1. 2012 IgNobel prize for neuroscience went to Craig Bennett, Abigail Baird, Michael Miller, and George Wolford [USA], "for demonstrating that brain researchers, by using complicated instruments and simple statistics, can see meaningful brain activity anywhere — even in a dead salmon." From the poster:
Subject. One mature Atlantic Salmon (Salmo salar) participated in the fMRI study. The salmon was approximately 18 inches long, weighed 3.8 lbs, and was not alive at the time of scanning.
Task. The task administered to the salmon involved completing an open-ended mentalizing task. The salmon was shown a series of photographs depicting human individuals in social situations with a specified emotional valence. The salmon was asked to determine what emotion the individual in the photo must have been experiencing.
Analysis. Voxelwise statistics on the salmon data were calculated through an ordinary least-squares estimation of the general linear model (GLM). Predictors of the hemodynamic response were modeled by a boxcar function convolved with a canonical hemodynamic response. A temporal high pass filter of 128 seconds was include to account for low frequency drift. No autocorrelation correction was applied.
Results: A t-contrast was used to test for regions with significant BOLD signal change during the photo condition compared to rest.... Several active voxels were discovered in a cluster located within the salmon’s brain cavity (Figure 1, see above). The size of this cluster was 81 mm3 with a cluster-level significance of p = 0.001.... Out of a search volume of 8064 voxels a total of 16 voxels were significant.... Identical t-contrasts controlling the false discovery rate (FDR) and familywise error rate (FWER) were completed. These contrasts indicated no active voxels, even at relaxed statistical thresholds (p = 0.25).
Moral of the story: when working with fMRI data, generously apply robust statistical methods to reduce false positive findings!
2. There is not enough work for vets-- the current estimate is that supply exceeds demand by the equivalent of over 11,000 full time jobs. (NPR)
3. A meta-analysis in the british medical journal of 72 RCTs (total n>10,000) trying to determine the effects of IV iron vs oral iron/placebo. IV iron more effective in increasing Hgb and reducing risk of transfusions (esp when given with epo or in patients with baseline low ferritin), but also associated with an increased risk of infections. Overall, there was no difference in mortality. I guess anemia of chronic disease really does serve a purpose... evolution wins again. (BMJ)
4. In a dog bite in a child: recently published RCT data shows that given good quality debridement, irrigation, and antibiotic treatment, there is no difference in outcomes between suturing the wound or leaving it to heal by second intention. Cosmetic outcomes are better with primary closing, thus facial wound should be sutured. Time to treatment of <8 hours from bite was associated with a deceased risk of infection. (Injury) Other studies have shown that location on the hand is also associated with an increased risk of infection. Organisms to cover: Pasturella (clinda does not cover, amp does), anaerobes, gram positives from skin flora of victim. First line antibiotic: penicillin+b-lactamase inhibitor (unasyn, zosyn, augmentin). Other options: 3rd gen cephalosporin plus flagyl, floroquinolone plus flagyl, carbapenem monotherapy. Amp/clinda is a good option if you're worried about MRSA, amp covers pasturella and some anaerobes, clinda hits anaerobes gram+ incl MRSA. Don't forget to get clinda sensitivities before you send someone home on it!
5. Cat/human bites in a child: should both be debrided to remove all nidus of infection, irrigated, and left to heal by second intention. Human bites: eikenella is one of the more common organisms that you'll find.
6. Catfact: 89% of cat bites are provoked.
7. Erysipelas vs Cellulitis: Same organisms cause both, treat with amox. Erysipelas are more superficial infections: red, more acute-onset with systemic symptoms. Lesion is less warm, more raised/well-demarcated/clear borders. Often on face, although you can get cellulitis on your face. Cellulitis is deeper, more chronic; in the mid-face area can progress to sinusitis/orbital cellulitis and finally to (rare) cavernous sinus thromboses. Skin infection in an immunocompromised person: think pseudomonas.
8. Neonatal hgb/hct reaches a nadir at 6-8 weeks of life, as lysis of fetal hemoglobin cells begin. At birth, 2/3 of neonatal blood is HgF and 1/3 is HgA. By 4 mos of age, the adult variant predominates.
9. Mammalian bites: 60-90% dogs, 5-20% cats, rest is other animals (raccoon, bats, etc)
10. Increased ICP 2/2 pancytopenia 2/2 lupus: possibly due to microclots decreasing CSF drainage (a-cardiolipin associated with increased risk of clots), or perhaps an increased CSF production in response to severe anemia.