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(listed in reverse chronological order)
Sites chosen in 1996
December 22-28, 1996
Healthlink Natural Resources Forum. This is a frustrating site to
use because of its rather complex setup and use of frames. It requires
registration, but there is no clear path to the registration area, or once
registered, no clear path to continue. Anyway, if you get through it all,
the site has a wonderful and free
MEDLINE interface.
I put the words "hemodialysis hypotension" into this search engine for
94-96 and got 90
results. Healthgate (www.healthgate.com) returned only 34 for the last two
years. I was
initially, and still am, enthusiastic about Healthgate's medline interface,
but Healthlink now provides a very useful and possibly superior
alternative. Both the Healthlink and Healthgate sites offer reliable
access to the MEDLINE database.
December 15-21, 1996
Osler Medical Journal. This is a new journal, but one that, with
its premier issue, leapfrogs to near the top of what is available on the
internet in terms of useful medical content. The journal is run by
residents at Johns Hopkins, who, after cutting the call schedules back a
few years ago, now appear to have time for other useful activities. In the
journal, which is devoted to Oslerian principles of medical education,
there are sections on case reports, topic reviews, images in medicine, and
on clinical and basic science reports (usually projects run by residents).
For cardiovascular and nephrology devotees, there is a discussion of
bolus vs. continuous administration of diuretics to treat refractory
CHF along with a description of a prospective study designed by the
housestaff and apparently in progress. In a section called "Osler at the
Bedside" there is a discussion of
Cervical Bruits. A third section called
"Images of Osler" (actually images in medicine) presents photos
of purpural fulminans and Osborne waves (for those of you who forgot, J-
type waves in the QT interval on the EKG found in patients with severe
hypothermia. Quite an effort, of interest to medical residents and those
who teach them.
December 8-14, 1996
Community of Science Web Server. It's not clear to me exactly
what this organization is or does. It has members from most major drug
companies and claims to have representations from major universities as
well. In any case, it's a nice information server. It has a WONDERFUL
Medline access module, which unfortunately is free only until December 31,
1996. This is not only better designed than that at www.healthgate.com,
but also much faster. Also available is the full text of the Federal
Register, Commerce Business Daily, and the U.S. Patent Citation Database.
The catch is, of course, that these resources are not open to you and me,
but only to member institutions. Some of the areas are open if you come in
with a .edu browser, but not with a .com browser extension. A
Funding Opportunities Database is accessible to all and has good
disease specific information regarding grant opportunities. There is also
a list of federally funded research in the U.S.
December 1 - 7, 1996
Transplant Pathology Internet Services.
Specifically, this is the page on the server dealing with renal
allograft pathology, created by Drs. Parmjeet Randhawa, Lorraine Racusen,
and Kim Solez. Excellent discussions are found re grading of acute and
chronic allograft rejection, and differential diagnostic considerations in
the allograft biopsy. This page is part of the larger
TPIS server, which deals with transplantation of many organs and
which is sponsored by the University of Pittsburgh Pathology Department.
November 24 - 30,. 1996
United States Renal Data Systems. Although this site has been
up for more than a year,
it was upgraded last month, and its utility has increased greatly. It now
contains a full version
of the
1996 Annual Data Report, complete with full color slides. You
can also download each
chapter in Microsoft Word format, and each chapter's slides in Power Point
format.
November 17 - 23, 1996
American Heart Association CME Page. So far only two programs
are up, only one of which
(Implications of the Treatment of Mild Hypertension Study [TOMHS])
, can be accessed. The other concerns angina and CAD.
The TOMHS-inspired program is quite well done.
This study compared
nutritional therapy alone with nutritional plus drug therapy, randomizing
to 5 drug classes. It
turned out that drug therapy was superior to nutritional therapy, and all
drugs were comparable,
with a slight edge to amlodipine in terms of numbers of patients still on
therapy after 4-5 years.
This CME program develops the arguments and rationale for the study, with
many nice tables and
figures showing the results. Another new addition at the AHA site, is a
nascent list of scientific
guidelines. Only one up at the moment:
Prevention of Bacterial Endocarditis. Unfortunately, I was
hoping that the AHA would
have a nice summary of key presentations at its 69th Scientific Sessions
which took place this month
at New Orleans. They have this huge Scientific Sessions On-Line Program,
but there is no meat in
that large refrigerator.
November 10 - 16, 1996
Endocrinology Database. Compiled by Dr. A.G. Amador of Southern
Illinois University, and
hosted by the Illinois State Academy of Science site. The database has a
list of the normal values
for almost every conceivably measured hormone in both men and animals, a
list of chemical names for
common steroid hormone derivatives, and conversion factors to go from SI
units to common units and
vice versa. Where else could one find what normal serum prolactin levels
are in black bears?
Also useful is a series of
acid-base formulas.
November 3 - 9, 1996
Morning Report by Theodore Moon, M.D., a second year resident in
internal medicine at Los
Angeles County Hospital. Dr. Moon states that he sees many interesting
cases at LA County, and has
put up one so far, a patient who has been treated for transitional CA of
the bladder and who now
presents with nausea, vomiting, abdominal pain and hyperkalemia. It's up
to the viewer to make the
diagnosis of this interesting electrolyte problem. (Note, this case is no longer
available -- update 12/26/97).
October 27 - November 2, 1996
Clinical Guidelines from the American Association of Clinical
Endocrinologists. This
site has both a public and a "members only" section. The latter I couldn't
visit as I am not an
endocrinologist. What hormonal hors d'oeuvres are hidden there beyond
one's grasp are left to the
imagination. The useful info on the public site is a series of guidelines,
five posted so far (not
of direct use to nephrologists, however). Guidelines include those
pertaining to
diabetes, osteoporosis, hyper- and hypothyroidism, and
management of thyroid nodules.
October 20-26, 1996
American Diabetes Association On-Line Site. This site
hyperlinks to the primary ADA
journals, namely
Diabetes and
Diabetes Care. Particularly useful is the entire
January 1996 Diabetes Care Supplement on-line . This contains
the full text of 23
position statements, 8 consensus statements, and one standard, from
everything ranging from diabetic
foot care, food labeling, bedside blood glucose monitoring, to the
treatment of hypertension in diabetes and the
diagnosis and management of nephropathy in diabetes.
October 13-19, 1996
University of Pittsburgh Department of Pathology Case Database.
This includes 81 cases
at this time, indexed either by diagnosis or by patient history. The first
50 or so are quite
skimpy, and include only a 1-2 line history. The last 30, however, include
a more detailed history
and microscopic pathology description. A detailed discussion of the
disease in question and
differential diagnosis, however, are lacking for most cases. Of particular
interest to
nephrologists are:
Pregnancy-induced
hypertension and antiphospholipid antibody syndrome
Immunotactoid
glomerulonephritis
Wegener's
Granulomatosis
Two cases (renal artery stenosis #48, and fibrillary glomerulophathy #78)
are under construction.
The first group of 50 cases (pathology only), include post-transplant
lymphoproliferative disorder
(#41), renal cell carcinoma (#35,29), renal allograft rejection (#20), and
polycystic disease (#2).
On the home page there is a
link to the First Annual
Conference for Anatomic Pathology Informatics, Imaging, and the Internet,
which will take place in
Pittsburgh on November 8-9, 1996.
October 6-12, 1996
Cyberounds. This site, with executive editor Harry Levy, M.D.,
and the product of
interMDnet Corporation, is a collection of essays more than rounds, in
several subspecialty areas of
medicine, including cardiovascular medicine, nephrology, geriatrics, and
hematology. A new
essay/rounds is posted each month, hosted by a moderator who is a physician
with academic
credentials. The site has been going just two months now. You will
need to
register before you
can access any
material, and apparently you MUST be a physician or medical student to get
a
password.
In nephrology, Eli Friedman M.D. is the host/editor. Last month there was a discussion of
-
diabetes
management: preventing protein denaturation, basically a discussion
of use of
aminoguanidines to block formation of advanced glycosylation end products.
This month's topic is
replacing renal
function with GI nitrogen extraction, which contains a reference to
a paper in Nature
Medicine by TMS Chang describing the use of genetically engineered E. Coli
which eat urea and make
amino acids to reverse experimental uremia in rats! Both topics are
"vanguard" topics, with little
present clinical application. A more practical rounds is in the hematology
section by Dr. Robert G.
Lerner on heparin induced
thrombocytopenia. Although the rounds are generally of high
quality, the use of hyperlinks
and hypertext is not very functional. In particular, the rounds are
presented on a page with both a
horizontal and vertical frame which have minimal functional utility and
make the text area
annoyingly small. I suggest printing out the rounds first before trying to
read them. All in all,
however, this may very soon turn out to be one of the premier sites on the
internet for physicians.
September 29-October 5, 1996
Medconnect Board Reviews in Primary Care. This is the fourth
time this site has been
chosen. This month's board review, by Dr. Ajay Singh from RWJ Medical
School in New Jersey, focuses
on both acid-base and on glomerulonephritis. It includes:
Acid-Base Presentation
Acid-Base Challenge
Glomerular Disease Challenge
Glomerular Disease Perls
Acid-Base Pearls
September 22-28, 1996
The Nephrology Exchange. This is a review journal edited by
Francisco Llach, M.D., with
a focus on bone disease sponsored by Abbott Laboratories, makers of IV
calcitriol. Most
nephrologists get this newsletter in print form in the mail. Abbott Labs
has put Vol.3 No.1 on the
internet. The material posted, unfortunately, dates back to November,
1993. Nevertheless, it
contains three nice reviews, all relating to hyperparathyroid bone disease,
one by Jill S. Lindberg,
one by Robert L. Benz, and one by John R. Valdin (all M.D.s). One wonders
why Abbott Laboratories
did not put the entire series of these lectures on the net. The lectures
posted have the most to do
with control of hyperparathyroidism and indications for calcitriol, and it
is understandable why
Abbott would focus on this topic, but the other lectures in the series are
equally valuable. (Update 12/16/97: Link no longer available)
September 15-21, 1996
The Lancet. The Lancet has always been one of my favorite
journals. The online site is
very well done, although only a portion of the article abstracts in each
issue are linked. Check
out the paper on white-coat hypertension by
Glen et al in the September 7 issue , for example, along with an
accompanying
editorial by McGrath. Before you can get to the goodies,
however, you must first register (open to all) at the Lancet site. The Lancet
hyperlink is available on the journals page of HDCN (see Journal tables of
contents/abstracts).
September 8-14, 1996
(Update 12/16/97: Links no longer available)
Reuters - The Internist's Casebook. We reviewed the Reuters
site in early February 1996.
The site continues to grow, providing searchable up to date medical news.
It's "clinical challenge"
section has now undergone a mitosis, into the internist case files, linked
above, and also to
The
Dermatology Files.
Two relatively recent casebook files are:
70 year old
diabetic Chinese male with severe acidosis.
Hyperkalemia
in an AIDS patient.
These cases are really vignettes, but they are growing in length and
detail, and have several
intermediate steps where the reader is prompted for input and a diagnosis.
September 1-7, 1996
Clinical Reviews in Depth. This is a subsite located on the
EMBBS Emergency Medicine and Primary
Care
Homepage. It was not clear to me who runs the EMBBS site, save
that many of the
participants are from the Morristown Memorial Hospital in Morristown, New
Jerey. The
Clinical Reviews in Depth subsite is run by Dr. Robin Hemphill
from the Brooks Army
Medical Center. To-date three reviews are posted, all of interest to
nephrologists:
Toxic Alcohols
Acute Renal Failure
Diabetic Ketoacidosis and Nonketotic
Hyperosmolarity
Each review beings with a case presentation, a list of identified goals of
the teaching module, and
then the teaching module itself. There are some gaps. The actual
diagnosis of the first case is
not specifically discussed. The text is broken up into pages requiring
successive hyperlinking
without rhyme or reason; it would be easier to download the entire
discussion as one long page to
make printing out easier. Also, the review is similar to one long book
chapter; creative use of
hyperlinking or graphics is absent. However, the material is excellent and
well written.
The EMBBS home page also has one of the nicest interfaces that I've seen
regarding a case
presentation: it is the
EMBBS ACLS Megacode
Simulator.
Two cases are presented, a patient with severe bradycardia, and one with
acute chest pain. The text
is updated in a column flanked by two imagemaps, one showing options such
as "IV Line", "Begin CPR",
etc., and the other a drug cabinet with drugs and doses. You proceed to
treat the patient and the
middle text column is updated based on the results of your actions. The
case presentation is then
extended by an in-depth discussion of bradycardia, various drugs which can
be used, pacemakers, etc.
This is a wonderfully creative and interesting way to teach ACLS, and could
be adapted to other
types of cases as well. I finally saved patient #1. I can't wait to go
back and see how case #2
will turn out.
August 25-31, 1996
Virtual Anaesthesia Textbook: Water and Electrolyte Homeostasis; Renal
and Acid-Base Physiology.
Remember in the film "Witness", when the Amish get together to
build a barn? Well this is
a neat idea by a group of anesthesiologists to parcel out and write an
on-line virtual textbook of
anesthesiology, except that each piece of the barn is on a different
computer! The link above is to
a chapter (by Dr. Ken Pauker, from Laguna Beach, California) on acid-base,
which is still in
progress
(internet "books" should be continually in progress, I suppose). The
chapter represents one of those
Russian dolls, as it includes a collection of hyperlinks to other on-line
books and lectures across
the internet. Perhaps most notable among these links is to a chapter in
another internet book, the
Global Textbook of Anesthesiology, by Dr. Alan Grogono of Tulane
entitled
The Fundamentals of Acid-Base Balance. Dr. Grogono's book
contains many of the basic
acid base equations and nomograms and is quite extensive in its treatment
of common acid-base
disorders.
August 18-24, 1996
Dr. Deloughery's Famous Handouts. These are present at the
CLINIWEB
site from Oregon Health
Sciences University. These are actually more than simple handouts, and are
similar to the topic
cards presented in Dr. Burton Rose's Up to Date in Medicine series.
There are 14 handouts
posted to-date, four of which have to do with cardiovascular disease:
Antithrombotic therapy,
antiphospholipid antibody syndrome, atherosclerosis, and strokes and
myocardial infarction in the
young patient. All are very well done. It is not clear how current they
are, however, as among the
numerous references, I could not find a reference cited later than 1993.
August 11-17, 1996
Bandolier. This is an evidence-based journal from the National
Health Service Oxford
Anglia Region in the UK. The journal is published monthly, and summaries
of articles including
figures and references are on the Website. Articles are conveniently
grouped on a
major
topics page, where one
can find a discussion under "Cardiac" of ACE inhibitors in CHF, Calcium
channel blockers (the
figures from the Furberg and Psaty papers are reproduced) and cholesterol
lowering in CHD. Under
"Trial Methods and Reporting" one can find succinct discussions of many
statistical tests such as
use of meta-analysis, odds ratios, risk ratios, etc., to the point that
this section comprises a
useful statistical primer. A list of
evidence-based medicine links rounds out the usefulness of this
fine site.
August 4 - 10, 1996
Rockefeller University Press. Something for the basic scientists
this week. RU Press is the
outfit that publishes JCI: the
Journal of Clinical Investigation
, and also the
Journal of General Physiology
, the
Journal of Experimental Medicine
, and the
Journal of Cell Biology. Each is now on-line with tables of contents
and abstracts. Abstracts
are not yet searchable, although a major transformation is promised for
October of this year. Links
to these journals have now been added to the home page of HDCN.
July 28 - August 3, 1996
Medconnect Board Reviews in Primary Care: Three Hypercalcemia
Cases. There are three of
these, each in the style of a board exam presentation with intermediate
break points and questions.
I don't quite agree with the management chosen for the first case (saline
diuresis in an 81 year old
lady with hypercalcemia and ARF and a creatinine of 5.3 mg/dl), but I think
the three cases are
quite instructive and generally the discussion is of high caliber. We have
reviewed the Medconnect
site before. It continues to be the best site that I know of on the
internet regarding content and
CME, although it's main emphasis continues to be pediatrics, toxicology,
and emergency medicine.
July 21-27, 1996
Radiology Society of North America. At a time when the ASN is
planning its internet
presence, it is nice to examine a few models of those who have gone before.
The RSNA has a
wonderful internet site, providing easy access to information about its
publications, learning and
practice resources, and most useful, its annual meeting. ALL of the
abstracts of the October 1995
annual meeting are online in a searchable database (Update 12/16/97: link to
1995 abstracts no longer available). For useful info pertaining to dialysis,
link up to this page and
put in dialysis access in as key words. You will come up with the texts of
relevant
abstracts presented at the meeting. Hopefully ASN might eventually provide such a
service.
July 14 - 20, 1996
Nephrology Dialysis Transplantation. For those of you not subscribing to this
journal,
you are missing something! NDT has become increasingly relevant and interesting, and
particularly
strong in publishing excellent clinical material, including a series of short editorials
in each
issue, teaching cases, etc. Now NDT is on-line, and includes abstracts of most of its
articles.
HDCN is now linking up to these abstracts texts whenever it reviews an interesting paper,
and the
NDT site is hyperlinked on the home page of HDCN (under "journals tables of contents").
In the June
issue, the EDTA abstracts are also printed. These have a wealth of clinical information,
and a
selection will be reviewed on HDCN in the next two months. The on-line site also has a
valuable
search tool, where one can search back issues of the journal by key word.
July 7 - 13, 1996
TRANSWEB. This is a transplantation information server run out of the
University of
Michigan. The site has excellent graphics, which are small and don't impede downloading,
organization, and is regularly maintained. It has an excellent calendar of events. A
feature found
on few other sites is "Ask TRANSWEB", run by Jeff Punch, a local transplant surgeon. Most
of the
questions are from patients, but they come at a rate of about 20/month, and are answered
competently
and archived nicely.
June 30 - July 6, 1966
Journal of the American College of Cardiology. Although this journal has few
articles on
hypertension, it is within the sphere of interest of HDCN readers. Abstracts of all
original
articles are given on the site, along with the full text of featured articles (this
month's feature
article is on Chlamydia and atherosclerosis). There is no searchable index. We have
added the JACC
to the home page of HDCN.
June 23-29, 1996
American Society of Transplant Physicians (ASTP) 15th Annual Meeting Abstracts.
The ASTP has hit a home run with its internet site. ALL of the abstracts from
the May 26-
30, 1996 Annual Meeting are listed here, and there is a search engine to help find
abstracts on a
given topic. For future reference, we added a hyperlink to this page on the homepage of
HDCN.
June 16-22, 1996
Case of the Quaker. This is another toxicology case presentation by the Rocky
Mountain
Poison Control Center. It has nephrologic aspecs to it. The format is wonderful! This
is the
third time we've selected something on medconnect.com. Unfortunately, this is primarily a
pediatrics/ER site.
June 9-15, 1996
The "other" HDCN. My sons and I enjoy playing "Zelda", where objects in "Light
World" have
their counterparts in "Dark World". While surfing the net, I found HDCN's alter ego,
although both
HDCNs are most assuredly in "Light World". I even suspect that the other HDCN'ers are
having a lot
more fun!
June 2-8, 1996
Free Medline Access via HealthGate.
This is the site I've been waiting for! It offers completely, absolutely, free, unlimited
MEDLINE
searching (registration is required); and the search engine is fast, clean, and works
wonderfully
well (some more instructions could be provided on how to do complex searches). HealthGate
offers a
subscription based search service with access to other databases, and also access to
newswire
services. It also is aiming toward patients, with a complete online manual of medical
tests and
procedures. For now, HealthGate is the only service, other than Physicians On-Line, that
offers
free MEDLINE access, and with HealthGate, access is not limited to physicians. Access is
limited to
US residents, although it is not clear if the latter stipulation is being enforced.
There is now a link to HEALTHGATE
from the
home page of
HDCN for easy access to MEDLINE.
May 26-June 1, 1996
American Medical Association Weekly Press Releases. This site has also been
linked on HDCN
for quite awhile, but it is not getting the traffic it deserves. Every week, selected
press
releases feature an article published in an issue of JAMA or the Archives of Internal
Medicine.
There is a direct link from the press release, which gives a lay description ot the
article, to the
original abstract. See the May 22/29 press release
which focuses
on hypertension. The AMA press release site, the selected releases,
as well as
the AHA Media News Release site are conveniently linked from the home page of HDCN.
May 19-25, 1996
American Heart Association
News Releases.
This site has actually been linked on HDCN for the past 6 months.
However,
it has been a slow week and this site fully deserves CME site of the week status. It
lists press
releases organized by date, usually describing a key article published in Circulation,
Circulation
Research, Hypertension, or one of the other AHA scientific journals. By browsing this
site you can
find summaries of key articles in these journals going back from the present to June of
1995.
May 12-18, 1996
The American Society
of
Hypertension. This site has the program for the 1996 Annual Meeting of the ASH.
As the
meeting (May 15-18, 1996) will progress, highlights will be made available. You can
subscribe by
email by sending the message:
SUBSCRIBE ASH-EHLB firstname lastname in the body of an
email sent
to LISTSERV@hslc.org.
May 5-11, 1996
Renal Pathology
Tutorial.
This is a unique event on the internet. It appears to be the beginnings of a full fledged
book on
introductory renal pathology by J. Charles Jennetee, MD, from the University of North
Carolina at
Chapel Hill. Sections on normal kidney histology, clinical presentation of glomerular
disease,
nephrotic syndrome, minimal change disease, membranous nephropathy, focal GN, and Type I
and II
membranoproliferative GN are ready now, complete with teaching slides.
April 28 - May 4, 1996
This Month (March, 1996)
in
Urology. This will be a regular feature offered at the Journal of Urology home page. "This
Month in
Urology" offers a 4 line synopsis of the major articles in the Journal, plus a featured
commentary
(about 2 pages with references) on a selected topic. This month it is a discussion of the
testicular microenvironment by Dr. Harris Nagler. The home page also lists tables of
contents.
April 21-27, 1996
New England Journal of Medicine On-Line. This
excellent site includes abstracts of all articles starting 1996. Full text is also
presented of the following features, including figures and tables:
Images in Clinical Medicine, Case Records of
the Mass General Hospital, Molecular Medicine, Editorials, Sounding Board articles,
Correspondence, and Book Reviews. You can search for these full text offerings by
category
in the "recent issues" link from the home page. This is a very generous and brave move on
the part the of the Mass Medical Society, to put so much of the content of the journal on-line for
free.
April 14-20, 1996
Americal College of Cardiology on
the
Net. This site, certain areas of which require registration, has excellent
information
about the ACC Meeting which just took place in late March. One can
search for any
presentation by keyword. Also there are pages where various press releases and news
alerts
regarding the clinical trials are presented. These include Real Audio interviews with
some of the
presenters.
April 7-13, 1996
CME at the University of
Laval
Faculty of Medicine. This is a new site, still largely under construction. The
authors have ambitions to provide CME courses and tutorials in all medical specialties. Both
(Update 12/27/97: Many of the previous links are gone. CME courses no longer appear to be
present.)
March 31 - April 6, 1996
American College of Physicians On-Line.
The long-
awaited ACP site is finally active. It includes tables of contents, abstracts, and
selected
articles from Annals of Internal Medicine, Evidence Based Medicine, and the ACP
Journal
Club. One also can find news stories from the ACP Observer.
March 24-30, 1996
Renal Pathology Society
Conference
Page: Biopsy Cases. As part of the upcoming Renal Pathology Society (RPS)
meeting, five
renal cases have been posted as unknowns. They include a history of present illness,
physical
examination, lab values, and pathology slides. It is up to the audience to make the
diagnosis. The
correct diagnoses will be unveiled at the RPS meeting this week and posted. If you look
at the
pictures, remember to click on the smaller images to see enlarged slides; otherwise the
detail is
hard to discern. You can check the
Renal Pathology Society
Home
Page for more info on this society.
March 17-23, 1996
French Language Peritoneal
Dialysis
Registry. This primarily European registry and its accompanying journal, the
Bulletin de
Dialyse Peritoneale (BDP) are run by Dr. Christian Verger and
Dr. Jean Phillippe Ryckelynck. Dr. Verger is
one of the "gurus" of peritoneal dialysis permeability testing, and has devised the
APEX test
as an alternative to the standard PET to assess peritoneal function. This site
includes a
status of the PD Registry. It also includes titles from the last two
issues of
"Bulletin de Dialyse Peritoneale" (one may request reprints of individual titles from Dr.
Verger).
PD Calculators: The most interesting feature of this site is the availability of 3
PD
calculators, written in JavaScript by dr. Jacques Chanliau: One
calculator computes
body surface area and total body water (similar to the calculator
available on HDCN). The other two pertain directly to PD kinetics. One computes the APEX
time as
an index of peritoneal permeability, and the other PCR, Kt/V, and various clearances based
on a 24
hour collection of urine and dialysate. You need Netscape 2.0 or better to use
these calculators.
March 2-16, 1996
Kidney Patients'
Resources. This is
a
site organized by Curtis L. Atkin, a medical researcher with renal disease. It is one of
the
largest compendiums available on the Internet of sites related to renal disease. The
information is
useful not only to patients but to medical professionals as well.
February 25-March 2, 1996
Primary Care Board
Reviews on
the
Net. We chose medconnect.com as Site of
the Week
only 3 weeks ago. Now they've gone and done it again! This is an absolutely wonderful
review of a
classical case of gout. It must be viewed with Netscape Navigator 2.0! It involves a
wonderful
series of discussions each preceded by a set of multiple choice questions about the
disease,
complete with a wonderful graphic of a neutrophil engulfing a uric acid crystal.
February 18-24, 1996
"Dr.
Web" at the
Section of Electrophysiology and Pacing at the Cleveland Clinic Heart Center.
(Update 12/27/97: This section is no longer available.)
February 11-17, 1996
Reuters Health Information
Services. This
is a professional news site run by Reuters, which is free for the moment, but which will
probably be
subscription only very soon. You can get the week's top health stories here, or use the
news search tool to find news
relevant to
hypertension, dialysis, renal or any other topic. Try putting in the above key words.
You will not
be disappointed. Enjoy this free site while you still can.
February 4-10, 1996
Medconnect. This is the best site which
we have
found so far on the internet that provides CME and patient case summaries. The site is
focused on
Emergency Medicine and
Toxicology, but has a growing collection of material in primary care. In addition to a
series of
case studies such as a patient with theophylline toxicity or digoxin toxicity, there is an
excellent collection of CME essays, seven
posted so
far, including an in-depth review of the management of acute pulmonary edema.
January 28-February 3, 1996
Medical News from DOCTOR'S GUIDE TO THE
INTERNET. This is a commercial site which aims very broadly at all physicians,
and the site
even has patient information material. Much of the site is under development. Most
useful right
now is the Medical News page to which the hyperlink above travels. Here one can find a
collection
of news releases, mostly from pharmaceutical firms and medical device manufacturers, but
sometimes
from universities, highlighting recent discoveries or approvals of new indications for
various
drugs. It would be better if each news release title were dated and the releases should
be sorted
by category, as under the present organization schema their sheer number becomes daunting.
However,
this is the only place on the internet we know of that such news releases are collected.
We have
placed a direct link to this site
on our
"NEWS ALERTS" page.
January 21-27, 1996
Tokai University
Department of
Radiology Cases. This site is the brainchild of Prof. Yutaka Suzuki. Sixteen
radiology
cases
are presented as unknowns, with various imaging test results. In some cases the diagnosis
is
obtained by a hypertext link; in others the diagnosis becomes obvious from viewing the
images. The
presentations are short, as is information pertaining to the diagnosis. The images are of
good
quality, although in the case of chest X-rays and some of the scans, some of the image
files are not
fine enough to appreciate the pathology. Two cases pertaining to HDCN are among the 16:
60 year old male with hypertension, throbbing headaches, and
palpitation
Pulmonary calcifications in an ESRD patient
January 14-20, 1996
Unit II Pathology Course at the
Bowman Gray
School of Medicine of Wake Forest University. This site, created by Dr. Robert
Rainer, is
designed for medical students and contains about 50 case presentations with pathology
slides,
disease information, and review questions. The question answers are not provided, and
there is no
interactive component, however. Renal cases include:
Acute cell mediated and vascular allograft rejection.
Churg-Strauss syndrome (allergic granulomatosis and angiitis).
SLE with crescentic glomerulonephritis.
Renal infarct, coagulative necrosis.
January 7-13, 1996
Year two medical school learning programs at USC. This is a medical student site
developed
by the University of Southern California. The renal sections include some simple cases
and
discussion pertaining to inherited renal diseases, glomerulonephritis, and causes of
nephrotic
syndrome. The inherited renal disease section, by Dr. Miroslaw Smogorzewski, includes a
brief
overview of Alport Syndrome, autosomal dominant polycystic kidney disease, medullary
sponge
kidney, and medullary cystic disease. Two case summaries are presented with branching
questions, similar to the old US ACP internal medicine board examination. Case 1 is a
25 year
old male with gross hematuria after exercise, with a family history of renal disease, and
Case 2 is a
patient
with Alport syndrome. In the second case, pathology slides of both Alport syndrome and
medullary
sponge kidney are presented.
In another page on the site, Dr. Michael Koss presents an overview of the pathology of
glomerulonephritis, with hyperlinks to pathology slides of membranous GN, MPGN, Lupus,
IgA,
post-infectious, and crescentic GN. A related page summarizes the pathology of the
nephrotic syndrome, including MCD, FSGS, diabetes, and amyloidosis. The nephrotic
syndrome page
has no hyperlinks and only text. Six cases are presented, with very brief histories.
Only the
first case in the series has been developed.
December 31-January 6, 1996, 1996
Emory University's
"MEDWEB" list of medical
electronic newsletters and journals.
This excellent and current list has been compiled by the Woodruff
Health Sciences Library staff at Emory University in Atlanta, GA.
The list is now 10 pages long, single-spaced, and there are separate
groupings of journals which provide tables of contents, and of journals
which include full text articles. (Happy New Year!)
December 24-30, 1995
Case Studies in
Toxicology.
This is a site maintained by Mark Crockett, M.D., a senior resident in
Emergency Medicine at the University of Illinois at
Chicago. Ten interesting case studies are listed, several of which
have renal involvement. Some examples are:
Vomiting 3 year old child with anion gap
acidosis who ingested radio-opaque pills
68 year old woman with dizziness,hyperkalemia,
bradycardia, and heart block
Alcoholic with renal failure after ingestion
of mystery substance
The layout is very stylish, and cases are followed by self-assessment
questions and summaries. Overall an extremely well done site. See
also the related Toxikon site,
from the UIC department of Emergency Medicine, with a Poison
Review section as well as a Poison of the Week.
December 17-23, 1995
Hot topics from the November 1995 ASN
Meeting
(on HDCN). This week
we looked for a site of the week and, as Lancelot sings in "Camelot",
we're forced to disclose that
this week's best site is us! Specifically, we list for emphasis the
"hot topics" section, where key
new clinical findings at ASN have been reviewed. Topics listed
include:
ACE
gene
polymorphism and renal disease (David Leehey)
Urea kinetics (James Tattersall)
Inflammatory mediators, albumin, and
mortality (Tom Depner)
New methods of measuring access flow and
recirculation (John Daugirdas)
Cholesterol and progression of renal disease (Vardaman
Buckalew)
HIV in Nephrology (Stephen Pastan)
New techniques for dry weight assessment (Ravi Mehta)
December 10-16, 1995
Recurrent CMV viremia after renal
transplantation (NEPHROL
thread).
This is a discussion of a patient in whom ganciclovir therapy apparently failed to control
symptomatic CMV viremia soon after an episode of graft rejection. Contributors include
Dr.
Alessandro Bellucci (Manhasset, NY), Dr. Paul B. Lim (Sacramento, CA), Dr. Thomas Gonwa
(Dallas,
TX), Dr. Daniel C. Brennan (St. Louis, MO), Dr. Daniel M. Canafax (Minneapolis, MN), and
Dr. Daniel
R. Salomon (La Jolla, CA). Your additional comments are welcome and can be added at the
bottom of
the thread.
A NEPHROL thread posted on HDCN earlier pertained to acute renal failure after eating
mushrooms (for
further information on NEPHROL click here).
December 3-9, 1995
RENAL CPCs at
Emory University
This site offers three CPCs in the renal
field prepared by Dr. Stephen Pastan:
A "middle aged" woman with rapidly progressive
renal failure 1 month post cardiac cath
Progressive renal failure and severe worsening of longstanding
hypertension
Acute complication of balloon angioplasty of the renal artery
(same URL as above: scroll down to "patient 2".
.
November 26-December 2, 1995
AMERICAN HEART
ASSOCIATION's "Journals at Home" page
This new site offers
tables of contents and abstracts of current issues of the following AHA
journals:
(Click on the main site above for the current issue of each of these
journals, or click on each individual journal title for an index by
volume and number) "Hypertension","Stroke", "Circulation",
"Circulation
Research", and "Arteriosclerosis, Thrombosis, and Vascular Biology".
November 19-25, 1995
Abdominal pain, renal failure, and thrombocytopenia
This
is a test case posted by Dr. Brian Levy of the University of Colorado,
who is designing a series of interactive Medical Rounds. The patient
history and findings are interesting in themselves, as is the novel use
of e-mail by which viewers can pose questions to a "moderator" about
various aspects of the case. One minor problem is that the laboratory
data are expressed in tabular form. Those with earlier browser versions
are left looking at a jumble of numbers.
November 12-18, 1995
Renal
Biopsy Case Reviews by J.C. Jennette, MD
This is a wonderful
collection of monthly case discussions including color slides of the
biopsy findings created by Dr. Jennette from the University of North
Carolina at Chapel Hill. We won't tell you what the September case had,
(a 72 year old woman with a 1 month history of worsening nausea and
vomiting), but there were kappa light chains in the urine. The site is
located on RENALNET,
a renal communications server with wide links to nephrology sites of
interest and also containing several nascent discussion forums.
November 5-11, 1995
American
College of Physicians (ACP) Journal Club On-Line
(Our
apologies. The ACP Journal Club is a
print journal summarizing evidence-based research papers (mostly
randomized trials and some meta-analyses) in internal medicine. In
addition to the summary, a commentary and further references are also
provided. At this site all of the articles summarized in the ACP
Journal Club since 1991 are listed, and you can search all of the
summarized articles by title and by abstract section (e.g., you can put
"lupus" in the title search and find all of the reviewed articles in
ACP journal club pertaining to this disease).
October 29 -
November 4, 1995
Stanford University -- UCSF Primary Care Teaching Modules
These teaching modules (there are about 17 of them and more on the way)
were developed as a joint effort between the Divisions of General
Internal Medicine at Stanford University and the University of
California at San Francisco. They are targeted to medical students and
residents in primary care specialties. The three modules of particular
interest to HDCN readers are:
Hypertension - by Dr. Eliseo Pérez
Stable.
Lipid Disorders - by Dr. Stephen Fortmann
Urinary Tract Infection - Dr. Douglas Bell
and Dr. William Detmer
All are excellent and quite
comprehensive! The Lipid Disorders and Urinary Tract Infection modules
contain sample case reports and summaries. Other modules at the main site include hyperthyroidism, hypothyroidism, immunization,
obesity, sinusitis, tuberculosis, COPD, and many more.
October 22-28, 1995
Late acute renal failure after
mushroom
poisoning
This case discussion thread (which we are
posting with the express permission of all parties involved) actually
began on Friday the 13th of October on the listserv called NEPHROL.
NEPHROL is an unmoderated online discussion group and Internet resource
for nephrology professionals and those in allied areas of medicine (for further information on NEPHROL click here). The discussion,
which is typical of the fascinating interchanges that go on within
NEPHROL, involve Dr. Joan Fort from Barcelona, Spain, Dr. Steven B.
Tucker from Anchorage, Alaska, Dr. K.W. Rumpf from Goettingen, Germany,
and Dr. Carl M. Kjellstrand from Alberta, Canada. The link includes
comments from mycologist Dr. Tom Volk of the Forest Products Research
Laboratory in Madison, Wisconsin, including a link to a site developed
by Dr. Volk which includes pictures of
Cortinarius mushrooms.
October 15-21, 1995
A 30-year old man with hypertension (Radiology Quiz)
The
site location is the St. Francis Journal of Medicine, from the St. Francis Medical
Center in Pittsburgh, PA., Volume 1, Number 1. There also is a very
interesting CPC of a patient with headache, hyponatremia, and abnormal chest X-ray (wonder
what that one could be?).
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