The Dangers of FaceBook

Journal article from Student BMJ:

The Dangers of Facebook

Posted 12/29/2008

Neil Graham; Philippa Moore

Abstract
Increasing numbers of doctors and medical students are turning to websites such as Facebook to make friends, chat, and organise social events. These innovations have made some aspects of life easier and are a powerful tool for communication, but they also blur the line between our personal and professional personas. With the veneer of friendship that's offered on these sites, it's all too easy to reveal more information than is appropriate. If this information falls into the wrong hands, problems can arise about your integrity, employment, and fitness to practise medicine.
Introduction

In a recent study in the Journal of General Internal Medicine, the Facebook profiles of a group of medical students in Florida were scrutinised with the aim of establishing how dangerous Facebook could be in the intersection of personal and professional identities. The study found some profiles publicly displaying photographs of trainee medics drinking to excess, engaging in sexual behaviour, and, in one instance, posing with a dead racoon. Three of the 10 students in the sample had also joined groups on Facebook that could be interpreted as sexist or racist.[1]

Whether the private activities of a medical professional have an impact on their ability to practise is debatable, but it cannot be denied that putting private material in such a public arena has the potential to undermine trust in the profession.

What's interesting about this is that Doctors are normal people (surprised?). We get up to the same shit that others do. That's why Scrubs is such a bloody realistic show! Believe it or not.

The difference now? Our real personalities are available on the web for our patients to see. If we're not careful. Suddenly they know we're not God. Bummer.

A NEW STEALTH WEAPON ACUPUNCTURE GOES TO WAR..AIR FORCE DOCTOR HAS BEEN TRAINING MILITARY DOCTORS IN BATTLEFIELD COMBAT ACUPUNCTURE

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ACUPUNCTURE TO REDUCE PAIN IN COMBAT

I have read that some medical centers offer acupuncture but I was amazed to read that the U.S. Military has enlisted acupuncture into combat and will start to train combat doctors to use acupuncture. The military plans to enlist acupuncture in the battle against war time pain. Military doctors will learn battlefield acupuncture.




"Acupuncture involves placing very thin needles at specific points on the body to try to control pain and reduce stress. There are only theories about how, why and even whether it might work".



Colonel Richard Niemtzow of Andrews Air Force Base developed and named the battlefield acupuncture technique in 2001. "It is a radical departure from classical Chinese, French and German ear acupuncture. He said he realized its possible military value and the events of the World Trade Center influenced him to name it battlefield acupuncture.






As an Air Force acupuncturist, Colonel Niemtzow has trained hundreds of his military counterparts. Battlefield acupuncture focuses on locations on the ear that he said have been known for hundreds of years as effective areas for pain control. The ear is also practical because it can be readily accessed whether on the battlefield or in a hospital bed".




"Now the Air Force, which runs the military’s only acupuncture clinic, is training doctors to take acupuncture to the war zones of Iraq and Afghanistan. A pilot program starting in March will prepare 44 Air Force, Navy and Army doctors to use acupuncture as part of emergency care in combat and in front line hospitals, not just on bases back home".

Battlefield Acupuncture Introduced

Acupuncture for Acute and Chronic Pain in Air Force Personnel

Air Force to Train Combat Docs to Use Acupuncture

POINTING AND SHOOTING YOUR WAY TO BETTER PHOTOS WITH A POINT AND SHOOT DIGITAL CAMERA

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MORE THAN MEETS THE EYE WITH DIGITAL PHOTOGRAPHY YOU AS THE NEXT ANSEL ADAMS WITH A DIGITAL CAMERA

If you follow this blog you may know that one of my avocations besides medicine is digital photography and digital cameras (and if you don't I'm telling you now). Here is an illuminating article from the NYT about how to get better pictures and photos even if you have one of those "point and shoot cameras". There are so many things you can do with digital photography ,it's limited only by your imagination.



"The not-so-dirty, not-so-little secret about even the simplest point-and-shoot cameras is that they work best if you know just a tiny bit about what’s going on when you snap a picture. Otherwise, even scads of megapixels and image stabilization and other ballyhooed features can’t save you from overexposed images and washed-out colors".

Point-and-Shoot (Digital Camera) Does Not Preclude Thinking

Video Review of Casio EX-FH 20

WHAT ARE PROTEINS WHY DO VEGETARIANS HAVE TO WORK HARDER TO GET PROTEIN

WHAT ARE PROTEINS?

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When people talk about food having protein do they know what they are talking about? Do you know what protein is? Most people know in a general sort of way, that meat like steak, hamburger and chicken and fish have protein. That's because they are made of muscles and other tissue that is constructed out of biological material generically know as protein. Protein is a vital building block of all biological organisms. But there are many thousands, in fact hundreds of thousands of proteins throughout nature. What do they have in common? Proteins are made of chemicals called amino acids. So by eating protein, your body can deconstruct the proteins and get a source of amino acids to use for building..

WHY DO VEGETARIANS HAVE TO WORK HARDER TO GET PROTEIN?

Because many non meat proteins may not have all the amino acids the body needs. Therefore, vegetarians need to insure that they are getting a variety of protein sources that have the adequate amino acids. See the famous book Diet for A Small Planet by Francis Moore Lappe.

WHAT DO PROTEINS DO IN THE BODY?

What don't proteins do in the body? Besides being structural parts, proteins are involved as enzymes that make chemical reactions possible. Insulin, for example, is a protein made in the pancreas and released into the blood stream to push the glucose in the blood into the cells of the body. Prescription insulin is made by bacteria that have been programmed with the genes to manufacture insulin. Although the human body has hundreds of thousands of proteins and proteins are made by following the instructions of genes, the body is estimated to have 25,000 or 30,000 genes. So the manufacture of a protein is not just a one to one correspondence with a gene. In fact, it's turning out that the old idea of genes as long strands of dna is just a part of the whole genetic story. Besides the fact that dna strands are broken apart and recombined in new arrangements there are other factors added to the dna that impact the genetic behavior, a field called epigenetics, but I digress.

How to Cure HIV. The Book.

OH MY GOD! That picture I used in the last post led me to this book. WTF.

New Revised! Including new research and findings showing what the true causes of HIV & AIDS are and lead directly to their cure! 53 CURED Cases The First Year Cure, not treatment, is the subject of this book. In 1991 Dr. Clark discovered the source of HIV. Once the source became clear the cure became obvious. but would it work? After curing 53 cases in a row, all who used this method, Dr. Clark could wait no longer to present these findings. Since that time many more have been cured, too many to be added to this book. Most important is adding yourself to that list! Electricity can now be used to kill bacteria, viruses and parasites in minutes, not days or weeks as antibiotics require. If you have been suffering from HIV infection or AIDS related illness, learn to build the electronic device that will stop it immediately. It is safe and without side effects ad does not interfere with any treatment you are now on.

Buy it now and save yourself. Crisis. Real medicine is not about anecdotal case studies - it's about randomised control trials.

How to cure HIV

Sometimes, "lost in translation" can be bloody dangerous. See this site.

"What is this HIV Cure meant for?- This cure for HIV is a holistic HIV cure with A bio Magnetic Cards / Bio Magnetic Tablets and immune enhancing herbal medicines. No side effects in this. This s purely ethical and most successful treatment in the history of HIV. Very easy to use -Even a 10 year old boy can use this. This is most potent HIV cure available.

What is the procedure of action of treatment?
Bio Magnetic Cards Or Bio Magnetic Tablets will perform as very strong fusion inhibitor (entry inhibitor) that completely stop HIV cure from entering CD4 Cells. by creating a negative charge CD4 which will repel negatively charged HIV and prevent it from attaching the surface of CD4. So HIV can not complete its life cycle. Thus it will die in due course and will be expelled from body through excretion like that of urine etc.

What will be result-?
HIV will be destroyed and soon the body will start to gain weight . All symptoms will be subsided and CD4 count will be back to the normal. All opportunistic diseases will be cured as well. The HIV cure will be termed that because HIV 's end is the result of the HIV cure."

HIV is the biggest epidemic we've ever had. This kind of stuff makes me want to cry. It should be taken down. Someone phone Google.

PUSH UPS PULL UPS AND LET DOWNS HOW LONG DOES IT TAKE TO GET FIT AND TO CHANGE THE WAY YOU LOOK BY EXERCISING

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SIX MONTHS TO SEE THE CHANGES IN YOUR BODY FROM WORKOUTS AND EXERCISE

You join a fitness club or start a workout regimen and say to yourself "this time it's for real I am going to A. Lose weight B. Buildup my triceps C. Get a better figure" or all the above. And then reality smacks you in the face as you exercise day after day and no changes seem to be happening. All that weight lifting, treadmill running, push ups. pull ups and let downs!



"To make a change in how you look you are talking about a significant period of training." That's Dr. William Kraemer, a professor of kinesiology. " In our studies it takes six months to a year.".."that is with regular strength training workouts using appropriate weights and with a carefully designed individualized program."



See the NYT article

Fitness Isn't an Overnight Sensation

Find your way around the Internet when sick...

Are you lost? Think you have a rare tropical disease? Which site do you trust?

The Aussie Government launched this initiative:

The Fifty-first World Health Assembly (Resolution WHA51.9, May 1998) requested the Director-General of WHO to develop a guide on medical products and the Internet. The guide was intended to serve as a model for Member States to adapt into locally meaningful advice for Internet users in order to help them to obtain reliable, independent and comparable information on medicinal products. The guide in this booklet has been prepared to meet the Health Assembly request. It has been developed in consultation with drug regulatory authorities, drug information experts, consumer organizations, and the pharmaceutical industry. It is a model guide, designed to be translated into national languages and modified as the local situation may require.

WHO would be grateful to receive any comments on experience gained from the practical use of the guide which would help in developing it further

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At last. Someone who isn't just indexing all the bullshit diagnoses out there - and someone really trying to help the internet junkies properly embrace the cyberchondria!

It might be old. At least they're thinking right.

Medical Quackery - Cyberchondriacs

Stumbled across an old, but interesting post. Excerpt below:

"Experts warn there is a great deal of false and misleading information on the Internet. That’s true – I learned the hard way that eating a bucket of chocolate pudding doesn’t alleviate a headache.

But, for me, the outright quackery was far less damaging than the cold, hard, accurate facts. There is no more devastating statistic than a Survival Rate. That number rattles around your brain like it’s the solution to an equation that could save your life. You massage it, you toy with it… “If 75.2% survive, that means 24.8% don’t… and if 24.8% don’t that means almost 1 in 4…” There’s no better, darker way to learn math."

All to often in practice you get patients who come in and tell YOU what they have. They Google'd it and now know that they have some bacterial infection, or rare intestinal disease or worse. They want "augmentin" or something else they read up about... You smile as a doctor, say you just need to check, only to find out that they have a simple cold, or a viral gastro and nothing more..

Just try and Google the symptoms for Inflammatory bowel disease and I bet most of you will think that you have it...


The lesson is this. We study for more than 6 years to DISTINGUISH symptoms and diseases. Anybody can read medical textbooks or google symptoms and will think they have the answer, but medical school teaches you how to work out what is a headache and what is a brain tumour.

Clinical examination is important. You'd be suprised to know what I can diagnose the way you walk into the room, or by simply looking at the back of your eye (and you would laugh at the amount of information we get out of a touch-your-nose-then-my-finger neurological examination).

Ah... sometimes I miss clinical medicine... but only sometimes...

NetCare in an organ transplant scam.

Yikes. Click on the image to enlarge.

Marketing a Journal Article...

We received this mail a while ago from Dan Jeffers...

While reviewing blogs and Web sites that discuss blood disorders, I noticed that yours seems to be well-read and well-informed. Your readers may be interested in the recent clinical practice guidelines for von Willebrand Disease (VWD) offered by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health. These are the first clinical guidelines in the United States for the diagnosis and management of von Willebrand Disease (VWD), the most common inherited bleeding disorder. The guidelines include recommendations on screening, diagnosis, disease management, and directions for future research. An extensive article on the guidelines is published online Feb. 29 in the journal Haemophilia.

“These are the first guidelines on von Willebrand Disease published in the United States and we are pleased to offer clinicians science-based recommendations in the evaluation and treatment of patients,” said NHLBI Director Elizabeth G. Nabel, M.D. “The disease can be difficult to diagnose, especially in women of child-bearing age and in children, and the danger of excessive bleeding is often under-recognized.”

The guidelines can be found at http://www.nhlbi.nih.gov/guidelines/vwd/index.htm, and are available for purchase or download.

We hope that you will reach out to your audience by posting a link and/or commenting about the recent guidelines. Thanks for helping us spread the word.

Regards,
Dan Jeffers
Internet Marketing Specialist for
National Heart, Lung, and Blood Institute

What interests me most is not the guidelines for Von Willebrands disease (for medical personel can be found here), it's the fact that medical marketing seems to have taken a new turn.

Before, if a new guideline was published, it could be found in the latest journals like the NEMJ, BMJ, AMJ, SAMJ, CME (there are many (x 100) more) and you would get to know about it via word of mouth. Usually a collegue in the specific field of medicine would have either seen it in his journal, heard about it at a conference, or a drug rep would spread the word. Mostly reputable sources.

It is interesting, that in this new landscape of everything being accessible online (don't get me into the exhorbitant prices you pay to access journals) that this seems to be a new way to market. Get it on Blogs, have the medical Bloggers promote it. It's definately a cheaper and perhaps more far reaching marketing tool. But do you always trust the bloggers information?

This at least comes from a reputable site, so I know the info is good. But in the ever increasing world wide web, where a ton of stuff is factitious (see earlier post about men having babies) and where is it getting harder to distinguish legitimate medical sites from the hocus-pocus out there - I am sceptical about the marketing means...

I don't know...

Jury is out for me...

I'm still trying to decide if I like this type of marketing or if it going to create more headaches in the long run with the large, and sometimes painful, website and information verification process.

LOSE YOUR JOB..JOIN THE CLUB..HOW TO LOSE YOUR JOB BUT SAVE YOUR MARRIAGE

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WHAT IS THE EFFECT OF JOB LOSS ON COUPLES AND MARRIAGE AND HUSBAND WIFE FAMILY RELATIONSHIPS?

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Why do people fall in love with each other? What makes one couple stay together through thick and thin when another couple has a partner than runs for the exit soon after the love boat springs a leak? It's a topic that has fascinated me since, well always. The NY Times has thrown some light on the subject with the story of a married couple who are feeling the financial storm that is blowing all around us and how they are coming through it.






In December, 2007 Scott Berry lost his job as a technology analyst at a boutique investment firm. "He immediately looked for a new position but found opportunities puzzlingly elusive." His plan for his next job has been (temporarily ) deferred. "So Scott and Tracey Berry have faced a complex series of choices about work, money and the roles and responsibilities each would assume in the family. Their goals: to keep their domestic economy from mirroring the national one-and to stay married."

Daddy is Home

IS A BLOCKED ARTERY IN THE HEART LIKE A CLOGGED PIPE IN YOUR PLUMBING WHAT IS A FIBROUS CAP AND ASPIRIN AND YOUR HEART

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IS A BLOCKED ARTERY IN THE HEART LIKE A CLOGGED PIPE IN YOUR PLUMBING AND WHAT DOES A FIBROUS CAP BREAKING HAVE TO DO WITH A HEART ATTACK?

A clogged artery is and is not like a clogged pipe, Huh, What? You go to the doctor and they explain why it is important to avoid trans fats and cholesterol to prevent blocked arteries. The heart depends on it's own blood supply, the coronary arteries to feed the heart muscle itself with oxygen rich blood. The impression is that the arteries which feed the heart become clogged with cholesterol like debris. Lowering cholesterol and trans fats definitely helps your heart but the picture is more complicated than the doctor may tell you.

WHAT CAUSES A BLOCKED ARTERY IN THE HEART?

As Jane Brody pointed out in a recent NY Times column "Most heart attacks do not occur because an artery is closed by a large plaque. Rather, a relatively small, unstable plaque ruptures( something called a fibrous cap breaks off) and attracts inflammatory cells and coagulating(clotting) agents,leading to an artery blocking clot."

WHAT IS A PLAQUE IN A HEART ARTERY?

A plaque in the blood vessel is a complex of cholesterol and various cells and other chemicals that builds up in the wall of the blood vessel. As Brody points out "most Americans of middle age and older have small plaques ubiquitous in coronary arteries." Actually evidence has been accumulating for years that the reason for many blockages is that cholesterol is deposited in the lining of the artery and triggers an inflammatory cascade in the lining of the artery. That inflammation builds up in the lining and is covered by a cap. When that cap breaks, the contents beneath the cap, cause a blood clot to form in the blood that is passing by in the lumen of the artery and voila it's a blockage.

WHY DO DOCTORS RECOMMEND ASPIRIN TO PREVENT A HEART ATTACK? HOW DOES ASPIRIN WORK?

Most doctors recommend aspirin to lower the chance of a heart attack. Thus, you see the so called low dose 81mg aspirin sold at drug stores "for the heart." How does aspirin work to lower the risk of a heart attack? They don't know but it may be because aspirin interferes with the formation of blood clots or because it an an anti inflammatory agent and lowers inflammation.










As Dr. Peter Libby points out "sometimes a plaque grows so large that it virtually halts the blood flow in an artery and generates a heart attack or stroke. (he means a stroke caused by a blockage, a thrombotic stroke, but there's also another kind called a hemorrhagic stroke which is due to bleeding) Yet only 15% of heart attacks happen in this way. By carefully examining vessel walls of people who died from heart attacks, pathologists have demonstrated that most attacks occur after a plaque's fibrous cap breaks open" attracting a blood clot that leads to the blockage of the artery. See the fascinating and instructive article by Dr. Libby Atherosclerosis The New View.

Aspirin in Heart Attack Prevention

Brody Coronary Care

WHAT TO WATCH OUT FOR WITH DIABETES TYPE ONE AND TYPE TWO DIABETES HOW DO THEY TREAT DIABETES WITH MEDICINE AND INSULIN

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How Do They Treat Type 1 and Type 2 Diabetes? What is the Difference in Medications?

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Most people with Diabetes have Type 2. It tends to happen in middle age and is often treated with drugs and not insulin although insulin may also be added to the treatment. In Diabetes the fundamental problem is with how glucose (sugar) is handled in the body. Type 2 Diabetes is sensitive to weight loss. That is, if you lose some weight by dieting you have a good chance to get better control of your diabetes. Type 2 Diabetes seems to be due to "insulin resistance". This means that even if your body's pancreas is producing enough insulin the insulin doesn't seem to have the desired effect in sugar control. Type 1 Diabetes is less common, tends to appear earlier and needs insulin.

What Did the American Diabetes Association Recommend for Treating Type 2 Diabetes?

The Diabetes Association thinks that lifestyle changes, like weight loss and watching what you eat along with certain diabetes drugs like the so called sulfonylureas and metformin along with insulin should be used for type 2 Diabetes.

What are Examples of the Sulfonylurea Drugs in Diabetes?

Glipizide and Glyburide are examples of the diabetes drugs called sulfonylureas. They tend to be started by doctors if dietary modification isn't doing the trick.

What Four Parts of the Body Organ Systems Need to Be Watched With Special Care in People with Diabetes?

Gastric Bypass Surgery May Help Diabetes

The Heart, the Kidneys, the Eyes and the Feet all need special attention in people with Diabetes. People with Diabetes are often started on the so called low dose aspirin to lower the chance of a heart attack. Similarly, the doctor often checks the urine for something called proteinuria, protein the urine as a sign of potential kidney problem and may start the person with diabetes on a certain blood pressure pill called an ace inhibitor. Also diabetes can make the nerves in the feet less sensitive. Frequent checks of the feet especially the bottom surfaces is a good idea.So are eye exams for changes in the back of the eye.

Video Proper Shoes for People with Diabetes Not Simple Feat