
Best wishes from the Medgadget team to all of our readers. May you have a safe, healthy and prosperous new year!
We will resume our regular publishing schedule and see you back here on Wednesday, January 2nd.
Archives: 12/2007

Folks suffering from carpal tunnel syndrome and those with limited hand movement may want to look into a tracking camera from NaturalPoint that lets the user control a computer mouse by simply moving the head.
Here’s a short video demonstrating the device’s abilities.
(hat tip: PopGadget)
Investigators from the University of Minnesota are reporting in the latest issue of Journal of Medicinal Chemistry that their compound called sulfanagen was found to be twice as effective as a standard cyanide antidote when orally administered to lab mice. This novel potential treatment is based on 3-mercaptopyruvate (3-MP), a substrate for the enzyme 3-mercaptopyruvate/cyanide sulfurtransferase (3-MPST), an enzyme that converts naturally occurring (in pitted fruits, grasses and other foods) cyanide to the nontoxic thiocyanate. Here’s the reaction that is thought to be catalyzed by sulfanagen through sulfurtransferase :
From the press statement by the University of Minnesota:
Current cyanide antidotes work slowly and are ineffective when administered after a certain point, said Steven Patterson, Ph.D., principal investigator and associate director of the University of the Minnesota Center for Drug Design.
Patterson is developing an antidote that was discovered by retired University of Minnesota Professor Herbert Nagasawa. This antidote works in less than three minutes — meeting the United States Department of Defense “three minute solution” standard. The research will be featured in the Dec. 27, 2007 issue of the Journal of Medicinal Chemistry.
“It’s much, much faster than current antidotes,” Patterson said. “The antidote is also effective over a wider time window. Giving emergency responders more time is important because it’s not likely that someone will be exposed to cyanide near a paramedic.”
The antidote was tested on animals and has been exceptionally effective, Patterson said. Researchers hope to begin human clinical trials during the next three years.
The antidote is also unique because it can be taken orally (current antidotes must be given intravenously) and may be administered up to an hour prior to cyanide exposure.
Cyanide is a rapid acting toxin that inhibits cellular respiration — it prevents the body from using oxygen. This means it rapidly shuts down many of the fundamental biochemical processes the body needs to survive. Symptoms of acute cyanide poisoning include headache, vertigo, lack of motor coordination, weak pulse, abnormal heartbeat, vomiting, stupor, convulsions, coma, and even death.
When released in an enclosed area, cyanide can be particularly deadly and impact a victim very quickly. Survivors of cyanide poisoning are also at risk of short-term memory loss and development of a Parkinson’s-like syndrome.
Press release: U of M researchers discover fast-acting cyanide antidote …
The abstract: Novel, orally effective cyanide antidotes. J Med Chem. 2007 Dec 27;50(26):6462-4.
More from Star Tribune …

A motley crew of four engineering and computer science students at Calvin College is developing a portable electronic stethoscope as a student side project. The project, dubbed Rhythm Reloaded, is focused on building an embedded unit that will run on Linux and feature these capabilities:
Record high-quality audio data from a patient’s body Store this audio data in a convenient format Use a USB interface to transfer the audio files to a computer Reduce the amount of ambient noise that a doctor hears Be simple, accurate, and easy to use!
More at Rhythm Reloaded…

Radiation-induced oral mucositis is the most common complication observed in patients with head and neck cancer who underwent radiation therapy. Thanks to a newly developed supersensitive infrared camera from Argonne National Laboratory, early diagnosis and possible prevention and/or treatment of oral mucositis could be possible:

While buccal and other head-and-neck cancers are treatable and frequently curable, patients who undergo the necessary treatment regimen — a combination of radiation and chemotherapy — frequently develop unpleasant side effects. One of the most common and painful of these, oral mucositis, involves the inflammation and ulceration of the mucous membranes of the mouth and soft palate. These sores can make speaking, eating or even opening the mouth extraordinarily painful. If patients experience especially severe toxicity, they may temporarily lose the ability to taste or may even need to be fed through a tube…
As part of the ongoing National Cancer Initiative, researchers at the U.S. Department of Energy’s Argonne National Laboratory have teamed up with oncologists at the University of Chicago to use infrared imaging of the head and neck to predict which patients have the highest risk for severe mucositis. Patients who show local increases in temperature around the tumor site in the immediate wake of the initial round of treatment may be more likely to suffer later side effects, said Ezra Cohen, a University of Chicago oncologist who will head up the clinical side of the project.
Cohen, in collaboration with Valentyn Novosad, a principal investigator in Argonne’s Materials Science Division (MSD), has already run a pilot study of six patient volunteers, which they parlayed into a successful grant proposal to the National Institutes of Health that will enable them to undertake a two-year study of 34 patients with head and neck cancers.
Oncologists use radiation therapy as an aggressive, but crude, method for fighting cancer. Although the radiation beam is typically focused on the area that contains the tumor, it cannot tell the difference between healthy and malignant cells. As a result, normal tissues suffer collateral damage as tumors are zapped. “At this point,” Cohen said, “we have no treatment that allows us to kill tumor cells without also damaging normal tissue. We accept the toxicity because it’s a necessary part of the intended cure, and we know that it eventually gets better…”
In order to detect possible toxicity, Novosad and Argonne physicist Volodymyr Yefremenko developed a prototype infrared camera that detects temperature gradations as small as one-twentieth of a degree Celsius. Typically, the tumor appears warmer than the surrounding tissue, but for some patients the infrared image taken after the first round of chemo- or radiation therapy shows a larger region of elevated temperature around the tumor site, indicating the beginning stages of inflammation. These patients, Cohen said, are the ones most likely to encounter problems with mucositis down the road, even if they are not yet symptomatic. Argonne scientists are developing a standardized approach to quantify changes in thermal signature of individual patients during the course of therapy…
Without this technology, doctors would have no way of telling which patients had the greatest risk for developing mucositis, Cohen said. “Right now, I can only say to a patient that there is a small chance of severe toxicity, a good chance of moderate toxicity, and a small chance of very little toxicity. The problem has been that we’ve had no way to predict upfront who will suffer the most.”
If doctors can use this technology to detect that a patient is likely to suffer a great deal of toxicity, it may enable them to tailor their treatment regimens more closely to patients’ individual needs, according to Cohen. “If I knew that a patient would encounter severe toxicity, I might want to reduce the doses of chemotherapy a little bit. Or I might want to put in a feeding tube early on knowing that they’re going to have trouble eating and drinking down the road. Or I might want to have very early consultations with physical therapists knowing that these are patients who are going to have trouble.”
New thermal-imaging technique may help victims of head and neck cancers …

Amy Tenderich over at DiabetesMine is featuring a couple innovative designs for a glucometer and an insulin pump. The devices don’t exist, but the prototype concepts are interesting nevertheless.
Check them out at DiabetesMine…

With the latest additions, and for your consideration, here is the current list of 2007 Medical Weblog Awards nominees:
Aetiology
Biomedicine on Display
ButYouDontLookSick.com
CareerMedicine
Clinical Cases and Images
Diabetes Mine
Dr Shock MD PhD
Dr. Val and The Voice of Reason
Dr. Wes
Ελεύθερος Νευρώνας
ERnursey
The Fitness Fixer
A fortunate man
I’m a Medical Student, Get Me Out of Here
The Independent Urologist
Kevin, M.D.
The Last Psychiatrist
Mousethinks
NeuroLogica Blog
Nurse Ratched’s Place
Of Short White Coats and Stethoscopes
other things amanzi
Panda Bear, MD
paradoxuganda
The Physician Executive
Random Acts Of Reality
Respectful Insolence
retired doc’s thoughts
Running a hospital
Six Until Me
Surgeonsblog
Terra Sigillata
TomographyBlog
Unprotected Text
Women’s Health News
Baby blue pyjamas
Belaray Dermatology
Brain Scramble
Canadian Medicine
CareerMedicine
Corazén Hispano
The Derm Blog
Doctor David’s Blog
Dr Shock MD PhD
Dr. Val and The Voice of Reason
EverythingHealth
A fortunate man
The Happy Hospitalist
KOLAHUN
MedBlog.nl
Miami, M.D.
Mousethinks
NY Emergency Medicine
The Physician Executive
Prudence, M.D.
Respiratory Therapy 101: Just Keep Breathing
Suture for a Living
TomographyBlog
Unprotected Text
USMLEMD
A Chronic Dose
crzegrl.net
Dr. Hébert’s Medical Gumbo
In Sickness and In Health
intueri
impactEDnurse
Random Acts Of Reality
Respectful Insolence
Street Watch: Notes of a Paramedic
Surgeonsblog
Aetiology
Clinical Cases and Images
The Corpus Callosum
Ελεύθερος Νευρώνας
The Fitness Fixer
NY Emergency Medicine
Pallimed: A Hospice & Palliative Medicine Blog
Sumer’s Radiology Site
UroStream
Bioethics International
The Blog that Ate Manhattan
The Carlat Psychiatry Blog
Dr. Wes
InsureBlog
Health Care Organizational Ethics
Health Care Policy and Marketplace Review
Health Care Renewal
JAY PARKINSON + MD + MPH
KOLAHUN
Managed Care Matters
MSSPNexus Blog
PharmaGossip
The Physician Executive
The Pump Handle
Respectful Insolence
Running a hospital
Scientific Misconduct Blog
We Stand FIRM
Women’s Bioethics Blog
Biomedicine on Display
Challenge Diabetes
Clinical Cases and Images
davidrothman.net
Dr. Wes
InsureBlog
Ελεύθερος Νευρώνας
Life as a Healthcare CIO
ScienceRoll
Billy Bob’s Wild Ride
The biopsy report
Brass and Ivory
ChronicBabe.com
A Chronic Dose
Corazén Hispano
Diabetes Mine
Finding Optimism
In Sickness and In Health
Six Until Me

The 2007 Medical Weblog Awards is proudly sponsored by ScrubsGallery.com
Nominations are being accepted! Nominate here…
The 2007 Medical Weblog Awards announcement…
UPDATE: 2007 Medical Weblog Awards Sponsored by ScrubsGallery.com: Meet the Winners!
Hello and welcome to Grand Rounds at Medgadget! Grand Rounds is the weekly collection of the best in online medical blogging, with posts collected from doctors, nurses, students, researchers, policy wonks, and patients.
Today’s edition falls on Christmas Day! When growing up, we always looked forward to a bunch of presents (gadgets?) under the tree — and hope you are waking up to a warm and plentiful Christmas scene today. Perhaps you’ll consider the links below a kind of Christmas bounty, with gifts from around the world designed to provoke, delight, and capture your fancy.

To begin with, it’s the season of giving, and pediatric oncologist Dr. Samuel Blackman of Blog, MD has been shared his thoughts on the strange new concept of medical gift cards. He’s also got some stats on gift card craze.
On a broader level, Liana from Med Valley High revisits the UN’s Millennium Development goals, which ask the richest nations to donate 0.7% of their GNI to the poorest. As nations, we’ve fallen short, and as individuals, she’s issued a challenge for charitable giving.
On the ligher side, Henry Stern of Insureblog has some commentary on direct-to-consumer advertising, and promotes an important public service announcement about the side effects of a powerful drug that many people take for shyness (though in the ER we might see this drug’s off-label uses).

Onto the world of science and research! Shedding light on controversial or complicated medical news is something the blogosphere does very well, and this week we’re highlighting a number of posts that you’ll be mulling over with some egg nog.
It’s not everyday you head the word “cure” bandied about for a common and deadly disease — but as Prof. Tara Smith of Aetiology points out, it’s even rarer that the cure is quite so repugnant.
Blogging at Sharp Brains, Alvaro Fernandez interviews Dr. Elizabeth Zelinski about her new trial of a commercially-available cognitive training regimen for aging minds. There’s hope!
Christian Bachman of Med Journal Watch describes new research that suggests demanding jobs keep brains spry. There’s more hope!
The psychiatrist behind How to Cope with Pain notes a sea change in pain research, as studies now look at combinations of pain meds, instead of relying on less clinically relevant head-to-head trials.
Over at MyDiabetesCentral, Gretchen Becker gives an overview of new insulin delivery study, and explains how recent news reporters jumped to the wrong conclusions about how this lettuce-derived insulin can help (these are not the salad days of TV journalism).
Scienceroll‘s Bertalan Mesko has ventured a possible explanation for the phenomenon of green sweat (and it doesn’t involve gatorade or the Grinch).
Long before there were Grand Rounds of medical blogs, hospitals have been using another version of Grand Rounds, to teach. In a very meta moment, Dr. Shock has submitted a post about the accuracy of bold statements made during grand rounds. We boldly, and accurately, claim this post is worth a look.
Speaking of Grand Rounds, the blogger at Ten out of Ten has a compiled his or her own medical blog roundup , to the tune of a familiar holiday song.

We asked bloggers to recall some holidays they spent in the hospital, and they responded with some poignant stories. Susan Palwick, from Rickety Contrivances for Doing Good, recalls her grandfather’s admission two decades ago.
Laurie Edwards of A Chronic Dose looks back at the holidays she’s spent in the hospital, and looks forward to a healthy year.
Terry Freemark from the Counting Sheep blog describes the marathon shift she’ll be working over Christmas. Stop by her site and drop a note of encouragement!

We also asked bloggers to come up with some year-end reviews. Writing in Teen Health 411, Nancy Brown, PhD looks back on the year’s top teen health stories.
Over at the DiabetesMine, Amy Tenderich and friends have composed a smartmob-style group review of diabetes news in 2007.
Never one to conform, future doc Jan Martens sends in his edition of hosting the Medicine 2.0 carnival, a preview of online medicine in the year 2015.
Back to the present, another retrospective comes from Prudence MD, where Filipino doctor Tess Termulo, who reviews a year of blog posts.

This time of year, carolers encourage peace on earth, and godwill toward all. But at Nurse Ratched’s Place, Mother Jones tells a tale of interdepartmental nastiness, in her delightfully wicked post entitled Give ‘Til It Hurts .
She’s not the only one two notice that hospital administration isn’t always on the ball. ER Nursery rants about the latest fat from the suits in management.
Over in Gruntdoc‘s neck of the woods, he’s bummed about an ER nurse leaving… for the greener pastures of management.
But there are some places where hospital administration is different. Or at least, they’re blogging, and getting results. CEO Paul Levy, when he’s not busy Running a Hospital, recently challenged the US News rankings — and the reporter responded in the comments!
Administrator Tony Chen returns from a blogging sabbatical and makes an impact, with his review of the year in healthcare.
But Executive Physician Dino Ramzi notes that we should pat ourselves on the back, because customer service in medicine isn’t that bad.
The blogger behind Health Psych notes that ’tis the season to be jolly … but maybe not if you suffer from depression, or are vulnerable to the season’s extra pressures. She offers some warning signs and coping tips.With New Year’s resolutions coming up, psychologist Dr. Deb Serani looks at some risks of discontinuing SSRIs.
And EverythingHealth‘s Dr. Toni Brayer blogs about some bad habits that may harm our New Year’s resolutions.
Jenni Prokopy, the Chronic Babe is winding down a year full of tough setbacks, but these 5 steps for a fresh mindset kept her afloat, and may help you make the most of 2008.

It wouldn’t be Grand Rounds without a word from our surgery colleagues, who always seem to offer up some meaty reading. First, ENT specialist Dr. Bruce Campbell reflects on a special patient, who chose an operation that left her mute (but not unheard).
Ever the provacateur, Bongi has a post on carjacking and all-to-common surgical scenarios in South Africa.
On that note, the Monash Medical Student, Jeffrey Leow, asks some interesting questions about music playing in the OR.

For you policy and politics mavens, Grand Rounds has an extra helping this week. We’ll start with David E. Williams from the Health Business blog, who has an eye-opening analysis about the complex relationship between the American Academy of Ophthalmology, a drug company, and the two similar medications it makes to treat cancer (similar in many ways except price).
The blogger named Kolahun discusses a troubling chart in last week’s NEJM disparities in doctor-to-AIDS patient ratios in different countries. It’s a 10,000-fold swing between the UK and Malawi.
Rachel from Tales of my Thirties is miffed about a gym that misrepresents thyroid disorders.
Joshua Schwimmer writes in from the Efficient MD, with a holiday wish — a free HIPAA-compliant email system that’s as good as (or part of) Gmail.

The holidays mean different things to different parts of the health care world. For the students, like Jeffrey MD, it’s a time to reflect on the highs and lows of medical school thus far.
Another student, Vitum Medicinus feels lucky to emerge intact after the storm of final exams , and surveys the landscape in a confused state.

Of course, medical blogging really shines in its stories. Val Jones, MD is ordinarily the Voice of Reason — but here she shares a funny tale involving her family at Christmas… it’s not quite medical, but features a strong biological component.
And finally, Dr. Wes shares a poignant remembrance of his dad, whose final year was chronicled on Dr. Wes’ blog.
It’s worth recalling Rev. Susan Palwick’s words, from her post above:
This Christmas, give something bright and beautiful to the people you love, especially if they’re sick. And don’t wait to thank the people to whom you’re grateful: let them know now how much they mean to you.
Have a happy and healthy holiday — hopefully with your loved ones, or at least working at a job you love. And with that, this Grand Rounds comes to a close. It’s certainly been a Christmas (and Christmas eve) unlike any other we’ve experienced, and we’re grateful for the chance to share it with you.
Please be sure to nominate medical blogs you think are worthy of an award, and check back after January 8th to vote for the finalists!
And next week, be sure to check out the first Grand Rounds of 2008, coming to you for the first time from Africa.











