Top medicine articles for September 2014

A collection of some interesting medical articles published recently:

Doctors Are Talking: EHRs Destroy the Patient Encounter - Medscape - It depends on the EMR and how you use it

Gluten May Cause Depression in Subjects With Non-Celiac Gluten Sensitivity. Such findings might explain why patients with non-celiac gluten sensitivity feel better on a gluten-free diet despite the continuation of gastrointestinal symptoms

Dalbavancin Approved for Bacterial Skin Infections, including MRSA, 2 doses, 1 week apart, as effective as vancomycin

Residues of Roundup (glyphosate), the world's most popular herbicide, found in breast milk

90% of doctors would choose a do-not-resuscitate status for themselves near the end of life. 80% of patients wish to avoid high intensity care at the end-of-life, but their wishes are often overridden

Matisse reinvented himself as an artist to accommodate his disability and moved from working with paint to collage -- "An artist should never be a prisoner of himself, prisoner of style, prisoner of reputation, prisoner of success” -- “Every day that dawns is a gift to me and I take it in that way. I accept it gratefully without looking beyond it. I completely forget my physical suffering and all the unpleasantness of my present condition and I think only of the joy of seeing the sun rise once more and of being able to work a little bit”, he wrote.

Antibiotics - a brief hiatus in man's millennia-old battle with germs?

You're Not on the 'Best Doctors' List - Does It Matter? -- Doctors themselves are highly skeptical about the lists

Hot weather kills more Americans than all other natural disasters combined. Cerebellum is especially sensitive to heat, which explains the early signs of a heatstroke: unsteady gait, confusion

Facial recognition technology used to spot genetic disorders

The articles were selected from Twitter and my RSS subscriptions. Please feel free to send suggestions for articles to clinicalcases AT and you will receive acknowledgement in the next edition of this publication.

Pendulum Wave Demonstration (video)

This is a large-scale demonstration of the interaction between period and pendulum length, using 16 bowling balls hung from a wooden frame.

Here are answers to some common questions:

What am I seeing? How does this work?

The length of time it takes a ball to swing back and forth one time to return to its starting position is dependent on the length of the pendulum, not the mass of the ball. A longer pendulum will take longer to complete one cycle than a shorter pendulum. The lengths of the pendula in this demonstration are all different and were calculated so that in about 2:40, the balls all return to the same position at the same time - in that 2:40, the longest pendulum (in front) will oscillate (or go back and forth) 50 times, the next will oscillate 51 times, and on to the last of the 16 pendula which will oscillate 65 times. Try counting how many times the ball in front swings back and forth in the time it takes the balls to line up again, and then count how many times the ball in back swings back and forth in the same time (though it's much harder to keep your eye on the ball in back!)

Read more here:

Care of the Homeless - 2014 review from Am Fam Physician

The impact of the problem

On any given night, more than 610,000 persons
in the United States are homeless; a little more than one-third of these are families.

Homeless persons are more likely to become ill, have greater hospitalization rates, and are more likely to die at a younger age than the general population. The average life span for a homeless person is between 42 and 52 years. Homeless children are much sicker and have more academic and behavioral problems.

What are the causes?

Insufficient personal income and the lack of affordable housing are the major reasons for homelessness.

A complex, unique challenge

Complex, advanced medical problems and psychiatric illnesses, exacerbated by drug and alcohol abuse, in combination with the economic and social issues (such as the lack of housing and proper transportation) make this subset of the population a unique challenge for the health care system, local communities, and the government.

Multidisciplinary approach

An integrated, multidisciplinary health care team with an outreach focus, along with involvement of local and state agencies, seems best suited to address the components needed to ensure quality of care, to help make these patients self-sufficient, and to help them succeed.

Family physicians are well suited to manage the needs of the homeless patient, provide continuity of care, and lead these multidisciplinary teams


Care of the Homeless: An Overview. Maness DL, Khan M. Am Fam Physician. 2014 Apr 15;89(8):634-640.

How playing an instrument benefits your brain - TED-Ed video

When you listen to music, multiple areas of your brain become engaged and active. But when you actually play an instrument, that activity becomes more like a full-body brain workout. What's going on? Anita Collins explains the fireworks that go off in musicians' brains when they play, and examines some of the long-term positive effects of this mental workout.

View full lesson:

The Science of Depression - moving from neurotransmitters to neurogenesis and synaptogenesis

From ASAP Science: What's going on inside the brain of a depressed person?

Recent thinking suggests that rather than a shortage of serotonin, a lack of synaptogenesis (the growth of new synapses, or nerve contacts) and neurogenesis (the generation and migration of new neurons) could cause depression.

The main group of medications to treat depression, SSRIs, might promote synaptogenesis and neurogenesis by turning on genes that make ITGB3 as well as other proteins that are involved in these processes. ITGB3 stands for integrin beta-3.

If the neurogenesis and synaptogenesis hypothesis holds, a drug that specifically targeted miR-221 or miR-222 could bring sunnier days to those suffering from depression. The miRs are two microRNA molecules.

From DW: What helps relieve depression, according to Professor Malek Bajbouj, Berlin's Charité Hospital:


Unraveling the Mystery of How Antidepression Drugs Work. Scientific American, 2013.
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