September 30, 2014

Top medicine articles for September 2014

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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.
September 29, 2014

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

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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
September 26, 2014

Best of Medical Blogs - monthly review

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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
September 25, 2014

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

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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.
September 22, 2014

Micron Ships Its Cheapest SSD With New 16n, Node

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Last week Micron announced its newest solid-state drive (SSD), one that uses its densest process ever and one that has a chip capable of programming the memory to act like a high-performance SLC or high-capacity MLC flash drive. This new client-class SSD is known as the M600 SSD and uses Micron's new 16nm lithography with 128GB NAND density.

That greater density allows the company to drop the cost per GB to as low as $0.45. In addition to that, the ability to dynamically program the flash also reduces power use while improving write performance up to 2.8 times over models without this feature, according to Senior Technical Marketing Engineer for Micron Jon Tanguy. Tanguy also added that the M600 also has a sequential read/write rate of 560 MBps and has a random read/write rate of up to 100,000 I/Os per second and 88,000 I/Os per second, respectively.

The M600 is based on an 8-channel Marvell controller that comes with government-grade hardware encryption using the 256-bit AES protocol. This SSD is being marketed to manufacturers of corporate notebooks and ultra-thin netbooks as well as workstations and desktop PCs. As a result, the M600 comes in three form factors: a 2.5" SSD, an mSATA card and an M.2 memory stick. The mSATA and M.2 form factors come in 128GB, 256GB and 512GB capacities for $80, $140 and $260, respectively. The 2.5" SSD comes in all the same capacities for the same prices but adds in a 1TB version that runs $450. In addition to that, the prices drop depending on the quantity you purchase, meaning the more you buy the cheaper they are per unit.

These prices may seem a little steep but they are in line with consumer-class products. SanDisk recently released its Ultra II SSD, which sells for $0.44 per GB. This SSD uses triple-level cell NAND flash, which means it stores three bits of data per NAND flash cell making it the densest industry specification to date. However, the more bits that are stored in cells the bigger the potential for data errors, which requires companies to create more sophisticated ECC.

Micron, instead of packing more bits in cells or over-provisioning its SSD with flash capacity, reduced the size of its process technology and added what "Dynamic Write Acceleration". Dynamic Write Acceleration is a special firmware that changes flash cells from single-level cell technology to multi-level cell technology. According to Tanguy, "So you can swap back and forth dynamically in order to deliver a pool of SLC or MLC capacity. Any new data programming is performed in SLC mode for really high performance."

This new firmware allows Micron to create a dynamic pool of cache without the need to overprovision. "We think doing this gives us a good method to address client loads that tend to be bursty in nature as opposed to enterprise data center write workloads that tend to be sustained," Tangy added. However, changing the NAND flash from SLC to MLC and back does increase write amplification. Increasing this wears out the usable lifespan of NAND flash more quickly. "The additional write amplification introduced with the new dynamic write acceleration firmware is manageable," Tanguy stated.

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September 15, 2014

High Blood Pressure,Are You at Risk for?

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High Blood Pressure


High Blood Pressure,Are You at Risk for?


Do you know what the risks are of high blood pressure? How do you know if you are at risk? There are many different causes for high blood pressure. In this article you will find out if you are at risk and how you can help prevent and control your high blood pressure.

Your blood pressure is high if it is over 120/80, which is the normal level of blood pressure. There are many everyday lifestyle habits that raise your pressure that you might not be aware of. One of those is being overweight. If you are overweight you are at a greater risk of developing high blood pressure.

Try to start a healthy diet or start exercising. Even losing a measly ten pounds can help you drastically and keep your blood pressure normal. Physical inactivity is also another lifestyle habit that causes many Americans to develop high blood pressure.

If you are not very physically active, consider starting to be. You can easily adapt exercise to your everyday routine; you just have to plan it out. Try to do at least thirty minutes of exercise a day. This will help lower or control your blood pressure.

Many people are not concerned with what they eat, yet they want to be healthy. These two do not go together. If you want to stay healthy, you have to watch what you eat. Having unhealthy eating habits can cause high blood pressure as well. Try to eat less salt or sodium and more vegetables and fruits.

Using tobacco products is a great risk for developing high blood pressure. Smoking is a very common habit among the world and many of these people might have high blood pressure and not even know it. There are many ways to help rid the habit of nicotine or use of any tobacco product.

Every one is stressed at some point during their lives. You might be stressed every day or just once in awhile. Whatever the case may be, you can still develop high blood pressure through stress. If you find yourself stressed more often than not, consider some relaxation techniques. Meditation is a great way to start. If this doesn't work, consider something different.

Drinking alcohol also causes high blood pressure. Do you drink quite a bit? More than two drinks for a man and more than one for a woman can raise their blood pressure. If you drink more than this, consider cutting back. Once again, if you are addicted to drinking, or smoking, you can find many ways to help you quit.

These are very common lifestyle habits that cause high blood pressure. If you are at risk for high blood pressure or already have it, consider purchasing a home blood pressure monitoring device. This can help ensure that whatever habits you are changing or modifying are working.

Sometimes this change is not enough. You might have to use medication or incorporate medication with your exercise routine, etc. The best way to know this is to visit your doctor. Ask any and all questions you might be concerned about. They will happy to assist you in helping you have a healthier and active lifestyle.

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