Annals of Int Med: The Death of a Clinician-Educator

The Annals of Internal Medicine published an interesting and thought-provoking piece called
The Death of a Clinician-Educator by Dr. Kimberly Manning, a junior faculty at Emory University. I can certainly share some of the feelings expressed by the author.

The full text is paid subscribers only for the next 6 months but you get a nice bonus if you listen to the Annals podcast -- the author reads the whole piece herself (MP3 file, 10 MB).

Lasix and NSAIDs for Thoroughbred Race Horses

Barbaro was a young American thoroughbred horse that won the 2006 Kentucky Derby. On May 20, 2006, he ran in the Preakness Stakes as a heavy favorite, but he fractured three bones. Barbaro underwent surgery but he soon developed laminitis in his left rear leg. While his right leg eventually healed, a final risky surgery on it proved futile because the colt soon developed further laminitis in both front legs. It then became clear he could not be saved, and Barbaro was euthanized (source: Wikipedia, image: Godolphin Arabian).

A NY Times article comments on drug use in horse racing and different training styles used on both sides of the Atlantic:

"Horses racing in America are allowed to be injected with various drugs on race day, the most common being Lasix, a powerful diuretic, and phenylbutazone, an anti-inflammatory medication.

“A horse will try his hardest,” Dr. Stewart, head of veterinary regulation for the Hong Kong Jockey Club said, “and if he can’t feel pain he will run through it, increasing the risk of injury.”

Barbaro was running on Lasix in the Preakness, and there is no evidence that this had anything to do with his accident. But his story became a rallying point for improving safety for thoroughbreds."

As an interesting fact, all modern thoroughbreds carry the genetics of three Arabian stallions imported to England from the Middle East in the 17th and 18th centuries: the Darley Arabian, to whom 95% of today's thoroughbred pedigrees trace, the Godolphin Arabian, and the Byerly Turk. (Source: Wikipedia).

References:

I’m Not Barbaro, for Lots of Reasons. NY Times.
Death and Disarray at America’s Racetracks -  24 horses a week die at racetracks around the country - NYTimes, 2012.
Veterinarian Says Goodbye to a Patient. NY Times.
Barbaro from Wikipedia, the free encyclopedia.
Still Caring for Barbaro. NYTimes, 05/2007.
Image source: Wikipedia, public domain.

A very special dog: Skidboot

A heart-warming segment from Texas Country Reporter (8 min). There may never be another Skidboot -- the smartest dog in the world, according to Jay Leno, at least.

Related:
See more videos at Skidboot.com.
Link via FatDoctor.

How a Doctor Almost Killed Her Dog - ibuprofen, the key ingredient in Motrin, poisons dogs. NYTimes.

Medical News

Former Italian premier Silvio Berlusconi had a pacemaker implanted at the Cleveland Clinic

According to the International Herald Tribune, a pacemaker was implanted in the heart of former Italian Prime Minister Silvio Berlusconi at Cleveland Clinic’s Heart Center on Dec. 18. Andrea Natale, a Sicilian-born physician and a Section Head of Electrophysiology & Pacing, performed the surgery "to correct a problem with the heart rhythm." Berlusconi was hospitalized at the Clinic for 4 days and returned to Italy on Dec. 22.

The 70-year-old Berlusconi collapsed while giving a speech in Tuscany on November 26, his aides and doctor blamed the episode on a sharp drop in blood pressure.

References:
Clinic: Ex-Italian Premier Berlusconi doing well after operation. IHT.
Surgeon: ex-Italian Premier Berlusconi doing well following surgery to implant pacemaker. IHT.
Silvio Berlusconi from Wikipedia, the free encyclopedia.
Image source: Wikipedia, public domain.

Related:
Cleveland Clinic names chair of new Heart and Vascular Institute. Cleveland Plain Dealer, 10/04/2007.


EarthLink CEO Dies of a Rare Tumor

According to a company press release, Charles (Garry) Betty, a President and CEO of EarthLink has died from complications of adrenocortical carcinoma on January 2, 2007. He was only 49. Before joining EarthLink, Betty served as CEO of Digital Communications Associates, Inc. (DCA) and became the youngest CEO of a NYSE listed company.

Adrenocortical carcinoma (also adrenal cortical carcinoma or adrenal cortex cancer) is a neoplasm of the cortex (outer layer) of the adrenal gland. It is a vary rare malignant tumor with an estimated incidence of 1 in 1.5 million people.

References:
Charles (Garry) Betty, from Wikipedia, the free encyclopedia.
Adrenocortical Carcinoma. Medscape.
Adrenocortical carcinoma, from Wikipedia, the free encyclopedia.
EarthLink CEO passes away at age 49. CNN.
Garry Betty, 49, Chief of the Internet Provider EarthLink, Dies. NYTimes.

Updated: 10/04/2007

Interesting Links

Evidence Based Medicine Resources. New Media Medicine Blog.

A long list which seems both useful and comprehensive. I will send it to my residency program director, he is a devoted follower of evidence-based medicine and I am sure many residents will find something interesting to read when they prepare for a journal club.


Alcohol Consumption and Risk for Coronary Heart Disease among Men with Hypertension. Annals of Int Med, 1/2/2007.

One of our hospital medicine fellows recently presented a noon conference about the health effect of alcohol. He mentioned that "the body of evidence supporting the beneficial effects of alcohol is so large that there is almost no doubt at this point." This study adds just a little bit more and MedPundit comments on it.


UpToDate Founder Talks About Starting the Project in 1992

Burton D. Rose, MD, the founder and editor-in-chief of UpToDate, is interviewed by MDNetGuide.


Medical ultrasound cases with images

A collection of videos and clinical cases by Dr. Joe Antony, a radiologist in South India.


Mozilla Discloses 2005 Revenues: $53M. GigaOM.

If nothing else, we should be happy that Google allows Firefox and Opera browsers to be distributed and used for free. How is that possible? The integrated search box in those browsers covers the cost handsomely and it actually makes money. This is not surprising, considering the fact that Google reportedly makes 2o cents from every search query. Yahoo! lags behind, making "only" 10 cents per search. Yes, we live in a different world since Google launched AdWords/AdSense, at least from the perspective of the Internet economy.

Maps of Visited Countries and States

Visited Countries

11 countries (4%):
Hungary
France
Romania
Czech Republic
Serbia
Greece
Bulgaria
Italy
United States
create your own visited countries map

Visited States

23 states (45%):
Florida
Louisiana
Massachusetts
New Jersey
North Carolina
Rhode Island
West Virginia
California
DC
Georgia
Illinois
Michigan
South Carolina
Texas
Virginia
Wisconsin
Delaware
Indiana
Maryland
Minnesota
New York
Ohio
Pennsylvania
create your own visited states map

Source: Visited Countries. Douweosinga.com.

Updated: 11/17/2007

Translate Your Medical Website Automatically with Google Translate

Casesblog and ClinicalCases.org have had automatic translation via Google Translate for a while now (see the form in the lower right corner of any page). I have noticed through SiteMeter statistics that some international visitors are using the form to translate the blog and ClinicalCases.org into their native language.

Google released a translation algorithm from English to Russian a few weeks ago and I just added this function to the form. The automatic translation is far from perfect grammatically but in most cases it can convey the sense of what is written. The translation works seamlessly from technical point of view though -- if somebody closes the top frame, he/she can browse any English website, translated into his/her native language, without even knowing that the website is originally written in English -- try it with CNN. If you hover the mouse over any text in Firefox, you can see a callout with the English translation. This is neat. It works only in Russian, Arabic and Chinese, as far as I tested it.

Using Google Translate makes your website accessible to medical students and residents from around the world who may not know English well. Callouts could help them learn the language better and faster.

I have included the HTML code of the translation form here (click to open a new page). Feel free to use it for your own website, just replace "casesblog.blogspot.com" with the URL of your site.

References:
Google Russian Translator. Google Operating System.
Embed Google Translate widget in your blog template: Translation Widgets for Your Site. Google Operating System, 11/2007.

Related:
Read Googlified in Multiple Languages. Googlified.
Useful Google Translate Addresses. Google Operating System.
Google Translate Becomes the Best Free Online Translator. Google Operating System, 05/2008.

Updated: 05/09/2008

James Brown, 'the Godfather of Soul', Died Early Today

From Wikipedia:

"James Joseph (May 3, 1933 – December 25, 2006), also known as The Godfather of Soul, was an African American entertainer who was recognized as one of the most influential figures in 20th century music.

Brown was admitted to the Emory Crawford Long Hospital in Atlanta, Georgia on December 24, 2006 after a dentist visit where he was found to have severe pneumonia. Brown died the next day on December 25, 2006, around 1:45 a.m. at the age of 73.

Frank Copsidas of Intrigue Music said the cause of death was uncertain. "We really don't know at this point what he died of," he said."

According to eMedicine: "Pneumonia is the 6th leading cause of death in the U.S. and is the most common infectious cause of death. The mortality rate is reported to be 1% in the outpatient setting but may increase to up to 25% in those requiring hospital admission."

James Brown "was renowned for his shouting vocals, feverish dancing and unique rhythmic style." (Wkipedia). Many videos showing memorable James Brown's performances during the years are uploaded to YouTube. There are also several hundreds photos on Flickr. Motocchio described what it felt to be at a James Brown concert:

"Tonight turned to be one of the most special nights in my life.... Marco and i went to JB's concert tonight!

he's 73 years old. but he's still damn good, and the concert was one perfect entertainment show. and, his charisma... when he appeared on the stage, everybody got crazy and screamed.... including us. when he was singing "it's a man's man's man's world," i understood very very well why bruce brothers got enlightened by a church minister played by him... his music really touches people's soul. he's truly the king of soul.


James Brown & Pavarotti

References:
James Brown, from Wikipedia, the free encyclopedia
Pneumonia, Bacterial. eMedicine.
James Brown, the 'Godfather of Soul,' dies at 73. CNN.
James Brown RIP: Jump Back, Jack, See You Later, Alligator. Steve Anderson.
Image source: James Brown performs at the Yunfeng Theater in Shanghai. Licensed under Creative Commons.

Updated: 12/01/2007