Saturday morning coffee [November 10 2012]

So much happens each and every week that it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….

The coffee mug to the right is from Chicago, Illinois, obviously. The first time I was in Chicago was in October 2011, so about a year ago. I’ve been in and around Chicago three times since. I find Chicago and the surrounding area fascinating. It is one of the few places that I would consider spending an extended amount of time. I’ve really enjoyed my time there. I say all of this with one giant caveat, and that is that I’ve never been there in the dead of winter. Based on what I know about the winters in Chicago that could be enough to quickly change my mind about staying. One thing that I really need to do before I die is attend a Bears game at Soldier Field. I’ve wanted to do that for a long time now, at least since the days of Walter Payton.

I have been systematically going through all the coffee mugs in my cupboard to generate these posts. All my mugs used to reside on a single shelf in one of our cupboards. After using a mug for one of these poses, and using it for the weekend, I move it to another shelf; simple way to remember which mugs I’ve used. Well, this morning when I went to retrieve the next mug in line, the cupboard was looking a little bare. It looks like I’ll be out of mugs by the end of the year, which means I need to either get more mugs or find something else to do on Saturday mornings.

I didn’t put up a Saturday Morning Coffee post last weekend because I was down at UCLA enjoying Dad’s Day Weekend with my daughter; something her sorority puts on for new members. It was a lot of fun. I was able to spend a great weekend with my daughter and watch UCLA throttle Arizona 66-10 on Saturday night. The Rose Bowl was electric with more than 81,000 fans in attendance. The Bruins led at the Half 42-3. It was a dominant performance from all aspects of the game; offense, defense, special teams. UCLA and USC meet next Saturday. Should be an interesting game.

Wreck-It Ralph was #1 at the box office last weekend. I haven’t seen it, and likely won’t as my kids are apparently too old now to be bothered with such childish things; bummer. Maybe I can convince my brother to go see it with me. I did manage to see The Man with the Iron Fists last weekend. Oie! Don’t bother with that one.

– Did you know that instant coffee was invented in 1901 by Japanese American chemist Satori Kato of Chicago? True story. I don’t like instant coffee, but I’ve been known to throw it in my chocolate flavored protein shakes from time to time.

– Mmmm, chicken noodle soup! The taste of chicken noodle soup brings back fond memories of childhood. My grandma used to make me chicken noodle soup and grilled cheese sandwiches on cold winter days. Those were some good times right there. Anyway, Greatist website has 31 different recipes for variations on good old fashioned chicken soup. They all look great, but the one I’d like to try most would be Chicken Soup with sweet potatoes, pumpkin and corn.

– By now everyone is well aware of the outbreak of fungal meningitis linked to a contaminated batch of epidural steroid injections made by the New England Compounding Center (NECC) in Framingham, Massachusetts. It has caused quite a stir in the healthcare circles. My position on the issue is well known to anyone that has talked to me and has even been documented on this site a couple of times. That’s why my heart sank when I read this editorial in The New England Journal of Medicine (NEJM).  The authors, of which none appear to be a pharmacist, write “we believe that the best way to balance the need for “designer therapeutics” from these pharmacies with the need for product safety is to give the Food and Drug Administration (FDA) broader powers to monitor and control the agents produced by such pharmacies and any adverse events that are associated with them. The current system, in which regulation is almost entirely state-based, is clearly inadequate to protect the public health.” I disagree. NECC broke the law, and as a result people died. That is terrible and cannot be undone. However, NECC should be held accountable for their actions, like all law-breakers, not the entire profession of compounding pharmacies and pharmacists across the country. There are rules and regulatory requirements in place already, NECC simply failed to abide by them. That’s it. More regulation by the FDA won’t stop people from skirting around the rules put in place to protect patients if they choose. All it will do is create more problems for the law-abiding pharmacies doing nothing more than providing a necessary service. The editorial in NEJM is nothing more than a knee-jerk overreaction.  I’m ashamed to see healthcare professionals behaving this way and lumping themselves in with ignorant law makers and politicians. I’d like to hear where the pharmacy organizations like ASHP, ASCP, APhA, etc. stand on the issue. Haven’t come across anything from them yet.

– Speaking of meningitis, The Lancet has published an article on “Advances in treatment of bacterial meningitis” in their November 10, 2012 issue.(1) The article reviews the therapeutic challenges associated with bacterial meningitis, “with a focus on strategies to optimise antibiotic efficacy in view of increasingly drug-resistant bacteria, and discuss the role of current and future adjunctive therapies.” That’s great and all, but you have to have a subscription to read the article. That’s a major fail if ever there was one. Let me see if I can get this straight. You put together an incredibly useful piece of literature on the treatment of a deadly bacterial infection, then limit access to it. Bravo.

- ASHP Midyear 2012 is quickly approaching. The meeting will take place in Las Vegas, NV, December 2-6. I’ll be there the entire time, so if you’re going to be in Vegas let me know and we can grab a Cup o’ Joe or go to Hash House A Go Go for some Twisted Farm Food. Seriously, they serve insanely good breakfast; chicken and waffles and pancakes rock! Just sayin’.

– Ever heard of PhaSeal? If you’ve worked in a hospital pharmacy anytime in the past few years you probably have. The product isn’t all that common, but its name gets tossed around from time to time. A recent article in the International Journal of Compounding Pharmacy(2) took a look at the impact of PhaSeal on chemotherapy compounding time. The study was small, using only four technicians preparing six batches of simulated chemo with and without PhaSeal. The results showed a fair amount of time saved when using PhaSeal. Safety is clearly the number one priority when preparing chemo, but doing it more efficiently couldn’t hurt. Of course to make the study worthwhile you’d need to repeat it with about ten times the number of technicians and batches.

– This is the most amazing bionic hand I’ve ever seen.

– GeriTech: “I got one [an iPad]. I sent it back. Here’s the main reason why:  Typing is an integral part of the work I do with patients, and when participating in healthcare teams. And I found that typing on the iPad was a lousy experience, even with Bluetooth keyboard and ZaggFolio.  Now you may be thinking: How will you show patients pictures, or videos, or engage in FaceTime, or otherwise participate in 21st century doctoring? Um…my Windows apps will do the trick, no? And my laptop, like most, comes with an integrated webcam.” – I came to a similar conclusion a few years back when I tried to integrate iPads into my pharmacy practice. I was using a tablet PC prior to the iPad. There was no comparison. Ended up giving the iPad to my wife and going back to a three year old tablet PC. I’ve said it many, many times before: my tablet PC from nearly a decade ago will do nearly everything an iPad will do today (minus things brought on by “normal” advances in technology like processor speed, RAM, etc). Go read the entire article, it’s short. We’ve taken a step back in my opinion; a big step back. I can’t imagine where we’d be today if we’d put as much effort into advancing computer technology in medicine as we have trying to get the iPad integrated into physician’s workflow. I spent a year working to create a model only to have it shattered when that toy arrived on the scene. Really pissed me off. Still bitter about it. People get distracted by shiny objects. It happens.

– mHIMSS: “Darkins [Adam Darkins, MD, the VA’s chief consultant for telehealth services], speaking at the Center for Connected Health’s Connected Health Symposium last week in Boston, said the VA is poised to boost its video consult program into the home and add more mHealth programs, e-consults and teleradiology programs to reach some 825,000 veterans by the end of 2013. – Telehealth is one of those things that just makes sense. Pharmacy has severely underutilized this technology.

– Blausen Medical has some neat products for Android and iOS. I blogged about the Blausen Human Atlas HD application for iOS back in July 2010. It’s a cool app. Well, Blausen now has a Google Chrome app that does some pretty amazing things. Check the video below. I’d love to see someone develop an app like this for pharmacy.

– I drove down to UCLA last night to pick up my daughter for the weekend; it’s her birthday. There just so happens to be a Microsoft retail store down the street from UCLA so I stopped in for about 30 minutes or so. I’ve already played with a Surface RT tablet, but wanted to have a second look and see if they had anything new. I spoke to several of the staff members and one of them told me that the new Samsung ATIV Smart PC should be in the store in the next week or two. I asked if it would be the one with the Clover Trail (Atom) processor, and he said yes. But he also said they’d be getting the Intel Core version as well. I was skeptical, but he assured me it was true. Needless to say I’ll be back down to UCLA soon to have a look. The Samsung ATIV Smart PC Pro is on my short list of potential purchases.

– Speaking of Surface, I’ve seen a lot of confusion regarding the difference between the RT and Pro. In a nutshell the RT is running an ARM processor while the Pro version will be using a more powerful Intel  Core processor (Ivy Bridge?). Unfortunately the RT model running the ARM processor offers limited applications at this time as none of the “native” Windows apps will run on it. The display on the Pro version will be full HD (1,920 x 1,080), while the RT version is using a 1,366 x 768 display. Many have balked at the RT display stats, but honestly it’s a nice display that appears to work well for everything including video. And finally, Surface Pro will offer digital inking. This feature alone is what has me waiting for Surface Pro in Q1 of 2013.

– “But in the future, we’d like to enable several people to create one document, like with Google Docs, actually using real-world paper while far apart.” – Tomoko Hashida, Naemura Lab, University of Tokyo. This is exactly what I’ve been waiting for. Nothing beats pen and paper.

– This is really cool. Fast Company: “Spanish photographer Alejandro Guijarro, fascinated by the philosophical implications of the most challenging branch of physics, has spent the past three years visiting research institutions to photograph their work. But Guijarro doesn’t shoot the professors or students. Rather, at each university he visits, he waits until everyone has cleared out of the lecture hall and then gets to work, snapping beautiful images of the blackboard scribbles they leave behind.” – It is possible that you will never see the likes of this again as blackboards are going the way of the dinosaur. [image below taken from Fast Company site]

– Looking for a new smartphone? Yeah, me too. I’m always looking for a new smartphone. Lucky for me Gizmag has put together this awesome 2012 Smartphone Comparison Guide. The guide does a great job of using tables to compare the Apple iPhone 5, the Samsung Galaxy SIII, the Motorola Droid Razr Maxx HD, the HTC One X+, the Nokia Lumia 920, and the Google/LG Nexus 4. It’s really is well done.

– My new favorite game on my Galaxy Nexus: Hill Climb Racing. Hours of fun while traveling.

– From the this-is-kinda-creepy file: “Scientists in Australia are a step closer to printing living cells for tissue engineering with the development of a new bio-ink that allows the cells to stay alive until they are printed and not clog up the printer nozzle.” – Chemistry World.

- Physics of the Future: How Science Will Shape Human Destiny and Our Daily Lives by the Year 2100 just went to the top of my reading list. Off to Amazon to add it to my Kindle.

@jfahrni That book Physics of the Future talks about this a good amount. Think it will happen.

— Greg Hart (@greghartpa) November 10, 2012

And with that I bid you a great weekend. Time for another cup of coffee and a little college football.

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References:

1. Advances in treatment of bacterial meningitis. The Lancet. 2012 Nov 10;380(9854):1693-1702
2. Use of a closed-system drug transfer device (PhaSeal) and impact on preparation time. Int J Pharm Compd. 2012 Sep-Oct ;16(5):431-3