Shout Outs

 Updated 3/2017:  all links removed as many no longer active and it was easier than going through each one.

Grand Rounds continues to be on hiatus.  If you would like to host a future edition of Grand Rounds send an email to Nick Genes (you can find his contact info at here).   The most recent edition can be found here at Medgadget.  Other editions can be found here on the Grand Rounds Facebook page.

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Kim, Emergiblog, is the host of the latest edition of Change of Shift (May 2011)! You can find the schedule and the COS archives at Emergiblog.

Welcome to the latest edition of Change of Shift, the nursing blog carnival!
…..Let’s get started!
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Sue Hassmiller is the Robert Wood Johnson Foundation Senior Advisor for Nursing. She is also a volunteer with the Red Cross. Abandonment Guilt, her final blog post from tornado-ravaged Alabama, can be found at AJN’s Off the Charts.

Best. Post. EVER! From BabyRNDeb at Life and Times of an L&D Nurse. What a difference One Year can make!

Over at oncRN, “the silence needs to be listened to and honored.”   …….

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H/T to @palmd  for the link to this article by  @stevesilberman:  23 amazing writers offer me tips on writing a book.  Here are just a few:

Bill Wasik (Author of And Then There’s This: How Stories Live and Die in Viral Culture) --

The first tip is that readers expect books to be exhaustive on their subjects. That doesn’t mean they want the books to be long ….

Deborah Blum (Author of The Poisoner’s Handbook and Ghost Hunters)  -- …..the best advice i got in writing narrative non-fiction was to get my hero in trouble and keep him there. …..

Sylvia Boorstein (Author of Happiness is An Inside Job and It’s Easier Than You Think)  -- …..Do not read other people’s work on the same subject. That might be hard for you, since you are collecting research data, but I say very little about what other people have said or thought. They’ve already said or thought it. ….

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Kerri (@sixuntilme)  who will soon be a 25 year Medalist shares a Video from the Joslin 50 Yr Medalists.   Amazing and inspiring.  Go check it out.

To be a Joslin Medalist, you need to mark 25, 50, or 75 years with diabetes.  (Well, technically, you get a certificate at the 25 year mark, but it's definitely a milestone to celebrate.)  And over the weekend, I had the opportunity to spend the day with Joslin's medalists who have spent over 50 years with type 1 diabetes. 

……  These generous medalists allowed me to listen to their stories, and offered a few sage words of advice into my video camera. …..

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Not only is this year the 30th Anniversary of HIV/AIDS, but Margaret Polaneczky, MD (TBTAM) reminds us it’s also the 40th anniversary of the seminal journal article on DES – An Endocrine Disruptor

An interesting NEJM article on the 40th anniversary of the seminal journal article on The DES Story serves as a potent reminder of the potential effects of exposure to endocrine disruptors during critical times in development.

Beginning in the early 1960′s DES, a synthetic estrogen compound, was given to women in early pregnancy to prevent miscarriages. Females born from these pregnancies had an increased risk of a rare vaginal cancer during childhood, increased rates of uterine malformations that can cause infertility and premature birth, and are at a moderately higher risk for breast cancer. Use of DES in pregnant women stopped in the early 1970′s.  . ……….

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What great news this week regarding the treatment of melanoma.  Check out this NY Times article by Andrew Pollack:  Drugs Show Promise Slowing Advanced Melanoma

Two new drugs have been found to prolong the lives of people with advanced melanoma, representing what researchers say is notable progress against the deadly skin cancer after decades of futility.

The drugs represent success in two new approaches to combating cancer: one by attacking a specific genetic mutation that accelerates tumor growth; the other by unleashing the body’s immune system to fight the disease  ……….
The drugs do not cure melanoma, except perhaps in rare cases.   …………

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Shared by @DrVes on twitter:  The days of his life: NY photographer takes Polaroid picture every day for 18 yrs until his death from cancer at 41 (photo credit)

What started as a project, quickly became an obsession for one New York photographer, who managed to take a Polaroid picture every day for 18 years.

Jamie Livingston took his first snap of then girlfriend Mindy Goldstein and a friend on March 31 1979.

Six thousand shots later the series ends tragically on 25 October 1997 with Mr Livingston on his deathbed from cancer on his 41st birthday.  ……….
To see the whole collection go to www.photooftheday.hughcrawford.com

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I read about this quilt by Cathy Ott in my local Sunday paper but it’s subscription only online and there was no photo with the article.  So I googled it and found this Journal Sentinel article which had a photo (the one below):   Military uniforms across decades go into gift of quilt

Zach Radtke didn't notice right away when a few of his Army uniform patches went missing.

The next time the Army Reservist saw them, they were on a beautiful quilt made by his girlfriend's mother. Five different Army uniforms spanning several decades make up the quilt.

When Cathy Ott came up with the idea for her military camouflage quilt she calls "The Boot," she didn't need to do much shopping for old military uniforms. She just opened her closet. ……

Thoughts on the AIDS/HIV 30th

Updated 3/2017-- photos and all links (except to my own posts) removed as many no longer active. 

The first reports of the infection which would come to be known as AIDS appeared in the June 5, 1981 issue of CDC’s MMWR.  The 5 cases reported in the MMWR involved young homosexual men being treated for Pneumocystic carinii pneumonia.  All were in Los Angeles, California during the period October 1980-May 1981.

I did not become aware of this disease until the fall of 1982 as an intern in Baton Rouge, LA.  Our patient presented with Kaposi sarcoma.

Last week I had a short discussion with a friend who is an HIV expert here in Little Rock, AR.  He graduated from medical school a year ahead of me.  He first recalls hearing of HIV when the NEJM article appeared in December 1981.  He mentioned taking note of the article and thinking he would never see any of those cases.

We both marveled over how the diagnosis of HIV has gone from an automatic death sentence to a chronic disease the person can live with.  LIVE with HIV.

He noted the change came in the 1995 with the introduction of highly active antiretroviral therapy (HAART).  My friend went from feeling like he might need to give up treating AIDS/HIV patients (too many deaths were taking it’s toil on him) to feeling hopeful for his patients.

We both noted that prevention continues to fail.  He mentioned he often will have a patient with a birth date of 1987 or so who will present to his office.  Not good as this age group has always had HIV prevention discussed in the media, etc during their lifetime.

Even though HIV is not the death sentence it once was, prevention needs to remain a major focus.

It is important to know your HIV status so that treatment can begin early. It is especially important to be tested yearly if you participate in any of these behaviors:

• Have injected drugs or steroids or shared equipment (such as needles, syringes, works) with others
• Have had unprotected vaginal, anal, or oral sex with men who have sex with men, multiple partners, or anonymous partners
• Have exchanged sex for drugs or money
• Have been diagnosed with or treated for hepatitis, tuberculosis (TB), or a sexually transmitted disease (STD), like syphilis
• Have had unprotected sex with someone who could answer yes to any of the above questions

If you test positive for HIV, then it is important to see a doctor, preferably one with experience treating people living with HIV.

REFERENCES
Pneumocystis Pneumonia --- Los Angeles: CDC MMWR, June 5, 1981 / 30(21);1-3

Gottlieb et al. Pneumocystis carinii pneumonia and mucosal candidiasis in previously healthy homosexual men. NEJM (1981) 305:1425-1430

Kent A. Sepkowitz, M.D.; AIDS — The First 20 Years; N Engl J Med 2001; 344:1764-1772

CDC:  HIV

Aging with AIDS: Living longer, living with loss; Linda Dahlstrom; MSMBC News, June 2, 2011