Tuesday, May 31, 2005


Image hosted by Photobucket.comWelcome to Grand Rounds XXXVI ! This week we will hold our Rounds while touring an exhibit of drawings by the incomparable Leonardo Da Vinci born in 1452. Leonardo's Self Portrait is to the left. Da Vinci was not only an artist, but an anatomist, a philosopher, an inventor, and engineer.

This month marks the 486th year since Leonardo's death in 1519 at age 67. His beautifully detailed anatomical drawings with their copious notes and close attention to detail were undoubtedly the result of Leonardo's own dissections of animals and human beings. He was the quintessential Rennaisance Man. Sigmund Freud once said, "Leonardo da Vinci was like a man who awoke too early in the darkness, while the others were all still asleep."

Image hosted by Photobucket.comWe begin our art tour with Vetruvian Man, one of Leonardo's most reproduced and popular sketches, in which he draws the "measure of man" to demonstrate that "man is the measure of all things."

Grand Rounds XXXVI begins with several posts that deal with one measure of medicine, the Pharmaceutical Industry. In this category we have three blogs which discuss issues regarding the relationships between Pharmaceutical Companies and Medicine. California Medicine Man talks about the major "non-event" that occurs when a drug company repackages the same basic drug and simply renames it. Blogs for Industry takes a capitalist approach and exposes the myth that universities are major contributors in the drug development pipeline, and wonders why those universities think that the law of supply and demand doesn't apply to them? Meanwhile, DrugInjury.com argues for more FDA drug safety oversight in the wake of the Vioxx debacle.

Image hosted by Photobucket.comA Drawing of Concave Mirrors and Reflections allows us a to pause for moment or two to reflect on multiple ethical, legal, and philosophical and entrepreneurial issues in Medicine. InsureBlog's post on "It's All in the Genes" tackles the debate about genetic testing and the impact of several legislative attempts to constrain the ability of insurance companies to use genetic information against the insured. The Rest of the Story explains a procedure called SCNT (Somatic Cell Nuclear Transfer) which may be a way to sidestep the embryonic stem cell controversy. Overlawyered takes a look at the demands of disabled doctors who want hospitals--and patients--to accommodate their disabilities. So Many Lawyers, So Little Time gives some medical advice to a lawyer--but not the advice he really wants to give. Kevin, M.D. asks two compelling questions about patients' and doctors' use of time and theorizes a "spectrum of waiting". Interested Participant discusses a recent conference where German physicians state that "unemployment makes people sick"--and have recommended that the unemployed be exempt from paying for doctor's visits. Far From Perfect: The Life of A Paramedic argues that Emergency Medical Services should no longer be the stepchild of the Fire Services, but its own separate Public Service. Health Business Blog finds that it isn't as easy as you might think to give away $50 Million. And, Sense of Soot stares socialized medicine in the eye, and finds that he doesn't like it much. Much to reflect on.

Image hosted by Photobucket.comWe stop to examine Leonardo's View of a Skull and use it as the inspiration for several blogging mental health professionals and some psychological issues. First, ShrinkWrapped talks about the doctor's dilemma in dealing with drug company representatives. Shrinkette discovers that the hits on her blog have suddenly increased dramatically because she once wrote about pro-Anorexia websites and now anorexic teens are directed there by Google. Horsefeathers (hat tip: Dymphna) explores the power of delusion and its connection to Saddam's underpants. And, along similar lines, Dr. Sanity ponders on the phenomenon of psychological insight and murderous impulses.

Image hosted by Photobucket.com In The Study of An Old Man, Leonardo has captured our essential humanity, and so it becomes the backdrop for four great posts. Neo-neocon, another mental health professional, takes the patient's point of view when she presents for her annual physical exam as an "aging boomer." Another patient perspective can be found at Diabetes Mine, as Amy reports what she learned at a diabetes symposium for those who suffer from the disorder. Over at Oasis of Sanity, Joan reflects that if you are a hammer, then everything looks like a nail to you. And likewise medical specialists tend to believe their specialty's treatments are the only treatments. Finally, before we move on to the next part of the exhibit, The Examining Room of Dr. Charles has a Memorial Day tribute to "those who died in the defense of our better nature, our freedoms, and our best achievements."

Image hosted by Photobucket.com The Study of Lungs brings us to Gill Blog's excellent discussion of managing SARS in Canada; and then to Dr Emer's post at Parallel Universes about how laughing may excacerbate asthma. The good doctor points out that noone should live without laughing and discusses a treatment to help.

Image hosted by Photobucket.com Drawing of the Heart and Blood Vessels brings us to Medpundit , as she looks at the "miracle" of St. Statin and the latest study showing that statins not only reduce heart disease risk, but also reduce the risk of colon cancer.

Image hosted by Photobucket.comLeonardo's Study of a Womb seems appropriate for Red State Moron as he writes about his "calling" to medicine and gynecology. A very personal memoir.

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The good-natured and curious Kidney Notes deals with an unusual case in his nephrology practice, as we continue to move through the exhibit to Principal Organs, Vascular and Urino-genital Systems of a Woman, completed in 1507. This detailed anatomical drawing is perfect for including medically related posts in a variety of disciplines. Aggravated DocSurg notes that the British Journal of Surgery is advocating raising the minimum age for purchasing sharp pointy objects and wonders if this will save the modern world from the evils of kitchen knives. What would Crocodile Dundee think? Dr. Andy summarizes two studies that show that allergic disease is on the rise and notes that it is a good time to be an allergist.

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Image hosted by Photobucket.com A Study of Arms and Hands along with Study of A Leg will frame and highlight several posts in our Grand Rounds. Gruntdoc tells the story of his experience with one of the built-in hazards of medicine: a needlestick injury with a 'dirty' needle; while Zap*Germs details the UK media frenzy over a Marine's death by MRSA-PVL Infection. Orac at Respectful Insolence takes on the anti-vaccination folks posting at the Huffington blog.

Image hosted by Photobucket.com We move on through the exhibit, and Dr. Tony presents a case history of an autistic boy who lives on an "edge" only he can see, until he finally and tragically goes over it. As The Cheerful Oncologist reflects on some of the positive aspects of working on the graveyard shift; and Maria at Intueri contemplates her ICU nightmares; we contemplate Da Vinci's Sketch of a Dragon Costume, where the dragon seems conjured from a child's nightmare.

Image hosted by Photobucket.comAs we come to the end of our Da Vinci exhibit, and the end to Grand Rounds, viewing Leonardo's concept for A Flying Machine, reminds me to tell you that next week's Grand Rounds XXXVII will be hosted over at medGadget, so be sure to visit! It has been my pleasure to host Grand Rounds. Have a great week!
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