Healthcare social media #HCSM - top articles

Here are my suggestions for some of the top articles related to healthcare social media (#HCSM) in the past 2-4 weeks:

'Like' Facebook's 'Year in Review' function? Many don't http://buff.ly/1rrmFpS - Facebook "Year in Review" feature highlights a larger digital design problem: Algorithms and code aren't intelligent, they just do what they're told.

Students distracted by electronic devices perform at the same level as those who are focused on the lecture http://www.ncbi.nlm.nih.gov/pubmed/25279260?

Using social media offers a host of practical benefits to the modern academic or public intellectual. Look for Powerful tweets that supply original analysis, theoretical insight or historical context. On a basic level, Twitter gets people, including non-­traditional audiences, reading your work. Apply the “billboard test”: imagine that anything you tweet is going to be put up on a sign for the world to see. http://buff.ly/1s3XRUh

Dr. Jeffrey B. Matthews, Professor and Chairman of the Department of Surgery at the University of Chicago: "I would have ZERO trouble convincing our promotions committee that a high visibility blog with high traffic views that had evidence of thought leadership in the public domain would qualify as high impact and outstanding. And that is at the University of Chicago." What do you think of the University of Chicago's progressive stance? Have any other schools taken such steps? http://buff.ly/1BPmIuP

'Instagram for doctors' to be launched in Europe http://buff.ly/1BPpiAS - Will be just as successful as "Facebook for doctors", etc.

Could you be a star blogger or vlogger? The Guardian features successful bloggers, still in high school http://buff.ly/1qwGchr

Utility of a dermatology interest group blog at University of Texas http://buff.ly/1sDvWLa

Ebola, Twitter, and misinformation: a dangerous combination? | The BMJ http://bit.ly/1xXmvFA

The Kardashian index: a measure of discrepant Tiwtter profile and publication record for scientists http://buff.ly/1sOwlZP

Orthopedic patients who use social media have researched their condition prior to visit and travel longer to clinic http://buff.ly/1vze8kj

Uses and abuses of Facebook: A review of Facebook addiction http://buff.ly/1vzeF5B "Some addicts use it to escape from negative moods"

Digital Junk: Food and Beverage Marketing on Facebook http://buff.ly/1vzeW8L - Food brands are hyperactive on Facebook...

The articles were selected from Twitter @DrVes and RSS subscriptions. Please feel free to send suggestions for articles to clinicalcases at gmail.com and you will receive an acknowledgement in the next edition of this publication.

Keeping HIV and AIDS in check - Deutsche Welle video

Keeping HIV and AIDS in check: Dr. Keikawus Arastéh is an internist at the Center for Infectious Medicine and HIV of the Berlin-based Auguste-Viktoria-Klinikum. He explains how to recognize an HIV infection, how to avoid contracting it in the first place, and what therapies help keep it in check.

How to relax - DW video

From Deutsche Welle (DW): Dr. Christian Kessler discussed stress and its harmful impact. What are some good ways to relieve stress and relax? And how can meditation help both body and mind cope with stress?

Healthcare social media #HCSM - top articles

Here are my suggestions for some of the top articles related to healthcare social media (#HCSM) in the past 2-4 weeks:

Social media and physicians: Exploring the benefits and challenges. http://buff.ly/1yNZ0iV

Are You Tweeting Away Your Relationship? http://buff.ly/1mN0rqH -- Imagine you invested 50 min a day actively listening to your loved ones.

Will the internet eat your brain? A neuroscientist warns Digital Technologies are Leaving their Mark on our Brains. The scientist is worrying that smartphones and social networks are sucking users into an unsatisfying digital facsimile of reality, frying their memories, atrophying their social skills and generally rotting their brains http://econ.st/1q9ENSr

Family Dinners May Buffer the Effects of Cyberbullying http://buff.ly/1w4ynog

Massive Open Online Courses (MOOCs) on Health and Medicine: Review of what is available http://buff.ly/YacKI4

The majority of You-Tube videos purporting to be about CPR are not relevant educational material http://buff.ly/Yad1L6

9 online safety tips every parent should do for their children - Never ban technology, Set up parental controls from the router and more http://buff.ly/Wbaz5s

Have You Checked Your Online Rating as a Pediatrician? If You Haven’t, Your Patients Probably Have! http://buff.ly/YeY9du

From Blogging to Tweeting to Facebook: researchers can share their successes and see what resonates with the public http://buff.ly/1DS9UHV

To earn money, many professional bloggers have had to embrace sponsored content, breeding distrust among readers. Advertising rates have dropped significantly because advertisers are flooded with options. http://nyti.ms/1BxVBEw

Surgeons are less engaged with social media than other Health Care Professionals http://buff.ly/ZpM7zq

Patients' search for online diagnoses not useful - Fewer than 5% of doctors felt it was helpful http://buff.ly/1tlx699

Google's Eric Schmidt: Medicine will expand its noninvasive technological capabilities, to a point where a transdermal patch might pick up on symptoms before the person does, such as early signs of Alzheimer's, or a troubled heartbeat. "Your phone will call you and say, 'You're going to die, and you need to go to the hospital," Schmidt said. "Then it will call the hospital and say, 'He's coming in 10 minutes" - Cleveland Plain Deale http://buff.ly/1uH6Lbi

The articles were selected from Twitter @DrVes and RSS subscriptions. Please feel free to send suggestions for articles to clinicalcases at gmail.com and you will receive an acknowledgement in the next edition of this publication.

What are those floaty things in your eye? Muscae volitantes

Sometimes, against a uniform, bright background such as a clear sky or a blank computer screen, you might see things floating across your field of vision. What are these moving objects, and how are you seeing them? Michael Mauser explains the visual phenomenon that is floaters.



Eye floaters are called muscae volitantes, Latin for “hovering flies". Floaters are visible because of the shadows they cast on the retina.

View full lesson: http://ed.ted.com/lessons/what-are-those-floaty-things-in-your-eye-michael-mauser

Related reading:

Your Eyes: Understanding Flashes and Floaters - Cleveland Clinic http://buff.ly/1zNgIr8

Top 10 cutest animal stories in science in 2014 - Nature video

From TV-watching marmosets to pretend baby penguins, this is Nature’s pick of the cutest animal stories in science this year:

Walking While Texting - National Geographic video

Texting shrinks peripheral vision to only 10%. "Cell phone use is on the rise and our eyes keep looking down. Try looking up and see what you've been missing."

Top medicine articles for December 2014

A collection of some interesting medical articles published recently:

What Kids Around the World Eat for Breakfast. “In many parts of the world, breakfast is tepid, sour, fermented and savory.” After birth, babies prefer the foods they were exposed to in utero, a phenomenon called “prenatal flavor learning” http://buff.ly/1tbjAYf

High Milk Consumption Linked to Higher Mortality in Adults, Without Fracture-Prevention Benefits http://buff.ly/1wET24c

90% of workers perform better when listening to music, different genres of music are better tailored to certain tasks http://buff.ly/1xE1RJK

A Push to Back Traditional Chinese Medicine With More Data. Researchers Marry Modern Analytical Techniques to Centuries-Old Theories on What Makes People Sick - WSJ. U.S. government has a budget of $120 million to fund research on the efficacy and safety of alternative medicines http://on.wsj.com/1tKufv1

What You Learn in Your 40s - We still have time for a second act, but we’d better get moving on it - NYTimes -- If you worry less about what people think of you, you can pick up an astonishing amount of information about them http://nyti.ms/1tKvI4r

Colon Cancer on the Rise for U.S. Adults Under 50. Reasons behind trend unclear http://buff.ly/1xw3eha

Gluten Isn't the Only Culprit in Celiac Disease - patients have immune reactions to 5 groups of non-gluten proteins http://buff.ly/1xw3soC

Long-term marijuana use may change brain structure - orbitofrontal "shrinkage" seen on MRIs. The more THC is introduced in the system, the brain responds by reducing the number of THC receptors http://buff.ly/1xw451q

Misuse of contact lenses (wearing them too long, not cleaning them properly) causes 1 million eye infections/yr in US. "Contact lenses offer many benefits, but they are not risk-free. Keratitis can be a scary infection, but it is preventable if people follow healthy habits and take care of their eyes and their lenses". Some bad habits, such as sleeping with contact lenses, failing to clean and replace lens solution frequently, and letting contact lenses get wet while swimming or in the shower, greatly raises the risk for keratitis. People who wear their contact lenses overnight are more than 20 times more likely to get keratitis. http://buff.ly/1xw4iSn

AstraZeneca is developing an antibody treatment to reverse the blood-thinning effect of its heart drug Brilinta http://buff.ly/1qNSuDB

U.S. FDA approves Sanofi's MS drug Lemtrada | Reuters http://buff.ly/1xw4YHh

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

The language of lying - TED-Ed video

From TED-Ed: We hear anywhere from 10 to 200 lies a day. And although we’ve spent much of our history coming up with ways to detect these lies by tracking physiological changes in their tellers, these methods have proved unreliable. Is there a more direct approach? Noah Zandan uses some famous examples of lying to illustrate how we might use communications science to analyze the lies themselves.



Lesson by Noah Zandan, animation by The Moving Company Animation Studio.

View full lesson: http://ed.ted.com/lessons/the-language-of-lying-noah-zandan

New way to lose weight - color everything blue to suppress appetite?

The color blue suppresses appetite more than any other color. Apart from blueberries and plums, which are mostly purple, there are few naturally blue foods. The hypothesis is that in the remote past, when humans foraged for food, blue was a warning of spoilage or danger.

The Buffet Blues by National Geographic: Everyone loves an all you can eat buffet, but controlling our appetites can be a bit of a struggle. We’re testing to see if a simple change of scenery can impact peoples’ portion sizes.

What we know (and don't know) about Ebola - TED-Ed video

The highly virulent Ebola virus has seen a few major outbreaks since it first appeared in 1976 -- with the worst epidemic occurring in 2014. How does the virus spread, and what exactly does it do to the body? Alex Gendler details what Ebola is and why it's so hard to study.

Lesson by Alex Gendler, animation by Andrew Foerster. View full lesson:
http://ed.ted.com/lessons/what-we-know-and-don-t-know-about-ebola-alex-gendler

How do lungs and liver work? TED-Ed videos

How do the lungs work? TED-Ed video



When you breathe, you transport oxygen to the body’s cells to keep them working, while also clearing your system of the carbon dioxide that this work generates. How do we accomplish this crucial and complex task without even thinking about it? Emma Bryce takes us into the lungs to investigate how they help keep us alive.

Lesson by Emma Bryce, animation by Andrew Zimbelman for The Foreign Correspondents' Club.

Read the full lesson here: http://ed.ted.com/lessons/what-do-the-lungs-do-emma-bryce

What does the liver do?



There’s a factory inside you that weighs about 1.4 kilograms and runs for 24 hours a day. It’s your liver: the heaviest organ in your body, which simultaneously acts as a storehouse, a manufacturing hub, and a processing plant. Emma Bryce gives a crash course on the liver and how it helps keep us alive.

Lesson by Emma Bryce, animation by Andrew Zimbelman for The Foreign Correspondents' Club.

Fibromuscular Dysplasia - Cleveland Clinic video

Fibromuscular dysplasia (FMD) is an angiopathy that affects medium-sized arteries predominantly in young. Renal involvement occurs in 60-75%, cerebrovascular involvement in 25-30%, visceral involvement in 9%, and arteries of the limbs in about 5%.



Cleveland Clinic physician, Dr. Gornik and Pam Mace from FMDSA answer questions about fibromuscular dysplasia (FMD) on this spreecast video chat (6/2014).

References:

Fibromuscular Dysplasia (FMD): Causes, Types, Symptoms and Treatment - Cleveland Clinic http://bit.ly/1sRTXKw

Quality Improvement in Healthcare - DocMikeEvans video

Thanks to St. Michael's Hospital http://www.stmichaelshospital.com, Health Quality Ontario http://www.hqontario.ca, and Institute for Healthcare Improvement http://www.ihi.org

Check out our new website http://www.evanshealthlab.com/
Follow Dr. Mike for new videos: http://twitter.com/docmikeevans

Dr. Mike Evans is a staff physician at St. Michael's Hospital and an Associate Professor of Family Medicine. He is a Scientist at the Li Ka Shing Knowledge Institute and has an endowed Chair in Patient Engagement and Childhood Nutrition at the University of Toronto.

Written, Narrated and Produced by Dr. Mike Evans
Illustrations by Liisa Sorsa
Directed and Photographed by Mark Ellam
Produced by Nick De Pencier
Editor, David Schmidt
Story/Graphic Facilitator, Disa Kauk
Production Assistant, Chris Niesing
Director of Operations, Mike Heinrich

©2014 Michael Evans and Reframe Health Films Inc.

Reviving Penmanship: "Ink is forever"

From DW: "Handwritten texts are experiencing a boom. A Berlin startup offers invitations, cards and love letters written by hand: it's more personal and original. And calligraphers who copy famous people's handwriting or important documents are more in demand than ever."

Leading causes of death in 2030, if we continue down the current path

This CDC video provides information about the leading causes of death in the U.S. and where we may be in 2030, if we continue down the current path. It suggests small steps that providers can take now to make a difference in the future health of our nation.

Police officers’ risk of sudden cardiac death is 34-69 times higher during restraints or altercations

This BMJ study found that police officers’ risk of sudden cardiac death (SCD) was 34 to 69 times higher during restraints or altercations; 32 to 51 times higher during pursuits; 20 to 23 times higher during physical training; and 6 to 9 times higher during medical or rescue operations, as compared with routine or non-emergency activities. The researchers also found that SCD accounts for up to 10% of all U.S. on-duty police deaths.



References:

Law enforcement duties and sudden cardiac death among police officers in United States: case distribution study. BMJ 2014; 349 doi: http://dx.doi.org/10.1136/bmj.g6534 (Published 18 November 2014).
http://www.bmj.com/content/349/bmj.g6534

Around the table - National Geographic video

Chefs and authors discuss the importance of the communal meal:



The Future of Food. Chefs Jose Andres and Barton Seaver talk about the importance of food as a resource and how we can save it:

Top medicine articles for November 2014

A collection of some interesting medical articles published recently:

'To Burn Off Calories in This Soda, Walk 5 Miles' - new label http://buff.ly/1vzbCKH

Two new medications for IPF: Pirfenidone (Esbriet) affects scarring, Nintedanib (Ofev) is a kinase inhibitor http://buff.ly/1psam6m

80% of people have at least 1 distressing symptom in a given month, yet fewer than 1 in 4 persons sees a doctor. At least one third of common symptoms do not have a clear-cut, disease-based explanation. History and physical examination alone contribute 73% to 94% of the diagnostic information. The patient's history alone yields 75% of the diagnostic information. Most patients have multiple symptoms rather than a single symptom. Symptoms become chronic or recur in 20% to 25% of patients. http://buff.ly/1yf7S0w

A Small Practice's Fight to Stay Independent: Can It Work? Walk-ins only mornings work for this Chicago practice. 40% of patients seen at convenience clinics do not have a "medical home" or regular primary care physician http://buff.ly/1yfa87N

9 Brain Boosters to Prevent Memory Loss http://buff.ly/1ps8VVn

History and physical examination alone contribute 73% to 94% of the diagnostic information http://buff.ly/1yf7cIk

New 2-in-1 diabetes pill approved, Xigduo XR once-daily combines SGLT2 inhibitor dapagliflozin and metformin http://buff.ly/1ujxOtN

Running is a Life-Saver, Study Finds - running even as few as 5 to 10 minutes each day is fine http://buff.ly/10mYFrV

Fixing the EHR Beast: Old, Unfriendly, Decentralized, and Incompatible - by Medscape editor-at-large http://buff.ly/10mZGjy

How to Make Published Research True: many published research findings are false/exaggerated, 85% of resources wasted http://buff.ly/10n1Ekc

Men often don't appreciate their fathers until it's too late - Telegraph http://buff.ly/1tQDZp0

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

How to Teach Teens to Drive Safely - WSJ video

Along with parking and steering, parents also need to teach teenagers how to spot crash hazards. WSJ's Sue Shellenbarger and Tanya Rivero discuss some tips.

Adrenal insufficiency - 2014 Lancet review

Adrenal insufficiency is the deficient production or action of glucocorticoids, with or without deficiency also in mineralocorticoids and adrenal androgens.

It is a life-threatening disorder that can result from:

- primary adrenal failure
- secondary adrenal disease due to impairment of the hypothalamic—pituitary axis

Prompt diagnosis and management are essential.

The clinical manifestations of primary adrenal insufficiency result from deficiency of all adrenocortical hormones, but they can also include signs of other concurrent autoimmune conditions.

In secondary or tertiary adrenal insufficiency, the clinical picture results from glucocorticoid deficiency only, but manifestations of the primary pathological disorder can also be present.

Diagnostic investigation can be challenging, especially in patients with secondary or tertiary adrenal insufficiency.

References:

Adrenal insufficiency : The Lancet http://buff.ly/1r18eER

A company called I Heart Guts makes a whole range of plush toys and lapel pins based on anatomical organs:

Why use Twitter - tips from Mayo Clinic's social media director

In this video, Dr. Timimi discusses the quiet revolution of Twitter in healthcare, including how it can be used in practice and in education. Of time spent online in the US, one in six minutes is spent in a social network. Of the popular social networks, Twitter is one of the best introductory platforms, with one in five adult Internet users in the United States maintaining a presence on Twitter.

Understanding Drug Resistance - video by National Institute of Allergy and Infectious Diseases

Resistance to antimicrobial drugs is a growing public health concern. Watch this NIAID video to learn more about how antimicrobial resistance develops and what scientists are doing to fight it.

Trying to Walk After the New York City Marathon (video)

After completing the 2014 New York City Marathon, participants fight through fatigue and physical exhaustion on the streets of Manhattan. Produced by: Deborah Acosta for The New York Times.

Which are the world's most highly-cited scientific papers of all time?

Fifty years ago, Eugene Garfield published the Science Citation Index (SCI), the first systematic effort to track citations in the scientific literature. Nature’s news team wondered which were the most highly-cited papers of all time, so asked Thomson Reuters and Google for their top 100. They are not what you might think. Watson and Crick on DNA structure misses out, along with many other historic discoveries. Instead, methods and software papers dominate the lists.

Find out more at nature.com/top100



The discovery of high-temperature superconductors, the determination of DNA’s double-helix structure, the first observations that the expansion of the Universe is accelerating — all of these breakthroughs won Nobel prizes and international acclaim. Yet none of the papers that announced them comes anywhere close to ranking among the 100 most highly cited papers of all time.

It takes a staggering 12,119 citations to rank in the top 100 — and that many of the world’s most famous papers do not make the cut.

The most cited work in history, for example, is a 1951 paper describing an assay to determine the amount of protein in a solution. It has now gathered more than 305,000 citations — a recognition that always puzzled its lead author...

Top medicine articles for October 2014

A collection of some interesting medical articles published recently:

Once-weekly insulin shot - Novo Nordisk's next idea http://buff.ly/1tiUC6v

How Lufthansa Cares for Passengers' Medical Needs http://buff.ly/1pK4ILC

How scammers trick your mind - they repeatedly use one or more of the same 7 persuasion principles. Scammers have used these principles for centuries. For instance, the Nigerian email scam might seem the product of the digital age, but a version of it existed in 16th Century Europe. http://buff.ly/1rIf4jo -- Understanding scam victims: 7 principles for systems security (University of Cambridge report) - PDF http://buff.ly/1uH14df

The prevalence of celiac disease in screening studies is 0.5 to 1%. The serologic test of choice for celiac is IgA anti-tissue transglutaminase - specific (94%), and sensitive (97%) http://buff.ly/1CIEr9x

Why Are Americans So Fascinated With Extreme Fitness? - NYTimes.com http://nyti.ms/1EVWdZ5

History of rheumatology http://bit.ly/1EVWgnC

Why exercise boosts IQ http://buff.ly/1sJqqXp

Cleveland Clinic offers patients virtual visits in walk-in kiosks in the grocery store http://buff.ly/1xQVhjW

3 new antibiotics for skin infections: dalbavancin (Dalvance), tedizolid (Sivextro), oritavancin (Orbactiv) http://buff.ly/1vzabfm

Shift workers and people who get jet lag may gain weight because they disturb their "inside garden" (gut microbes) http://buff.ly/1vzaJSs

Exercise May Help Fight Depression – But low mood can be a barrier to physical activity http://buff.ly/1ps8Elj

When we are able to diagnose rare diseases with smartphones - BBC http://buff.ly/1vzb4Va -- Ebola only has 5 genes

The enduring enigma of Alan Turing : The Lancet http://buff.ly/1vzbevI

A renaissance in surgery - A new and welcome vigour is evident in surgery, writes The Lancet http://buff.ly/1vzbj2r

Robotic surgery: where are we now? : The Lancet http://buff.ly/1ps8Ukv

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

Is math discovered or invented? TED-Ed video

Would mathematics exist if people didn't? Did we create mathematical concepts to help us understand the world around us, or is math the native language of the universe itself? Jeff Dekofsky traces some famous arguments in this ancient and hotly debated question.

Top medicine articles for October 2014

A collection of some interesting medical articles published recently:

Hand-grip strength is an amazingly good predictor of future rates of mortality and morbidity, or sickness http://buff.ly/1BK759H -- Hand grip strength should be considered as a vital sign useful for screening middle-aged and older adults http://buff.ly/1DglFaI -- Measuring hand-grip strength is very simple and cheap. Every primary care doctor should have a dynamometer in their office. At every visit, the doctor could check grip strength for older patients. If someone was in the 45th percentile for their age and the measurements were stable, great. But if that person suddenly dropped to the 25th percentile, then that’s a sign that the doctor should look seriously at what might be going on.

Full fat milk (3%) cut the risk of getting diabetes type 2 by 20% http://buff.ly/1m9ghRL

Urine Test for Diagnosis of HPV Works Well (not yet available in practice) http://bit.ly/1pnswES

Weekly Injectable Drug for DM2 Approved -Trulicity (dulaglutide) a glucagon-like peptide-1 (GLP-1) receptor agonist. http://bit.ly/1pnsyNh

FDA approved for treating fibromyalgia: pregabalin (Lyrica), duloxetine (Cymbalta), milnacipran (Savella) http://reut.rs/1pnsWet

Human Body, According to Venture Capitalists - which body systems stand to benefit most from their decisions - WSJ http://bit.ly/1pntgdp

Sodium conundrum: 9 in 10 U.S. children eat too much salt http://buff.ly/1wdlXx5

With 23andMe, this biologist gave his parents the gift of divorce http://bit.ly/1uvevub

People who spend more time preparing and cooking meals are more likely to have healthier diets http://buff.ly/1DTvZG4

Walking is the superfood of fitness, experts say -- “Walking is a superfood. It’s the defining movement of a human". “Actively sedentary is a new category of people who are fit for one hour but sitting around the rest of the day," Bowman said. “You can’t offset 10 hours of stillness with one hour of exercise.” http://buff.ly/1BxXEbA -- Exercise: “If you’re going to pick one thing, research says it should be walking”

Acupuncture May Not Help Chronic Knee Pain after all http://buff.ly/ZpQw5B

Epic holds the health records of nearly half of all Americans http://buff.ly/ZpRcIc

Gene affects your taste for bitter flavors. People who aren't as sensitive eat 200 more servings of vegetables/year http://buff.ly/YSQRMT

Ebola drug ZMapp is produced in the leaves of tobacco plants. 10 years from now, plants might be the dominant vaccine-production system http://buff.ly/1vzaN4f

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

Multi-dose flu shot has only 25 mcg of mercury - most commercial fish contain 23 mcg of mercury per 8 ounces of fish

Multi-dose flu shot has only 25 mcg of mercury - most commercial fish contain 23 mcg of mercury per 8 ounces of fish http://buff.ly/11CTRPw

Are multi-dose vials less expensive?

Economics are a bit complicated due to wastage with multiple vials:

Single versus multi-dose vaccine vials: an economic computational model
http://www.ncbi.nlm.nih.gov/pubmed/20566395

Most of the Western world, apart from the US, has moved on to single vials:
http://www.medscape.com/viewarticle/733986

Whenever possible, CDC recommends that single-use vials be used and that multi-dose vials of medication be assigned to a single patient to reduce the risk of disease transmission (http://www.cdc.gov/injectionsafety/patients/syringeReuse_faqs.html).

Where to get a thimerosal/mercury-free flu shot?

Many local Costco stores carry only single vials and the cost is $14.99 if no insurance is used. The availability of additional options may improve immunization rates.

Search for a Costco pharmacy near you here, and call them to verify availability: Warehouse Locations - Costco: www.costco.com/warehouse/locator.aspx

Personal Flu Stories - CDC:



Each year in the US, nearly 20,000 children under age 5 are hospitalized due to flu-related complications. CDC recommends that children aged six months through 18 years old get a flu vaccination. Moving personal stories help parents and caregivers learn about the dangers of influenza to children and the benefits of vaccination.

Image source: Influenza virus, Wikipedia, public domain.

How to Pick the Right Bedtime - select a wake up time, count back 7 hours and add 10 minutes to fall asleep

Given the importance of a good night's sleep, how do you pick the best possible bedtime? WSJ's Heidi Mitchell and Stanford University's Dr. Rafael Pelayo discuss with Tanya Rivero.



Related:

What Makes A Great Bedtime? | Craig Canapari, MD http://bit.ly/1vstZzJ
Shift workers and people who get jet lag may gain weight because they dusturb their "inside garden" (gut microbes) buff.ly/1vzaXci

65-yo patient received a standard-dose flu shot already this season. Should she get the high-dose shot too? Or get a second regular flu shot?

A 65-yo female patient received a standard-dose flu shot already this season. Should he get the high-dose shot too? Or try to get a second regular flu shot?

The simple answer is no. The patients should consider herself immunized. Studies show that getting a delayed second dose doesn't necessarily increase antibody response, and there's some concern that it might actually have a negative effect on the immunity. If you've already had the regular seasonal dose, wait until next year for another dose.


Image of the H1N1 Influenza Virus, CDC.

From CDC's Immunize.org website:

Sometimes patients age 65 years and older who have received the standard-dose influenza vaccine hear about the high-dose product (Fluzone High-Dose, sanofi) and want to receive that, too. Is this okay to administer?

No. ACIP does not recommend that anyone receive more than one dose of influenza vaccine in a season except for certain children age 6 months through 8 years for whom two doses are recommended.

Would giving an older patient 2 doses of standard-dose influenza vaccine be the same as administering the high-dose product?

No, and this is not recommended.

References:

New High-Dose Flu Shot for Older Americans: Answers to Flu Season Questions - AARP http://buff.ly/1ttjluQ

Ask the Experts about Influenza Vaccines - CDC experts answer Q&As; http://buff.ly/1ttjn6e

Fluzone High-Dose Seasonal Influenza Vaccine | Seasonal Influenza (Flu) | CDC http://buff.ly/1ttjnTu

How to get your research published: The BMJ's tips (video)

In this video, the BMJ's research team discuss what they look for in a paper submitted for publication.

They discuss some of the pitfalls authors fall into when writing up their research, and how to present some of the information that all journals will require.



More BMJ-specific info here: http://www.bmj.com/about-bmj/resources-authors

Healthcare social media #HCSM - top articles

Here are my suggestions for some of the top articles related to healthcare social media (#HCSM) in the past 2-4 weeks:

15 Lessons from 15 Years of Blogging: Link to everything you create elsewhere on the web. And if possible, save a copy of it on your own blog. Things disappear so quickly, and even important work can slip your mind months or years later when you want to recall it. If it's in one, definitive place, you'll be glad for it.

Always write with the idea that what you're sharing will live for months and years and decades. Having a long-term perspective in mind is an incredibly effective tool for figuring out whether a topic is meaningful or not, and for encouraging a kinder, more thoughtful perspective.

Your blog can change your life in a month. If you want to understand an idea, or become a meaningful voice on a topic, or change your own thinking about a concept, write a little bit about it every day for a month.

http://buff.ly/1pwjuWg

Too many crying babies: a systematic review of pain management practices during immunizations on YouTube http://buff.ly/1j4PHaz

Unprofessional behavior is prevalent among surgical residents who use Facebook (study) http://buff.ly/1j4POCV

Support network: People discussing their weight loss are happier with Twitter (more support, less negativity) than Facebook and in-person relationships http://buff.ly/1j4PUKK

A Facebook teaching forum was set up in a London Hospital for undergraduate medical students: 92% approved http://buff.ly/1j4QacM

Why Wikipedia matters for healthcare: it dominates search results for medical information - BMJ http://buff.ly/1vOMP1Y

YouTube as a source of patient information for lumbar discectomy. http://buff.ly/1qLVd4m

The Anatomy of a Scientific Rumor http://buff.ly/TP1v4K

Email Alerts Services You Should Use http://buff.ly/TP2yBC

Are You Tweeting Your Marriage Away? Time spent on social media can create friction in relationships (study) http://buff.ly/1ooRKmc

Twitter: an opportunity for public health campaigns : The Lancet http://buff.ly/U7drPJ

Do you "like" my photo? Facebook use may increase eating disorder risk http://buff.ly/WqD284

Cleveland Clinic has a blog for patients - Health Hub http://buff.ly/1yHsRtt and a blog for physicians - Consult QD http://buff.ly/1yHsr6g

The articles were selected from Twitter @DrVes and RSS subscriptions. Please feel free to send suggestions for articles to clinicalcases at gmail.com and you will receive an acknowledgement in the next edition of this publication.

Prozac "Revolution in a Capsule" - Retro Report by The New York Times

When Prozac was introduced in 1988, the pill to treat depression launched a cultural revolution that continues to echo. Read the story here: http://nyti.ms/XMXik9

What Causes Bad Breath (Halitosis)?

Halitosis is a generic term used to describe unpleasant odor emanating from the mouth air and breath, independent of the source where the odor substances originate. It affects between 50 and 65% of the population, but despite its frequency, this problem is often unaccepted and declared as taboo.

90% of patients suffering from halitosis have oral causes. A small, but important percentage, of oral malodor cases have an extra-oral etiology, very often falling into the category of "blood-borne halitosis".

Several systemic diseases have been found to provoke malodor or to be a cofactor; bad breath may be an early sign of a serious local or systemic condition.

A psychogenic halitosis also exists including the variant "pseudo-halitosis", when the oral malodor does not exist, but the patient believes he or she is suffering severely from it, and the halitophobia, when, instead, there is an exaggerated fear of having halitosis.

It is important to determine quickly whether the odor comes from an oral cause or not: if so, it requires referral to a dentist; if not (extra-oral origin alone or combined), its management requires the treatment of the underlying causes. Extra-oral disorders can be the cause in up to 15% of cases.

From The WSJ: What really causes bad breath, what can you do to prevent it and can you tell if you have it? WSJ's Heidi Mitchell joins Lunch Break with Tanya Rivero with the answers.



References:

Oral malodour (halitosis) - BMJ 2006 http://1.usa.gov/1sXOO8m
Halitosis: could it be more than mere bad breath? [Intern Emerg Med. 2011] - PubMed - NCBI http://1.usa.gov/1sXOR3U
Image source: Head and neck. Wikipedia, public domain.

How to diagnose Ebola? Lab tests are similar for most viral diseases - ELISA and PCR

Diagnosing Ebola in an person who has been infected for only a few days is difficult, because the early symptoms, such as fever, are nonspecific to Ebola infection and are seen often in patients with more commonly occurring diseases.

However, if a person has the early symptoms of Ebola and has had contact with the blood or body fluids of a person sick with Ebola, contact with objects that have been contaminated with the blood or body fluids of a person sick with Ebola, or contact with infected animals, or suggestive travel history, they should be isolated and public health professionals notified. Samples from the patient can then be collected and tested to confirm infection.

Laboratory tests used in diagnosis include:

Within a few days after symptoms begin
Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing
IgM ELISA
Polymerase chain reaction (PCR)
Virus isolation

Later in disease course or after recovery
IgM and IgG antibodies

Retrospectively in deceased patients
Immunohistochemistry testing
PCR
Virus isolation

Ebola discoverer: 'This is unprecedented'. CNN's Christiane Amanpour speaks with Dr. Peter Piot about an "out of control" Ebola epidemic in West Africa:



References:

Diagnosis | Ebola Hemorrhagic Fever | CDC http://buff.ly/1rIdM81
'In 1976 I discovered Ebola - now I fear an unimaginable tragedy' | World news | The Observer http://buff.ly/1EoqpvD
Image source: OpenClipArt.org, public domain.

Irritable Bowel Syndrome (IBS) - DW video

Professor Hubert Mönnikes talks about why people with IBS are often mislabeled as hypochondriacs, and how to best treat the symptoms.



Are Dietary FODMAPs a Cause of Irritable Bowel Syndrome? (Fermentable, Oligo-, Di-, Monosaccharides, And Polyols).

IBS symptoms improved with a diet low in short-chain carbohydrates (FODMAPs - fructose, lactose, polyol sweeteners) http://buff.ly/1fdzBWJ -- A Diet Low in FODMAPs Reduces Symptoms of Irritable Bowel Syndrome - the evidence supports its use as a first-line therapy http://buff.ly/1Ch3scU

DOWNLOAD the Handout  Stanford University: Low FODMAP Diet Handout

References:

A Diet Low in FODMAPs Reduces Symptoms of Irritable Bowel Syndrome - supports its use as a first-line therapy http://buff.ly/1Ch3scU

Top medicine articles for September 2014

A collection of some interesting medical articles published recently:

FDA Approves Inhaled Insulin: Afrezza, is a rapid-acting insulin to be taken at mealtime or soon after http://buff.ly/1qd6lFF

Can meditation help prevent the effects of ageing? BBC http://buff.ly/1qzXyzm

New Weapon in Fight Against 'Superbugs': aspergillomarasmine A (AMA) extracted from a common fungus found in soil http://buff.ly/1oqhscL -- Soil sample from a Canadian national park produced a compound that may reverse antibiotic resistance in bacteria.

British Airways launches in-flight 'slow TV' to calm passengers, with 7 hour film of train journey http://buff.ly/1wzPLBQ

Essential medical apps for surviving intern year of residency | iMedicalApps http://buff.ly/1sZHTeG

A Headbanger's Headache: hearing loss at a Motörhead concert is almost certainly a greater risk than a brain bleed http://buff.ly/1jiz0bL -- Chronic subdural haematoma secondary to headbanging : The Lancet http://buff.ly/1jiz5fz

Every person is host to 100 trillion bacteria. They outnumber human cells 10 to 1, account for 99.9% of genes in body http://buff.ly/1ykfFui

Physicians rate top EMR - good news for the free EMR provider Practice Fusion - Medscape EHR Report 2014 http://buff.ly/1qfqOvX

The $300,000 Drug - Kalydeco for a small subsets of CF patients http://buff.ly/1yHnYR9

Probiotic consumption may decrease systolic BP by 3.56 mm Hg and diastolic BP by 2.38 mm Hg http://buff.ly/UodXZv

Google Glass: Paramedics' next tool. Out of the box, Glass does not comply with the federal privacy law (HIPAA). "By hospital equipment standards, Google Glass is a steal"- University of California at Irvine School of Medicine http://buff.ly/1jSyuBH

Low Vitamin D May Increase Risk of Erectile Dysfunction http://buff.ly/1lIQ8cd -- Vit D linked to all sorts of diseases, causation link unclear.

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

Why eating insects makes sense: same protein, less fat than beef, better for the planet (Economist video)

From The Economist: "An unusual way to boost the food supply and feed people sustainably: by eating less meat, and more insects.

About 2 billion people already eat bugs. Mexicans enjoy chili-toasted grasshoppers. Thais tuck into cricket stir-fries and Ghanians snack on termites. Insects are slowly creeping onto Western menus as novelty items, but most people remain squeamish. Yet there are three reasons why eating insects makes sense.

First, they are healthier than meat. There are nearly 2,000 kinds of edible insects, many of them packed with protein, calcium, fibre, iron and zinc. A small serving of grasshoppers can contain about the same amount of protein as a similar sized serving of beef, but has far less fat and far fewer calories.

Second, raising insects is cheap, or free. Little technology or investment is needed to produce them. Harvesting insects could provide livelihoods to some of the world’s poorest people.

Finally, insects are a far more sustainable source of food than livestock. Livestock production accounts for nearly a fifth of all greenhouse-gas emissions – that’s more than transport. By contrast, insects produce relatively few greenhouse gases, and raising them requires much less land and water. And they'll eat almost anything."

Typical cattle requires roughly 8 pounds of feed to produce a single pound of beef. Insects on the other hand require only 2 pounds of feed to produce 1 pound of meat, making them four times as efficient.

Wikipedia has an article on Insect farming, and an open-source DIY kit is available.

Thailand is the world leader of insect farming and consumption. Here is how they do it: http://www.fao.org/docrep/017/i3246e/i3246e.pdf



Crickets are the latest health food craze - CNN - In the crowded health food market, there's a new bug taking hold - the cricket. http://bit.ly/1B1WNnB

Related:

Forget the vegetable patch! This kit lets you grow your own edible INSECTS to help cut down on meat eating. Daily Mail, 2013.

RT @CfA_research: The majority of shrimp allergic persons were found to be allergic to mealworm, so eat insects with caution! #FAAM2014 -- Why not eat insects as alternative protein source? Insect components are included in many processed foods, so you eat them already. Do we need to have a caution text: may contain traces of insects?

Entomophagy (eating insects): cricket chips and power bars taste like almonds with a hint of bacon. http://buff.ly/1D8dbSf -- McGill University Chirp reactor is a countertop cricket farm: Crickets are the gateway bug for people who haven’t eaten insects before. A beta version is currently on sale for $150, although Dzamba also offers DIY instructions for free.

Could insects be the wonder food of the future? BBC, 2014 http://buff.ly/1sJqCWu

Best of Medical Blogs - monthly review

The “Best of Medical Blogs - monthly review” is a monthly summary of the best posts from medical blogs. Please email your suggestions for inclusion to clinicalcases AT gmail DOT com. Best of Medical Blogs (BMB) is meant to continue the tradition of the Grand Rounds carnival (discontinued in 2008).

The Last Reprogramming

No one writes quite like @doctorwes - it's a must read... http://buff.ly/1qzv6I9

5 lessons learned by a successful physician blogger

Family comes first - the online community is virtual - it is not real. The cost of free is immense. Learn to say NO. Multi-tasking is a myth. Value your time – not in monetary terms – but in terms of self-preservation. Learn who to trust. Accept assistance - You are not a one man show http://buff.ly/1pGpEsD

Crowdsourcing medical advice - good or bad idea?

Skeptical Scalpel: Crowdsourcing medical advice is another example of a classically good business model which involves having other people do the work. http://buff.ly/1jwaQUn

Dr. Wes proposes a "Real Medicine Seal of Approval" for real doctors

The seal would mean an MD (or DO) spends over half his time, and earns the most of his income, actually directly caring for patients. It also means that the doctor who uses this designator attached to his MD designation actually works outside the normal 8am - 5pm business day and takes call for clinical patient care (available 24-hours/day) on a regular basis annually. http://buff.ly/Ld5TXU

A rheumatologist cured his mid-life crisis with Twitter - see how: http://buff.ly/1cJZokO

Social Media Workshop for Emergency Medicine Physicians http://buff.ly/1f5hByf - Great basic info for a quick start

The prevailing winds of hospital medicine, a dispatch from SHM 2014 - Notes from Dr. RW http://buff.ly/1igV1Gx

The top 50 science stars of Twitter according to AAAS/Science. What does it mean?

It's nice to be on the list of The top 50 science stars of Twitter according to AAAS/Science. However, the list is based on somewhat arbitrary criteria and is meant to provoke discussion rather than to be taken seriously. What is valuable, however, are some of the quotes by scientists interviewed for the story. A selection of the quotes is posted below.

The skeptic view on Twitter

Fact of life: Most high-performing scientists have not embraced Twitter. Why? "Highest ranking chemist considers Twitter a waste of time that he’d much prefer spending on reading, writing papers".

Twitter proponents win this argument

However, this is changing. Researcher: "Twitter may be the most valuable time I spend in terms of learning things". "Twitter is a virtual classroom connecting people interested in psychology of happiness. It’s another teaching tool". “In a minute, I can skim through a hundred Twitter posts. It’s pretty amazing for getting a feel of what’s going on". Tweeting ongoing research at research lab has attracted graduate students as well as two grants. Active social media presence might aid applications for research funding, as it shows a commitment to public outreach.

Know the risks

There are pitfall to Twitter user, of course. Spontaneity of Twitter can backfire, for example, live-tweeted brusque criticism at academic conferences can come back to bite you.

Twitter is ill-suited for nuanced, in-depth scientific discussions. The tweets are only 140-characters after all, and it is difficult to follow a conversation because every single tweet is a separate web page. One approach is to tweet links that appeal to a general audience, rather than complex scientific papers.

How to use Twitter in science

Twitter can be a crowdsourcing platform for new ideas and research.

Twitter can surface and bring to you the latest, most noteworthy research in medical science. Your own tweets about papers and presentations you find interesting can form an archive.

Twitter functions as “another dimension of peer review”.

Here is an approach I suggested a few years ago:

Cycle of Patient Education (click here to enlarge the image):



Cycle of Online Information and Physician Education (click here to enlarge the image):



References:

The top 50 science stars of Twitter | Science/AAAS | News http://buff.ly/1uiCBqK

The Kardashian index: a measure of discrepant Tiwtter profile and publication record for scientists http://bit.ly/1xXm8uv

Disclaimer and clarification: I am listed at 44 among The top 50 science stars of Twitter. Also, in 08/2014, I made a transition from University of Chicago to Cleveland Clinic.