The “New & Interesting” series is a biweekly compilation of select research findings, news articles, and random tidbits in bullet-point format. The entries are highly abbreviated, but provide links to the original articles or abstracts if you desire to read further.

General Articles

• Video games may cause kids to suffer finger and wrist pain (WebMD)

• Researchers at the University of Pittsburgh School of Medicine employed high-sensitivity MRI scanners to evaluate the effect of glucosamine on progression of knee osteoarthritis. They “did not find any evidence that glucosamine can prevent or slow joint damage in individuals with mild to moderate knee pain.” The results from the study resemble findings from an earlier meta-analysis that did not demonstrate substantive symptomatic benefit from the use of chondroitin. (WebMD)

• Universal health coverage in Massachusetts does not reduce visits to the Emergency Department (American Medical News)

Technical Articles

• Prophylactic administration of acetaminophen for febrile reactions at the time of vaccination reduces antibody responses to vaccine antigens in children (Lancet)

The “New & Interesting” series is a biweekly compilation of select research findings, news articles, and random tidbits in bullet-point format. The entries are highly abbreviated, but provide links to the original articles or abstracts if you desire to read further.

General Articles

• Most powerful 9.4-Tesla MRI is stronger than the Large Hadron Collider (Wired)

• A blind patient regained sight via a tooth implanation into her eye. The procedure, a modified osteo-odonto-keratoprosthesis (MOOKP), was performed at the University of Miami School of Medicine and is the first done in the United States. (U Miami)

• DARPA-funded study at Duke University to detect viral infections even before the development of symptoms (Duke Health)

• Smoking bans cut incidence of heart attacks by as much as 36% after 3 years (Reuters)

Given the prevalence of video-sharing sites, such as YouTube and its niche derivatives, it was only a matter of time until there would be one devoted to echocardiography. This week, Medgadget announced the launch of EchoJournal, “an online ultrasound video sharing website and discussion board”. Despite the site’s description, it solely focuses on echocardiograms (i.e., cardiac ultrasound via transthoracic or transesophageal approaches), as opposed to general body ultrasound videos. EchoJournal is already populated with 50+ echocardiograms featuring a diversity of cardiac pathologies, such as severe left ventricular hypertrophy, cardiac tamponade, and lipomatous hypertrophy of the interatrial septum. The site is moderated by Dr. David E. Winchester, a cardiology fellow at the University of Florida.

Similar to its brethren in the social networking genre, EchoJournal permits users to create profiles and avatars, upload videos, maintain a list of “friends”, subscribe to video feeds, rate videos, join groups, and discuss cases. Its target audience includes “current and future physicians as well as health care professionals who use echocardiography as part of their practice”. There is also a feature to embed videos on external websites (as seen below).

The concept of video-sharing is not new, but the medical profession has been slow in adapting such technologies. The field is ripe with endless untapped possibilities. It would only be a matter of time until we see similar video sites sprout for capsule endoscopy, bronchoscopies, laparoscopic surgeries, VATS, etc. As for gastrointestinal endoscopy, there is the The DAVE (Digital Atlas of Video Education) Project from the Massachusetts General Hospital … sans the social networking features.

In today’s issue of the New England Journal of Medicine, there is the case of a 13-year old tuba player who was found to have left facial pain and swelling. Palpation of the parotid gland produced foamy secretions from the duct. There were otherwise no signs of an infection. The only laboratory abnormality was an elevation in the serum amylase level, which could corroborate a parotid gland inflammation or injury. The computed tomography (CT) scan of the head revealed air collections in the parotid gland (image) and the patient was diagnosed with pneumoparotid. According to the article’s authors, “Pneumoparotid can arise in wind-instrument players, glassblowers, and persons in whom air under positive pressure in the oral cavity is forced into the parotid ductal system.” There goes my aspirations in glassblowing.

On a related note, the Journal had published one year ago the case of an abnormal air collection in the head, or pneumocephalus.

• Sources
• Mukundan D, Jenkins O. A tuba player with air in the parotid gland. NEJM 2009;360:710.
• Image Copyright: New England Journal of Medicine

The figurative use of the word “airhead” originated in the late 1970’s and signified a simple-minded or stupid person. But what are the characteristics of the literal “airhead” (or in medical jargon, pneumocephalus)? Does this person also exhibit similar deficits in cognitive function?

The New England Journal of Medicine recently featured the case of an Argentinian patient who spontaneously developed the so-called pneumocephalus. She is a 54 year-old woman who experienced progressive visual, auditory, and speaking abnormalities. A head radiograph demonstrated an air pocket along her left temporal region (enlarged image). A computed tomography (CT) scan revealed similar findings, with the pocket measuring 4 cm x 3 cm x 5 cm. There was no evidence of fracture or trauma.

The cause of the woman’s sensory and speech deficits can be explained by the air compressing against her brain, with indirect compromise of her brainstem. Her symptoms resolved soon after undergoing neurologic surgery to decompress the air and to repair a defect in an adjacent bone (mastoid). No tumor or infection was noted. Although most cases of pneumocephalus occur secondary to head trauma, it is possible the mastoid bone defect discovered during surgery may have been the source for air to enter the skull.

On a lighter note, the next time someone accuses you of being an airhead, you could refute him figuratively and literally with the following response: “I do not manifest the typical characteristics of pneumocephalus”.

• Sources
• Villa RA, Capdevila A. Spontaneous otogenic pneumocephalus. NEJM 2008;358:e13.
• Image Copyright: New England Journal of Medicine