Category: Uncategorized

Take a look at my post on Andy Warhol, Coke and the iPhone

And now, Gruber’s post on the same subject.

One time. Just one time, I want to get linked by Gruber.

I spilled an entire cup of coffee on my laptop.

Dead laptop.

Last back-up, 7 weeks old.

Lost blogging momentum.

I have a pile of half written posts and should be out of the funk soon.

I have also purchased a dropbox account and will not be caught with two-month old back-ups again. That’s a pretty good new years resolution, though better would be to not spill cups of coffee into my laptop.

Kamran Boka, a resident at St John’s wrote an excellent on-call manual. It has been released under creative commons license.

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License.

Free to share and free to make derivative versions, with attribution. The manual is nicely put together and you can find the PDF at his blog, Vagal Thoughts.

My pithy little push for exercise is that it is the closest thing we have found to the fountain of youth. That it doesn’t mater what disease you look at, increasing you exercise or fitness is associated with better outcomes.

Love this video.

Thought provoking article at Zocalo Public Square by Ken Murray a family practice doctor who writes that he was so frustrated with futile end-of-life care he suspended his hospital practice.

Of course, doctors don’t want to die; they want to live. But they know enough about modern medicine to know its limits. And they know enough about death to know what all people fear most: dying in pain, and dying alone.

The essay feels right but relies on anecdote rather than data to support the central premise that doctors are more likely to to use hospice and palliative care to have gentler passing.

I was invited to do grand-rounds at St John and was given no guidance on selecting my topic. I recently received a phone call from a long-time family friend, this man had literally changed my diapers, and he asked me to help a relative get bardoxolone. My group is participating in Beacon (the current phase II trial for bardoxolone) and though I am not one of the investigators I assured him that we would evaluate his friend. I couldn’t guarantee he would get study drug rather than placebo or even qualify for the trial.

The whole event shocked me. I had no idea that the results of the Bardoxolone study had slipped beyond the geek fringes of nephrology. It reminded me of a story that Judah Folkman told. He came to Indiana University to collect an award and give a lecture, shortly after a NYTimes profile. In that front page story James Watson (yes that James Watson) said Folkman would cure cancer in two years.

Judah told the story that he was getting phone calls from strangers and friends asking for his miracle cure and was heart broken because he had nothing to offer them. At that stage his drug was only for mice.

That’s Judah and me following the afore mentioned lecture in 1999.

Getting that call from my friend gave me the same sort of Folkman moment. I never thought people would be calling me trying to get experimental therpy. So I decided to talk about Bardoxolone.

As I started my research I became concerned that patients randomized to bardoxolone developed increased albumniuria.

I bet this becomes a real trend as school districts become short for cash.

Anoka-Hennepin teachers write their own online textbook, save district $175,000

Instead of mass-produced textbooks, the more than 3,100 sophomores in the state’s largest district are learning from an online curriculum developed by their teachers over the summer with free software distributed over the web.

 For the extravagant tuition charged at medical schools it seems they should throw in the course materials for free. No?

I received the following announcement from our hospital librarian

We are conducting a trial of the online clinical resource Dynamed for the month of November.  We wanted to get some feedback on this product as an alternative to UpToDate, or possibly as an addition to our electronic resources before we negotiate with UpToDate.

The treatment section contains 159 words, and really gives you no idea how to treat this condition. In fact, about a third of the treatment section is dedicated to combination ACEi and ARB therapy, a window dressing issue in the treatment of this rapidly progressive and potentially fatal disease. I would give this reference a failing grade. You read all 159 words and have no idea what to do. You need to go to a second source.

Their is no author associated with the outline of Goodpastures. Dynamed’s editorial team does not list any nephrologists. The editorial board does have a single nephrologist, which is exactly how many podiatrists they have on the board.

As my colleague, Dr Steigerwalt, said, it should be spelled DinoMed as in Dinosaur.

Say hello to eAJKD. Kenar Jhaveri of Nephron Power is the editor and he has enlisted much of the nephrology blogosphere, including your humble author to assist him on this endeavor.

Recently some of the all guard of media have started compelling blogs (see the New York Times’ page of blogs for an example). Medical publishing seems to have lagged in this phenomenon.

All of the interesting medical bloggers are independent agents, though The Lancet, JAMA and NEJM have all launched blog initiatives.

I hope that eAJKD aspires to be something special, I’ll do my best to assist it.

It should be a fun adventure.