomatic participants, those with moderate and severe symptoms of gastroenteritis had an adjusted relative risk of hypertension of 1.15 (95% confidence interval [CI] 0.97–1.35) and 1.28 (95% CI 1.04–1.56) respectively. A similar graded association was seen for reduced kidney function, defined as the presence of an estimated glomerular filtration rate below 60 mL/min per 1.73 m2 (trend p = 0.03). No association was observed between gastroenteritis and the subsequent risk of albuminuria.

Interpretation: Acute bacterial gastroenteritis necessitating medical attention was associated with an increased risk of hypertension and reduced kidney function 4 years after infection. Maintaining safe drinking water remains essential to human health, as transient bacterial contaminations may have implications well beyond a period of acute self-limited illness.
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William Shatner Wants to Sell Kidney Stone
William Shatner is hoping to persuade medics who removed his kidney stone to hand it over so he can sell it on auction site eBay...
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The New England Journal of Medicine Audio Summary (Clinical Cases and Images)

Via Clinical Cases and Images:
The New England Journal of Medicine offers a [free] audio summary of the journal's weekly content. You can listen to the 14-minute summary online or download the 6 mb file to an MP3 player.
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Wednesday, November 16, 2005

A Review of Google Analytics

Google Blogoscoped has a review of Google Analytics.

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"public pillowfight organized by newmindspace at toronto's dundas quare on 13th of november 2005."

From Flickr. Uploaded by wvs on 13 Nov '05, 11.54pm PST.

Medlogs Down & Bloglines

Anyone withdrawing from Medlogs is welcome to read my feeds on Bloglines.

Addendum: Medlogs is back up.

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Semen Sample to be Collected at Dialysis

The dialysis nurses are dying. Someone just put in a computer order for a semen sample to be collected at dialysis. They're hoping it was an error.

"Font of Wishes"

From Flickr. Uploaded by Corporal Tunnel on 12 Nov '05, 10.28pm PST.

"Wildflower Bubbles"

"using the recent rave in Photoshop transformations, then trying to save a little bandwidth led me to go beyond combining variations into a patchwork 4-pane grouping."

From Flickr. Uploaded by 0 W8ing on 10 Nov '05, 8.02am PST.

Tuesday, November 15, 2005

First Blood Vessels Grown From Patient's Skin for Hemodialysis Fistula

Via USA Today:
Two kidney dialysis patients from Argentina have received the world's first blood vessels grown in a lab dish from snippets of their own skin, a promising step toward helping people with a variety of diseases...

People with certain chronic conditions, such as dialysis patients, often run out of healthy vessels.

Growing them involves taking a piece of skin and a vein, less than a quarter-inch square, from the back of the hand. It's placed in a lab dish and nurtured with growth enhancers that help it produce substances like collagen and elastin, which give tissues their shape and texture...

Sheets of this tissue are produced — "You can cover your desk with a sheet," said Todd McAllister, a scientist and co-founder of the company — and then stacked and rolled into vessels 6 to 8 inches long...

Patients often run out of healthy vessels that can be cut out and moved to form a shunt, and synthetic vessels often don't last long and can develop complications...

The woman's new vessel has withstood needle punctures three times a week for six months and the man's, for almost three.
Technorati Tags: Dialysis, Cytograft, Tissue Engineering

Coffee Notes #3: Abortive Therapy for Migraine

Eye aches are my migraine equivalent. Today's therapy was a tall eggnog chai latte -- happy holidays -- and two excedrine migraine tablets. (A recent study showed that excedrine migraine is as effective as Imitrex at treating migraines. I don't know about the latte, but the more caffeine right now, the better...)

Ten years of

From Salon:
Ten years ago, on Nov. 20, 1995, the first issue of Salon went live. Its Web address was "" because "" was owned by a hair salon owner in Texas, who stubbornly refused to give it up until one of our founders flew down there and, after frank, open and increasingly Mafia-like negotiations, received the precious in exchange for a large bushel of Salon stock. The cunning, not to say Mephistophelean, nature of the hair salon owner, and certain ambiguities in the account our negotiator, Andrew Ross, gave of the transaction, combined with Salon's Blackbeard-like refusal to die even while being simultaneously shot, strangled, drowned, garroted and keelhauled, have given rise to suspicions that some sort of Faustian pact was struck...
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Hilarious Journal Articles #28: Make Slough Happy

From the Times Online:
If you were searching for the path to lasting happiness, Slough probably wouldn’t be the place you’d start. But for Richard Stevens, a leading psychologist, the Berkshire town proved the ideal location for a pioneering experiment: take all the theory and speculation about what makes human beings happy and test it over ten weeks on people in an ordinary British town. He believes he now knows what works...

And at the end of the experiment, did Stevens’s post-hippy message of connection, love, transcendence, meaningful labour and suspicion of materialism work? “We designed a complex assessment survey and the results showed a significant overall effect on the volunteers’ reported levels of happiness in areas such as work and relationships,” he reports. “We produced more change than we expected. Generally, people misjudge what makes them happy, particularly in relation to materialism...”
From Shrinkette, thanks. I assume this study will eventually be published somewhere.

Technorati Tags: Hilarious Journal Articles, Happiness

Grand Rounds 2.08

Grand Rounds 2.08, this week's best posts of the medical blogosphere, is up at Doc Shazam.

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Jail Demanded For Doctor Who Overlooked Boy's Fatal Chopstick Brain Injury

From Mainichi:
A doctor who failed to notice that a chopstick had pierced the brain of a 4-year-old boy brought to him and sent the boy home should be jailed for one year for his death, prosecutors told the Tokyo District Court on Monday.
(Thanks, W. Ellis.)

"Wrongful Life" Lawsuit

From Court TV:
A blind and deaf Australian woman who claims she never should have been born is suing a doctor for a lifetime of suffering in the country's first "wrongful life" suit.

Alexia Harriton, 24, is seeking compensation from the doctor who misdiagnosed rubella in the first trimester of her mother's pregnancy, claiming Olga Harriton would have aborted her had she been aware of the potential birth defects arising from the illness.
Technorati Tags: Rubella, Lawsuits

Doctor Stories #8: Lymph Nodes Aren't Hollow

From The Doctor Is In:
The bulk of the nodes were out in little time, titanium clips sealing the lymphatic channels and small blood vessels which feed them. The final packet was located near the point of the triangle, at the upper part of the pelvis below the vein. Several small vessels were clipped, and these nodes were removed easily as well.

I inspected the nodes, feeling them for firmness that might suggest cancer spread. One node looked peculiar. Hollow. Lymph nodes aren’t hollow.


Inspection of the surgical field confirmed my worst fear: I had removed a short section of the external iliac artery, the main vessel to the leg. Located in a highly unusual location: underneath the vein, rather than above and lateral to it–an aberrant knuckle of vascular conduit enveloped in fat and lymph nodes–a section of artery had been cleanly removed with the nodes...
Technorati Tags: Doctor Stories, Surgery

...and here's the FDA's formal warning about the Ortho Evra birth control patch

The complete warning is here.
FDA notified healthcare professionals and patients of revisions to the label for Ortho Evra, a skin patch approved for birth control, that includes a bolded warning about higher exposure to estrogen for women using the weekly patch compared to taking a daily birth control pill containing 35 micrograms of estrogen. A woman on Ortho Evra may be exposed to approximately 60% more estrogen than if she were taking a typical 35 microgram estrogen birth control pill. Estrogen use is linked to blood clots in the legs and lungs and other clotting problems such as strokes and heart attacks. It is not known if women using Ortho Evra have a higher risk of serious side effects than women taking the typical 35 microgram estrogen pills.
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Monday, November 14, 2005

Addendum: Code Magenta

By this logic, if a patient has a code blue after being set on fire (a code red), this is a code magenta.

Code Purple

Arriving in the coronary care unit, I learn that the residents and nurses are in the midst of a code brown and a code blue. We decide to call this a code purple.

Nephrology Cases #8: Creatine Supplements Lead to Increase in Serum Creatinine

I recently encountered an otherwise healthy 35 year old woman with a serum creatinine of 2.5 mg/dL (elevated). An initial workup was negative. Further questioning revealed that she was taking creatine supplements to enhance exercise. The supplements were stopped, and a repeat creatinine was 1.0 mg/dL (normal).

Creatine is converted into creatinine, which apparently explained the increased value. I was surprised that creatine supplements could lead to an increase in creatinine of this magnitude. I routinely ask about over the counter medications and supplements, but this experience suggests that patients with otherwise unexplained serum creatinines should be asked specifically about creatine supplementation.

A Google Scholar search on this topic is here.

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A Minor Cut in the Cardiothoracic ICU

While in the cardiothoracic ICU, I notice a small cut on my hand. I ask the nurses for a band aid, and they say here, try this, and apply Dermabond to the cut. Dermabond is a liquid skin adhesive that's basically sterile superglue. They use it to close chest wounds. Works pretty well on minor cuts, too.

Paying for Dialysis

From Nathan's PKD:
I had to call my previous insurance company this morning. I was covered by this company from August 2005 – mid-October 2005. The dialysis clinic was out-of-network for this insurance, so my total out-of-pocket expenses should be $4000. Now, I understood this amount, and can accept it as company policy. However, I received a bill from the dialysis clinic on Saturday totaling over $16,000 in patient responsibilities (that’s me!). The bill is for 08/02/2005 – 09/29/2005 and came to $46,890.25. The insurance company is listed as paying $24,758.19 and writing off $6,089.52. This (supposedly) means that I have to pay $16,042.54. I called the insurance company and asked them (again) what an “out-of-pocket maximum” means. The agent told me that there most have been some mistake in the billing system and that they would look in to it. She also told me not to pay anything yet, as they are going to have to figure out what went wrong that kept them from stopping my bill at $4000. So, I will continue to go to dialysis and not pay them for the time being.
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Safety of Outpatient Angioplasty

From CBS News:
It hasn't become quite as routine as having your teeth cleaned, but a growing number of people are going to hospitals to get their heart arteries unclogged and going home the same day.

New research presented Sunday at an American Heart Association conference suggests the approach is safe. It found complications were no greater in people who went home a few hours after having angioplasty than in those who were hospitalized overnight.
Technorati Tags: Angioplasty, Coronary Artery Disease

From Flickr: Crazylegs takes flight

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Sunday, November 13, 2005

EKGuard: Cardiologists Remotely Evaluate Your Home Electrocardiogram Anytime

Just saw this commercial. From MedGadget:
Do you know how to make a medicine intern drool? Talk about decreasing the number of chest pain admissions. Now, some wealthy patients can have an EKG at home, and discuss it with a cardiologist, before deciding to head in to the hospital.
EKGuard apparently uses a handheld modified 12-lead EKG device that connects to the phone. From the website:
Ever feel a slight pain or squeezing in your chest? Ever feel an ache in your arm or jaw that just didn’t seem right? Is it a heart attack? Or, is it simply indigestion?

Over 1.1 million of us will suffer a heart attack this year, but many won’t realize it until too late. Symptoms can be ambiguous, intermittent, even mild. (And who’s eager to take a potentially unnecessary trip to the E.R.?) But, the clock is ticking and indecision can be deadly. Irreversible heart damage begins at two hours and death rates double.

Now, with E.K.Guard, there's no need to delay. Check your heart over the telephone, from any location, at any time 24/7.
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American Society of Nephrology Renal Week 2005 Blog

A group of nephrologists from Columbia and Dr. Kim Solez are blogging at the American Society of Nephrology Renal Week 2005 in Philadelphia. (If I was able to go this year, I'd be joining them.)

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Website Redesign

I've updated the website: pages should load more quickly, and an excerpt from the Medical Blogosphere Tag Cloud is now at the top of the home page. Have a look and let me know what you think. Suggestions are welcome.

A Booster Shot for Medical Data-Sharing

Via Businessweek:
The movement to build a medical Internet linking millions of Americans' electronic health records advanced on Nov. 11. Officials of the U.S. Health & Human Services Dept. awarded four contracts to build regional networks that will let doctors and hospitals share medical data. The network is aimed at improving medical quality and slashing health-care costs.

Contracts went to groups led by IBM (IBM), Accenture (ACN), Northrop Grumman (NOC), and Computer Sciences (CSC). Although the contracts total only $20 million, bidding by some of technology's titans reflects the industry's recognition that the $1.7 trillion U.S. health-care business could generate the next big wave of tech investment and productivity growth.
Technorati Tags: Medical Informatics

News from New York #17: They're Soft and Cuddly, So Why Lash Them to the Front of a Truck?

From the New York Times:
A bear with a prominent grease spot on his little beige nose spends his days wedged behind the bumper guard of an ironworker's pickup in the Gowanus section of Brooklyn. A fuzzy rabbit and a clown, garroted by a bungee cord, slump from the front of a Dodge van in Park Slope. Stewie, the evil baby from "Family Guy," scowls from the grille of a Pepperidge Farm delivery truck in Brooklyn Heights, mold occasionally sprouting from his forehead.

All are soldiers in the tattered, scattered army of the stuffed: mostly discarded toys plucked from the trash and given new if punishing lives on the prows of large motor vehicles, their fluffy white guts flapping from burst seams and going gray in the soot-stream of a thousand exhaust pipes.

Grille-mounted stuffed animals form a compelling yet little-studied aspect of the urban streetscape, a traveling gallery of baldly transgressive public art. The time has come not just to praise them but to ask the big question. Why?
Technorati Tags: Stuffed Animals

Confusion Is Rife About Drug Plan as Sign-Up Nears

From the New York Times:
Enrollment in the new Medicare drug benefit begins in three days, but even with President Bush hailing the plan on Saturday as "the greatest advance in health care for seniors" in 40 years, large numbers of older Americans appear to be overwhelmed and confused by the choices they will have to make.
Technorati Tags: Drugs, Medicare Drug Benefit, Medicare

From Flickr: Treetops in blossom

Uploaded by essjay nz on 10 Nov '05, 5.20pm EST.

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From Flickr: Web 2.0

Uploaded by kosmar on 12 Nov '05, 4.21am EST.

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Saturday, November 12, 2005

Study of CERA (Continuous Erythropoietin Receptor Activator) in Kidney Disease Patients Demonstrates Control of Anemia

Via PRNewswire:
Roche's innovative anti-anemia agent CERA (Continuous Erythropoietin Receptor Activator) was able to control anemia in patients with chronic kidney disease (CKD) not on dialysis within a narrow target range set out in expert guidelines for more than one year. The Phase II extension data presented for the first time at the American Society of Nephrology 38th Annual Meeting & Scientific Exposition - Renal Week meeting in Philadelphia today...
Technorati Tags: CERA, Roche, Anemia

Breakfast at Google

In case you were wondering, from the Google Blog:
  • Googlers prefer Canadian bacon (45 lbs.) to chicken-apple sausage (30 lbs.)
  • Steel-cut oatmeal (10-12 gallons) wins out over organic grits (6-8 gallons)
  • We polish off 5 cases of fresh fruit (cantaloupe, honeydew, pineapple)
  • Devour 160 breakfast burritos (eggs, veggies, cheese)
  • We cook 80-100 lbs. of red bliss potatoes
  • We use 2 gallons of egg whites (for the omelets)
  • Googlers gulp down 9 gallons of fresh coffee every morning (just in our cafe)
  • My biggest surprises: people consume 1-1/2 gallons of kombucha tea - a little-known fermented drink - every day
  • And against all logic, some people ask for an omelet that's half egg whites, half regular eggs.
As a related aside, you can find nutritional values instantly at

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Radical Cartography

Future Feeder has a review of the website Radical Cartography, a collection of unusual maps.

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More Aggressive Anemia Treatment Does Not Help Left Ventricular Hypertrophy in Chronic Kidney Disease

Via Medscape:
Treating patients with chronic kidney disease (CKD) for anemia earlier and to a higher-than-standard hemoglobin level did not confer a significant treatment benefit for left ventricle hypertrophy, according to data presented here at Renal Week 2005, the annual meeting of the American Society of Nephrology.
Technorati Tags: Anemia, Chronic Kidney Disease, Epoetin

Bone Marrow Transplant Patient Accepts Kidney Transplant From Same Donor -- Without Anti-Rejection Drugs

From Xinhua:
A Singaporean, who had a bone marrow transplant in July last year, survived a recent kidney transplant operation without taking drugs to prevent rejection...

Both the transplanted bone marrow and kidney came from his younger brother, which cured his pre-leukemia illness first and then took him back to a normal life.

The two immune systems blended in Koh's body after the bone marrow transplant and now his younger brother's bone marrow cells have completely taken over his own immune system...
Technorati Tags: Kidney Transplantation, Bone Marrow Transplantation

Hilarious Journal Articles #27: Anger May Be Good For You

From the Carnegie Mellon press release:
A provocative new study has found that people who respond to stressful situations with angry facial expressions, rather than fearful expressions, are less likely to suffer such ill effects of stress as high blood pressure and high stress hormone secretion...

"We tested whether facial muscle movements in response to a stressor would reveal changes in the body's two major stress-response systems—the sympathetic nervous system (SNS) and the hypothalamic pituitary adrenocortical (HPA) axis. Analyses of facial expressions revealed that the more fear individuals displayed in response to the stressors, the higher their biological responses to stress. By contrast, the more anger and disgust (indignation) individuals displayed in response to the same stressors, the lower their responses," said Jennifer Lerner, the Estella Loomis McCandless Associate Professor of Psychology and Decision Science at Carnegie Mellon and lead author of the study.
Technorati Tags: Anger, Stress Hormones, Hilarious Journal Articles

Genetic Find Stirs Debate on Race-Based Medicine

From the New York Times:
In a finding that is likely to sharpen discussion about the merits of race-based medicine, an Icelandic company says it has detected a version of a gene that raises the risk of heart attack in African-Americans by more than 250 percent.

The company, DeCode Genetics, first found the variant gene among Icelanders and then looked for it in three American populations, in Philadelphia, Cleveland and Atlanta...

Only 6 percent of African-Americans have inherited the variant gene, but they are 3.5 times as likely to suffer a heart attack as those who carry the normal version of the gene, a team of DeCode scientists led by Dr. Anna Helgadottir reported in an article released online yesterday by Nature Genetics...

Dr. Kari Stefansson, the company's chief executive, said he would consult with the Association of Black Cardiologists and others as to whether to test a new heart attack drug specifically in a population of African-Americans.

The drug, known now as DG031, inhibits a different but closely related gene and is about to be put into Phase 3 trials, the last stage before a maker seeks the Food and Drug Administration's approval.
The original letter appears in Nature Genetics.

Technorati Tags: Genetics, DG031

Friday, November 11, 2005

From Flickr: On the way to Périgord

Uploaded by mistca on 10 Nov '05, 10.29am EST.

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First-Time Generic Approvals: Amaryl, Norvasc, Altace

Via Medscape:
The U.S. Food and Drug Administration (FDA) has approved first-time generic formulations of glimepiride 1-, 2-, and 4-mg tablets and first-time doses of 3-, 6-, and 8-mg tablets for the management of diabetes mellitus; amlodipine besylate 2.5-, 5-, and 10-mg [base] tablets for the treatment of hypertension and coronary artery disease; and ramipril 1.25-, 2.5-, 5-, and 10-mg capsules for the treatment of hypertension and reduction of cardiovascular risk.
Technorati Tags: Amaryl, Norvasc, Altace

Medical Blogosphere Tag Cloud Weekly Update

The following are the top 100 keywords from the Medical Blogosphere Tag Cloud, a way of seeing at a glance what people are talking about online. The full cloud with links to individual posts is here.
access ... american ... avian flu ... big pharma ... bioethics ... bird flu ... blog ... blogosphere ... bottles ... bush ... bush administration ... california ... canada ... carnival ... case ... china ... cincinnati ... clinic ... computer ... consumers ... contact ... death ... department of health ... diagnosis ... doctors ... drugs ... email ... evidence based ... family ... fark ... federal ... flu ... flu shots ... google ... grand rounds ... guess ... health care ... health policy ... heart ... hospital impact ... hospitals ... hubby ... hurricane katrina ... image ... imaging ... impact ... intelligent design ... internal medicine ... interviews ... job ... kent ... listening ... love ... mail ... malpractice ... malpractice case ... malpractice insurance ... media ... medical malpractice ... medications ... medicine ... merck ... money ... mssp ... nejm ... new england journal ... new orleans ... new york ... nexus ... nurses ... nursing school ... pandemic ... parents ... photo ... physicians ... pneumonia ... podcast ... primary care ... product ... quality ... reading ... rita ... schwab ... science ... scientists ... service ... sick ... south ... spread ... star trek ... state ... story ... tamiflu ... united states ... vioxx ... wal mart ... wall ... wall street journal ... war ... washington
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FDA Suggests Warnings for Condoms

From the LA Times:
Against a background of pressure from social conservatives, the Food and Drug Administration is recommending a new series of labels for condoms, warning that they "greatly reduce, but do not eliminate" the risk of some sexually transmitted diseases.
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Study Finds Patients with Moderate to Severe Chronic Kidney Disease Go Undiagnosed

From PRNewswire:
Study results presented today at the American Society of Nephrology's 38th Annual Meeting and Scientific Exposition demonstrated that patients, particularly women, with moderate to severe chronic kidney disease are often undiagnosed and have a low rate of referral to nephrologists...
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Amazon's Mechanical Turk -- "Artificial, Artificial Intelligence" -- And A Blog

The description:
In 1769, Hungarian nobleman Wolfgang von Kempelen astonished Europe by building a mechanical chess-playing automaton that defeated nearly every opponent it faced. A life-sized wooden mannequin, adorned with a fur-trimmed robe and a turban, Kempelen’s "Turk" was seated behind a cabinet and toured Europe confounding such brilliant challengers as Benjamin Franklin and Napoleon Bonaparte. To persuade skeptical audiences, Kempelen would slide open the cabinet’s doors to reveal the intricate set of gears, cogs and springs that powered his invention. He convinced them that he had built a machine that made decisions using artificial intelligence. What they did not know was the secret behind the Mechanical Turk: a chess master cleverly concealed inside.

Today, we build complex software applications based on the things computers do well, such as storing and retrieving large amounts of information or rapidly performing calculations. However, humans still significantly outperform the most powerful computers at completing such simple tasks as identifying objects in photographs—something children can do even before they learn to speak.

When we think of interfaces between human beings and computers, we usually assume that the human being is the one requesting that a task be completed, and the computer is completing the task and providing the results. What if this process were reversed and a computer program could ask a human being to perform a task and return the results? What if it could coordinate many human beings to perform a task?

Amazon Mechanical Turk provides a web services API for computers to integrate "artificial, artificial intelligence" directly into their processing by making requests of humans. Developers use the Amazon Mechanical Turk web services API to submit tasks to the Amazon Mechanical Turk web site, approve completed tasks, and incorporate the answers into their software applications. To the application, the transaction looks very much like any remote procedure call: the application sends the request, and the service returns the results. In reality, a network of humans fuels this artificial, artificial intelligence by coming to the web site, searching for and completing tasks, and receiving payment for their work.
And a blog about one person's experiences: Turk Lurker.

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Thursday, November 10, 2005

From Flickr: Volcano meets Ocean

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Hilarious Journal Articles #26: Trained Wasp Hounds

From the Washington Post:
A team in Georgia has built a tiny device that uses trained wasps to detect specific odors -- a prototype "biological sensor" capable of sniffing out anything from chemical warfare agents to corpses.

Five fly-size parasitic wasps -- which don't sting -- are placed in a disk-shaped chamber about the size of two stacked checkers, with a hole in the bottom and a tiny fan that sucks air into the disk. If the wasps detect the suspect odor, they gather around the hole, creating a cluster of pixels for a tiny webcam that sends an alarm signal.

Entomologist W. Joe Lewis of the Agriculture Department's Agricultural Research Service said he and colleagues have known for nearly 20 years that, with a reward of sugar water, wasps can be trained in as little as five minutes to respond to almost any odor.
From Biotechnology Progress:
Behavioral Monitoring of Trained Insects for Chemical Detection

A portable, handheld volatile odor detector ("Wasp Hound") that utilizes a computer vision system and Microplitis croceipes (Cresson) (Hymenoptera: Braconidae), a parasitoid wasp, as the chemical sensor was created. Five wasps were placed in a test cartridge and placed inside the device. Wasps were either untrained or trained by associative learning to detect 3-octanone, a common fungal volatile chemical. The Wasp Hound sampled air from the headspace of corn samples prepared within the lab and, coupled with Visual Cortex, a software program developed using the LabView graphical programming language, monitored and analyzed wasp behavior. The Wasp Hound, with conditioned wasps, was able to detect 0.5 mg of 3-octanone within a 240 mL glass container filled with feed corn (2.6 × 10-5 mol/L). The Wasp Hound response to the control (corn alone) and a different chemical placed in the corn (0.5 mg of myrcene) was significantly different than the response to the 3-octanone. Wasp Hound results from untrained wasps were significantly different from trained wasps when comparing the responses to 3-octanone. The Wasp Hound may provide a unique method for monitoring grains, peanuts, and tree nuts for fungal growth associated with toxin production, as well as detecting chemicals associated with forensic investigations and plant/animal disease.
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Patient Quote of the Day #2: Smoking

MD: Are you interested in quitting smoking?

Patient: I've been smoking since before you were born.

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Dying of Liver Cancer: Marjorie Williams in Slate

From Slate:
Imagine being told, at 43, that you have a few months to live. And imagine—among other things—that you have a career deepening in new ways, and two young children, a boy and a girl, who still believe that Santa Claus is real. The truth is, most of us can't imagine anything like it. But this is what Marjorie Williams, a Washington Post columnist who died last January at 47, describes in her extraordinary essay about being diagnosed with advanced liver cancer, "Hit by Lightning: A Cancer Memoir." It appears in The Woman at the Washington Zoo: Writings on Politics, Family, and Fate, a new collection of her journalism edited by Slate's Tim Noah, her husband. Reading the essay, one is rocked back on one's heels not only by the steady summoning of detail—including the split-second thrill she felt when the doctor first discovered a tumor—but by the fact that she wrote the essay in the first place. " 'I don't want to end my life in some hospital barfing in the name of science," " she recalls telling Tim. " 'I mean it: I want to be realistic about what's happening to me.' " And she was. The essay is the distillation of the gift that Williams, whom I never met, displays throughout the volume: total engagement inextricably connected to a comic detachment—a stoic determination to make the most of her tragic, and at times absurd, situation. ("I savored the things I'd avoid forever. I'll never have to pay taxes, I thought, or go to the Department of Motor Vehicles. … I won't have to be human, in fact, with all the error and loss and love and inadequacy that come with the job.")
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Smokers Quit and Blog About It

From the American Cancer Society:
On November 17, the day of the Great American Smokeout, smokers will attempt to stay smoke-free for 24-hours and blog all day long about the experience. You may read their blogs and post comments to them at The American Cancer Society hopes to show other college-age young adults that nicotine addiction is very real, anyone who smokes can become addicted and that quitting is harder than you think.
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A Map of the Katrina Diaspora

A map of the Hurricane Katrina diaspora is at Epodunk.

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Hilarious Journal Articles #25: Sex Differences In Brain Activation Elicited By Humor

From the Proceedings of the National Academy of Sciences:
With recent investigation beginning to reveal the cortical and subcortical neuroanatomical correlates of humor appreciation, the present event-related functional MRI (fMRI) study was designed to elucidate sex-specific recruitment of these humor related networks. Twenty healthy subjects (10 females) underwent fMRI scanning while subjectively rating 70 verbal and nonverbal achromatic cartoons as funny or unfunny. Data were analyzed by comparing blood oxygenation-level-dependent signal activation during funny and unfunny stimuli. Males and females share an extensive humor-response strategy as indicated by recruitment of similar brain regions: both activate the temporal-occipital junction and temporal pole, structures implicated in semantic knowledge and juxtaposition, and the inferior frontal gyrus, likely to be involved in language processing. Females, however, activate the left prefrontal cortex more than males, suggesting a greater degree of executive processing and language-based decoding. Females also exhibit greater activation of mesolimbic regions, including the nucleus accumbens, implying greater reward network response and possibly less reward expectation. These results indicate sex-specific differences in neural response to humor with implications for sex-based disparities in the integration of cognition and emotion.
(Via BoingBoing.)

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News from New York #16: Public Urination by New York City Marathon Runners

From the New York Daily News:
Brooklyn Heights nephrologist Dr. Neal Mittman stopped short of endorsing public urination, but said: "If you need to pee, I'm all for peeing. It's not good to hold it in. But maybe not when people with cameras are around."
Technorati Tags: New York City Marathon, New York Marathon

Wednesday, November 9, 2005

New England Journal of Medicine Podcast: Internal Medicine's New Recertification Requirements

The NEJM has an interview with Dr. F. Daniel Duffy on internal medicine's new recertification requirements.

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Gonorrhea Down, Syphilis Up, Chlamydia Up

Via RedOrbit:
Gonorrhea rates in the United States have fallen to their lowest level on record, but rates of two other sexually transmitted diseases, syphilis and chlamydia, are rising, federal health officials said Tuesday.

The rates, though of concern, are low compared with years ago. Still, an estimated 19 million new infections of sexually transmitted diseases, or STDs, occurred in 2004 at estimated health care costs of $19 billion, officials from the Centers for Disease Control and Prevention said.
Technorati Tags: Gonorrhea, Syphilis, Chlamydia

Wednesday Recommendations: Doctors Research Group

Doctors Research Group GELSeal Eartips
Doctors Research Group Puretone Cardiology Stethoscope
Doctors Research Group Stethoscope Diaphragm

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Starbucks Notes #2

Upside down triple espresso con panna. Powerful, tasty, and cheap.

Coffee, High Blood Pressure, and Death

Good news. In a recent study in JAMA, coffee was not associated with high blood pressure. Drinking too much, however, can still kill you.

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Tuesday, November 8, 2005

Hilarious Journal Articles #24: "Honeymoon Meningitis"

From the Emergency Medicine Journal:
Streptococcus agalactiae is a rare cause of meningitis in healthy non-pregnant adults. A case of S. agalactiae meningitis is reported in a previously healthy young woman following sexual intercourse for the first time. The vaginal flora was the verified source of infection...
Technorati Tags: Meningitis, Streptococcus, Honeymoon Meningitis, Hilarious Journal Articles

A Plan To Kill MRSA And Other Resistant Bacteria By Using... Viruses?

Via RedOrbit:
HOSPITAL superbugs could be all but wiped out in ten years by viruses that are harmless to humans, say Scottish scientists.

Dr Mike Mattey and a team of researchers at Strathclyde University have come up with a new method of tackling bugs such as the killer MRSA that does not involve using antibiotics.

They have patented a technique to allow bacteriophages - viruses which are the natural enemy of bacteria - to be used in normal cleaning products...
Technorati Tags: MRSA, Bacteriophages

Companies that Clone Dogs: Genetic Savings & Clone, ForeverPet and Perpetuate

From Salon:
In recent years, a trio of pet-cloning companies, Genetic Savings & Clone, ForeverPet and Perpetuate, have sprung up to meet the growing demand for carbon copies of Rex and Fluffy. Already the companies have a backlog of customers who have paid to store their pets' genes in the companies' freezers...
Technorati Tags: Cloning, Genetics, Dogs

News from New York #15: The TranStrap, a Strap for the Subway

From the New York Daily News:
A Boston inventor wants to put the "strap" back in straphanger for New Yorkers.

The TranStrap, which hooks over horizontal subway bars and has a nylon loop to grasp, offers subway and bus riders a steadier, less-germy ride...
Technorati Tags: TranStrap, Subways