Saturday morning coffee [May 25 2013]

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 cup below is several years old. It’s a plastic Starbucks cup that I picked up somewhere in either Fresno or Visalia, California during my time as an IT Pharmacist at Kaweah Delat Medical Center in Visalia. The commute from my front door to Kaweah is just under an hour. There’s a Starbucks around the corner from my house and I used to swing by there on the way to work several mornings each week. Seemed like a shame to throw away all those cups, so I bought this dude. This weekend it’s sitting on the desk of a hotel room in San Mateo, California as I wait for my crew to stir so we can make our way to my daughter’s volleyball tournament.

I’ve been playing with my French Press (“press pot”?) all week; 8-cup Bodum.. After reading several articles on how to best use it, I’ve settled on the following:
1) Add coffee to pot
2) Add water to pot; steady pour
3) Use a woden chopstick to stir the slurry
4) Allow to steep for 3-4 minutes
5) Press (“plunge”)
6) Pour and enjoy
So far , so good. Although to be honest I don’t think the coffee is any better than when I use a good old fashioned drip coffee maker. Just sayin’.

Star Trek Into Darkness was #1 at the box office last weekend. Not a surprise, but it only made just over $70 million during its first weekend at the box office. Great money. Many people, including myself, expected it to do at least a $100 million. I had a chance to see it with my wife earlier this week. I thought it was a great movie.  Iron Man 3 continues to do well as it came in second with a cool $35.7 million. In total Iron Man 3 has done over $1 billion worldwide. Not too shabby.

iiSphere: “Imagine the ability to seek important health information without touching a book, computer, or tablet. Imagine a world where obtaining crucial information on your patient’s health is just merely a look away. Integrating innovative technology into the healthcare system to better diagnose and treat patients has the potential to be the forefront in healthcare outcomes and delivery. Google Glass can change the way doctors and healthcare clinicians provide their services as it will allow the integration of web information and human interaction be one in the same.” – There’s some great examples presented here.

This technology from Fujitsu – Fingerlink Interaction System – is absolutely phenominal:

JAMA. 2013;309(20):2105-2106: “Medication nonadherence is widely recognized as a common and costly problem.1 Approximately 30% to 50% of US adults are not adherent to long-term medications leading to an estimated $100 billion in preventable costs annually. Despite the widespread prevalence and cost of medication nonadherence, it is undetected and undertreated in a significant proportion of adults across care settings. According to the World Health Organization, “increasing the effectiveness of adherence interventions may have far greater impact on the health of the population than any improvement in specific medical treatments.”  – Medication adherence/nonadherence is getting a lot of press these days, and rightly so. But this is an interesting approach as the article looks at medication adherence as “a diagnosable and treatable medical condition”. Not sure I buy that one.

MIT Technology Review: “The Ginger.io app doesn’t diagnose patients directly. But it does warn that a person’s behavior has changed in ways that are linked to what doctors call “noncompliance” with a drug or treatment plan. With the app silently logging those changes, says Madan,” now the doctor or nurse can get a sense of the patient’s life and help as needed.” – This is an interesting concept that uses your smartphone and behavioral analytics to determine what’s going on with a patient. I can see a day when pharmacists will use all these tools to help ensure safe, effective, cost-conscious medication therapy for patients.

FDA News Release:  “The U.S. Food and Drug Administration is working closely with the Centers for Disease Control and Prevention and Tennessee Board of Pharmacy to investigate reports of seven adverse events associated with steroid injections compounded by Main Street Family Pharmacy, LLC (Main Street) of Newbern, Tenn.” – With all the recent problems, the negative press and the heavy hand of regulatory agencies it is likely that we are looking at the final days of pharmacy compounding. Say goodbye to a big chunk of pharmacy history.

How many of you have scene Oblivion with Tom Cruise? I have, and it wasn’t bad. It wasn’t great, but it wasn’t bad; Redbox rental. Anyway, here’s an alternate ending for you. Uh, if you haven’t seen the flick think before watching; could be a bit of a spoiler. If you decide to watch the clip make sure to watch it through to the end.

Medical Xpress: “…we repeated the experiment using isoniazid and a different reducing agent— vitamin C,” said Dr. Jacobs. “The combination of isoniazid and vitamin C sterilized the M. tuberculosis culture. We were then amazed to discover that vitamin C by itself not only sterilized the drug-susceptible TB, but also sterilized MDR-TB and XDR-TB strains.” – This is very preliminary work, but the potential to use vitamin C as a treatment for TB is exciting.

Speaking of vitamin C, did you know that the human body does an incredible job of regulating vitamin C plasma concentrations through a mechanism called rate utilization? Yep, even at maximum oral doses ascorbate plasma concentrations remain below 250 micromol/L. But when given via i.v. infusion, ascorbate concentrations go way higher; 25-30 mmol/L. The body is an amazing machine. Something to think about when we start playing with Vitamin C as an alternate TB treatment.

Microsoft announced the new and improved Xbox One this week. I’ve already read some negative things about the Xbox One system, which I find strange as it’s not actually on the market yet. I thought it was pretty cool. I love my Xbox 360, and the ‘One’ will only make things better.

Microsoft’s Kinect can detect your heartbeat. Check out the video below, specifically the section starting at about 3:15.

abc News: “The tornado that struck an Oklahoma City suburb this week may have created $2 billion or more in damage as it tore through as many as 13,000 homes, multiple schools and a hospital, officials said Wednesday as they gave the first detailed account of the devastation. Also Wednesday, authorities released the identities of the 24 people, including 10 children, who perished.” – A grim reminder that Mother Nature can be brutal. The tornado was only on the ground for 40 minutes.

I took a field trip to the Verizon store this week and took a good hard look at both the Nokia Lumia 928 and the BlackBerry Z10. I’m toying with the idea of moving away from Android for a while and using something else. The Lumia 928 is a fairly large phone, but was pretty intuitive to use. If you’ve used Windows 8 you’ll be right at home. The Z10 is smaller than the 928, and I found it more difficult to navigate. The UI wasn’t all that intuitive to me. My daughter stood there smirking as I tried to navigate the BlackBerry screens. It would be a bit of a learning curve.

How’d you like to be driving on a bridge and have it collapse sending you off the edge into the water? That’s exactly what happened on Thursday this week in Washington when a large span of an I-5 bridge section collapsed. Nice. You can read about it at CNN.com if you’re interested.

The Economist: “The main reason why Americans dislike dealing with the Internal Revenue Service is not the bureaucrats’ fault. Congress keeps making the tax code more complex. It is now 4m words long, and has been changed over 4,000 times since 2001. Americans spend 6.1 billion hours a year complying with it.” – What the heck is going on? And just think, the same people in charge of the IRS are the same ones everyone wants in charge of our healthcare system. Give it some time and getting admitted to the hospital will be like doing your taxes. <Smirk> Actually, I think we’re already there.

“Scientists at the University of Bath have developed a prototype medical dressing that detects the first signs of the lethal Toxic Shock Syndrome (TSS) and could potentially save the lives of children with serious burns.” – An amazingly simple concept with incredible potential.