The BBC is reporting. May you rest in peace.

klangklangston at metafilter has it right:

Terry Schiavo died eight years ago. They finally stopped animating her body.

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A really great summary from RangelMD on Terry Schiavo . Her cranial nerves (the ones that control the face and neck muscles) are still working, but she has no cortex left. May we let her body rest and she die in peace.

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Heard today in class, which seems like it’ll be a really interesting month of classes. (Oh, the ESR is the “erythrocyte sedimentation rate,” a lab test that’s known for being very non-specific.)

Q: What’s the best reason to get an ESR?

A: To tell if the lab’s open or not.

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GET IT WHILE IT’S HOT, READERS! It’s been an absolutely CRAZY week across the medlogosphere–from PARIS HILTON to KEVIN MD ; from BRITNEY SPEARS to MATTHEW HOLT ! (next week’s at Polite Dissent !

ITEM! The ANONYMOUS CLERK DISCUSSES the antipsychiatry movement: is mental illness real? Should depression be a disease? Must SANDRA BULLOCK be crazy to star in Miss Congeniality 2: Armed And Fabulous ? Only time will tell!

GORILLAS, PENISES ATTACK! The drug companies have jumped the shark, SHOUTS DR. CHARLES . Monkey medicine mascots and phallic obsession on par with the WASHINGTON MONUMENT have taken Big Pharma from its research and academic roots!

NEWS FLASH: SOMETHING WILL KILL YOU! Will America’s obsession with portions the size of Texas tip our scales toward death? Let’s not sound the tornado sirens yet, WARNS DR. ANDY ! Medical progress has improved significantly in the past decade, and even our obesity is hurting us, other advances help us. Speaking of which, who’s seen KIRSTIE ALLEY’S NEW SHOW?

LEFT FOOT, GREEN! It’s not easy balancing research and clinician duties, as only ORAC KNOWS . Where do you find the balance? Your duty to your patients today, but your need to contribute to the treatments of tomorrow?

A DOCTOR’S NOTE’S TOO MUCH! We’re not truly advocating for our patients if we give them an all-access pass to worker’s comp, BLASTS DR. TONY ! “We are advocates for our children, but don’t give them everything they want, do we?” Zing! Unless they’re WEALTHY CHILD ACTORS, and they threaten their parents with court orders! Pop!

IN A THEATRE NEAR YOU! A new sure-to-be-smash-hit movie, CANCER INFECTS THEATERS THIS WEEK . A wonderful synopsis by THE CHEERFUL ONCOLOGIST. Early prevention and early screening, the two go hand in hand!

BREAKING NEWS FROM FLORIDA! There appears to be a case in Florida involving a woman named Terri Schaivo-the scoop’s been had, RANTS DB ! Some excellent summaries of points you won’t hear on cable news. FOX INTERVIEWED A PSYCHIC ABOUT SCHIAVO ; now that’s scientifically brilliant!

ITEM! If we don’t know what we’re doing wrong, how can we fix it? MEDICAL CONNECTIVITY EXAMINES throughput and efficiency in-depth; they’re doing some great work to try to squeeze every last drop of health out of healthcare! Almost like JENNIFER ANISTON trying to fit in that dress last week!

OH THE IRONY! From the “Overly Conflicted Department” comes this hypothetical from MudPhud TWO TERMS LATER : could Schaivo have been saved with stem cells? Sure, maybe not today, but supported now, could they help future Schaivos? Those same people fighting for Terri’s tube reinsertion barred stem cell research from progressing. Can’t have it both ways, Dubya!

HEALTH CARE BLASPHEMY! MATTHEW HOLT COMES TO THE RESCUE of single-payer, tearing down a shoddy Op-Ed about the health care financing scheme. While no idealist about the costs and benefits of SP, Holt takes Jeff Jacoby to task, and gets a mention by Eric Alterman!

I’M NOT LEBOWSKI, I’M THE DUDE! BIOETHICS DUDE WAXES PHILOSOPHIC and tries to understand some other bioethics viewpoints. Not an easy task. Then again, neither was teaching ASHLEY SIMPSON to lip-synch, but it can be done!

RIPPED FROM RESCUE 911! A frightening tale told by CONSERVATIVE DIALYSIS , and a very personal look at the effects of diabetes. We here at Over My Med Body are just glad you’re safe and sound, Nick; don’t scare us like that anymore!

ITEM! Fetal abortion policy thickens, just like molasses in January! RED STATE MORON has the story: should the military have to pay for an abortion of an anencephalic fetus? JUDGE JUDY rules! (But Judge Zilly actually heard the case.) We like JUDGE MARILYN MILIAN, too, although she’ll never be JUDGE WAPNER.

EQUAL OPPORTUNITY SEXUAL BODY PARTS! We’d never want to leave the women out of this one (or the men, either, we’re not here to judge), so we’re glad to report that EMERITUS HAS FOUND news of a new Japanese gum that increases breast size! I’m sure GWEN STEFANI, lover of Japanese culture and Harajuku Girls has already ordered 100 packs!

WE MUST DO BETTER! There are diagnoses we can miss without serious consequences, and ones that we can’t. KEVIN MD WRITES about the latter: a woman who died from a bacterial pneumonia, complication of influenza (the flu). The internist is now facing a malpractice suit.

DRINK AND LIVE, DRUNK AND DRIVE? MEDBLOG WINNER GRUNTDOC REPORTS on a frightening trend: we’re not catching those with the highest of blood alcohol levels. “Great. More disconnect between reality and the law.” Well said, well said!

WHEN MEDGADGETS ATTACK! US Marshalls seized Vail Beds, MUCKRAKES ENOCH CHOI . It was probably a bad 50s movie, and now it’s real. Art imitating life? Or US Marshalls 2, starring HARRISON FORD and CLINT EASTWOOD, against those diabolical beds?

WE HEART TECHNOLOGY! MEDGADGET PROMOTES a new in-the-field intubation and bronchoscopy device donated by Karl Storz Endoscopy-America, Inc. It will allow for faster access in war zones. Support our trooops!

I’m all gossipped out, and school starts tomorrow again. Signing off, your medlogossip, Graham.

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One of my many side projects is working as the Database and Technology chair for our two student-run free clinics– Arbor Free Clinic and Pacific Free Clinic . Each clinic does an excellent job, serving hundreds of patients each year. 99% of our patients are uninsured, and we’ve had patients come from hundreds of miles away; the clinics are some of the only free clinics around, open on weekends.

The clinics both use a Stanford-managed database for collecting data (they’re great because they’re all HIPAA-compliant and… stuff), but we’ve always had trouble with the data entry. So I made it my goal to redesign the form to make it easier to enter and view the data. If you use a electronic medical record (or even if you don’t), take a look at my redesign and let me know what you think, or if you have ideas to make it more usable: Pacific Free Clinic New Patient Registration .

PS: I’m especially proud of the “diagnosis” field. Go down to it, start typing something, and it’ll filter out results until it finds the disease–it has our top 50 or so most common diseases. And even better, it enters the ICD9 for you automatically!

PPS: New pics up , from Las Vegas.

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I haven’t eaten beef for 3 years now, thanks to Fast Food Nation , and this just reminds me of why I’m so happy I quit: Woman bites into finger at San Jose restaurant . Nast. Seriously.

Read the paragraph in FFN about how cattle are slaughtered, and you’ll understand why I stopped eating it. One hint: poop.

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I’m in charge of Grand Rounds this week. Please get your submissions to me ASAP. Use my contact form , or email me: grandrounds@grahamazon.com

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Grand Rounds is up at The Well-Timed Period . And, much to the medblogosphere’s chagrin, you’re stuck with me as a host next week.

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Just finished my final full quarter of preclinical work in medical school. Have a month of psych after this week’s spring break, but then it’s boards and then clinics. Be very afraid if you come to a South Bay hospital in July. You might get stuck with me.

Also, new photos are up . Some from the Monterey Acquarium, some from my backyard.

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Yours truly made it onto the stage for Hardball, and sat right behind The Governator. Arnold’s a politician all right; he was able to dodge and laugh through most of the tough questions. I was particularly disgusted with Arnold’s handling of steroids:

MATTHEWS: Are steroids bad for you?
SCHWARZENEGGER: What?
MATTHEWS: Are they bad for you?
SCHWARZENEGGER: Steroids can have side effects, if people don‘t do it under supervision with a doctor. I‘ve seen people in our own sports that have died because of it.
MATTHEWS: Yes.
SCHWARZENEGGER: That have had side effects, health side effects.
MATTHEWS: Right.

Even though he’s publicly admitted it , I’m sure he’d like to try to bury that 1977 article if possible. Steroids have plenty of side effects (note: HIV and hepatitis are on that list due to IV injections, they are not directly linked). I remember being really confused about steroids and my brother being “prescribed steroids” for his asthma, so I thought I’d take a minute to procrastinate explain what people mean by steroids .

Okay, so technically, a steroid is just any chemical with a certain structure. But the body uses 3 main types of steroids. Physicians usually prescribe one type, body builders usually use another, and while the third type is very important, you probably won’t run into it much. All three are made in the adrenal glands . And here we go:

1. Glucocorticoids. These are what are generally prescribed by physicians. They’re usually prescribed to lower a person’s immune system. Cortisol, hydrocortisone, prednisone. They reduce inflammation. They’re commonly used for autoimmune disorders, or transplant patients-both need to supress their immune system, because it’s either hurting them or their transplanted organ.
2. Sex hormones. These are the steroids you hear about all the time: testosterone, estrogen, progesterone. First, testosterone . Body builders will use testosterone to get bigger muscles. This is the “anabolic steroid”-anabolic just means metabolism that builds, like building muscle. Other chemicals can work too-either things that the body can turn into testosterone, or things that look like testosterone, so that the body thinks they’re testosterone. These have a number of scary side effects-“roid rage,” shrunken testicles, gynecomastia (male breast tissue development). Not hot. There’s also estrogen and progesterone . These are the hormones found in birth control pills and hormone replacement therapy during menopause. These are also the hormones involved in RU-486 and “the morning after pill.” These are made in the adrenal glands, but they’re also made in the ovaries and testicles. (And yes, men and women have both in their systems, just different amounts.)
3. Mineralocorticoids. These you probably won’t hear a whole lot about. Aldosterone is the main one, and it makes your kidney reabsorb water and sodium. If you’re getting dehydrated, your body releases this to tell your kidneys to make less urine, so you save more water and sodium. Some people’s diuretics (water pills) block aldosterone, so you pee more.

So there you have it. Now it’s back to neuropharm for me.

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