Think Anatomy is an impressive collection of the best anatomy study aids on the net.

This week, Clinical Cases and Images hosts the Medicine 2.0 Blog Carnival. See especially 10 Reasons Why I Use Twitter, Strengths and Challenges of Medical Education in Virtual Worlds, New Idea: Use Twitter for Daily Q&A for Board Preparation, and Screencasting and Podcasting: Experience of the Yale Medical Library.


A new study by the MacArthur Foundation suggests "America’s youth are developing important social and technical skills online – often in ways adults do not understand or value."

Real time digital dictation for doctors is coming to the iTunes App Store. Via the press release for Anymodal CDS Mobile (which, as of this writing, doesn't yet seem to be available):

While clinical dictation was possible before via telephone or PDA
devices, the resulting report was not available for hours. AnyModal
CDS Mobile delivers documents in real time to the physician's
iPhone, making it the first device to capture, understand and transcribe
dictation in real-time. Physicians can now immediately review and sign
off on a clinical document.

JustAnswer Health is a service which allows physicians and other health experts to provide answers to health-related questions in real-time for a fee.

In The Lancet, researchers report transplanting a "tissue-engineered airway," that is, a windpipe cultured from stem cells. (Coverage from Medpage Today is here.)

Stumped by Medical Abbreviations? Now there's a $0.99 iPhone App with 1600 commonly used terms. (Helpful for students and patients trying to understand their own medical records.)

Osirix, the open-source Mac image viewer which I wrote about in my last post, now has an iPhone app. (Via Not Totally Rad.)

Parentdish has a review of their favorite iPhone apps for parents, including a baby monitor, a nursing tracker, a cookbook app with over 160,000 recipes, a white noise app, a drawing app, a diaper tracking app, a grocery list app, a dictionary of food additives, and a game for preschoolers.

For $1.99, the Pocket First Aid and CPR Guide iPhone app has dozens of articles on topics including CPR, the Heimlich maneuver, bites, bruises, burns, seizures, diabetic emergencies, "fever, nausea, blisters, and tooth loss," and "bug, snake, and mammal bites."

Enough about the iPhone for now — Phillips research has introduced the "iPill," an intelligent pill about 1 x 2.5 cm which contains a chip, battery, pH and temperature sensors, fluid pump, drug reservoir, and wireless transceiver.



Certain digestive disorders, like inflammatory bowel disease, may best be treated by targeted drug delivery at the site of activity. Medications that are given systemically, like steroids, have many potential side effects, and targeted drug delivery systems like the iPill may potentially reduce this risk by allowing a smaller dose of medication to be given locally.

Via the Web site:

What Philips Research has developed is a pill that can be swallowed
with food or water in the normal way and is then carried along by
the normal movement of food through the gut. Knowing where the iPill
is in the gut relies on the fact that the gut’s pH value (a measure
of acidity) rises sharply upon exiting the stomach and becomes
progressively alkaline from the upper intestine onwards. In
addition, there is typically a noticeable drop in pH between the
small intestine and the colon. Armed with pH information, which is
measured by the iPill itself, and data about typical transit times
through the gut, the iPill’s location in the gut can be determined
with good accuracy. Where greater accuracy is required, external
medical imaging equipment could be introduced. Locations where the
drug needs to be released could also be determined by medical
imaging – for example, endoscopy, MRI or CT scans.

Apple's Web site has a feature on the use of OsiriX, a mac-based open-source software system for viewing radiologic images. A surgical team at Teikyo University Chiba Medical Center in Japan uses Osirix to project "surgical roadmaps" on patients as they perform minimally invasive surgery.

For patients with early-stage gastric or colonic cancer, the surgical team typically opts for minimally invasive laparoscopic surgery. With the patient anesthetized, Sugimoto projects OsiriX-generated 3D images onto the body surface of the patient with an Epson EMP-1715 projector. Using a motion-sensing wireless remote, Sugimoto uses physiological markers (such as the navel) to register the image to the patient’s body. Then using a Color Look Up Table (CLUT) feature in OsiriX, he makes the skin of the image transparent. The display now shows the patient’s internal body parts and the area that he will need to operate on.

Osirix, which is easy to learn, allows the surgeons to use the 3D images as a reference and guide during surgery. The images may be rotated to provide the surgeons a real-time view of the operation. The remote may also be linked to the laparascope, allowing the image on the display and the image on the scope monitor to move simultaneously. Dr. Sugimoto provides more details on the use of Osirix during surgery:

“The 3D visualization shows us relationships between the cancer and the
arterial vessels and other surrounding organs,” says Sugimoto. “It also
allows us to see the extent of the spread of cancer. When a patient has
upper biliary (bile duct) cancer, we have to cut the liver. If the
patient has lower bile duct cancer we have to remove the pancreatic
head and duodenum. The HBP system is very complex; that’s why 3D
visualization in the OR is so crucial. When doing a midline open
surgery, the surgeon can only see the organs from the top. With OsiriX
on the Mac, surgeons can rotate and see the surrounding organs in 3D to
guide them during surgery.”

More information on OsiriX may be found here.

A new study by Manhattan Research looks at the number of physicians who use the Internet and other digital technologies in their practices. According to the survey, 36% of physicians communicate with their patients online and 54% of physicians own a smartphone. (Thanks to Sean Khozin.)

Google searches for search words related to the flu — "flu," "symptoms of the flu," and the like — are significantly associated with flu outbreaks. In fact, the data on flu-related searches closely mirror the actual incidence of flu activity but are available two weeks earlier than the Centers for Disease Controls own data. The paper, accepted in the journal Nature, is "Detecting Influenza Epidemics using Search Engine Query Data."



iPod headphones — even those that are disconnected — can interfere with pacemakers and implantable defibrillators. The abstract from the American Heart Association is here.

“For patients with pacemakers, exposure to the headphones can force the
device to deliver signals to the heart, causing it to beat without
regard to the patients’ underlying heart rhythm,” he said. “Exposure of
a defibrillator to the headphones can temporarily deactivate the
defibrillator.” In most cases, removal of the headphones restores
normal device function.

The MDRD equation is commonly used by physicians to estimate kidney function. New data suggests that the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation may be even more accurate. (If you know of an online calculator for the new equation, please leave a comment.)

Dr. Atul Gawande appeared on the Charlie Rose Show and discussed using checklists to improve patient safety. Dr. Val has a report.

Tech Medicine Links is a collection of selected developments in the worlds of technology and health care. Have a suggestion? Please email techmedicine@gmail.com.