NEJM Resident e-Bulletin Teaching Topics 11.03.11

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The next time you get asked by a sales professional why you rated her client for ulcerative colitis pull out this cheat sheet for talking points.

Q. What is the risk of cancer in patients with ulcerative colitis?

A. On the basis of data from referral centers, the cumulative risk of colorectal cancer among patients with chronic ulcerative colitis may reach 20 to 30% at 30 years, but the incidence rate is much lower in population-based series (approximately 2%). Risk factors for cancer include a long duration of disease, regardless of clinical activity; extensive involvement; a young age at onset; severe inflammation; the presence of primary sclerosing cholangitis; and a family history of colorectal cancer.

QT Interval Duration and Mortality

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Watch those QT’s.

Conclusion: Shortened and prolonged QT-interval durations, even within a reference range, are associated with increased mortality risk in the general population.

via Arch Intern Med — Abstract: QT-Interval Duration and Mortality Rate: Results From the Third National Health and Nutrition Examination Survey, October 24, 2011, Zhang et al. 171 (19): 1727.

Four Days, Three Earthquakes – Still OK in OK

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Welcome to the USGS – U.S. Geological Survey.

I would like to thank one and all who expressed concern for our well-being this past week.  The most recent earthquake was a 4.7 in magnitude and came in the midst of severe thunderstorm and flash flooding activity.  I heard a loud bang that was immediately followed by walls shaking in the house.  Fortunately I reside around 60 miles from the epicenter of the recent quakes.  Still OK in OK.

You'll find Edmond a little to the left of the star.

Magnitude 5.6 – OKLAHOMA…(we’re OK)

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Magnitude 5.6 – OKLAHOMA.

It’s been a rough year weather-wise out here in OK.  Not that I’m keeping count but in the past year we have experienced:

  • record snowfall
  • torrential flash floods
  • flat wind storms
  • softball size hail
  • nados
  • excruciating  relentless heat wave
  • drought
  • Texas Rangers losing the World Series in 7
  • 5.6 earthquake

If you’ve never experienced an earthquake your brain starts firing off like crazy trying to figure out what’s happening.  The noise is one of the strangest noises I have heard in my life.  Did something hit the roof?  But when the house started shaking I said “Earthquake”!!!!

Then I went back to sleep.

 

 

 

Thought For Today – 11.5.11

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Our life, as individual persons and as members of a perplexed and struggling race, provokes us with the evidence that it must have meaning.  Part of the meaning still escapes us.  Yet our purpose in life is to discover this meaning, and live according to it.  We have, therefore, something to live for.  The process of living, of growing up, and becoming a person, is precisely the gradually increasing awareness of what that something is.  This is a difficult task, for many reasons.

Thomas Merton No Man is an Island

How fitting a coincidence that this is my 1000th post.

If you believe in coincidences.

 

ADHD Drugs and CV Events

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ADHD Drugs and Serious Cardiovascular Events in Children and Young Adults — NEJM

In conclusion, in our study involving children and young adults with 2.5 million person-years of follow-up, there were 3.1 serious cardiovascular events per 100,000 person-years. Although the point estimates of the relative risks for ADHD drugs did not indicate increased risk, the upper limit of the 95% confidence interval suggested that a doubling in the risk could not be ruled out. However, the absolute magnitude of any increased risk would be low.

The entire article is worth reading given the potential serious side effects of the drugs in question.