J. Michael Bostwick, M.D., Professor of Psychiatry, Mayo Clinic Rochester, discusses the issue of medical marijuana. In 1970, the Federal Government declared cannabis to be a dangerous drug of abuse without any medical benefit and made it illegal. Over the past two decades, however, more than 20 states have taken matters into their own hands in defiance of federal law and legalized marijuana for medical purposes, recreational use, or both. The result is chaos for physicians and patients alike because there is no uniform law of the land.



Comments from Twitter:

Pat Rich @cmaer: Good Mayo clinic overview of "chaotic" medical marijuana situation facing US physicians

Mayo Clinic emergency medicine specialist Dr. David Nestler talks about how cold weather affects our bodies and what we need to know about frostbite:



“It’s a shame whenever anyone gets a frostbite injury,” says Lawrence Gottlieb, MD, professor of surgery at the University of Chicago and director of the Burn and Complex Wound Center. “People need to be aware of it and take precautions when the temperature drops, like it has this week. Be especially cautious when temps fall below zero, especially when there is a strong wind. Obviously, wear warm clothes. If you are driving a long way, especially at night, make sure you have enough extra clothes to cover up effectively if you get stuck somewhere. And don’t get stuck. Put enough gas in the car.”

Tips for people who go out in the cold

- If the temperature is below zero you could sustain a cold injury in less than 15 minutes.
- Mittens are warmer than gloves.
- Insulate the affected body part to prevent additional heat loss and damage.
- Immobilize and protect the frostbitten tissues from further injury.
- Prevent thaw-refreeze cycles. Do not begin rewarming until there is no risk of further exposure.
- Once in the hospital, physicians recommend rapid rewarming in a water bath at 104°-107.6°F (40°- 42°C) for 15-30 minutes until thawing is complete.

References:

Chicago midwinter – a user’s guide for preventing frostbite | Science Life buff.ly/1xHErpy

MD degree does not teach doctors how to tweet scientific meetings, reported Reuters (http://buff.ly/1xAOPkO): A study assessed the accuracy of tweets posted by physicians at a medical conference and concluded "it is very easy to misunderstand tone and brevity, so there are dangers here."

First the study authors asked speakers at the meeting to identify key messages for their presentations. Then, they asked the speakers to review tweets posted during their talks to see how accurately these points were communicated.


Duty calls. Image source: Xkcd.com, Creative Commons license.

14 speakers participated in the experiment, and 13 had at least one tweet posted about their presentations. There were only 37 tweets altogether! Editor's note: This seems incredibly low. Allergy/Immunology conferences such as AAAAI and ACAAI generate thousands of tweets, sometimes more than 30-50 for each talk.

The speakers found 16 of the tweets accurately reflected their findings, while an additional 16 posts were partially accurate. In 3 instances, the tweets misrepresented key points. In 2 cases, the speakers were uncertain about the accuracy.

It's possible that the inaccurate tweets indicate that the speakers didn't do a good job of explaining their research. And it's also possible that the doctors listening to presentations didn't use the best language to tweet results.

To be sure, the sample size was quite small. This is the biggest limitation of the study and it qualifies it as what we sometimes call "half-baked research."

This statement also looked inaccurate in the Reuters report: "Asked about the impact of social media on medical education, 82 percent of survey participants said they didn't access websites for medical journals, research articles or major gastroenterology professional organizations." And indeed, it was inaccurate: 82% of GI's didn’t access social media sites of professional organizations, not their main websites.

We all agree on this though: Many physicians prefer to limit use of social media to their personal lives.

Here is an example how to use Twitter when attending a scientific conference:
http://allergynotes.blogspot.com/search/label/Twitter

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):





"And it’s free."



References:

MD degree may not teach doctors how to tweet | Reuters http://buff.ly/1xAOPkO
Are you a SCEPTIC? SoCial mEdia Precision & uTility In Conferences - Emergency Medicine Journal http://buff.ly/1vQCq6j, and bit.ly/1tii1pz Digestive and Liver Disease

Comments from Twitter:

re: SCEPTIC? SoCial mEdia Precision & uTility In Conferences -- Skeptical Scalpel @Skepticscalpel: I've seen some forced acronyms in my time, but that one wins the prize.

@DrVes re: acronym, agree. the whole research endeavor left more to be desired...

Skeptical Scalpel @Skepticscalpel: I liked it because it supported my bias, but really--37 tweets?

Michael Katz @MGKatz036: Pls remember this as I tweet from @Boston_AF! MT @DrVes: MD does not teach doctors how to tweet scientific meetings buff.ly/1xzpiXF

Cytisine, also known as baptitoxine and sophorine, is an alkaloid that occurs naturally in several plant genera. In this trial in New Zealand, cytisine was superior to nicotine-replacement therapy in helping smokers quit. The findings are summarized in the NEJM video. Cytisine was first marketed in Bulgaria in 1964 (called Tabex) and then became widely available in other European countries.

Read the full NEJM Original Article: http://www.nejm.org/doi/full/10.1056/NEJMoa1407764

Related reading:

Quitting smoking: Still a challenge, but newer tools show promise - CCJM http://buff.ly/1xCK2fP

From Mayo Clinic: Running your hands under the faucet with some soap for a few seconds isn't enough to kill germs.

To help avoid catching the flu and other illnesses, wash your hands thoroughly and frequently with soap and warm water or alcohol-based hand sanitizer, particularly before leaving a restroom, eating or touching your face.

Wash your hands for about 20 seconds, about as long as it takes to sing "Happy Birthday" twice. When visiting a public restroom, use a paper towel to turn off the faucet and open the door when leaving.

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: 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.