Saturday, February 28, 2009

Health News of the Day

Health News of the Day is a daily summary made from the selected links I post on Twitter. It is in a bullet points format with links to the original sources which include 350 RSS feeds that produce about 2,500 items per day.

  • Reglan (Metoclopramide) Gets 'Black Box' Warning for tardive dyskinesia. More than 2 million Americans use Metoclopramide, according to the FDA. Reglan (metoclopramide) is the most common cause of drug-induced movement disorders. 20% of patients who took Reglan did so for longer than 3 months despite recommendations to limit use to less than 3 months http://is.gd/l9CD

  • Weight Loss May Take 250 Minutes of Exercise a Week http://is.gd/l9ED

  • Hostile men more prone to weight gain than their laid-back peers. Prior studies have linked hostility to heart disease, high blood pressure, and a greater overall mortality risk http://is.gd/la0c

  • Emotional stress raises older adults' fall risk: 12-fold following a bout of anger. Sadness was linked to a nearly 6-fold increase in the risk of a fall-related fracture http://is.gd/la15

  • Nucleic acid amplification tests for TB can cut the time for laboratory diagnosis from weeks to days http://is.gd/l9ui

Image source: OpenClipArt.org, public domain.

Describe what Twitter means for you in 140 characters

Dave Winer, the creator of RSS describes what Twitter means for him in 126 characters:

Dave Winer
davewiner Twitter is my shared notepad. If I want to remember something and I don't mind if everyone else knows it, I just post it here.

Dave Winer
davewiner More and more I use Twitter as if it were del.icio.us.


I agree.

Ed Bennett
EdBennett @markhawker Thanks. I like Twitter, but get nervous investing time and attention on a platform that feels fragile.


James Booth
jsebooth just overhauled my twitter account. i scrapped the idea of using twitter for RSS feeds. Twitter now for humans. Google Reader for RSS.


om
om twitter is like blogging. that is why everyone likes to twitter and blog about twitter itself. Sometimes, a tweet is just that a tweet!


Bertalan Meskó
Berci My brother-in-law told me Twitterers are absolutely not normal to be on Twitter on Christmas night... :) I said it's called commitment


DrCris
DrCris @AllergyNotes If you follow more people you start to see twitter as a party conversation - if you are there, you are there. If not, fine.


Ves Dimov, M.D.
AllergyNotes Twitter: "I know that there is always a friend, at any time, which has the answer I am looking for about anything" http://tinyurl.com/9qynx5


Heidi Allen
dreamingspires I agree w @allergynotes using Twitter just 2 push blogs is not what it's about, bt sharing quality info in context of yr relevant group is


If you are included in this post but would like to have your tweet removed for any reason, please email me and will comply with your request the same day.

Friday, February 27, 2009

Health News of the Day

Health News of the Day is a daily summary made from the selected links I post on Twitter. It is in a bullet points format with links to the original sources which include 350 RSS feeds that produce about 2,500 items per day.

  • Healthier living could prevent about a third of the most common cancers. Better diet, more exercise and controlling weight could also prevent more than 40 percent of colon and breast cancer cases http://is.gd/kYvn

  • Good Diet, Physical Activity, and Healthy Weight May Prevent 34% of 12 Common Cancers in the U.S. http://is.gd/kYwa

  • Obama to create one bundled Medicare payment to cover both hospital stay & care for the patient for 30 days after release http://is.gd/kYwK

  • The Most Dangerous Place to Drive in the U.S? The South has the Highest Rate of Traffic-Related Deaths. Lowest Rate in NE. The Northeast annual rate of motor vehicle-related deaths was 9.8/100,000 people. The rate in the South was double at 19.5. The state with the highest average annual motor vehicle-related deaths is Mississippi http://is.gd/l0qU

  • Drug tandem of meropenem and clavulanate (part of Augmentin) works against extensively drug-resistant (XDR) TB. Of 9 million new TB cases annually worldwide, 490,000 are MDR-TB and 40,000 are XDR-TB http://is.gd/l0tU

  • Bacteria found in human spit generally similar around the world -- different between individuals, not between continents. Human body harbors 10 times more bacterial cells than human cells http://is.gd/l1ub

  • Men with prostate cancer taking statins were 63% less likely to die from the disease than men not taking statins http://is.gd/l1Bw

Image source: OpenClipArt.org, public domain.

NIH Consensus on Management of Hepatitis B

The Annals of Int Medicine published the National Institutes of Health Consensus on Management of Hepatitis B (free full text). The main points are presented in an easy to understand question and answer format and some of them are summarized below.

What Is the Current Burden of Hepatitis B?

400 million people worldwide are living with chronic HBV infection.

Each year, 500 000 die of cirrhosis and hepatocellular carcinoma.

One million U.S. residents have chronic hepatitis B infection, 2,000-4000 deaths occur per year.

0.3-0.5% of U.S. residents have chronic infection, 47-70% of them are foreign-born.

What Is the Natural History of Hepatitis B?

A small proportion (less than 5%) of adults develop chronic HBV infection.

Chronic infection occurs in almost all children who are infected with hepatitis B during the perinatal period and in up to 50% of children who become infected between 1 and 5 years of age.

Lifelong monitoring is indicated.

What are the Therapeutic Options for Hepatitis B?

7 agents have been approved by the FDA, categorized as either interferons (interferon-2b and peginterferon-2a) or nucleoside or nucleotide analogues (lamivudine, adefovir, entecavir, tenofovir, and telbivudine).

The medications may be used as monotherapy or in combination.

References:
National Institutes of Health Consensus Development Conference Statement: Management of Hepatitis B. Michael F. Sorrell et al. Annals of Int Medicine. 20 January 2009 | Volume 150 Issue 2.
Image source: A simplified drawing of the HBV particle and surface antigen, Wikipedia, public domain.

Thursday, February 26, 2009

CNN Video: Millions of Americans take performance-enhancing drugs for the brain



CNN Video: Steroids for the mind, 2:10 minutes.

Medical Geek Humor on Twitter

Twitter is a microblogging service where people answer the question "What are you doing?" via 140-character messages from their cellphone, laptop or desktop. You can select the messages (called "tweets") that you find useful, amusing, or both.

The tweets below are part of the series Medical Geek Humor on Twitter:


RobboBiteTheDust @Berci: @Pudliszek @laikas @BiteTheDust While the US twitterers are sleeping, we can rule the twitterosphere. They are just too many-so true Ves Dimov, M.D.AllergyNotes @BiteTheDust @Berci @laikas "While the US twitterers are sleeping, we can rule the twitterosphere.They are just too many" - Who's sleeping? doc_robdoc_rob @BiteTheDust @Berci @laikas "While the US twitterers are sleeping, we can rule the twitterosphere." Are there people outside the US?

Bertalan MeskóBerci RT @doc_rob: @"Are there people outside the US?" Outside the what? :)


If you are included in this post but would like to have your tweet removed for any reason, please email me and will comply with your request the same day.

Health News of the Day

Health News of the Day is a daily summary made from the selected links I post on Twitter. It is in a bullet points format with links to the original sources which include 350 RSS feeds that produce about 2,500 items per day.

  • NEJM: Any low-calorie diet works - Reduced-calorie diets result in weight loss regardless of their macronutrients http://is.gd/kUTD

  • Obama:"Health care reform cannot wait, it must not wait, and it will not wait another year" http://is.gd/kP0J

  • Obama's budget will seek (staggering) $634 billion over 10 years as a down payment on health care reform. The health reform plan would trim $316 billion over 10 years from Medicare http://is.gd/kUJm

  • Governor Bobby Jindal was a ‘Pre-Existing Condition’ when his mother was pregnant with him http://is.gd/kOXq

  • Pork Workers With Novel Neurological Illness caused by exposure to aerosolized pig brains Much Improved A Year Later http://is.gd/kUPV

  • Cord Serum IgE Level Predicts Atopy up to Age 20 http://tinyurl.com/dzbopy

  • Teen Obesity as Deadly as Smoking http://tinyurl.com/cqoajy

Image source: OpenClipArt.org, public domain.

Wednesday, February 25, 2009

Selection of My Twitter Favorites, Edition 44

Twitter is a microblogging service where people answer the question "What are you doing?" via 140-character messages from their cellphone, laptop or desktop. You can select the messages (called "tweets") that you find useful, amusing, or both. Here is the 44th edition of My Twitter Favorites (the oldest post is at the bottom, the newest at the top): Micro-blogging on Twitter is easy, fun and can be very useful and educational if you follow/subscribe to interesting people.
You can read more here: A Doctor's Opinion: Why I Started Microblogging on Twitter and
visit my account at Twitter/AllergyNotes.
  1. Zappos.com CEO -TonyzapposBack in Vegas. I have a regular exercise routine everytime I land here: Spend 20 mins walking all around trying to remember where I parked
  2. Ves Dimov, M.D.AllergyNotesMany people don't feel like writing blogs -- so many great/funny/silly ideas would have gone unpublished if it weren't for Twitter...:)
  3. David SchronceschroncdI like to put on one of my old Joan Baez records once in a while just to see the hair stand up on the cat's back.
  4. David SchronceschroncdIt always amazes me how, right in the middle of the day, my entire brain can go night-night.
  5. Vijay scanmanJawaharlal Nehru: Laziness is the biggest enemy. Mahatma Gandhi: Always love your enemy. As a patriotic Indian, I'm forced to follow both :)
  6. Evan WilliamsevLately, I keep forgetting my wallet at home. Subconscious reaction to economic slowdown? (Related: thx @willotoons!)
  7. Paul KedroskypkedroskyField note: Between layoffs and park emptiness, Disneyland not happiest place in world
  8. Dave WinerdavewinerThe first virtual hug goes to @timoreilly just for being a guy who passionately believes in what he evangelizes. You don't have to agree
  9. Kent AndersonkandersonLate to bed, early to rise, makes a guy grumpy, gives him red eyes. Take that, Ben Franklin!
  10. Dave WinerdavewinerAll the escapes are scenic or climate-ic. How about human escapes. A trip for intellectual distance? A 3-day course?
If you are included in this post but would like to have your tweet removed for any reason, please email me and will comply with your request the same day.

Should Students Cite Wikipedia in their Academic Papers?

Should College Students Cite Wikipedia in their Academic Papers? The short answer is "no." Do they use it. You bet.


Wikipedia Tutorial: a guide for students

When I attended the NEJM Horizons conference last October, I was surprised to hear medical students reporting that their colleagues use Wikipedia as a medical reference text. The wiki platform has a place in medical education but Wikipedia does not require any expert knowledge or credentials verification to contribute.

A Wikipedia article is often in the top 5 of Google search results for many queries and the path of least resistance for most searchers is to focus only on the first page of results. This is not a good search (and research) pattern for future physicians, in my opinion.

References:
Should College Students Cite Wikipedia in their Academic Papers? Amit Agarwal, 2009.
NEJM Horizons Conference to Push Boundaries of Traditional Medical Publishing, Day 1

Health News of the Day

Health News of the Day is a daily summary made from the selected links I post on Twitter. It is in a bullet points format with links to the original sources which include 350 RSS feeds that produce about 2,500 items per day.

  • People obese at the age of 18 are twice as likely to die prematurely compared to normal-weight http://is.gd/kKrF

  • Being overweight as a teenager boosts risk of premature death by a third - as much as smoking up to 10 cigarettes a day http://is.gd/kKsr

  • The incidence of peanut allergy among Australian toddlers has doubled in the past nine years. New term "Gen-A" (generation allergy) reflects high incidence of allergic diseases among children http://is.gd/kIOw

  • Healthy men over 55 should consider taking finasteride to prevent prostate cancer. Finasteride is a 5-alpha reductase inhibitor used to treat prostate enlargement symptoms and baldness. Finasteride has 2 names: Propecia for baldness and Proscar for BPH, prostate cancer prevention will cost $1,000 a year http://is.gd/kK7Q

  • Even a little alcohol increses cancer risk in women. 13% of the cancers of the breast, liver, rectum, and upper respiratory/GI system may be related to alcohol use http://is.gd/kK8X

Image source: OpenClipArt.org, public domain.

Tuesday, February 24, 2009

Guest Post:: It Takes a Nation of Cowards to Prove Eric Holder Right

With permission from Rinku Sen (ok, her agent) I am reposting her fab post on race & America:

Attorney General Eric Holder's speech to Justice Department employees urging the country to suck it up and have those hard conversations about race generated the predictable accusations from the pundit crowd, both conservative and liberal. Why is he still trying to make white people feel guilty?! We just elected his boss! The media reaction largely proves Holder's point. Rather than actually talking about the causes and consequences of our racial divide, the story has been that this speech has created the latest "controversy" for the Obama administration, starting with the AP article highlighting the "nation of cowards" quote. Apparently, there's only room for one black man at the highest levels of government taking the nation to task on race, and that man can do it once a year at most.

Smartly, Holder noted that our goal should not be to move beyond our racial past, and for the press to turn a blind eye to racial realities is the wrong way to go. He focused instead on raising the question of whether the nation's attitude toward its diversity will give us strength or take us down. I especially loved his note about how we manage to get along in the workplaces, but as soon as we can, we retreat to our racial corners on the weekends. That's because the diverse people of this country hold unequal power, which often dictates where and how we live.

The word 'coward' is a strong one, but the reality is that because we have such wildly different perspectives on why racial disparities exist, and because they continue to exist long after explicit racism has been outlawed, discussion of racial issues requires a high degree of tolerance for conflict, both intellectual and emotional. In my work reporting on the lives of everyday people and the institutions that shape their lives, I can see how our current rules and structures continue to produce disparities, even when no one intends that outcome. Understanding how the structures work - which has little to do with whether individuals intend to be racist - helps to lower the heat level significantly when these conversations do take place.

The flipside of cowardice is courage - something we all could use a little more of if we truly want to deal with our past and present racism, while we create a future that works for all of us.


Rinku Sen is the President of the Applied Research Center and the publisher of ColorLines, the magazine on race and politics. AND a member of the 2009 Progressive Women's Voices program. I am seriously glad that I got in when I did. No way I could have competed with her!

Health News of the Day

Health News of the Day is a daily summary made from the selected links I post on Twitter. It is in a bullet points format with links to the original sources which include 350 RSS feeds that produce about 2,500 items per day.

  • NPR: "A patient of mine asks: 'Now Dr. Smith, are you a doctor doctor, or are you a doctor nurse?'" http://tinyurl.com/bcw43u

  • Child abuse leaves lasting 'scars' on DNA http://tinyurl.com/bg6ztc

  • Universal 'Antibody Cocktail' Would Stop All Flu Types http://is.gd/kt5o

  • Monoclonal antibodies could lead to the development of a flu vaccine that would not have to be changed yearly http://is.gd/kt7e

  • Antibodies against H5N1 are broadly neutralizing because many influenza strains share the same stem structure http://is.gd/kt7U

  • "Investigational ragweed vaccine Pollinex Quattro would require only a six-week, six-injection regimen" http://is.gd/kvia

  • White House budget director: Reducing healthcare costs is crucial for restoring the health of the United States' economy http://is.gd/kzXG

  • Understanding the epigenome: chromatin does a lot more than hold chromosomes together http://is.gd/kCcg

  • Play and down time may be as important to a child’s academic experience as reading, science and math http://is.gd/kCcv

Image source: OpenClipArt.org, public domain.

The future of pharmacologic stress testing: selective A2A adenosine receptor agonist regadenoson (Lexiscan)?

Adenosine and dipyridamole, the currently available vasodilators for myocardial perfusion imaging, produce hyperemic coronary flow by stimulating A(2A) adenosine receptors on arteriolar vascular smooth muscle cells. However, both vasodilators are nonselective activators of the adenosine receptors A(1), A(2B), and A(3), which contributes to common undesirable effects.

Regadenoson is a new highly selective, low-affinity A(2A) adenosine agonist that is a coronary vasodilator. It was approved by the United States Food and Drug Administration on April 10, 2008 and it will be marketed under the tradename Lexiscan.

Regadenoson is an adenosine derivative as you can guess from its chemical name: 2-{4-[(methylamino)carbonyl]- 1H-pyrazol-1-yl}adenosine.

It has a 2-3 minute biological half-life, as compared with adenosine's 30 second half life. Regadenoson stress protocols using a single bolus have been developed, obviating the need for an intravenous line.

The dose is 0.4 mg of regadenoson (5 mL) delivered by rapid intravenous injection, regardless of body weight, to simulate exercise in radionuclide myocardial perfusion imaging.

Regadenoson should not be given to patients with sinus node dysfunction, unless they have a functioning pacemaker, or second- to third-degree atrioventricular block.

Other warnings in the prescribing information include risk of fatal cardiac arrest, ventricular arrhythmias, myocardial infarction, hypotension, and bronchoconstriction and respiratory compromise in patients with chronic obstructive pulmonary disease or asthma.

References:
The future of pharmacologic stress: selective A2A adenosine receptor agonists. Cerqueira MD. Am J Cardiol. 2004 Jul 22;94(2A):33D-40D; discussion 40D-42D.
Regadenoson, from Wikipedia, the free encyclopedia.
FDA Okays Regadenoson (Lexiscan) as Pharmacologic Stress Agent. Todd Neale, Staff Writer, MedPage Today, April 11, 2008.
Image source: Regadenoson, Wikipedia, public domain.
Image source: Heart, Gray's Anatomy, 1918, public domain.
Image sources: MI, Wikipedia.

Health News of the Day

Health News of the Day is a daily summary made from the selected links I post on Twitter. It is in a bullet points format with links to the original sources which include 350 RSS feeds that produce about 2,500 items per day.

  • Low Vitamin D Levels Linked to Colds and Flu http://is.gd/kCgA

  • People with the lowest vit. D (less than 10 ng/mL) 36% more likely to have an URTI than those with levels higher than 30

  • Higher Calcium Intake May Reduce Risk of Colorectal and GI Cancers http://is.gd/kChC

  • Older people who got most calcium from food/suppl. had a 16% lower risk of colorectal and other cancers of the GI tract

  • MicroRNAs in blood may lead to new tests for liver toxicity http://is.gd/kCiy

  • Anger really can kill you by triggering potentially deadly heart rhythms (VT/VF) http://is.gd/kCiW

  • Earthquakes, war or even the loss of a World Cup Soccer match can increase rates of death from sudden cardiac arrest

  • Urine test for lipocalin 2 (Lcn2) may tell of breast cancer's spread http://is.gd/kCjz

  • Lipocalin 2 (Lcn2) gene associated with estrogen receptor (ER)-negative breast cancers

  • Only 60 percent of the lifeguards reported using sunscreen http://www.nytimes.com/2009...

Image source: OpenClipArt.org, public domain.

Monday, February 23, 2009

Book Review: Feminist Mothering edited by Andrea O’Reilly

I like to call myself a feminist mom blogger, but after reading Feminist Mothering I find myself questioning that label. Mostly I find myself questioning how I see feminist mothering and what that means to me. If asked to give a definition of feminist mothering before reading this text, I would have told you that it was about raising a feminist child, empowering that child and helping them rise above or thru the sexist ways of the world. Or something like that. Yes, it would have included being a good role model, but this text has helped me realize that feminist mothering is much more or should be much more than that.

This is a text book not a feminist Dr. Spock or guide to feminist mothering, rather it is a collection of fifteen thoughts on what is feminist mothering, how can it be done, and what does that mean for the world. It is moving, thought-provoking and a must read for any mother and any woman. Just as a survey of 15 women would result in 15 different definitions of feminist, the same is seen for feminist mothering. Yet at the core is the belief that feminist mothering is woman centered not child centered. It is empowering for both the woman and child, if not more for the woman. O'Reilly offers this definition in the introduction: "Feminist mothering functions as a counterpratice that seeks to challenge and change the many ways that patriarchal motherhood is oppressive to women (p 10)."

Feminist mothering is much more than raising empowered daughters or thoughtful son. It is about breaking down patriarchy thru the way we raise children. It is more than making sure our daughters know that clothes come in something other than pink, it is showing her that being a woman can be a strength in this sexist society.

O'Reilly's contribution to this text is the most moving piece in this collection. As a feminist activist, I carve out time from work and family to be active in my community. This requires time away from my daughter for meetings and trips as well as countless hours on my computer writing, organizing and keeping up with the latest news. I have often pondered how much this effects my daughter and if she will rebel in a way that I can't comprehend – anywhere between becoming an Alex P. Keaton to just plain tuning out of politics and the movement. Mostly I fear that she will hate me for all that I do to make this world a better place for all of us. O'Reilly's contribution is a conversation between her teenage daughters and if you can trust that they are pretty candid and honest with their mom, you see that raising a child with feminist methodology pays off in spades. It also proves that sometimes kids do forget the nights you missed tucked them into bed and can be proud of having a mom who spends more time writing than baking.

Gisela Norat's contribution tackles the question of whether a mother's movement is a feminist movement through a historical look at mother's movement in Latin America. Norat's historical summary of how ordinary women whose children were disappeared or jailed throughout Latin America and how the government's silence propelled these women to take to the streets is moving and still relevant. She makes an eloquent case for why mothering can be the force that joins all women in a struggle, yet at the same time what we struggle against is also filtered through race and class. All mothers should be allies in the battle for a just world, yet some injustices, like environmental toxins in a neighborhood, benefit some and harm others.

And that is the heart of Feminist Mothering – In order to be a feminist mom raising a child in a feminist way, we need to look beyond our family to see how decisions impact our community and world. The fight for affordable child care should not end when we get a big raise or our children are capable of watching themselves. It should be a struggle for all women with children and some would argue all of us in general. In the end, Feminist Mothering could be a handbook if one uses it to guide her in how decisions are made in the household, how to organize in the community and how to have faith that your children will grow up to be the strong adults we imagine. It won't tell us what to pack for the hospital, but it will help us recenter ourselves when we're about to blow our gasket at that precious child who keeps sassing you.

We need to politicize motherhood and to recognize the work that mothers do - we need to claim that work for feminism, to learn its strategies, so that we might convince mothers that as much as feminism needs motherhood, mothers also need feminism. (Quoted from Hirsh 367 on page 254)

Feminist Mothering can be purchased at an indie bookstore or Powell's and it would be a wonderful Mother's Day present!

Health News of the Day

Health News of the Day is a daily summary made from the selected links I post on Twitter. It is in a bullet points format with links to the original sources which include 350 RSS feeds that produce about 2,500 items per day.

  • Low Vitamin D Levels Linked to Colds and Flu http://is.gd/kCgA

  • People with the lowest vit. D (less than 10 ng/mL) 36% more likely to have an URTI than those with levels higher than 30

  • Higher Calcium Intake May Reduce Risk of Colorectal and GI Cancers http://is.gd/kChC

  • Older people who got most calcium from food/suppl. had a 16% lower risk of colorectal and other cancers of the GI tract

  • MicroRNAs in blood may lead to new tests for liver toxicity http://is.gd/kCiy

  • Anger really can kill you by triggering potentially deadly heart rhythms (VT/VF) http://is.gd/kCiW

  • Earthquakes, war or even the loss of a World Cup Soccer match can increase rates of death from sudden cardiac arrest

  • Urine test for lipocalin 2 (Lcn2) may tell of breast cancer's spread http://is.gd/kCjz

  • Lipocalin 2 (Lcn2) gene associated with estrogen receptor (ER)-negative breast cancers

  • Only 60 percent of the lifeguards reported using sunscreen http://www.nytimes.com/2009...

Image source: OpenClipArt.org, public domain.

Twitter Song: "You're No One If You're Not On Twitter"



Video: "You're No One If You're Not On Twitter" by Ben Walker, a musician and author of IHateMornings.com.

The video has had 297,011 views as of today. Make that 297,012...

Do you remember the Digg.com song?


Kina Grannis created the “Digg Song” and became an almost instant viral success, so much so that a record company has been in touch with her. Link via Dr Shock MD PhD. Song chorus:

"Gotta digg, gotta digg, gotta digg
Gotta make this story big!"

I have not heard of the "Diagnosis Wenckebach" singers being offered a record deal yet. Strange.

References:
Digg.com and Other Web 2.0 Songs

What USMLE scores do I need to get into the residency/specialty of my choice?

Who else is better to answer this question than the team from First Aid for USMLE? The list below is based on the Step 1 Scores for US Senior applicants:

Tier 1 (Median USMLE Step 1 Scores of 233-243):

  • Plastic Surgery
  • Dermatology
  • Otolaryngology
  • Diagnostic Radiology
  • Radiation Oncology
  • Orthopaedic Surgery
  • Transitional Year

Tier 2 (Median USMLE Step 1 Scores of 217-222):

  • Internal Medicine
  • Pathology
  • General Surgery
  • Emergency Medicine
  • IM/Peds
  • Anesthesiology
  • Neurology
  • Pediatrics

Tier 3 (Medan USMLE Step 1 Scores of 208-213):

  • Ob/GYN
  • Family Medicine
  • PM&R
  • Psychiatry
How to Score Well on the Board Exams

In 2004, I listed a few tips on How to Score Well on the Boards and some of them are still valid:

- Practice makes perfect
- Read a concise book
- Practice with a lot of MCQs
- The formula "first line, last line, answers" works for many test takers
- Pace yourself
- Calculate 2 variables: the percent of correct answers and the seconds you spend on each question
- For those who like mnemonics, the best free resource is Medical Mnemonics.com

References:
What Score do I need for my Specialty? Firstaidteam.com.
How to Score Well on the Boards?
ABIM Issues Warning Regarding Scam “Certification Boards” Plus How to Score Well on the Real Board Exam

Medical Geek Humor on Twitter

Twitter is a microblogging service where people answer the question "What are you doing?" via 140-character messages from their cellphone, laptop or desktop. You can select the messages (called "tweets") that you find useful, amusing, or both.

The tweets below are part of the series Medical Geek Humor on Twitter:


ruraldoctoring
ruraldoctoring Ever have one of those days when you didn't feel like being nice to everybody? I'm having one now.


Chris Seper

gruntdoc


If you are included in this post but would like to have your tweet removed for any reason, please email me and will comply with your request the same day.

Sunday, February 22, 2009

Book Review: Dancing at the River's Edge by Alida Brill & Michael D. Lockshin, MD

Dancing at the River's Edge: A patient and her doctor negotiate life with chronic illness by Alida Brill & Michael D. Lockshin, MD is an easy read intellectually, but difficult on the heart.

A few disclosures: 1) I haven't read the entire book. Sadly my life is so busy that if I did read the whole book you wouldn't get a review until summer. BUT I do feel I have read enough to give you an honest review; 2) Alida & I were in the Progressive Women's Voices program together where we nurtured a wonderful friendship.

Which is why when she offered me a review copy of her book I was scared. I was scared that it wouldn't be a good read for me. Would I have the courage to tell her the truth? Luckily I don't have to cross that bridge.

I prefer to not think of myself as someone with chronic disease. Those are people with chronic fatigue syndrome or a mystery illness that keeps them from working or enjoying the weekend with family. In reality I am someone with a chronic disease and I know a few are on deck just waiting to join the game.

Since at least age 7 I've been on some sort of allergy pill for hayfever. Sneezine, runny nose, itchy eyes & occasional bloody noces were just life not a disease. This view may stem from being poor and going to a health clinic instead of a doctor's office. You don't go there with tales of sneezing every time the season changes. The only time I recall seeing a doctor was when I had strep or my sister broke some bone.

But after having gestational diabetes and watching my mother die so young, I began reflecting on her own journey of chronic disease. I was barely in high school when she was diagnosed with rheumatoid arthritis - me about 13, her 31. Holy shit! I'm older than that already...and I can feel it. I've forced myself to think of people with chronic disease as someone other than me out of fear. Fear that I won't be able to live my life the way I want.

And that's just where Dancing at the River's Edge fits into my life, perhaps into yours. Alida has lived a full life, not the life one aspires to with her many trips to the hospital, but a life rich enough to be proud of. Upon being diagnosed with illness after illness, she did not sequester herself away from the world, even if some in her life might have wanted it that way. Her life story shows that even those of us with chronic diseases can live full and happy lives.

At the same time, Dancing also gives us a peek into our doctor's head. Alida's long-time doctor, Dr. Lockshin, takes his turn in telling his side of the story - both as Alida's provider, but also as a doctor who knows that most of his patients will never recover or get well. Kids don't grow up wishing to be doctors of people they can't cure. It's the cure that propels the young women I work with through hours of organic chemistry. I don't know if they have ever thought of working with people who most likely will never know a cure. But Dr. Lockshin takes us into those dark places for doctors.

In the end, Dancing is a book of hope. Hope that despite the pills, the IVs, the hours spent on that damn paper-lined table that we will still have full and rich lives. That we are still owed love and respect. That our doctors are struggling with us as well. This fact may scare some, but I am actually comforted by this tidbit. It flattens the playing field. It makes me think that perhaps some of us are partners in healing, not just receivers of wisdom in the form of a pill.

Alida will be on the Bonnie Hunt show TOMORROW! Set your DVRs!

You can purchase Dancing from an indie bookstore or Powells.

Health News of the Day

Health News of the Day is a daily summary made from the selected links I post on Twitter. It is in a bullet points format with links to the original sources which include 350 RSS feeds that produce about 2,500 items per day.

  • Children with peanut allergy given small daily doses of peanut flour were able to build tolerance - potential "cure"? http://is.gd/kgMK

  • You've heard about it in the news but this is the source: Successful oral tolerance induction in severe peanut allergy. http://is.gd/kg4L

  • Serum interleukin-17 levels are related to clinical severity in allergic rhinitis http://tinyurl.com/dhwjyq

  • Vitamin B12 Useful for Recurrent Aphthous Stomatitis (RAS), RAS affects 25% in the general population http://is.gd/kizv

  • in RAS, 74% of patients treated with sublingual vitamin B12 were aphthous ulcer-free compared with 32% with placebo http://is.gd/kizv

  • Ustekinumab (anti-IL12, IL 23) reduced symptoms of psoriatic arthritis and psoriatic skin lesions, well tolerated http://is.gd/kgAL

Image source: OpenClipArt.org, public domain.

Saturday, February 21, 2009

Health News of the Day

Health News of the Day is a daily summary made from the selected links I post on Twitter. It is in a bullet points format with links to the original sources which include 350 RSS feeds that produce about 2,500 items per day.

  • Stroke risk increases with the number of fast-food restaurants in a given area http://is.gd/k9vO

  • For every fast food restaurant in a designated neighborhood, the relative stroke risk increased 1% http://is.gd/k9vO

  • Psoriasis Drug Raptiva (Efalizumab) Linked to progressive multifocal leukoencephalopathy (PML) in 3 Cases http://is.gd/k9dX

  • Raptiva (Efalizumab) already has a black box warning about the risk of life-threatening infections, including PML http://is.gd/k9dX

  • Efalizumab (Raptiva) is a recombinant humanized monoclonal antibody that binds to CD11a, a component of LFA-1 (integrin) http://is.gd/k9fK
  • Most Americans infected with the AIDS live in cities, with 10 states accounting for 71 percent of cases http://is.gd/k9U2

  • 56,300 people became newly infected with HIV in the U.S. in 2006, 48% were men who have sex with other men http://is.gd/k9U2

Image source: OpenClipArt.org, public domain.

Selection of My Twitter Favorites, Edition 43

Twitter is a microblogging service where people answer the question "What are you doing?" via 140-character messages from their cellphone, laptop or desktop. You can select the messages (called "tweets") that you find useful, amusing, or both. Here is the 43rd edition of My Twitter Favorites (the oldest post is at the bottom, the newest at the top): Micro-blogging on Twitter is easy, fun and can be very useful and educational if you follow/subscribe to interesting people.
You can read more here: A Doctor's Opinion: Why I Started Microblogging on Twitter and
visit my account at Twitter/AllergyNotes.

  1. David Schronceschroncd Sports fans are skeptical about A-Rod's excuses at his newsconference. If I want to watch a millionaire lying to me, I can always watch CNBC
  2. medicalstudentmedicalstudent Whoever put into Google "feel completely lost medical student" & found my site, if you're out there, get in contact! There's help available
  3. Kent Andersonkanderson Even after a long winter, a light snow is still pretty.
  4. Ves Dimov, M.D.AllergyNotes Video: 100 days, 100 songs, 100 locations, 100 dances, by a graduate student at Yale http://vimeo.com/3237836 -- Not for the faint-hearted.
  5. Howard Lukshjluks Saw 4 patients today who want to "rush" surgery due to Cobra and no job prospects. Strange and sad.
  6. joemdjoemd MD Life: I saw a demented woman today. "Any children?" I asked. "No," she said. She has a daughter. What a loss for both.
  7. Howard Lukshjluks Do patient expectations(from surgery) vary by generation? Is *perfection* the next "standard of care"?
  8. Joey deVillaAccordionGuy @gapingvoid: Q: What's the difference between a large pizza and a social media specialist? A: A large pizza can feed a family of four.
  9. Ves Dimov, M.D.AllergyNotes RT @steverubel: Great advice from @garyvee about taking criticism http://is.gd/jKgq -- "Don't listen to anyone, listen to everyone "
  10. Bertalan MeskóBerci The Doctor as the Second Opinion and the Internet as the First http://bit.ly/16I9lW
  11. Loic Le Meurloic Video shows how you really are and most of you are scared about that. You should not.
  12. rlduganrldugan "Success is like wrestling a gorilla. You don't quit when you're tired - You quit when the gorilla is tired." Robert Strauss
  13. Ves Dimov, M.D.AllergyNotes Glad to see that now my blog is #1 Google search result for "wine allergy" before a website called "Nobody Knows Anything" http://is.gd/jEsC
  14. Steve Rubelsteverubel Lance Armstrong's tweets are also quoted in the press http://ping.fm/AnFPD
  15. David PoguePogue Landed in Chicago, taxiing. Pilot says, "Look out the left side of the aircraft"--there was AIR FORCE ONE!! Cool! My kids loved it. Me 2.
  16. Zappos.com CEO -Tonyzappos Be Humble: “In the beginner's mind there are many possibilities, but in the expert's mind there are few.” - Shunryu Suzuki
  17. Chris Seperchrisseper Icon_lock Wife: "You're too conservative. I'm the wild one." It's the glasses, isn't it?
  18. David Schronceschroncd TX Dept of Health is recalling products from peanut plant after finding dead rats. The rats families are also filing a $150 million lawsuit
If you are included in this post but would like to have your tweet removed for any reason, please email me and will comply with your request the same day.