Special History Lecture

"African American Physicians
in the Civil War"

Margaret Humphreys, MD, PhD

Wednesday, Apr. 1st; 12:00 - 1:00 pm

Rm 102 Lower Level

Light buffet available from 11:45 am

Tech Time with Dr. Adams

Don't look now, "social networking" influences are everywhere.

Did you see the CNN clip about surgeons at Henry Ford Hospital in Detroit using Twitter? Or the recent Newsweek report about drug companies using social networking to recruit patients for clinical trials? Others are vying for us physicians to engage with online networking, both WebMD and a new player, Sermo.

Twitter is one of my favorites. Whether professional or consumer oriented, seems to me, the value of Twitter is connecting the user to niche kinds of information. Jeff Loo (Information Science PhD candidate) tells me the #1 use of Twitter is about getting an answer to a question, for example, an answer needed by a med student study group or a "patients like me" group. The surgeons at Henry Ford Hospital used Twitter to send a live "tweet" during an OR procedure to get the message out about a new procedure.

Do look for Duke in the social networking sphere with Duke iTunes, Duke YouTube, and a new mobile app, DukeMobile!

Causes me to take note. Our current medical students have grown up with social networking. It's the norm. And, in case you haven't noticed, even Diane Rehm allows listeners to send a "tweet" during her popular daily NPR show. It's all about connecting.

Martha Adams, MD
Blog entry #2

Intensive Glucose Control May Raise ICU Mortality

Aggressive glucose control in critical illness seems to increase mortality, according to a New England Journal of Medicine study released online.
Investigators in the NICE-SUGAR trial attempted to define the best glucose target range by randomizing 6100 medical-surgical ICU patients either to intensive control (81 to 108 mg/dL) or to conventional control (180 mg/dL or less) with use of intravenous insulin. Death by 90 days (the primary outcome) occurred more often with intensive control than with conventional therapy. Intensive control also led to more episodes of severe hypoglycemia (blood glucose, 40 mg/dL or less). The authors estimate a number needed to harm of 38.

Editorialists point out that the NICE-SUGAR results "contrast starkly" with earlier trials. Their take on the study's lessons is that "there is no additional benefit from the lowering of blood glucose levels below the range of approximately 140 to 180."

Intensive versus Conventional Glucose Control in Critically Ill Patients. The NICE-SUGAR Study Investigators. NEJM published online March 24, 2009.

USPSTF Updates Recommendations on Aspirin for CVD Prophylaxis

The U.S. Preventive Services Task Force now recommends that aspirin be used in men to prevent MIs, and in women to prevent ischemic strokes, when these benefits outweigh the risks for gastrointestinal bleeding.
The task force considers older age and male sex as the major risk factors for gastrointestinal bleeding, followed by upper GI pain, ulcers, and NSAID use.
The recommendations, published in Annals of Internal Medicine, update the USPSTF's previous statement, released in 2002. The current statement factors in evidence from the Women's Health Study that "aspirin may have differential benefits and harms in men and women."
The task force also concludes that evidence is "insufficient" to weigh the benefits and harms of aspirin prophylaxis among people over age 79 and that use among men under 45 or women under 55 should not be encouraged.
An editorialist writes: "Aspirin continues to be underused, and the routine incorporation of the USPSTF's recommendations ... [will] prevent many thousands of cardiovascular events every year."

Annals of Internal Medicine March 17, 2009 150(6):394-404.

Duke/UNC Speaker Series

Join us on March 10 at 6:00 pm for a presentation by Seymour Mauskopf, PhD, on "Fritz Haber: A Cautionary Tale." read more...