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500 repetitions of 4 cardiac murmurs improved auscultatory proficiency of medical students

Posted: April 23, 2010 at 1:40 am

According to a 2004 study in Chest, the ability of medical students to recognize heart murmurs is poor (20%), and does not improve with subsequent years of training.

Five hundred repetitions of four basic cardiac murmurs significantly improved auscultatory proficiency in recognizing basic cardiac murmurs by medical students. These results suggest that cardiac auscultation is, in part, a technical skill.

Related resources
The Heart Sounds Tutorial by Blaufuss.org is a fancy flash-based simulator with animations. The McGill University Virtual Stethoscope is another useful website. Click here for more web-based teaching resources for hearts sounds from UCLA and breath sounds from Loyola University.
References:
Mastering cardiac murmurs: the power of repetition. Barrett MJ, Lacey CS, Sekara AE, Linden EA, Gracely EJ. Chest. 2004 Aug;126(2):470-5.

http://www.ncbi.nlm.nih.gov/pubmed/15302733

Image source: Modern stethoscope. Wikipedia, public domain.

Posted at Clinical Cases and Images. Stay updated and subscribe, follow on Twitter, Buzz, and connect on Facebook.


Recommendation and review posted by G. Smith

Tissue Engineered Skin Progresses

Posted: April 22, 2010 at 8:16 am

Spanish scientists "have generated artificial human skin by [tissue] engineering based on agarose-fibrin biomaterial. The artificial skin was grafted onto mice, and optimal development, maturation and functionality results were obtained. This pioneering finding will allow the clinical use of human skin and its use in many laboratory tests on biological tissues - which, additionally, would avoid the use of laboratory animals. Further, this finding could be useful in developing new treatment approaches for dermatological pathologies. ... The skin created in the laboratory showed adequate biocompatibility rates with the recipient and no rejection, dehiscence or infection was registered. ... The experiment [is] the first to create artificial human skin with a dermis made of fibrin-agarose biomaterial. To this date, artificial skin substitutes were elaborated with other biomaterials as collagen, fibrin, polyglycolic acid, chitosan, etc. These biomaterials [added] resistance, firmness and elasticity to the skin. ... Definitively, we have created a more stable skin with similar functionality to normal human skin."

View the Article Under Discussion: http://www.medicalnewstoday.com/articles/186185.php

Read More Longevity Meme Commentary: http://www.longevitymeme.org/news/

Recommendation and review posted by Fredricko

An Update on Scent and Longevity

Posted: April 22, 2010 at 8:16 am

A number of studies in recent years have suggested that calorie intake is not the only thing that can alter metabolism to change longevity in lower animals: "Specific odors that represent food or indicate danger are capable of altering an animal's lifespan and physiological profile by activating a small number of highly specialized sensory neurons ... Recent research in model organisms and in humans has shown that sensory experiences can impact a wide range of health-related characteristics including athletic performance, type II diabetes, and aging. Nematode worms and fruit flies that were robbed of their ability to smell or taste, for example, lived substantially longer. However, the specific odors and sensory receptors that control this effect on aging were unknown. Using molecular genetics in combination with behavioral and environmental manipulations, [researchers have identified] carbon dioxide (CO2) as the first well-defined odorant capable of altering physiology and affecting aging. Flies incapable of smelling CO2 live longer than flies with normal olfactory capabilities. They are also resistant to stress and have increased body fat. To many insects, including fruit flies, CO2 represents an ecologically important odor cue that indicates the presence of food (e.g. rotting fruit or animal blood) or neighbors in distress (it has been implicated as a stress pheromone). Indeed, this group of researchers previously showed that merely sensing one's normal food source is capable of reversing the health and longevity benefits that are associated with a low calorie diet. They now establish that CO2 is responsible for this effect."

View the Article Under Discussion: http://www.eurekalert.org/pub_releases/2010-04/plos-tss041410.php

Read More Longevity Meme Commentary: http://www.longevitymeme.org/news/

Recommendation and review posted by Fredricko

Standardized patient: Over the course of three days, I had 23 head-to-toe physicals from 23 medical students

Posted: April 22, 2010 at 8:15 am

From Slate:

"I was the first person these would-be doctors had ever fully examined on their own. Some were shaking so violently when they approached me with their otoscopes—the pointed device for looking in the ear—that I feared an imminent lobotomy.

A "standardized patient" is a trained person who is paid $15 an hour to be poked and prodded by inexperienced fingers, so that med students can learn communication and examination skills before they are sicced on actual sick people.

Now there are standardized patients trained for genital duty (they're called GUTAs, for genitourinary teaching associates).

Dr. N wasted the first eight minutes of the exam trying repeatedly to get a blood pressure reading. The panic in his eyes seemed to say, "She appears to be alive, yet she has no vital signs."

Comments:
Lakshman Swamy - Don't forget that some of them were capable! I have to say, in my experience as an MS2 at Wright State, our standardized patients are amazing teachers. It is much easier to learn physical exam skills and even interviewing when the patient can give you precise feedback. The author is right on with the characters that patients can portray... it is shocking when they break character to give feedback! Just recently I learned how to do the male exam with two standardized patients ("GUTA" -- never heard of that term before). I was definitely feeling a little ... awkward before the session began-- this was by far the most invasive thing I had ever done to another person. But the standardized patients were amazing about the whole process, even acting out the different hesitations that we might encounter in patients, emphasizing the importance of the exam, etc. Without being too graphic, I can't emphasize how much I learned about how to do those exams and what I was actually supposed to be finding. It was a totally different experience than I expected, and after it, I feel really confident about the whole process.

I can't even IMAGINE what it would be like to do that with my classmates-- and how much less I would have understood. Wow.

References:
Oh, no! I'm the first patient these 23 medical students have ever examined. Slate, 2010.
Image source: OpenClipArt.org, public domain.

Posted at Clinical Cases and Images. Stay updated and subscribe, follow on Twitter, Buzz, and connect on Facebook.


Recommendation and review posted by G. Smith

"The Rogue Taxidermy Kunstkammer," The Minnesota Association of Rogue Taxidermists, La Luz de Jesus, Los Angeles

Posted: April 22, 2010 at 8:14 am


This just in from Congress for Curious People participant and Friend-of-Morbid-Anatomy Robert Marbury; if I was in the greater Los Angeles area, I'd surely be there:

The Minnesota Association of Rogue Taxidermists proudly presents The Rogue Taxidermy Kunstkammer
Our contemporary culture has seen a growing interest in taxidermy fueled by the internet, ambivalence about the food industry, and concerns over animal extinction. The representation of animal form is wide-ranging, and this exhibition presents the first major group show of Rogue Taxidermy. Rogue Taxidermy, a mixed-media art utilizing taxidermy materials, is more closely related to Surrealism than to mainstream taxidermy. Ranging from the macabre to the sublime, this exhibition explores the Borgesian imaginary made real.

Featuring:
SCOTT A. A. BIBUS
SARINA BREWER
MELISSA DIXON
ENRIQUE GOMEZ DE MOLINA
JESSICA JOSLIN
JEANIE M
ROBERT MARBURY
ELIZABETH MCGRATH
ALAN WADZINSKI
BROOKE WESTON
MIRMY WINN

The Show runs May 7th - May 30th

OPENING RECEPTION
Friday May 7th, 8pm-11pm

SQUIRREL MASTERCLASS/GAMEFEED
This event will include a taxidermy demo, followed by Squirrel Chili. A vegan "Mock-Squirrel" Chili will also be available. Sponsored by Schmaltz Brewing Company.
Saturday May 8th 6pm-10pm

LA LUZ DE JESUS
4633 Hollywood Blvd
Los Angeles CA 90027
Phone: 323-666_7667
http://www.laluzdejesus.com

* All members adhere to a strict ethics charter. Only animals procured in an ethical and environmentally responsible manner were used, and none of the animals were killed for the purpose of this artwork.
* A portion of the proceeds of this show will be given to a local wildlife rehabilitation center.

For more information, check out the La Luz de Jesus website by clicking here. You can find out more about The Minnesota Association of Rogue Taxidermists by clicking here. Click on image to see larger version.

Recommendation and review posted by G. Smith

Humanity+ Summit at Harvard

Posted: April 22, 2010 at 8:14 am

The Humanity+ Summit will be held in June at Harvard: “The H+ Summit is part of a larger cultural conversation about what it means to be human and, ultimately, more than human. This issue lies at the heart of the transhumanism movement … The H+ Summit is a two day event that explores how humanity will be radically changed by technology in the near future. Visionary speakers will explore the potential of technology to modify your body, mind, life, and world. What will it mean to be a human in this next phase of technological development? How can we prepare now for coming changes? We foresee the feasibility of redesigning the human condition and overcoming such constraints as the inevitability of aging, limitations on human and artificial intellects, unchosen psychology, lack of resources, and our confinement to the planet earth. The possibilities are broad and exciting. The H+ Summit will provide a venue to discuss these future scenarios and to hear exciting presentations by the leaders of the ongoing H+ (r)evolution.” Amongst the confirmed speakers is biomedical gerontologist and engineered longevity advocate Aubrey de Grey, whose presentations are always well worth attending.

View the Article Under Discussion: http://hplussummit.com/

Read More Longevity Meme Commentary: http://www.longevitymeme.org/news/

Recommendation and review posted by G. Smith


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