January 2012 Archives

MedlinePlus is one of the best sources for consumer health information on the web.

Created by the National Library of Medicine, it provides short summaries on a wide range of conditions and then links out to high quality information created by non-profits, government groups, and other organizations. They also include links to information in other languages when possible. A Spanish version of the site is also available.

MedlinePlus also includes drug and supplement information, news alerts, and anatomy and surgery videos.

PatientsLikeMe is a site that lets patients with a wide range of conditions record their symptoms, medications (and adverse effects), and disease progression and talk to other people with the same condition and share information. Membership is free and is also open to physicians, though you have to promise not to survey or recruit patients through the service.

I think this is a fascinating tool and, from the researcher standpoint, one that provides a novel way to gather information on disease progression, symptom prevalence, treatment effectiveness, and drug adverse effects. From a patient standpoint, I think it would be good to talk others, see what has worked for them and what hasn't, and develop a sense of community.

So here is the wrinkle. PatientsLikeMe is very open that they sell their data, it is how they get funded. So before using it or recommending it, I would make sure to read the privacy policy and understand what they do with the data.

There was recently a patient on rounds with suspected Hashimotos encephalopathy, but the team had questions about diagnostic criteria. I pulled a few articles and wanted to share them:

Hashimoto's Encephalopathy 2008 - nice review article which focuses on diagnosis (and specifically relevant auto-antibodies)
Hashimoto's Encephalopathy: Systematic Review of the Literature and an Additional Case 2011 - case report and systematic review which includes summary of symptoms associated with HE
High prevalence of serum autoantibodies against the amino terminal of alpha-enolase in Hashimoto's encephalopathy 2007 - discusses the use alpha-enolase autoantibodies in diagnosing HE. While there there have not been many studies, they appear to have good sensitivity and specificity.

There was a question this morning about what the various neurological manifestations of Sjögren's Syndrome are.

Here are a few overviews of neurologic symptoms:
Neurological manifestations of primary Sjogren's syndrome 2010
Involvement of nervous system pathways in primary Sjögren's syndrome 2008 (Dr. Walk is co-author)
Peripheral neuropathies in Sjogren syndrome: a new reappraisal 2011

If you want to search further, here are some searches to get you started:
High specificity search
Lower specificity search

Here are a few videos from AccessMedicine (primarily Harrison's) that cover neuro-ophthalmology and the neurological exam.

Let me know if there are any other sources for exam videos that you like.