Cleveland Botanical Garden in Summer

Cleveland Botanical Garden and Hershey's Children Garden in Summer

Click on the slideshow to see the full-size photos on Google Picasa. Read more about Cleveland Botanical Garden.

Last year, I used a service called Tabblo to upload photos from Cleveland Botanical Garden (see below). HP bought Tabblo earlier this year.

See my Tabblo

Medicine 2.0, Blog Carnival About Web 2.0 and Medicine, Year 1, Issue 9

This is the 9th edition of Medcine 2.0 -- a blog carnival about Web 2.0 and medicine. The archive is available here. A blog carnival is a blog event similar to a magazine dedicated to a particular topic. Each edition of a blog carnival is in the form of a blog article that contains links to other blog articles on the particular topic (source: Wikipedia). The carnival is also available as a slide show on Google Presentations.



How and Why to use Second Life for Education? ScienceRoll.com.
Berci Mesko explains why education has its golden age in Second Life virtual world.

100 Web Resources for Medical Professionals. Nursing Online Education Database | NOEDb.
If you are employed in the medical field or are currently studying medicine, the 100 Web sites collected by NOEDb may be a good place to start. One hundred web sites may be too many or not enough, depending on one's perspective. During one of my recent talks about Web 2.0 in Medicine with Cleveland Clinic residents, I mentioned that I subscribe to 600 web sites to which one of the residents replied: "I probably don't even know the names of 600 web sites..." You do not have to read 100, 600 or even 5 web sites. Do what interests you and suits your research profile. A journalist once asked one of the best hedge fund managers on Wall Street how he gets the latest up-to-the-minute news -- by email alerts,RSS or watching Bloomberg TV... "From yesterday's newspaper," the manager replied modestly. It is not the data, it is what you do with it.

World's First Human-Powered, Doctor-Guided Search Service for Health by OrganizedWisdom.
"The New Health Search Engine Weeds out Spam Sites, Redundant Links and Clutter by Using People to Find and Organize the Best Health Resources on the Web." Nothing beats the combination of UpToDate/Pubmed/Google in my opinion but who knows, may be OrganizedWisdom's WisdomCard is the answer for some people.

Google News Image View: Allergy. Allergy Notes.
The image view allows you to quickly browse through a visual display of news articles of your interest -- just substitute "allergy" in the search query with any other topic, for example, "cholesterol."

Surfing the waves of medicine-two-point-oh! Constructive Medicine 2.0.
What is the difference between Health 2.0 and Medicine 2.0? Industry vs. science? Scott Shreeve, M.D. also tries to define Health 2.0.

Medgadget's Guide to Hacking into Social Networks for Doctors. Medgadget.
Medgadget shows that an "ultra-exclusive physician network" can potentially be penetrated by non-physicians using publicly available data.

Video: A Brief History of Medicine (American Style). ScribeMedia.org.
A video homage to Michael Wesch’s Web 2.0… The Machine is Us/ing Us.

Health 2.0: User-Generated Healthcare Conference 2007. Health Care Law Blog.
Bob Coffield live-blogged the conference: "... there was an incredible amount of excitement and enthusiasm around what is happening as this group tries to figure out how best to position themselves and their companies in this new non-traditional health sector. I was also struck by the fact that many of those who have jumped in with new ventures have done so as a result of a personal family health story or a frustration with how they were treated by the current health care system."

My Talk on "Health 2.0" for the 5th Annual Healthcare M&A and Corporate Development Conference. The Efficient MD.
Joshua Schwimmer, M.D. shares the transcript of his talk as a part of the panel titled "Healthcare 2.0: Technology & Healthcare Services of the Future."

Are Physicians Marginalized in Health 2.0? John Sharp.
Yes, they may be marginalized but this is not unexpected. Most physicians are too busy seeing patients (and writing guides how to penetrate unprotected social networks). By the way, anybody can start a social network now on Ning.com. UOP and one of the Boston schools already did.

Social Bookmarking for Physicians. DavidRothman.net.
David Rothman, one of the most productive blogging medical librarians, writes about PeerClip, the newest contender for the title of “Digg for Medical Literature.” Maybe it would be better to call it a “Digg/del.icio.us for Medical Literature.”

Web 2.0 in Medical Education. Medical Education Blog.
A good collection of links. One example of using a blog for medical education is shown below.

Topics Discussed During the Internal Medicine Rotation at Cleveland Clinic in September 2007. Clinical Cases and Images - Blog.
A blog can be used as an educational portfolio for both personal learning and teaching.

How to create a blog carnival: Step by Step. ScienceRoll.
If you like (or don't like) this edition of the carnival, Berci Mesko explains how to start your own on any topic you choose.

The next edition of Medicine 2.0 will be hosted at HighlightHealth on October 14, 2007.

Image source: ScienceRoll, a Creative Commons License.

Updated: 01/04/2008

Miguel de Cervantes, Author of Don Quixote

According to Writer's Almanac:

September 29 was the likely birthday of Miguel de Cervantes, "whose life was a series of misfortunes. As a young man, he fought in a war against the Ottoman-Turkish Empire, and he became a war hero, receiving special recognition from the king. But on the way home from the war, he was captured by pirates, held for ransom for five years, and chained to a wall for months at a time. He finally made it back to Spain, where nobody even remembered the battle he had fought in.

In 1595, he was charged with embezzlement, even though he was probably one of the only honest employees working for the government at the time. Having escaped five years of captivity in Africa, Cervantes now found himself imprisoned in his own country for a crime he didn't commit.

And it was in prison that Cervantes first got the idea for his masterpiece, Don Quixote..."

Being imprisoned twice while he did not do anything wrong, Miguel de Cervantes wrote this famous quote from Don Quixote:

"Freedom, Sancho, is one of the most precious gifts that heaven has bestowed upon men; no treasures that the earth holds buried or the sea conceals can compare with it; for freedom, as for honor, life may and should be ventured; and on the other hand, captivity is the greatest evil that can fall to the lot of man."

Writer's Almanac is one of the podcasts I subscribe to in Google Reader and try to listen to daily. The feed URL is below:

http://www.npr.org/rss/podcast.php?id=510101

References:
Don Quixote, from Wikipedia, the free encyclopedia.
Best Web Feeds Reader for Medical and General Information
Image source: Wikipedia, public domain.

Professor with pancreatic cancer gives his last lesson on life

According to Pittsburgh Post-Gazette:

"Randy Pausch is a 46-year-old computer science professor who has incurable pancreatic cancer. It's not that he's in denial about the fact that he only has months to live, he told the 400 listeners packed into McConomy Auditorium on the campus, and the hundreds more listening to a live Web cast."


WSJ video

After months of experimental chemotherapy at M. D. Anderson Cancer Center, Dr. Pausch had one of the most aggressive recurrences his doctors have ever seen and reportedly has only a few months to live.

"With his oldest son, 5-year-old Dylan, Dr. Pausch went on a recent trip to Disney World and to swim with dolphins, thinking Dylan may be the only child who will have strong direct memories of him."

"If I don't seem as depressed or morose as I should be, sorry to disappoint you," he said during his lecture.

References:
Randy Pausch's Cancer Update page. CMU.edu.
CMU professor gives his last lesson on life. Pittsburgh Post-Gazette.
A Professor’s Farewell Sparks a Media Frenzy. NYTimes, 11/2007.
Link via Kevin, M.D.

Related:
Keeping Priorities Straight, Even at the End. NYTimes, 04/2008.
A Final Farewell. WSJ, 05/2008.
Randy Pausch’s Last Lecture Video Available with Transcript & Slides. Digital Inspiration, 08/2008.

Updated: 08/14/2008

Doctors in 1950s Cigarette Ads: How Times Have Changed

1949 TV commercial: More Doctors Smoke Camels Than Any Other Cigarette

How times have changed... Click here to visit the web site for Smash The Ash campaign supported by Cleveland Clinic.


Quit Smoking Videos on YouTube

References:

Doctors Recommend Smoking Camels. Old-Time.com.

Related reading:

What cigarette do you smoke, Doctor? Respectful Insolence, 10/2007.
FDA Regulation of Tobacco — Pitfalls and Possibilities. NEJM Volume 359:445-448 July 31, 2008 Number 5.
When Doctors, and Even Santa, Endorsed Tobacco. NYTimes, 10/2008.
Top 40 Creative Ads Made to Stop You Smoking. Bored Panda, 2009.
"Cocaine for toothache" and other ads that would never be allowed now http://goo.gl/eeYX3 - Cocaine was sold over the counter in the U.S. until 1914.
The Physician in US Cigarette Advertisements, 1930–1953 (illustrated review) http://1.usa.gov/VcuA7W via @Skepticscalpel

A Hospitalist Night On Call

FatDoctor (her choice of pseudonym, not mine) is a hospitalist who had an eventful night on call and post-call day but she liked it. Here is the summary:

15 hours worked
1 direct admit
1 consult
9 ER admissions
38 calls from nurses
5 problems that needed immediate attention
13 moments of laughter with nursing staff
0 code
0 rapid responses
1 “stat medical consult” as I was on way out to parking lot

Read the rest in But, Who’s Counting? by FatDoctor.org. She also writes: "My work at urgent care and as a hospitalist is like the Jiffy Lube of healthcare. We can change your oil, but for real care, better see your PCP."

Further reading:
Practicing cost-effective medicine. One clinician's top 10 tips. Robert M. ACP Hospitalist, 2007.
Achilles Heel. FatDoctor.org.
Lube Job. FatDoctor.org.
Some Tips from a Hospitalist. FatDoctor.org.
In the Fatosphere, Big Is in, or at Least Accepted. NYTimes, 01/2008.

Updated: 01/21/2008

Unconventional Medical Textbooks: Mind Maps and Visual Mnemonics

Generally, I find self-made notes, mnemonics and mind maps useful when studying but was surprised to find out the number of unconventional textbook published in the last few years focused on using such tools. A short list is assembled below:

Mind Maps Books

Mind Maps in Medicine by Peter MacDermott, David Norman Clarke. 1998, Elsevier Health Sciences.
Google Books, $35
Elsevier Health Sciences
Amazon.com, $ 45.

Mind Maps in Pathology by Peter A. Dervan, Michelle Harrison. 2002, Elsevier Health Sciences.
Google Books, $35
Elsevier Health Sciences
Amazon.com, $ 32.

Books from Visual Mnemonics Series (VMS)

Visual Mnemonics for Pharmacology by Laurie L Marbas - 2002.
Google Books.
Amazon, $ 25.

Visual Mnemonics in Pathology by Laurie Marbas
Google Books.
Amazon, $ 27.

Other books included in the VMS are Visual Mnemonics for Physiology and Related Anatomy, Visual Mnemonics for Microbiology and Immunology, Visual Mnemonics for Biochemistry, and Visual Mnemonics for Behavioral Sciences.

Mnemonics Books

Medical Mnemonic Comics - Respiratory Diseases by Sotiri Athanasakis.
Self-published on Lulu.com, $ 27.
Google Books.

Mnemonics for Medical Students by Khalid Khan.
Amazon, $14.

Differential Diagnosis Mnemonics by Thomas J. Donnelly and Christopher C. Giza.
Amazon, $ 26.

References

Developing the medical mind. BMJ 7159 Volume 317, 5 September 1998.
Modern Education: Mind Maps and Second Life. ScienceRoll.com.
Image source: Mind Maps in Medicine by Peter MacDermott, David Norman Clarke. 1998, Elsevier Health Sciences.

Related reading

Medical profession's use of mind mapping - WikIT http://goo.gl/1Kjd
Can images (mind maps, infographics) stop data overload? Symptom of the computer age: overwhelmed, we delay decisions http://goo.gl/URMKm

Medical Mind Maps by the Wikipedia user Madhero88, a 3rd year Medical Student from Jordan.

Note taking with mind maps did not improve the scores of medical students (study)http://goo.gl/8qeQ
Medical Mnemonics
Study claims mind maps don't help learning - "you should just take tests" - NYTimes http://goo.gl/kvdSZ and http://goo.gl/6ql7n
University of Cambridge shows high-resolution Newton notebooks online. He used mind maps - check Trinity College Notebook, image 5.

Video: What is a mind map?

"What is a mind map" video by Tony Buzan

The psychologist Tony Buzan is one of the first proponents of the techniques of mind mapping. He launched his own software program to support this learning approach called iMindMap in 2006 and claims a trademark on the phrase "Mind Maps."

Buzan developed his own style of mind mapping whilst at University of British Columbia, out of the frustration that traditional notes took up so much time to create and review. He has argued that mind maps are a more efficient way to take notes from lectures or books.

I do not think he will be able to trademark the term "mind maps. " Tim O'Reilly's supposed claims to ownership of 'Web 2.0" proved fruitless and the fate of the trademark claims to "mind maps" will not be much different . While I don't agree that "curved links are better than straight lines in mind maps," Tony Buzan's work definitely deserves some attention.

Bubbl.us is currently one of the best web-based tools for mind map creation. It is free and allows seamless import/export and interoperability with other mind mapping software.

References:
Tony Buzan, from Wikipedia, the free encyclopedia.
Nobody Owns "Web 2.0" Because It's Yours. CasesBlog, 2006.
Mind Maps in Allergy and Immunology. AllergyCases.org.
How to Use Bubble.us to Make 2008 Your Most Productive Year Ever. LifeHack.org, 01/2008.

Related:
Video: Getting started with mind mapping podcast now available. The Mind Mapping Software Weblog, 02/2008.

Medical profession's use of mind mapping - WikIT http://goo.gl/1Kjd
Tony Buzan's Mind Mapping Videos.
Five Best Mind Mapping Applications. Lifehacker, 2009.
Medical Mind Maps by the Wikipedia user Madhero88, a 3rd year Medical Student from Jordan.
ICU Mind Maps http://bit.ly/1VIVOi and http://bit.ly/2EnZLi

Note taking with mind maps did not improve the scores of medical students (study) http://goo.gl/8qeQ
Study claims mind maps don't help learning - "you should just take tests" - NYTimes http://goo.gl/kvdSZ and http://goo.gl/6ql7n

Clinical Case: Sick euthyroid syndrome

A 57 yo female was admitted to the hospital with multilobar pneumonia.

On hospital day 2, thyroid function tests showed low levels of TSH, T4 and T3.

What is the most likely diagnosis?

Read more in Sick euthyroid syndrome in a patient with multilobar pneumonia on ClinicalCases.org.

Image source: Thyroid histology, Wikipedia, public domain.

Use Blogger.com to Make Video Podcasts for Free

InsideGoogle points out that video upload is now a feature of Blogger.com, owned by Google:

"Videos do not count against your limited free storage space for images. They are automatically added as enclosures in posts, so every blog using them is also a video podcaster and compatible with most podcatchers. In other words, people can subscribe to your blog in software like iTunes and automatically download the latest video."

I would be happy to see my favorite medical/science bloggers start producing videocasts by using this simple (and free) method.


This Google video shows that it takes about 2 minutes to start a blog on Blogger.com. Creating a web site has never been easier.

Visual Medical Dictionary Creates Mind Maps of Related Medical Terms

Visual Medical Dictionary by CureHunter Inc. can create mind maps of related medical terms. It is similar to WikiMindMap but somewhat more reliable since it is based on Medical Subject Headings (MeSH).

For example: a search for "obesity" will show a strong relationship with "insulin" and "exercise" among other terms -- see the image on the right.

Try other searches to see how the visual dictionary creates interactive network graph of related diseases and therapies.

It would be interesting to see if this type of visual tools and mind maps created on the fly will supplement regular PubMed searching strategies. Visual search engines like Kartoo are still far from replacing the plain Google interface.

Related:

Medical profession's use of mind mapping - WikIT http://goo.gl/1Kjd

Study claims mind maps don't help learning - "you should just take tests" - NYTimes http://goo.gl/kvdSZ and http://goo.gl/6ql7n

José Mourinho Leaves Chelsea with a String of Memorable Quotes

José Mourinho, the now former manager of the famous English soccer club Chelsea, is a talented coach and quite a character. Whether you like him or not, some of his sound bites proved memorable (see right).

Note: American soccer is called football by the rest of the world.

References:

Mourinho and Abramovich: The special one versus the tsar of limitless roubles. Daily Mail.
Top Soccer Players Are Seen to Have Superior Brain Function - NYTimes, 2012 -- Good to know, NYT.
Image source: Daily Mail.

Clinical Case: Central retinal artery occlusion (CRAO)

A 83-year-old female was admitted with sudden painless loss of vision in her right eye which started last nigh. She had a hip replacement surgery 2 weeks ago.

What is the most likely diagnosis?


BRAO (Branched Retinal Artery Occlusion). Multiple yellowish refractile bodies can be seen scattered throughout the arterioles in the superior arcuate region. Source: University of Iowa allows visitors/health care professionals to duplicate portions of the site for personal or educational use without seeking permission from the authors.

Read more in Sudden painless loss of vision in an elderly female due to central retinal artery occlusion (CRAO) on ClinicalCases.org.

Killer in the Lake -- Amoeba Called Naegleria

According to CNN, "something in the lakes around Orlando, Florida, has claimed the lives of three boys this summer." This thing is just there. It's lurking like some deadly thing in the water which can take our children's lives and we all have to be aware," said Orange County Health Department Director Dr. Kevin Sherin." See the video.

WSJ Health Blog has an informative post on the subject: A Deadly Amoeba Lurks in Florida.

Naegleria fowleri is a free living amoeba typically found in warm fresh water. It can can cause Primary Amoebic Meningoencephalitis (PAM or PAME) in humans characterized by rapid onset of coma and death.

Currently, there is no consistently effective treatment. Swimming in or jumping into fresh water is best avoided. Chlorinated swimming pools are safe from the perspective of contracting PAM.

References:
Deadly amoeba lurks in Florida lakes. CNN.
6 Die From Brain-Eating Amoeba in Lakes. Associated Press, 09/2007.
Image source: Wikipedia, public domain.

Related:
Brain-Eating Amoeba Strikes in Summer. WebMD, 05/2008.

Updated: 05/28/2008

Google Presentations Launches Today

Google Presentations looks good, simple and easy to use. The biggest limitation is that you cannot export the online presentation to PowerPoint (yet). Google cleverly circumvented this by exporting to zip/HTML which allows the presentation to be run locally on any computer without the need to install PowerPoint or similar programs.



See a sample new presentation here along with my old presentation on Web 2.0 in Medicine from 2006 (uploaded PowerPoint file).

I have linked to several in-dept reviews in the reference section below but Geeking with Greg provides the best summary:

"Stepping back and looking at the bigger picture here, I find myself getting to the point where my entire day is spent in the browser. Even on machines where I have Microsoft Office installed, I often find it faster to quickly view documents using the GMail integration with Google Docs than open other applications.

I was skeptical that Google would get us to that point, but they have. Google appears to be making remarkable progress chipping away at the utility of a desktop PC environment."


Google Docs in Plain English

References:
Google Presentations Finally Launched. Google Operating System.
Google Presentations Released. Philipp Lenssen.
Say Hello to Google Presentations. PStam.com.
Google Presentations a quick review. Google Tutor.
Google launches presentations, but shouldn’t have. Googling Google.
How To Embed Google Presentations. InsideGoogle.
Our feature presentation. Google Blog.
Google's PowerPoint launches. Geeking with Greg.
Matt Cutts: Gadgets, Google, and SEO. Matt Cutts.
Image source: Google Operating System, a Creative Commons Attribution license.

Related:
Google Docs & Spreadsheets Could Replace Word & Excel for the Average User
Adobe joins rest of industry in going for Microsoft’s throat. Scobleizer.com, 09/2007.

Updated: 09/30/2007

GruntDoc: Now you know a little more about me. Sorry ’bout that.

GruntDoc, a pseudonym for an emergency physician in Texas and one of the most popular medical bloggers, shares 8 things about himself in:

Admit eight things about yourself

He does not watch TV (apart from Scrubs) and does not need an iPod. "So, now you know a little more about me. Sorry ’bout that."

Related:
Interesting Blog Posts from GruntDoc
My Third TV Appearance. GruntDoc, 02/2008.
Image source: GruntDoc, a Creative Commons License.

Updated: 02/03/2008

Salary Stories: Hospitalist

Salary Stories Blog has an interview with Frank L. Urbano, MD, FACP who is also the author of several case studies on PrimeInc.org:

"I typically see between 20 to 30 patients per day, and that allows me to have a generous hospitalist compensation package. Hospitalist practices generally have very small overhead compared to outpatient offices, so hospitalist salaries can be higher."

Another hospitalist by the blog name of FatDoctor writes: "My work at urgent care and as a hospitalist is like the Jiffy Lube of healthcare. We can change your oil, but for real care, better see your PCP."

Related:
Definition of "Hospitalist" Added to Merriam-Webster Dictionary
Another Study Questions the Value of Hospitalists
Physician Assistant Salaries: A Day in the Life of a Physician Assistant. Salary Stories.
Lube Job. FatDoctor.

Updated: 10/02/2007

Clinical Cases: Allergies to Bee Sting and Intravenous Contrast

Two allergy and immunology cases from AllergyCases.org:

Anaphylactic Shock Due to Bee Sting

Allergic Reaction to Intravenous Contrast

Image source: Wikipedia 1, 2, GNU Free Documentation License.

5 Quick Fixes for Physician Resume and More Career Advice from Doctor Job Blog

The Doctor Job blog has some useful tips for making physician resumes more attractive to prospective employers. According to them, of the two examples below, B is a much better format than A.

Example A:

1999-2003, St. Francis Hospital, Queens, NY, Internal Medicine Resident

Example B:

Internal Medicine Resident, 1993–2003
St. Francis Hospital, Queens, NY

More links:
Structuring Your Resume for Success
Resume advice for visa holders
Why your resume annoys employers. CNN, 08/2007.
How to Construct a Killer Resume, From Start to Finish. The Simple Dollar, 11/2007.

Updated: 11/09/2007

Seniors Have Fun: Adventures in Dentures

According to some ratings, HealthBolt is the most popular health-related blog and this may be well-deserved if they keep discovering videos like the one below:


An elderly lady loses her dentures while sky-diving

ScienceRoll recently interviewed the author of HealthBolt.

Topics Discussed During the Internal Medicine Rotation at Cleveland Clinic in September 2007

September is one of my inpatient teaching months and we decided to assemble a list of topics for feedback and later reference. This is a list of the topics discussed during the internal medicine rotation with residents and medical students at Cleveland Clinic:

Guidelines for treatment of DVT/PE
Central retinal artery occlusion
Treatment of hyponatremia with ADH receptor antagonists
Treatment of DKA and hyperosmolar state
Sick euthyroid syndrome
Treatment of uric acid nephrolithiasis
Treatment of VIP patients
Idiopathic CK elevation
Different IV catheters and related complications
"Salami" paper and scientific conduct
Non-anion gap acidosis
RTA type 1, 2, 4
DKA labs with effect of treatment walk-through
Pleural effusion - transudate vs. exudate
Digoxin toxicity case 1, case 2, case 3
Treatment of Hyperkalemia
Guidelines for transfusion in sickle cell disease, Hgb goal?
Iron overload due to blood transfusions in sickle cell disease
Web 2.0 in Medicine (Google Presentation)
Blogs for medical students, CCLCM blog

Future topics:
Diagnosis and treatment of acute chest syndrome
Treatment of Hypokalemia
Hypernatremia
Guidelines for treatment of elevated INR due to Coumadin
DM gastroparesis and botulinum injections
SIADH

The list will be updated periodically as new topics are added by the end of the month. As you can see from the links above, a blog can be used as an educational portfolio for both personal learning and teaching.

Further reading:
Using a Blog to Build an Educational Portfolio. CasesBlog, 1/2007.
Becoming a Clinical Assistant Professor of Medicine and Web 2.0 Projects. CasesBlog, 10/2006.

Updated: 09/19/2007

Medscape Video Editorial on "Pimping" Medical Students

Christine Wiebe of Medscape has recorded an interesting video editorial on "pimping" or "hazing" of medical students (free subscription required):

"Pimping" students on hospital rounds is an age-old practice that forces them to be prepared and to think on their feet. At some point, however, the "tough love" approach to medical training crosses the line into abuse."

She quotes a medical student blog:

"It seems that the first thing they do to us on entering school is to strip us of our soul... Before you realize it, the sweet and caring person who once chose this course to care for human life, turns into a monster that couldn't care less for the human. . . "

As a disclaimer, I do teach medical students and residents at Cleveland Clinic but I have never done nor I am planning to do any "pimping," which can be broadly defined as making somebody uncomfortable by asking questions in a certain way. I generally try to ask stimulating questions in a friendly and non-judgmental atmosphere which I believe promotes better learning and work relationship.

Related:
Asking: Or Is It Pimping? Doc Gurley, 08/2008.
Image source: Medscape.

Updated: 09/02/2008

Adam Bosworth, Google Health Architect, Leaves Google

Google Health has reportedly been in the works since 2004 but has not been released yet.

Google responded to the news published by Search Engine Land with this statement:

"Adam is a great talent and was instrumental in starting Google Health. He is now on vacation and has decided to pursue other opportunities after that. Marissa Mayer is taking over the health team in the interim until a new team leader takes over. Google is moving forward with work on our health products."


Adam Bosworth talks about GoogleHealth. Image source: AlphachimpStudio, a Creative Commons license.

InsideGoogle points out that "Bosworth was a great hire for Google. Google hired him in July 2004 from BEA System. Previously, he had worked for Microsoft, designing Microsoft Access and running the team that built Internet Explorer 4’s HTML engine. At Borland, Bosworth developed Quattro spreadsheet application. Bosworth is one the pioneers of XML, and you could even say that he is responsible for a little thing called AJAX."

Adam Bosworth lasted at Google 3 years as a Vice President but no major health-related product was released during that time.


A leaked screenshot of Google Health. Image source: Philipp Lenssen, a Creative Commons license.

According to InsideGoogle: "Adam Bosworth was able to deal with Microsoft and ship Access and IE4. He was able to deal at Borland and ship Quattro. Bosworth was able to ship at every company he worked at and produce hit products and market changers. But not at Google. Whose fault do you think that is?"

Related:
Google Health is Part of Google Co-op
Would you like to see Dr. Google or Dr. Microsoft for your personal health records?
BMJ: Build Google Medicine
Custom Google Search Engines to Help Patients Find Reliable Medical Information

Using Second Life Virtual World to Teach Medicine

ScienceRoll.com has several interesting posts about the potential use of Second Life virtual world for medical education:

How and Why to use Second Life for Education? ScienceRoll.com, 9/2007.

Virtual Medical Center: the Future of Medical Education. ScienceRoll.com, 4/2007.

Live Blogging Today: First Medical Simulation in Second Life! ScienceRoll.com, 8/2007.

CDC already have a presence in Second Life.


SecondLife video: Listen to a virtual patient’s chest to learn about heart sounds

According to SecondLife founder: "Many firms and educators were starting to use Second Life as an online collaboration space that helps them work together like they do in the real world but to which is added the malleability of a wholly digital space."

References:
"Second Life" Lets CDC Be Everywhere—All at Once. CDC.
Second Life and medicine. KevinMD, 04/2007.
Attending medical school in virtual reality. StudentBMJ, 12/2007.
A very real future for virtual worlds. BBC, 12/2007.

Updated: 12/15/2007

Aggregated Lifestream Combines All Content Created by You Into One Site/Feed

Steve Rubel has an interesting idea:

"I am posting to Flickr, del.icio.us, Twitter and Facebook. I also have tons of other less active accounts too - Digg, Blogger, MySpace, YouTube, MSN Spaces, Yahoo 360, Jaiku, Pownce and on and on.

I have set up a tumblelog at my personal domain at www.steverubel.com. It rolls up my blog, del.icio.us links, Flickr, Facebook notes and Twitter tweets all in one place.

I really like that there is a single place attached to my name that rolls up all of the content that I am publishing online. I also like that in just a couple of clicks I can set up a river of news that I can share at the domain of my choosing.

Aggregated Lifestreams could be the next big thing on the web."

For example, Joshua Schwimmer is a nephrologist from NYC who maintains 3 blogs: Kidney Notes, The Efficient MD and Tech Medicine Blog. He is using Twitter with Twitterfeed to tie together all 3 of them along with Facebook.

References:
Identity Through Online Lifestreams. Micro Persuasion, 08/2007.
Twitter and Twitterfeed Explained. Kidney Notes, 09/2007.
Image source: Knot, OpenClipArt.org, public domain.

Luciano Pavarotti Dies at 71: "Heaven Now Has a Tenor"

Luciano Pavarotti, the most famous opera singer of our age, died at 71 of pancreatic cancer. The CNN headline "Heaven Now Has a Tenor" reflects the great admiration millions have for the singer.

Listen to the NPR coverage along with their choice of 7 Pavarotti recordings you must hear. During a tenor's high C, his vocal folds close 500 times a second; for a soprano's high C, the rate is about 1,300 times each second (source: Slate.com).


Luciano Pavarotti Sings Ave Maria by Schubert

According to Wikipedia, "Pavarotti was diagnosed with pancreatic cancer in July 2006 and required emergency surgery to remove the tumor. Shortly after surgery he was reported to be "recovering well." On Thursday, August 9, 2007, he was hospitalized for observation in his hometown of Modena, in Northern Italy. On August 21, it was announced that he was being treated in the cancer ward, given tests related to his pancreatic cancer, and would not be released for another few days. On September 5, 2007, Italy's AGI news agency reported that Luciano Pavarotti's health had deteriorated and the 71-year-old singer was in a "very serious condition". He was reported to be in and out of consciousness multiple times, suffering kidney failure. Luciano Pavarotti died the morning of September 6, 2007 at home in Modena, Italy where he was surrounded by his wife, sister, and four older daughters. In an email statement, his manager, Terri Robson, wrote, "The Maestro fought a long, tough battle against the pancreatic cancer which eventually took his life. In fitting with the approach that characterized his life and work, he remained positive until finally succumbing to the last stages of his illness."


James Brown & Pavarotti

Further reading:
Profile: Luciano Pavarotti. NPR.
Tenor Luciano Pavarotti dead at 71. CNN.
A Patient with Pancreatic Cancer Presents with 30-lbs Weight Loss Over 3 Months. Clinical Cases and Images, 03/2005.
'He Loved Us As We Loved Him' - Luciano Pavarotti, 1935-2007. UBC Academic Search - Google Scholar Blog.

Updated: 12/01/2007

Build An Online Version of Your Library and Share It Via Google Books

The new version of Google Books offers a few tools which will likely have an impact on the future of medical education. This Google service helps you:

- Create your own virtual library online
- Review the books
- Share the list
- Let people subscribe via RSS and get updated when you add new books
- Search within the books you selected

The newly launched version of Google Books makes all that possible and more.

For example, a residency program or a medical school can create a list of recommended books which can be reviewed online by faculty, residents and medical students. Click here to see a sample medical library I assembled today in 5 minutes (a screenshot is shown above).

You have to be signed in with a Google account in order to create your own library.


My Interview With Google Discussing Google Book Search. The Efficient MD.

Further reading:
An Online Version of Your Library. Google Operating System.
Build Your Virtual Library Online with Google Book Search. LifeHacker.com.
Your Own Google Books Library, and More. Google Blogoscoped.
Google Book’s “My Library” and More. Googlified.
Using Google Book Search for Effective Point-Making. EfficientMD.com.
Google Book Search and Medical Education. Tech Medicine, 02/2008.

Updated: 02/28/2008

Clinical Case: Digoxin Toxicity

A 96-year-old female was admitted from a nursing home with complaints of abdominal pain, N/V, dizziness, confusion and double vision for 5 days.

Digoxin was started during a recent hospitalization for control of tachycardia in atrial fibrillation.

What is the most likely diagnosis?

Read more in Digoxin Toxicity in an Elderly Female on ClinicalCases.org.

Image source: Chemical structure of digoxin, Wikipedia, public domain.

Stock market is not working well for an oncologist/amateur investor

WSJ/Yahoo Finance:

"By day, Brian Abbott is a doctor at a cancer institute in Great Falls, Mont. In his off hours, he invests with borrowed money, shorts stocks and has taken a complex options position called a "short strangle" on wheat. Rather than protecting his $1 million or so in holdings, the 35-year-old physician says he left it vulnerable.

"Things that should have protected me weren't working," Dr. Abbott says of the market in recent weeks. "Everything was seeming to go down."

References:
Small Investors, Too, Get Nailed by Arcane Trades. Wall Street Journal, 08/2007.
When Bad Strategies Outperform. Seeking Alpha, 11/2007.
After a Devastating Trading Loss. TraderFeed, 11/2007.
Image source: Wikipedia, GNU Free Documentation License.

Related:
How Much Do You Save? The Happy Hospitalist, 01/2008.
How to become a stock broker. The Independent Urologist, 02/2008.

Updated: 01/24/2008

Available Online: Proceedings of Cleveland Clinic Perioperative Medicine Summit in CCJM

The Proceedings of the 3rd Annual Perioperative Medicine Summit at Cleveland Clinic are available online at the Cleveland Clinic Journal of Medicine (CCJM) web site. The access to all CCJM articles is free of charge.

The summit is one of the premier annual events in the field of perioperative medicine and has the strong support of the Department of Hospital Medicine. I have been involved as a faculty member since the beginning and launched the summit web site in May 2007 at PeriopMedicine.org. See the slide show from last year's summit below.



Cleveland Clinic has one of the busiest perioperative centers in the world - the Internal Medicine Preoperative Assessment Consultation and Treatment (IMPACT) Center has 13-15,000 patient visits per year.

My contributions to this year's proceedings include one article and 8 abstracts. Among the abstracts were Systematic Approach to Interpreting Electrocardiograms by Using Two Mnemonics and expanded versions of several of the perioperative cases in CKD.

References:
Proceedings of the 3rd Annual Perioperative Medicine Summit, Cleveland Clinic, September 10-12, 2007, CCJM.
A Systematic Approach to Reading Electrocardiograms by Using 2 Mnemonics. V. Dimov, Clinical Notes, 05/2001.
Preoperative Care of Patients with Kidney Disease. V. Dimov, Clinical Cases and Images, 05/30/2006.

How Do You Treat VIP Patients?

Medscape Roundtable Discussion: How Do You Treat VIP Patients? If a patient is a "very important person" (VIP), do you treat them differently?

The participants are 3 well-known medical bloggers: Robert Centor, Nicholas Genes, Graham Walker, and Theresa Polick, RN. There are some useful thoughts in the opinion pieces as well as in the open discussion at the end of the article.

I have treated several VIP patients and the most important thing to remember is to provide the usual care without cutting any corners. What often puts VIP patients in trouble is the false feeling that the usual rules do not apply to them, for example, let's take the shortcut and skip that routine chest X-ray prior to procedure x (put your choice of procedure here). This is never a good idea. I have read somewhere the story of a German (or Austrian) king who always insisted be admitted under a false name on a regular floor and not be given any special treatment. He was smart enough to know that was the best way to survive a hospital stay.

References:

How Do You Treat VIP Patients? Medscape Med Students, Roundtable Discussion, 07/17/2007.
Another Medscape roundtable. DB’s Medical Rants, 07/2007.
Image source: Dannyman, Flickr, a Creative Commons license.

Related reading:

Dennis Quaid’s Kids: Are VIPs Safer? Wachter's World, 11/2007.
I’ll take $67 million to go with that, please! Notes from Dr. RW, 02/2008.
From Personhood to Patienthood. Physician turned patient describes himself as P.I.P. - Previously Important Person. OUP, 2012.
Treating celebrity patients not all glitz and glamour. AMNews, 2009.
Caring for VIPs: 9 principles by a Cleveland Clinic team who should know all about it. CCJM, 2011.

Map your blog network with TouchGraph

This is the map of the web sites which are linked to/linked by CasesBlog.

You can create a map of your blog network with TouchGraph. There are several other options to replicate this effect listed by PR Thoughts.

References:
Explore web connections with TouchGraph Google Browser. Download Squad.
Link via ScienceRoll.

How to stay healthy while traveling

There are several useful tips by 60 IN 3 blog (whatever that means), including:

"Bring your gym gear—Most hotels do have a gym. It may be small and under equipped but it's still a gym. A simple workout doesn't have to involve much equipment. Pushups, situps, lunges, squats and other exercises can be done with just body weight."

This is a mnemonic for exercises that can be done with just body weight: PLSS

P ushups
S itups
L unges
S quats


Exercises that can be done with just body weight: PLSS.

And finally, what 60 IN 3 means (from About Me page):

"For those of you who are asking about the title of the page, 60 in 3 represents my progress as well as my philosophy. I started on my path to a healthy life style in the beginning of 2004. At the time, I weighed 280lbs. By the end of 2006 I was down to 220lbs. That’s 60lbs in 3 years. I have 30 more lbs to go which I’m hoping to lose over the next two years. It sounds a bit slow, but for me, it was just right. I made slow and gradual changes to my life rather than go on any sort of quick fix diet. I also realized that it wasn’t about being thin, it was about being healthy."

According to a study reviewed by Science Blog, daily brisk exercise reportedly decreases the risk of pemature death by 70%. The study found that “highly fit” men had half the risk of death compared to “low fit” men. For every 1-MET increase in exercise capacity, the risk for death from all causes was 13% lower.

If you need any more convincing, please see this "health promotion" video that clearly shows the benefits of exercise:

"Health Promotion" video: Benefits of exercise.

References:
Health on the run: How to stay healthy while traveling. 60 IN 3, Fitness For The Rest Of Us.
Conceptual Yoga mat triples as stereo, display. Engadget.com. 08/2007.
Five ways to stay fit on business trips. CNN, 2007.
Link via LifeHacker.com.
Image done with Bubbl.us mind maps.

Further reading:
15 Tips to Restart the Exercise Habit (and How to Keep It). LifeHacker.com.
An Enduring Measure of Fitness: The Simple Push-Up. NYTimes, 03/2008.
29 Exercises You Can Do At (Or Near) Your Desk. LifeHacker.com, 03/2008.
The Five-Minute Prison Workout Keeps You Fit in Any Space. LifeHacker, 03/2009.
Valsalva haemorrhagic retinopathy after push-ups. Lancer, 02/2011.