http://www.odeo.com/channels/59586-KidneyNotes-via-Talkr-com KidneyNotes no <b>Notes on Medicine,<br> Science & Technology<br> from a <a href="http://en.wikipedia.org/wiki/Nephrologist">Nephrologist</a><br> in <a href="http://www.flickr.com/photos/tags/newyorkcity/interesting/show/">New York City</a></b><br> Notes on Medicine, Science & Technology from a Nephrologist in New York City Notes on Medicine, Science, & Technology from a Nephrologist in New York City. en-US 40 Sat, 07 Nov 2009 05:03:40 -0800 Sat, 07 Nov 2009 05:03:40 -0800 http://www.odeo.com/episodes/25416546-Halloween-at-the-White-House .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: center; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } P103109PS-0527, originally uploaded by The White House. .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: center; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } P103109PS-0527, originally uploaded by The White House. .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: center; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } P103109PS-0527, originally uploaded by The White House. tag:odeo.com,2009-11-07,25416546 Sat, 07 Nov 2009 05:03:40 -0800 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/25404885-The-Uroplakins-Via-the-Renal-Fellow-Network The uroplakins form tiny, hexagonal arrays of particles--visualized best by electron microscopy (see figure taken from this excellent recent KI review by Wu et al)--which comprise structures called "urothelial plaques" that overlie the plasma membrane of superficial umbrella cells of the urothelium...Read more here. The uroplakins form tiny, hexagonal arrays of particles--visualized best by electron microscopy (see figure taken from this excellent recent KI review by Wu et al)--which comprise structures called "urothelial plaques" that overlie the plasma membrane of superficial umbrella cells of the urothelium...Read more here. The uroplakins form tiny, hexagonal arrays of particles--visualized best by electron microscopy (see figure taken from this excellent recent KI review by Wu et al)--which comprise structures called "urothelial plaques" that overlie the plasma membrane of superficial umbrella cells of the urothelium...Read more here. tag:odeo.com,2009-11-05,25404885 Thu, 05 Nov 2009 04:08:21 -0800 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/25404883-Fall Credit: Baard Overgaard Hansen http://www.pixum.com http://bestc.am/LUN5 Credit: Baard Overgaard Hansen http://www.pixum.com http://bestc.am/LUN5 Credit: Baard Overgaard Hansen http://www.pixum.com http://bestc.am/LUN5 tag:odeo.com,2009-11-05,25404883 Thu, 05 Nov 2009 03:48:56 -0800 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/25398330-Atypical-Hemolytic-Uremic-Syndrome-in-the-New-England-Journal-of-Medicine Image by roboonya via Flickr Every physician has diseases they see improbably often. For me, one of these conditions is hemolytic-uremic syndrome. Since writing one of my first papers on HUS as a resident — "De novo thrombotic microangiopathy in renal transplant recipients" — I've seen way more of it than you'd expect. For kidney fans, this review article on atypical hemolytic-uremic syndrome in this month's New England Journal of Medicine (subscription required) is a must read. It details recent advances in the genetics of atypical hemolytic-uremic syndrome. What was previously a confusing mess of similar-appearing diseases — hemolytic-uremic syndrome, atypical hemolytic-uremic syndrome, drug-induced hemolytic-uremic syndrome, and thrombotic thrombocytopenic purpura — may finally be understandable. Related: A List of Kidney Diseases Image by roboonya via Flickr Every physician has diseases they see improbably often. For me, one of these conditions is hemolytic-uremic syndrome. Since writing one of my first papers on HUS as a resident — "De novo thrombotic microangiopathy in renal transplant recipients" — I've seen way more of it than you'd expect. For kidney fans, this review article on atypical hemolytic-uremic syndrome in this month's New England Journal of Medicine (subscription required) is a must read. It details recent advances in the genetics of atypical hemolytic-uremic syndrome. What was previously a confusing mess of similar-appearing diseases — hemolytic-uremic syndrome, atypical hemolytic-uremic syndrome, drug-induced hemolytic-uremic syndrome, and thrombotic thrombocytopenic purpura — may finally be understandable. Related: A List of Kidney Diseases Image by roboonya via Flickr Every physician has diseases they see improbably often. For me, one of these conditions is hemolytic-uremic syndrome. Since writing one of my first papers on HUS as a resident — "De novo thrombotic microangiopathy in renal transplant recipients" — I've seen way more of it than you'd expect. For kidney fans, this review article on atypical hemolytic-uremic syndrome in this month's New England Journal of Medicine (subscription required) is a must read. It details recent advances in the genetics of atypical hemolytic-uremic syndrome. What was previously a confusing mess of similar-appearing diseases — hemolytic-uremic syndrome, atypical hemolytic-uremic syndrome, drug-induced hemolytic-uremic syndrome, and thrombotic thrombocytopenic purpura — may finally be understandable. Related: A List of Kidney Diseases tag:odeo.com,2009-10-27,25398330 Tue, 27 Oct 2009 13:42:04 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/25368089-Flu-Virus-Animation Via NPR. Via NPR. Via NPR. tag:odeo.com,2009-10-25,25368089 Sun, 25 Oct 2009 05:02:29 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/25277992-List-of-Kidney-Diseases-Updated Image via Wikipedia I've updated the list of kidney diseases for patients. Please let me know if I missed anything. Image via Wikipedia I've updated the list of kidney diseases for patients. Please let me know if I missed anything. Image via Wikipedia I've updated the list of kidney diseases for patients. Please let me know if I missed anything. tag:odeo.com,2009-10-12,25277992 Mon, 12 Oct 2009 19:08:02 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/25272484-Regulation-Works "Regulation works." (via @jayparkinson) "Regulation works." (via @jayparkinson) "Regulation works." (via @jayparkinson) tag:odeo.com,2009-10-12,25272484 Mon, 12 Oct 2009 00:27:47 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/25230344-List-of-Kidney-Diseases Image by Getty Images via Daylife Did I miss anything on this list of kidney diseases? (I intentionally left out a few rare disorders.) If you know of other links to patient information I might include, please post a comment. Thanks. Image by Getty Images via Daylife Did I miss anything on this list of kidney diseases? (I intentionally left out a few rare disorders.) If you know of other links to patient information I might include, please post a comment. Thanks. Image by Getty Images via Daylife Did I miss anything on this list of kidney diseases? (I intentionally left out a few rare disorders.) If you know of other links to patient information I might include, please post a comment. Thanks. tag:odeo.com,2009-10-03,25230344 Sat, 03 Oct 2009 20:40:41 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/25230343-Swine-Flu-on-Twitter-by-xkcd-com (original here) (original here) (original here) tag:odeo.com,2009-10-03,25230343 Sat, 03 Oct 2009 13:05:24 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/25226673-Surgery-by-xkcd-com (original here) (original here) (original here) tag:odeo.com,2009-10-03,25226673 Sat, 03 Oct 2009 06:35:05 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/25144329-High-Potassium-and-Kidney-Failure-Due-to-Matchstick-Ingestion The Renal Fellow Network Blog is essential reading, part 426... Matchstick heads are comprised of over 50% potassium chlorate (KClO3); it is an oxidizing agent which makes matches flammable and can also be found in many explosives and fireworks. Unfortunately, it also happens to be nephrotoxic. In this interesting case report by Mutlu et al, the authors describe a 21-year-old man who attempted to commit suicide by ingesting 120 matchsticks... The Renal Fellow Network Blog is essential reading, part 426... Matchstick heads are comprised of over 50% potassium chlorate (KClO3); it is an oxidizing agent which makes matches flammable and can also be found in many explosives and fireworks. Unfortunately, it also happens to be nephrotoxic. In this interesting case report by Mutlu et al, the authors describe a 21-year-old man who attempted to commit suicide by ingesting 120 matchsticks... The Renal Fellow Network Blog is essential reading, part 426... Matchstick heads are comprised of over 50% potassium chlorate (KClO3); it is an oxidizing agent which makes matches flammable and can also be found in many explosives and fireworks. Unfortunately, it also happens to be nephrotoxic. In this interesting case report by Mutlu et al, the authors describe a 21-year-old man who attempted to commit suicide by ingesting 120 matchsticks... tag:odeo.com,2009-09-18,25144329 Fri, 18 Sep 2009 05:39:45 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/24967663-Differential-Diagnosis-of-Urine-Color-and-Odor Via the Primer on Kidney Diseases. (Love that text.) Via the Primer on Kidney Diseases. (Love that text.) Via the Primer on Kidney Diseases. (Love that text.) tag:odeo.com,2009-08-11,24967663 Tue, 11 Aug 2009 13:26:11 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/24895071-Updated-iPhone-Home-Screen tag:odeo.com,2009-07-19,24895071 Sun, 19 Jul 2009 15:49:26 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/24895070-Show-Me-Something-New-from-Reaching-the-Animal-Mind tag:odeo.com,2009-07-19,24895070 Sun, 19 Jul 2009 14:29:27 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/24794907-Manhattanhenge-2009 tag:odeo.com,2009-07-13,24794907 Mon, 13 Jul 2009 03:17:32 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/24751167-Brain-with-Atherosclerosis .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: center; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } NCP 1277, originally uploaded by otisarchives1. .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: center; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } NCP 1277, originally uploaded by otisarchives1. .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: center; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } NCP 1277, originally uploaded by otisarchives1. tag:odeo.com,2009-07-02,24751167 Thu, 02 Jul 2009 12:20:09 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/24751166-A-Mindmap-Containing-All-Major-Topics-in-Biology-Chemistry-and-Physics Structure of the Kidney. Structure of the Kidney. Structure of the Kidney. tag:odeo.com,2009-07-02,24751166 Thu, 02 Jul 2009 12:08:12 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/24751170-Why-Doesn-t-This-Catheter-Work Have I mentioned recently that you must read Nathan Hellman's Renal Fellow's Blog? Have I mentioned recently that you must read Nathan Hellman's Renal Fellow's Blog? Have I mentioned recently that you must read Nathan Hellman's Renal Fellow's Blog? tag:odeo.com,2009-06-21,24751170 Sun, 21 Jun 2009 02:04:54 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/24751169-Steve-Jobs-Liver-Transplant Image via CrunchBase Via Daring Fireball: Yukari Iwatani and Joann S. Lublin, reporting for The Wall Street Journal: Steve Jobs, who has been on medical leave from Apple Inc. since January to treat an undisclosed medical condition, received a liver transplant in Tennessee about two months ago. The chief executive has been recovering well and is expected to return to work on schedule later this month, though he may work part-time initially. This must be a deliberate, timed leak from Apple. The timing is simply perfect from Apple's perspective — midnight on the Friday of what appears to be the most successful new product launch in company history. Image via CrunchBase Via Daring Fireball: Yukari Iwatani and Joann S. Lublin, reporting for The Wall Street Journal: Steve Jobs, who has been on medical leave from Apple Inc. since January to treat an undisclosed medical condition, received a liver transplant in Tennessee about two months ago. The chief executive has been recovering well and is expected to return to work on schedule later this month, though he may work part-time initially. This must be a deliberate, timed leak from Apple. The timing is simply perfect from Apple's perspective — midnight on the Friday of what appears to be the most successful new product launch in company history. Image via CrunchBase Via Daring Fireball: Yukari Iwatani and Joann S. Lublin, reporting for The Wall Street Journal: Steve Jobs, who has been on medical leave from Apple Inc. since January to treat an undisclosed medical condition, received a liver transplant in Tennessee about two months ago. The chief executive has been recovering well and is expected to return to work on schedule later this month, though he may work part-time initially. This must be a deliberate, timed leak from Apple. The timing is simply perfect from Apple's perspective — midnight on the Friday of what appears to be the most successful new product launch in company history. tag:odeo.com,2009-06-20,24751169 Sat, 20 Jun 2009 11:54:52 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/24751168-Marlo-Isis-Armstrong in the middle of the night Originally uploaded by dooce in the middle of the night Originally uploaded by dooce in the middle of the night Originally uploaded by dooce tag:odeo.com,2009-06-20,24751168 Sat, 20 Jun 2009 03:27:22 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/24636112-Manhattanhenge-2009 .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: center; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } manhattanhenge 2009, originally uploaded by mudpig. .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: center; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } manhattanhenge 2009, originally uploaded by mudpig. .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: center; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } manhattanhenge 2009, originally uploaded by mudpig. tag:odeo.com,2009-06-01,24636112 Mon, 01 Jun 2009 03:32:59 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/24496589-Clowns-vs-Cops-In-a-Hospital There are no words. There are no words. There are no words. tag:odeo.com,2009-04-24,24496589 Fri, 24 Apr 2009 01:35:57 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/24261241-Nephrology-Calculators-for-the-iPhone My colleague Joel Topf over at Precious Bodily Fluids reviews three nephrology calculators for the iPhone. He likes Neph Calc MedCalc the best. My colleague Joel Topf over at Precious Bodily Fluids reviews three nephrology calculators for the iPhone. He likes Neph Calc MedCalc the best. My colleague Joel Topf over at Precious Bodily Fluids reviews three nephrology calculators for the iPhone. He likes Neph Calc MedCalc the best. tag:odeo.com,2009-03-05,24261241 Thu, 05 Mar 2009 12:25:09 -0800 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/24261242-Bizarre-Devices-from-Medicine-s-Dark-Past From the New Scientist Web site. Not entirely safe for work. (Via Warren Ellis.) From the New Scientist Web site. Not entirely safe for work. (Via Warren Ellis.) From the New Scientist Web site. Not entirely safe for work. (Via Warren Ellis.) tag:odeo.com,2009-03-05,24261242 Thu, 05 Mar 2009 03:20:41 -0800 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/24059232-13-Things-I-Hate-about-Nephrology-by-Nephrogirl Image via Wikipedia In a recent post, "nephrogirl" — who is either a nephrology fellow or younger nephrologist — listed the "13 things [she hates] about nephrology." I appreciate that she took the time to vent her unhappiness. And while her experiences with nephrology aren't mine — which might have to do with differences in our patient populations and many other factors — I understand her perspective. Here's the list, along with my comments. 1) The incessant checking of labs, powerlessly watching the kidney function slowly deteriorate. [I'd say the ratio of patients for whom I make a significant difference to patients that I feel powerless to help is well over 50:1.]2) Sending patients for the critical intervention which you feel is going to make the difference, only to see them suffer a devastating complication from the procedure itself which was worse than the actual disease. [Interventions for renal artery stenosis and coronary artery disease might fall into this category. I've r... Image via Wikipedia In a recent post, "nephrogirl" — who is either a nephrology fellow or younger nephrologist — listed the "13 things [she hates] about nephrology." I appreciate that she took the time to vent her unhappiness. And while her experiences with nephrology aren't mine — which might have to do with differences in our patient populations and many other factors — I understand her perspective. Here's the list, along with my comments. 1) The incessant checking of labs, powerlessly watching the kidney function slowly deteriorate. [I'd say the ratio of patients for whom I make a significant difference to patients that I feel powerless to help is well over 50:1.]2) Sending patients for the critical intervention which you feel is going to make the difference, only to see them suffer a devastating complication from the procedure itself which was worse than the actual disease. [Interventions for renal artery stenosis and coronary artery disease might fall into this category. I've rarely seen catastrophic outcomes from either of these interventions, and the number of patients that I've seen helped far outweighs any of the complications I've seen.]3) The self-deception involved in thinking you might be slowing the progression of their kidney disease, when their main problem is the cardiovascular death that's waiting for them in the next 6-24 months. [Interventions to slow the progression of kidney disease, like improving control of hypertension and diabetes, also have the potential to also prevent or delay cardiovascular disease.]4) The rampant noncompliance of so many patients. [Agreed, this is frustrating. But I've also seen many patients stop smoking, lose weight, begin taking their medications, and change their lifestyles.]5) Reassuring the dialysis patient that his labs look better, when he'll be dead in a year. [Again with the fatalism and therapeutic nihilism, which is difficult to argue against, because the prognosis for many dialysis patients is so dismal. Then again, I've seen plenty of patients survive many years on dialysis and eventually get transplanted.]6) Relying on the creatinine to determine kidney function, a wildly imprecise measure at best. [Agreed, but the MDRD formula is now mainstream and is a more sensitive — though not a specific — measure of kidney disease.]7) Watching the diabetic dialysis patient slowly losing his eyes, feet, kidneys, heart, and brain…knowing the outcome will not change despite everything that you try to do…watching the health care system spend tens of thousands of dollars on him in his last year of life. [I agree, this happens, and is frustrating, and many nephrologists feel powerless.]8) Trying to explain kidney disease to patients and to other doctors – it's a wild mystery to most people that they usually equate with death. [A cardiologist once said, half-jokingly, that "Everyone understands the heart, and no one understands the kidney." The mysteriousness and non-intuitiveness of the kidney is what gets many nephrologists into the field in the first place.]9) The joylessness of a nephrologist's life, especially one who feels it is her duty to try to make a difference, despite constant evidence that her efforts are most likely futile. [Most days, I'm very satisfied with my work, and I don't feel this way at all.]10) The realization that it is easier and more financially rewarding to put a patient on dialysis than to try to preserve their kidney function. [I've suspected this phenomenon might occur, but I don't practice this way.]11) Knowing that the promise of a kidney transplant is what dialysis patients live for…and knowing that a transplant can in some cases be worse than dialysis, especially when the post-transplant care is handled by an erratic system more interested in doing surgery than in practicing medicine. [In general, it's better to get a kidney transplant than to be on dialysis, even taking into account transplant patients who do poorly.]12) Not being able to let go…for fear you'll miss the acute renal failure, the rapid correction of hyponatremia, the diagnosis of RPGN…then when your back is turned, an unexpected catastrophe happens. [Many medical specialties require a high level of vigilance, nephrology perhaps more than most.]13) The realization that the bill of goods you were sold when you chose this field is far different than the reality. [Personally, more than five years into practice, I still wouldn't choose any other field.] Thanks again for taking the time to leave your comments. Image via Wikipedia In a recent post, "nephrogirl" — who is either a nephrology fellow or younger nephrologist — listed the "13 things [she hates] about nephrology." I appreciate that she took the time to vent her unhappiness. And while her experiences with nephrology aren't mine — which might have to do with differences in our patient populations and many other factors — I understand her perspective. Here's the list, along with my comments. 1) The incessant checking of labs, powerlessly watching the kidney function slowly deteriorate. [I'd say the ratio of patients for whom I make a significant difference to patients that I feel powerless to help is well over 50:1.]2) Sending patients for the critical intervention which you feel is going to make the difference, only to see them suffer a devastating complication from the procedure itself which was worse than the actual disease. [Interventions for renal artery stenosis and coronary artery disease might fall into this category. I've rarely seen catastrophic outcomes from either of these interventions, and the number of patients that I've seen helped far outweighs any of the complications I've seen.]3) The self-deception involved in thinking you might be slowing the progression of their kidney disease, when their main problem is the cardiovascular death that's waiting for them in the next 6-24 months. [Interventions to slow the progression of kidney disease, like improving control of hypertension and diabetes, also have the potential to also prevent or delay cardiovascular disease.]4) The rampant noncompliance of so many patients. [Agreed, this is frustrating. But I've also seen many patients stop smoking, lose weight, begin taking their medications, and change their lifestyles.]5) Reassuring the dialysis patient that his labs look better, when he'll be dead in a year. [Again with the fatalism and therapeutic nihilism, which is difficult to argue against, because the prognosis for many dialysis patients is so dismal. Then again, I've seen plenty of patients survive many years on dialysis and eventually get transplanted.]6) Relying on the creatinine to determine kidney function, a wildly imprecise measure at best. [Agreed, but the MDRD formula is now mainstream and is a more sensitive — though not a specific — measure of kidney disease.]7) Watching the diabetic dialysis patient slowly losing his eyes, feet, kidneys, heart, and brain…knowing the outcome will not change despite everything that you try to do…watching the health care system spend tens of thousands of dollars on him in his last year of life. [I agree, this happens, and is frustrating, and many nephrologists feel powerless.]8) Trying to explain kidney disease to patients and to other doctors – it's a wild mystery to most people that they usually equate with death. [A cardiologist once said, half-jokingly, that "Everyone understands the heart, and no one understands the kidney." The mysteriousness and non-intuitiveness of the kidney is what gets many nephrologists into the field in the first place.]9) The joylessness of a nephrologist's life, especially one who feels it is her duty to try to make a difference, despite constant evidence that her efforts are most likely futile. [Most days, I'm very satisfied with my work, and I don't feel this way at all.]10) The realization that it is easier and more financially rewarding to put a patient on dialysis than to try to preserve their kidney function. [I've suspected this phenomenon might occur, but I don't practice this way.]11) Knowing that the promise of a kidney transplant is what dialysis patients live for…and knowing that a transplant can in some cases be worse than dialysis, especially when the post-transplant care is handled by an erratic system more interested in doing surgery than in practicing medicine. [In general, it's better to get a kidney transplant than to be on dialysis, even taking into account transplant patients who do poorly.]12) Not being able to let go…for fear you'll miss the acute renal failure, the rapid correction of hyponatremia, the diagnosis of RPGN…then when your back is turned, an unexpected catastrophe happens. [Many medical specialties require a high level of vigilance, nephrology perhaps more than most.]13) The realization that the bill of goods you were sold when you chose this field is far different than the reality. [Personally, more than five years into practice, I still wouldn't choose any other field.] Thanks again for taking the time to leave your comments. tag:odeo.com,2009-02-07,24059232 Sat, 07 Feb 2009 18:49:43 -0800 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/23823322-Electronic-Stethoscope-Oddities Happy New Year! If acoustic stethoscopes — the kind physicians have used for over two hundred years — are the equivalent of typewriters, then electronic stethoscopes are like word processors. Okay, this analogy is non-intuitive, but hear me out. Electronic stethoscopes, like word processors, are newer, more expensive than the previous generation, and are — well — electronic, with all the advantages and disadvantages this implies. The advantages to electronic stethoscopes are many. As I've written previously in my review of the Littman Electronic Stethoscope Model 3000, it's simply easier to hear heart and lung sounds with an electronic stethoscope than it is with an acoustic stethoscope. (For real-world examples of this, see the previous review.) Plus, some models, like the Littmann 4100 Electronic Stethoscope, allow you to record and playback — think copy and paste — heart and lung sounds for reference or teaching. But anything electronic is prone to failure, and when electronic st... Happy New Year! If acoustic stethoscopes — the kind physicians have used for over two hundred years — are the equivalent of typewriters, then electronic stethoscopes are like word processors. Okay, this analogy is non-intuitive, but hear me out. Electronic stethoscopes, like word processors, are newer, more expensive than the previous generation, and are — well — electronic, with all the advantages and disadvantages this implies. The advantages to electronic stethoscopes are many. As I've written previously in my review of the Littman Electronic Stethoscope Model 3000, it's simply easier to hear heart and lung sounds with an electronic stethoscope than it is with an acoustic stethoscope. (For real-world examples of this, see the previous review.) Plus, some models, like the Littmann 4100 Electronic Stethoscope, allow you to record and playback — think copy and paste — heart and lung sounds for reference or teaching. But anything electronic is prone to failure, and when electronic stethoscopes fail, they fail spectacularly. Don't misunderstand: I'm a fan of my Littman Model 3000, but it's worth pointing out the oddities you should expect if you decide to purchase one of these things. (Some of these observations are taken from my postings on Twitter.) First — and this might sound obvious — the electronic stethoscope requires batteries. Eventually, these batteries will die. Unexpectedly. At exactly the wrong moment. Almost certainly, when you're examining a patient. At this time, your electronic stethoscope will make a sad little noise, then — silence. An eerie silence. And unless you're walking around with an extra AA battery in your pocket — which you will suddenly realize is probably a good idea — you will then say, apologetically, "I'm sorry. The battery in my electronic stethoscope just died." Second, if you carry around an iPhone or a BlackBerry, you will experience intermittently the faint faraway static of your mobile device as you're listening to the heart of a patient. And while this doesn't interfere with your physical exam, it's unnerving. Finally, if you were planning to place another type of diaphgram on your electronic stethoscope — such as the excellent SafeSeal stethoscope covers by DRG — don't. It will cause unbelievable amounts of feedback. As I learned recently, placing incompatible diaphragms on electronic stethoscopes makes your patients' hearts sound like they're being played by Jimi Hendrix. (Also posted on Tech Medicine.) Happy New Year! If acoustic stethoscopes — the kind physicians have used for over two hundred years — are the equivalent of typewriters, then electronic stethoscopes are like word processors. Okay, this analogy is non-intuitive, but hear me out. Electronic stethoscopes, like word processors, are newer, more expensive than the previous generation, and are — well — electronic, with all the advantages and disadvantages this implies. The advantages to electronic stethoscopes are many. As I've written previously in my review of the Littman Electronic Stethoscope Model 3000, it's simply easier to hear heart and lung sounds with an electronic stethoscope than it is with an acoustic stethoscope. (For real-world examples of this, see the previous review.) Plus, some models, like the Littmann 4100 Electronic Stethoscope, allow you to record and playback — think copy and paste — heart and lung sounds for reference or teaching. But anything electronic is prone to failure, and when electronic stethoscopes fail, they fail spectacularly. Don't misunderstand: I'm a fan of my Littman Model 3000, but it's worth pointing out the oddities you should expect if you decide to purchase one of these things. (Some of these observations are taken from my postings on Twitter.) First — and this might sound obvious — the electronic stethoscope requires batteries. Eventually, these batteries will die. Unexpectedly. At exactly the wrong moment. Almost certainly, when you're examining a patient. At this time, your electronic stethoscope will make a sad little noise, then — silence. An eerie silence. And unless you're walking around with an extra AA battery in your pocket — which you will suddenly realize is probably a good idea — you will then say, apologetically, "I'm sorry. The battery in my electronic stethoscope just died." Second, if you carry around an iPhone or a BlackBerry, you will experience intermittently the faint faraway static of your mobile device as you're listening to the heart of a patient. And while this doesn't interfere with your physical exam, it's unnerving. Finally, if you were planning to place another type of diaphgram on your electronic stethoscope — such as the excellent SafeSeal stethoscope covers by DRG — don't. It will cause unbelievable amounts of feedback. As I learned recently, placing incompatible diaphragms on electronic stethoscopes makes your patients' hearts sound like they're being played by Jimi Hendrix. (Also posted on Tech Medicine.) tag:odeo.com,2009-01-01,23823322 Thu, 01 Jan 2009 23:57:11 -0800 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/23493805-Netter-for-the-iPhone Would have loved this during anatomy. Looking at the video, I can almost smell the gristle and formaldehyde again. This is one of the few medical apps I haven't used, though — any medical students find it helpful? Would have loved this during anatomy. Looking at the video, I can almost smell the gristle and formaldehyde again. This is one of the few medical apps I haven't used, though — any medical students find it helpful? Would have loved this during anatomy. Looking at the video, I can almost smell the gristle and formaldehyde again. This is one of the few medical apps I haven't used, though — any medical students find it helpful? tag:odeo.com,2008-10-16,23493805 Thu, 16 Oct 2008 02:28:18 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/23453173-Precious-Bodily-Fluids-a-New-Nephrology-Blog Image via Wikipedia Dr. Joel Topf is one of only two or three blogging nephrologists (including Dr. Arnold Kim, who publishes MacRumors.com, so that may not count). Joel writes the excellent Precious Bodily Fluids blog. PBF not only contains a wealth of clinical information, but scores huge points for the Dr. Strangelove banner. He's also the author of The Fluid, Electrolyte, and Acid-Base Companion, perhaps the easiest-to-understand primer on these brain-twisting disorders. Via Precious Bodily Fluids: Yesterday I gave a great lecture on interpreting ABG results. I added a problems set for gap-gap analysis and added a section on the osmolar gap. I also improved the anion gap section with my new favorite mnemonic. Forget PLUMSEEDS, forget MUDSLEEPS, forget MUDPILES. The new hotness is GOLD MARK: * G Glycols * O 5-Oxoproline (pyroglutamic acid) * L L-Lactic acid * D D-Lactic acid * M Methanol * A Aspirin * R Renal failure * K Ketoacidosis Related articles by Zemanta My Son, the Blogge... Image via Wikipedia Dr. Joel Topf is one of only two or three blogging nephrologists (including Dr. Arnold Kim, who publishes MacRumors.com, so that may not count). Joel writes the excellent Precious Bodily Fluids blog. PBF not only contains a wealth of clinical information, but scores huge points for the Dr. Strangelove banner. He's also the author of The Fluid, Electrolyte, and Acid-Base Companion, perhaps the easiest-to-understand primer on these brain-twisting disorders. Via Precious Bodily Fluids: Yesterday I gave a great lecture on interpreting ABG results. I added a problems set for gap-gap analysis and added a section on the osmolar gap. I also improved the anion gap section with my new favorite mnemonic. Forget PLUMSEEDS, forget MUDSLEEPS, forget MUDPILES. The new hotness is GOLD MARK: * G Glycols * O 5-Oxoproline (pyroglutamic acid) * L L-Lactic acid * D D-Lactic acid * M Methanol * A Aspirin * R Renal failure * K Ketoacidosis Related articles by Zemanta My Son, the Blogger: An M.D. Trades Medicine for Apple Rumors Image via Wikipedia Dr. Joel Topf is one of only two or three blogging nephrologists (including Dr. Arnold Kim, who publishes MacRumors.com, so that may not count). Joel writes the excellent Precious Bodily Fluids blog. PBF not only contains a wealth of clinical information, but scores huge points for the Dr. Strangelove banner. He's also the author of The Fluid, Electrolyte, and Acid-Base Companion, perhaps the easiest-to-understand primer on these brain-twisting disorders. Via Precious Bodily Fluids: Yesterday I gave a great lecture on interpreting ABG results. I added a problems set for gap-gap analysis and added a section on the osmolar gap. I also improved the anion gap section with my new favorite mnemonic. Forget PLUMSEEDS, forget MUDSLEEPS, forget MUDPILES. The new hotness is GOLD MARK: * G Glycols * O 5-Oxoproline (pyroglutamic acid) * L L-Lactic acid * D D-Lactic acid * M Methanol * A Aspirin * R Renal failure * K Ketoacidosis Related articles by Zemanta My Son, the Blogger: An M.D. Trades Medicine for Apple Rumors tag:odeo.com,2008-10-04,23453173 Sat, 04 Oct 2008 14:37:00 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/23446403-Urinary-Tract-Wallpaper Via the talented Shannon Wright: Via the talented Shannon Wright: Via the talented Shannon Wright: tag:odeo.com,2008-10-03,23446403 Fri, 03 Oct 2008 03:47:17 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/23400725-Sparklines-and-Hantavirus-Nephropathy .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: center; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } Sparklines and Hantavirus Nephropathy, originally uploaded by KidneyNotes. .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: center; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } Sparklines and Hantavirus Nephropathy, originally uploaded by KidneyNotes. .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: center; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } Sparklines and Hantavirus Nephropathy, originally uploaded by KidneyNotes. tag:odeo.com,2008-09-26,23400725 Fri, 26 Sep 2008 01:06:15 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/23355628-How-to-Blog-by-Merlin-Mann How To Blog View SlideShare presentation or Upload your own. (tags: advice blogging) And the talk itself, here. How To Blog View SlideShare presentation or Upload your own. (tags: advice blogging) And the talk itself, here. How To Blog View SlideShare presentation or Upload your own. (tags: advice blogging) And the talk itself, here. tag:odeo.com,2008-09-15,23355628 Mon, 15 Sep 2008 18:36:53 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/23295669-Right-Now-What-Are-You-Doing .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: center; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } Right Now: What Are You Doing?, originally uploaded by merlinmann. .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: center; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } Right Now: What Are You Doing?, originally uploaded by merlinmann. .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: center; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } Right Now: What Are You Doing?, originally uploaded by merlinmann. tag:odeo.com,2008-09-02,23295669 Tue, 02 Sep 2008 01:51:36 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/23295678-Transitioning-Blog-Comments-to-Disqus I'm transitioning Kidney Notes' blog commenting system to Disqus. The old comments will — hopefully — still be there, but things may look strange for a bit. I'm transitioning Kidney Notes' blog commenting system to Disqus. The old comments will — hopefully — still be there, but things may look strange for a bit. I'm transitioning Kidney Notes' blog commenting system to Disqus. The old comments will — hopefully — still be there, but things may look strange for a bit. tag:odeo.com,2008-08-30,23295678 Sat, 30 Aug 2008 05:29:20 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/23295682-Hello-Health .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: center; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } Hello Health, originally uploaded by KidneyNotes. .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: center; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } Hello Health, originally uploaded by KidneyNotes. .flickr-photo { border: solid 2px #000000; }.flickr-yourcomment { }.flickr-frame { text-align: center; padding: 3px; }.flickr-caption { font-size: 0.8em; margin-top: 0px; } Hello Health, originally uploaded by KidneyNotes. tag:odeo.com,2008-07-31,23295682 Thu, 31 Jul 2008 23:20:21 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/23295685-The-Controvery-Over-Cardiac-CTAs Image via Wikipedia Weighing the Costs of a CT Scan's Look Inside the Heart - NYTimes.com: A few minutes later, Dr. Hecht studied the results. As he had expected, the angiogram revealed that Mr. Franks's arteries were healthy. In some places, plaque had blocked 25 percent of their blood flow, but in general, cardiologists do not consider blockages clinically relevant until they reduce blood flow at least 70 percent. After Mr. Franks finished dressing, he joined Dr. Hecht, who went over the results, explaining that his heart appeared healthy and that he would not need a stent. Still, Dr. Hecht recommended that Mr. Franks have another CT angiogram next year to check that the plaque was not thickening. Mr. Franks agreed, pronounced himself satisfied and left. For Mr. Franks, the test was quick and painless. But it subjected him to a significant dose of radiation. Based on a reporter's notes about the duration of the scan and the power output reported by the scanner, Dr. Brenner of the ... Image via Wikipedia Weighing the Costs of a CT Scan's Look Inside the Heart - NYTimes.com: A few minutes later, Dr. Hecht studied the results. As he had expected, the angiogram revealed that Mr. Franks's arteries were healthy. In some places, plaque had blocked 25 percent of their blood flow, but in general, cardiologists do not consider blockages clinically relevant until they reduce blood flow at least 70 percent. After Mr. Franks finished dressing, he joined Dr. Hecht, who went over the results, explaining that his heart appeared healthy and that he would not need a stent. Still, Dr. Hecht recommended that Mr. Franks have another CT angiogram next year to check that the plaque was not thickening. Mr. Franks agreed, pronounced himself satisfied and left. For Mr. Franks, the test was quick and painless. But it subjected him to a significant dose of radiation. Based on a reporter's notes about the duration of the scan and the power output reported by the scanner, Dr. Brenner of the Center for Radiological Research estimated that Mr. Franks had received 21 millisieverts of radiation — even more than a typical test, equal to about 1,050 conventional chest X-rays. Given the radiation risks, Dr. Ralph Brindis, another cardiologist, said Dr. Hecht had erred. Because Mr. Franks had already taken a nuclear stress test with normal results, he did not need a CT angiogram, said Dr. Brindis, vice president of the American College of Cardiology. And particularly because the scan's results were benign, he said, Dr. Hecht should not have recommended a follow-up test. "The biggest problem we have with radiation is that the doses are cumulative and additive," Dr. Brindis said. "So the concept of doing serial CT testing on asymptomatic patients, I think, is abhorrent. I cannot justify that." Dr. Hecht said he sharply disagreed with Dr. Brindis. The scan was appropriate for Mr. Franks, despite his normal results from the nuclear stress test, because of Mr. Franks's other risk factors for heart disease, including his higher-than-average calcium score, Dr. Hecht said. And he said he recommended a follow-up scan next year so he could see how quickly the plaque in Mr. Franks's arteries was thickening. The article attempts to reconcile two sharply opposing points of view. In my opinion — and I hasten to add that I'm not a cardiologist or radiologist — cardiac CTAs are at the same level of clinical usefulness and acceptance now that CTAs of the pulmonary arteries were several years ago. It took years for a CTA of the pulmonary arteries to a widely accepted test for diagnosing or excluding pulmonary embolii. Within the next several years, I would expect that CTAs of the coronary arteries will become a well-accepted test for diagnosing or excluding coronary disease. Related articles by Zemanta How Dangerous Are CT Scans? Heart Scans Still Covered by Medicare Second Opinion: From a Prominent Death, Some Painful Truths Image via Wikipedia Weighing the Costs of a CT Scan's Look Inside the Heart - NYTimes.com: A few minutes later, Dr. Hecht studied the results. As he had expected, the angiogram revealed that Mr. Franks's arteries were healthy. In some places, plaque had blocked 25 percent of their blood flow, but in general, cardiologists do not consider blockages clinically relevant until they reduce blood flow at least 70 percent. After Mr. Franks finished dressing, he joined Dr. Hecht, who went over the results, explaining that his heart appeared healthy and that he would not need a stent. Still, Dr. Hecht recommended that Mr. Franks have another CT angiogram next year to check that the plaque was not thickening. Mr. Franks agreed, pronounced himself satisfied and left. For Mr. Franks, the test was quick and painless. But it subjected him to a significant dose of radiation. Based on a reporter's notes about the duration of the scan and the power output reported by the scanner, Dr. Brenner of the Center for Radiological Research estimated that Mr. Franks had received 21 millisieverts of radiation — even more than a typical test, equal to about 1,050 conventional chest X-rays. Given the radiation risks, Dr. Ralph Brindis, another cardiologist, said Dr. Hecht had erred. Because Mr. Franks had already taken a nuclear stress test with normal results, he did not need a CT angiogram, said Dr. Brindis, vice president of the American College of Cardiology. And particularly because the scan's results were benign, he said, Dr. Hecht should not have recommended a follow-up test. "The biggest problem we have with radiation is that the doses are cumulative and additive," Dr. Brindis said. "So the concept of doing serial CT testing on asymptomatic patients, I think, is abhorrent. I cannot justify that." Dr. Hecht said he sharply disagreed with Dr. Brindis. The scan was appropriate for Mr. Franks, despite his normal results from the nuclear stress test, because of Mr. Franks's other risk factors for heart disease, including his higher-than-average calcium score, Dr. Hecht said. And he said he recommended a follow-up scan next year so he could see how quickly the plaque in Mr. Franks's arteries was thickening. The article attempts to reconcile two sharply opposing points of view. In my opinion — and I hasten to add that I'm not a cardiologist or radiologist — cardiac CTAs are at the same level of clinical usefulness and acceptance now that CTAs of the pulmonary arteries were several years ago. It took years for a CTA of the pulmonary arteries to a widely accepted test for diagnosing or excluding pulmonary embolii. Within the next several years, I would expect that CTAs of the coronary arteries will become a well-accepted test for diagnosing or excluding coronary disease. Related articles by Zemanta How Dangerous Are CT Scans? Heart Scans Still Covered by Medicare Second Opinion: From a Prominent Death, Some Painful Truths tag:odeo.com,2008-07-07,23295685 Mon, 07 Jul 2008 17:00:00 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/23295689-You-d-Never-Confuse-Diabetes-Mellitus-With-Diabetes-Insipidus-The-New-York-Yimes-Has-It-Wrong Image via Wikipedia I'm still puzzling over this article in the New York Times, "Some Diabetics Don't Have What They Thought They Had." The article seems to imply -- and some other news outlets have picked up -- that some children diagnosed with type 1 diabetes mellitus (DM) actually have diabetes insipidus (DI). What the article means to imply, I think, is that some children with type 1 DM actually have maturity onset diabetes of the young (MODY). (I've looked, but I could not find a situation in which you'd ever confuse type 1 DM and DI. In DI, for example, you wouldn't have glucose in the urine.) Why is this important? Because if the myth propagates through the media that you can easily confuse DI and DM, countless younger adult patients with DM will approach their doctors demanding that they be tested for DI, which will require a lengthy explanation of how the two could not be confused... On the other hand, I've seen patients with MODY misdiagnosed as having type 1 DM -- and the... Image via Wikipedia I'm still puzzling over this article in the New York Times, "Some Diabetics Don't Have What They Thought They Had." The article seems to imply -- and some other news outlets have picked up -- that some children diagnosed with type 1 diabetes mellitus (DM) actually have diabetes insipidus (DI). What the article means to imply, I think, is that some children with type 1 DM actually have maturity onset diabetes of the young (MODY). (I've looked, but I could not find a situation in which you'd ever confuse type 1 DM and DI. In DI, for example, you wouldn't have glucose in the urine.) Why is this important? Because if the myth propagates through the media that you can easily confuse DI and DM, countless younger adult patients with DM will approach their doctors demanding that they be tested for DI, which will require a lengthy explanation of how the two could not be confused... On the other hand, I've seen patients with MODY misdiagnosed as having type 1 DM -- and they eventually are able to stop insulin and switch to oral therapy. This is the real message of the NYT article, I think, and it's great when it happens. Image via Wikipedia I'm still puzzling over this article in the New York Times, "Some Diabetics Don't Have What They Thought They Had." The article seems to imply -- and some other news outlets have picked up -- that some children diagnosed with type 1 diabetes mellitus (DM) actually have diabetes insipidus (DI). What the article means to imply, I think, is that some children with type 1 DM actually have maturity onset diabetes of the young (MODY). (I've looked, but I could not find a situation in which you'd ever confuse type 1 DM and DI. In DI, for example, you wouldn't have glucose in the urine.) Why is this important? Because if the myth propagates through the media that you can easily confuse DI and DM, countless younger adult patients with DM will approach their doctors demanding that they be tested for DI, which will require a lengthy explanation of how the two could not be confused... On the other hand, I've seen patients with MODY misdiagnosed as having type 1 DM -- and they eventually are able to stop insulin and switch to oral therapy. This is the real message of the NYT article, I think, and it's great when it happens. tag:odeo.com,2008-05-06,23295689 Tue, 06 May 2008 12:22:22 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/15097623-Free-unlimited-access-to-two-thousand-years-of-mankind-and-medicine-in-pictures-made-available-by-the-Wellcome-Library tag:odeo.com,2007-07-09,15097623 Mon, 09 Jul 2007 19:35:14 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/13666073-Updated-GTD-Mindmap-now-with-Printable-PDF-File tag:odeo.com,2007-06-24,13666073 Sun, 24 Jun 2007 01:57:43 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/13665983-Mortality-Data-for-Hospitals-Online-on-Hospital-Compare tag:odeo.com,2007-06-23,13665983 Sat, 23 Jun 2007 01:47:57 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/13665903-Links-for-2007-06-21-The-Onion-on-the-iPhone tag:odeo.com,2007-06-22,13665903 Fri, 22 Jun 2007 02:21:44 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/13665773-Yahoo-Green-Taxi tag:odeo.com,2007-06-20,13665773 Wed, 20 Jun 2007 20:16:18 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/13056283-Classic-Literature-AudioBooks-Read-by-Professional-Actors-Naxos-AudioBooks tag:odeo.com,2007-06-05,13056283 Tue, 05 Jun 2007 01:47:48 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/13056303-The-FDA-Advises-You-to-Avoid-These-Toothpastes tag:odeo.com,2007-06-04,13056303 Mon, 04 Jun 2007 19:07:16 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/12869823-TV-Kidney-Competition-was-a-Hoax tag:odeo.com,2007-06-04,12869823 Mon, 04 Jun 2007 11:06:59 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/12869833-Tech-Medicine-Post-on-Aquapheresis-a-New-Treatment-for-Heat-Failure tag:odeo.com,2007-06-03,12869833 Sun, 03 Jun 2007 22:10:18 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/12869773-Office-2007-Being-Rejected-by-Journals tag:odeo.com,2007-06-03,12869773 Sun, 03 Jun 2007 10:13:03 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/12869803-Genome-of-James-Watson-Who-Discovered-DNA-Deciphered tag:odeo.com,2007-06-03,12869803 Sun, 03 Jun 2007 10:09:10 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/12869813-Warren-Ellis-Second-Life-Sketches-from-Reuters tag:odeo.com,2007-06-03,12869813 Sun, 03 Jun 2007 09:53:04 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/12869743-Cache-of-Flea-s-Blog tag:odeo.com,2007-06-02,12869743 Sat, 02 Jun 2007 09:55:14 -0700 no KidneyNotes via Talkr.com http://www.odeo.com/episodes/12869763-Recommendation-BBP-Bags tag:odeo.com,2007-06-02,12869763 Sat, 02 Jun 2007 06:13:09 -0700 no KidneyNotes via Talkr.com