Grand Rounds

Grand Rounds 3.40 is now up and running over at the Wandering Visitor blog. There was a theme this week, and it is called, "Things That Inspire Us." It's also a creative layout in the form of a research article with sections like, "Methods," "Results," "Discussion," etc. Thanks to WV for including my post in GR this week...

Laurie from A Chronic Dose writes about her ultimate inspiration – Dad. Some of his words of wisdom: “You can’t always get the answers you need to pursue the dreams you have. Sometimes you just have to make a decision that might not make complete sense now and grow into it. It’s a risk, yes, but there are very few certainties in this world.” Dr. Anonymous also shares some memories of his father.

If you don't know what Grand Rounds is, it is a weekly compilation of the best posts from the medical blogosphere that moves to different sites each week. And, who doesn't like reading about medicine and science? Next week, GR moves to Over My Med Body. Enjoy!

Jessie Davis case: 2nd arrest made

Myisha Ferrell was arrested Sunday and will be arraigned today, in addition to Bobby Cutts, in connection with the Jessie Davis case. (Associated Press, Akron Beacon Journal) I kept watching the local and national news yesterday learning more and more details.

Something that gets me really frustrated are those who are blaming the victim. "Why would you stay with someone with a past history like his?" "Didn't she learn after the first child, or didn't she learn after she found out that this guy fathered other children with other women?"

Why don't I just step out of the way so those people can just stomp on this woman's coffin and grave? Like I said yesterday, we don't know what happened between those two people - despite what anyone (even family) are saying.

You can blame this guy and his accomplice all you want (and I know everyone is presumed innocent until proven guilty), but pointing the finger at Jessie before we can learn more about this case - that's just wrong. Everyone around here will be watching the news very closely today as these two go to court.

Jessie Davis found

This is definitely not how people wanted this to end up. Jessie Marie Davis, the 9 month pregnant mother from Ohio who has been missing for two weeks, was found in a Cleveland area park along with her unborn daughter. An arrest was also made of Bobby Cutts, her son's father. (Akron Beacon Journal)

Davis, 26, is believed to have been killed sometime between speaking to her mother by phone at 9:20 p.m June 13 and 5 a.m. the next day.

Cutts and Davis had a five-year relationship that included his fathering Blake and Davis' unborn daughter. Davis, her mother said, believed Cutts to be single for several years when, in fact, Cutts was married for about a year when he met Davis in 2002 and had two other children.

What a tragic situation. I have been watching this story closely, because this story is unfolding close to there I live and work. Unfortunately, as in the Laci Peterson case, I don't think we'll ever know the entire and complete truth. My thoughts and prayers go out to the family in a tragedy like this.

Caller ID spoofing

I ran across a story from the great state of Delaware this morning where there is a guy who is saying that he is from the federal district court and harrassing people. Why did people think it was legitimate? Well, because the caller ID made it look like it came from a government telephone. I really didn't know people could do that.

As I was doing more research on this, I had no idea that what is being termed, "Caller ID Spoofing," is becoming a real problem around the country. I found an article from USAToday.com in which a congressman was being accused of harrassing his own constituents over the phone because they saw the number from his office.

In the last few years, Caller ID spoofing has become much easier. Millions of people have Internet telephone equipment that can be set to make any number appear on a Caller ID system. And several websites have sprung up to provide Caller ID spoofing services, eliminating the need for any special hardware.

For instance, Spoofcard.com sells a virtual "calling card" for $10 that provides 60 minutes of talk time. The user dials a toll-free number, then keys in the destination number and the Caller ID number to display. The service also provides optional voice scrambling, to make the caller sound like someone of the opposite sex.

Yeesh! That's scary. So, now I can't even trust what the caller ID says? Wasn't that the entire point of this service? I guess when new technology comes along, there is always those out there who will try to exploit it. For a pretty good news report from Chicago describing the problem, see the video above, or click here.

Buyer beware of sunscreen

Got sunscreen? Good, then give some to this guy because he needs it. HA! (image credit)

If you're going to the beach this weekend, or if you're just going to be out and about in the sun, you'd better take a second look at your sunscreen. According to a recent report by the Environmental Working Group (EWG), only 16 percent of products are "safe and effective." For a list of the best and the worst, check out this article at FoxNews.Com.

Dr. Linda Franks, director of Gramercy Park Dermatology and clinical assistant professor at New York University School of Medicine, recommends everyone wear a moisturizer with SPF for daily protection, but people should not depend on that protection for extended periods of time in the sun. "Either you need to reapply it or use something stronger in the morning," she said.

Neutrogena and Coppertone, both of which had products that landed in the 'avoid' category, stood by the lab results of all their products. Neutrogena would not comment specifically on the report but stated, "all Neutrogena products undergo extensive testing to ensure safety and efficacy."

The report faulted many sunscreens for having active ingredients that actually breakdown in sunlight and do not actually protect against ultraviolet-A. Coppertone issued this statement defending their broad spectrum products: "Coppertone has formulated 100 percent of their products to be photostable to resist breaking down under exposure to the sun."

Now, an article like this could not be complete without the EWG taking a shot at the Food and Drug Administration. The article states that the FDA has been debating sunscreen safety standards for 29 years, but has yet to finalize mandatory standards. What I don't get is this: Sunscreen is neither a food nor a drug, so why is the FDA the regulatory agency managing this?

Finally, the American Cancer Society estimates that in 2007 there will be about 60,000 new cases of skin cancer and about 8000 deaths. So, be careful out there this summer and wear the right sunscreen.

Military to fix mental health system

You know, to be honest, no one in this country does mental health care very well, whether you're in the public or the private sector. The Virginia Tech tragedy brought to light the lack of communication between mental health databases and criminal justice databases. The press in regards to Walter Reed reported the lack of support for outpatient follow-up of soldiers.

The Washington Post is reporting that on Thursday Defense Secretary Robert Gates (to the left in picture above) is promising to speed up needed changes in the military's mental health system.

A recent Congressional study states that more resources (meaning money and people) are needed for proper care. This is no surprise. The need for more resources is frequently brought up in the private sector as well.

The Pentagon has been working for some time to end the stigma of counseling. Studies indicate that soldiers most in need of post-combat health care are the least likely to get it because they fear that others will have less confidence in them, that it will threaten career advancement and that it could result in the loss of their security clearance and possibly removal from their unit.

The yearlong study released last week was required by Congress, which wants a corrective action plan within six months. "I have no intention of waiting that long," said Gates, adding that he'd directed a plan be finished in 60 to 90 days.

Who knows if this is political posturing and who knows if anything will be really done. This post is not meant to be a political hit piece, but what I do know is that these soldiers, these heros, need mental health support and I hope they are able to get it through the VA health system.

VIdeo Game Addiction

Now, when I was growing up, we didn't have no playstation 3, xbox 360, or a Wii. The craze was above, the classic Atari 2600 (image credit). I played that thing for hours and hours. We didn't have fifteen different buttons like the consoles today. Nope, we had the "Red Button" and a joystick (insert joke here).

I remember my first (and only) Space Invaders tournament. I got killed on the first screen. I was crushed because I practiced hours and hours before that. I guess I just froze up. I remember counting down the days until Pac-Mac was released. Ah, those memories....

Little did I know at the time, that I had a problem. I had an addiction. I had an addiciton to video games. Yes, that's right. That was the reason I didn't go out and play outside as I was growing up. That was the reason I felt an attraction to computers and technology - because I couldn't get enough of it. That's why I'm not addicted to blogging.... Uh, sure.

The American Medical Association, my professional organization, is now going to bail me out. The organization I pay hunderds of dollars each year to be a member, is now going to vote to classify Video Game Addiction as a medical diagnosis (Associated Press).

A leading council of the nation's largest doctors' group wants to have this behavior officially classified as a psychiatric disorder, to raise awareness and enable sufferers to get insurance coverage for treatment.

In a report prepared for the American Medical Association's annual policy meeting starting Saturday in Chicago, the council asks the group to lobby for the disorder to be included in a widely used mental illness manual created and published by the American Psychiatric Association. AMA delegates could vote on the proposal as early as Monday.

It likely won't happen without heated debate. Video game makers scoff at the notion that their products can cause a psychiatric disorder. Even some mental health experts say labeling the habit a formal addiction is going too far.

I definitely have an opinion on this. Now, I'm not going to deny that probably a small percentage of children, adolescents, and adults will probably qualify for this medical/psychiatric diagnosis. We've all heard stories of addictions taken too far and destroying lives.

The problem that I have is that there will be many people out there who will try to take advantage of this and blame whatever is going on in their life to video games. A move like this by the AMA is going to continue to advance the idea of a lack of personal accountability and personal responsibility that is occurring in this culture.

We're all familiar with drug addiction. But, in recent years, there has been talk about internet addiction, sex addiction, and now video game addiction. When and where is this going to stop?

There are millions of Americans in this country right now who do not have basic health insurance. This move by the AMA will make is possible for insurance companies to cover treatment for Video Game Addiction. Is this the right thing to do?

Hey AMA, what about all the uninsured in America? Did you forget about them? What are you going to do about that? Maybe the Video Game Addiction lobby is making more contributions to your coffers than the uninsured are. This entire situation does not sit well with me. We'll have to see what the AMA does next week.

Doogie Surgeon, MD

Is this life imitating art, or art imitating life? You be the judge. The tv show Doogie Howser, MD (video above) was about a whiz-kid who becomes a doctor at age fourteen. And, yes, I do admit to watching the show when it was around. Little did we know that something like this would happen in real life.

The Associated Press this morning is reporting that Dhileepan Raj, a 15-year-old kid in India, performed a caesarean section "under his parents watch." Can you believe that?

How did people find out about this? Well, first of all, the entire thing was filmed. And, second, the kid's father showed the video at their local medical association meeting. How's that for being a proud father.

Of course, there is shock and outrage over this incident. I hope this guy's medical license is taken from him. Plus, there is talk over criminal charges being brought forth. Does this guy regret what he did? Absolutely not!

[Dr. K] Murugesan, who could possibly be prevented from practicing and face criminal charges for allowing his son to perform the operation, expressed no regret and accused the Manaparai medical association of being "jealous" of his son's achievements, [Dr. Venkatesh] Prasad [secretary of the medical association] added.

"He said this was not the first surgery performed by his son and that he had been training him for the last three years," said Prasad.

Murugesan told the medical association that he wanted to see his son's name in the Guinness Book of World Records [as the youngest surgeon].

Wait a sec. All this over getting into the Guinness Book of World Records? To jeopardize your medical license and international embarrassment, just to get some kind of world record? Sheesh! We'll have to see how this all plays out...

Adolescents doping up

Some of you out there may remember the commercial above by basketball player Charles Barkley where he said, "I am not a role model." This stirred up a lot of press at the time and a debate on whether professional athletes have a responsibility and accountability for their actions - especially with children as fans.

Now, what people don't remember is that Barkley later in the commercial says that parents should be the role models and not athletes. He makes a good point here, but as the press does, they take things out of context can causes an uproar.

A study from United Press International Wednesday reported something really disturbing. It stated that 3 percent of 15-year-old kids admitted using performance enhancing drugs. This study involved a secondary school in eastern France.

Health problems, including becoming violent, change of voice and loss of consciousness, were experienced by 4 percent of the users, according to the researchers.

What really bothers me is that this is probably an underestimation of the real number. Self-reporting studies usually gives an inaccurately low result. Much has been written about athletes taking (or allegedly taking) performance enhancing drugs from Barry Bonds to Floyd Landis to Ben Johnson to others.

I don't care what anyone says. Kids do see this stuff. In my opinion, kids are exposed even more now to the "win at all costs" attitude of sport. Being designated a winner means fame and fortune - just ask those kids going from high school straight to the NBA or kids like Michelle Wie who are balancing high school and being on a professional golf tour.

Finally, how about this. What if an accurate study could be done seeing what percentage of adolescents in the United States take performance enhancing drugs? What do you think the numbers would be? I'm kind of frightened to find out.

Mars seeking applications

Want to feel like you're going to Mars? Live in Europe? Well, have I got a deal for you. On Tuesday, the European Space Agency announced that it is seeking applications for you to spend 17 months in an isolation tank, and this will simulate you going to Mars. (Yup, not kidding -- AFP)

Their spaceship will comprise a series of interlocked modules in an research institute in Moscow, and once the doors are closed tight, the volunteers will be cut off from all contact with the outside world except by a delayed radio link.

They will face simulated emergencies, daily work routines and experiments, as well as boredom and, no doubt, personal friction from confinement in just 550 cubic metres (19,250 cubic feet), the equivalent of nine truck containers.

Are you excited yet? Where do you sign up? Well, the application form can be downloaded from their website. When you download the application form, it's really weird. Here is just a sample of their questions:

Mac or PC?

Have you ever seen 2001: A Space Odyssey?

What's your opinion of John Gray? How about Lisa Nowak?

Are you a member of the mile-high club?

What did you think of The Soprano's final episode? Genius or fraud?

Do you think Rosie should be the new host of the Price is Right?

Then, after the initial screening is completed, the website says that there will be a Survivor-type elimination round that will be broadcast on European television where viewers will vote on who is in and who is out....

Ok, enough of that silliness. Is this thing real? It looks kind of like that tv show big brother, but for 17 months. What will probably happen is that this will end up being a hoax like that kidney donation tv show was. But, we'll see.