DynaMed recently updated its navigation options that make finding the information you need more straightforward! The new interface still provides access to the latest information in DynaMed’s collection of clinically-focused, evidence-based, routinely updated articles, images, and updates. New functionality now makes searching within a topic even easier so you can find the information you need quickly. You can also quickly switch views from the homepage to see potentially practice-changing updates.
From the homepage, you can search for information using the standard search bar, or click on the links at the top of the page to search for information on specialties, recent alerts, drug information, or calculators. The main section of the homepage includes updates on recent alerts and any content you have followed, such as specialty updates.
DynaMed’s new features include a simplified in-topic navigation that allows you to jump straight through to relevant sections within a topic. From a topic page, the sections menu located on the left side of the page has been simplified to help you navigate to the sections you find most useful.
Once you’ve selected a section, simply click the “In This Section” menu at the top of the page to navigate within the section and explore sub-sections as shown in the screenshot below:
Within topic pages, you can also easily navigate between the topic information, videos, images, and updates by using the tabs at the top of the page. DynaMed is updated daily, so you can always be sure that you are looking at the most current information available on every topic.
Interested in learning more? See these updates in action in this short video:
If you’d prefer to use the DynaMed app, instructions for downloading the app are available on Himmelfarb’sApp Shelf.
Photo by Pixabay from Pexels: https://www.pexels.com/photo/clean-clear-cold-drink-416528/
Warning: This post tells the tragic true story of a woman’s death.
On January 12, 2007, a Sacramento radio station called KDND aired its morning show, The Morning Rave. That day, the show held an on-air contest called “Hold Your Wee for a Wii”, in which around 20 contestants competed to win a Wii console by drinking as much water as they could without urinating.
As the contest was occurring, the hosts – Adam “Lukas” Cox, Steve Maney, and Patricia “Trish” Sweet – joked about the contest.
Sweet: “Can’t you get water poisoning and, like, die?”
Cox: “Your body is 98% water. Why can’t you take in as much water as you want?”
A listener then called into the station to inform the hosts that the contest could have dangerous, even fatal consequences.
Caller: “I want to say that… those people that are drinking all that water can get sick and possibly die from water intoxication.”
Cox: “Yeah, we’re aware of that.”
Maney: “They signed releases so we’re not responsible so it’s okay.”
One contestant was 28-year-old Jennifer Strange. She drank approximately 2 gallons, or 7.6 liters, of water in 3 hours (Hochelaga, 2020). During the contest, Strange complained of a headache, and the hosts made fun of her distended stomach. After the contest, Strange called a friend and said she had an intense headache. Only a few hours later, Strange was dead. She had died from acute water intoxication.
Hew-Butler et al. (2019) explain what happens when a person becomes overhydrated:
When modest amounts of water (or other hypotonic fluids) are ingested above osmotically-driven thirst stimulation (overhydration), osmoreceptors located within the highly vascularized circumventricular organs (CVO’s) within the brain detect a (dilutional) decrease in plasma [Na+] once water is absorbed into the circulation from the gastrointestinal (GI) tract. These CVO’s, located outside of the blood brain barrier, suppress both the release of the body’s main anti-diuretic hormone, arginine vasopressin (AVP), from the posterior pituitary gland and suppress the sensation of osmotically-driven thirst to prevent further dilution of plasma [Na+]. Oropharyngeal receptors, activated by physical contact with ingested fluids, as well as gastrointestinal sensors responding to stretch receptors sensing fullness serve to terminate drinking behavior, perhaps as an anticipatory measure to prevent the pathophysiological consequences of overdrinking (i.e., cellular swelling).
Overhydration, particularly when not accompanied by polyuria (excess urination) can result in the dilation of the bladder, ureters, kidney, and stomach. The most extreme consequence is water intoxication.
Water intoxication results from an electrolyte imbalance defined as plasma sodium concentration < 135 mmol/L. This excess of total body water relative to extracellular sodium is called hyponatremia. Symptoms of hyponatremia include nausea, blurred vision, tremors, dizziness, lethargy, and seizures (Kotagiri et al., 2022). A recent systematic review analyzed case reports of hyponatremia and found that in 53% of the cases under consideration, the symptoms were severe, including seizures and coma (Rangan et al., 2021). In patients with severe symptoms of hyponatremia, practice guidelines recommend an IV infusion of 100 mL of 3% NaCl over 10 minutes, repeated twice if necessary (Verbalis et al., 2013). Hyponatremia causes swelling of the brain, and if cerebral edema exceeds the physical limits of the skull, it can lead to brain herniation, cerebral hypoxia, and, finally – as in Strange’s case – death (Hew-Butler et al., 2019).
Directly following Strange’s death, KDND discontinued the Morning Rave program and fired ten station employees, including the three DJs who had hosted the program. Strange’s family issued a wrongful death lawsuit on January 18 against Entercom, the company which owned KDND. The wrongful death case began in September 2009. On October 29, 2009, the jury awarded Strange’s family $16,577,118 in monetary damages and found Entercom Sacramento LLC to be 100% at fault for Strange’s death.
Do you know of another interesting true crime case with medical connections? Email Rachel Brill at rgbrill@gwu.edu.
References
Hew-Butler T, Smith-Hale V, Pollard-McGrandy A, VanSumeren M. Of Mice and Men-The Physiology, Psychology, and Pathology of Overhydration. Nutrients. 2019 Jul 7;11(7):1539. doi: 10.3390/nu11071539. PMID: 31284689; PMCID: PMC6682940. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6682940/
Rangan GK, Dorani N, Zhang MM, Abu-Zarour L, Lau HC, Munt A, Chandra AN, Saravanabavan S, Rangan A, Zhang JQJ, Howell M, Wong AT. Clinical characteristics and outcomes of hyponatraemia associated with oral water intake in adults: a systematic review. BMJ Open. 2021 Dec 9;11(12):e046539. doi: 10.1136/bmjopen-2020-046539. PMID: 34887267; PMCID: PMC8663108. https://bmjopen.bmj.com/content/11/12/e046539.long
Verbalis JG, Goldsmith SR, Greenberg A, Korzelius C, Schrier RW, Sterns RH, Thompson CJ. Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations. Am J Med. 2013 Oct;126(10 Suppl 1):S1-42. doi: 10.1016/j.amjmed.2013.07.006. PMID: 24074529. https://www.sciencedirect.com/science/article/pii/S0002934313006050?via%3Dihub
We are excited to invite you to share your creative projects with us! Himmelfarb Library’s annual art show features photographs, paintings of all mediums, drawings, sculptures, and more created by GW’s health sciences community! Starting March 13th, we encourage you to submit your favorite work of art! If you are uncertain about what types of media may or may not be accepted, feel free to contact us at himmelfarb@gwu.edu.
Important Dates:
Submissions: Monday, March 13 through Thursday, April 13. Submissions can be dropped off at the Himmelfarb Circulation/Reference Desk. For each submission, we need the name of your piece and the artist’s name.
Opening Reception: Monday, April 17, 4:00pm - 5:30pm.
Art Show: Monday, April 17 through Thursday, May 11
Need some inspiration? Here are some of last year’s Art Show submissions:
GW Paws N'Relax Date: March 8, 2023 Time: 2:00 pm - 4:00 pm Location: University Student Center, Third Floor Terrace Cost: Free
Having a ruff semester? Destress with therapy dogs. Join People Animals Love (PAL) to rejuvenate with some professional therapy pups and enjoy some paws-itivity! Registration is required. Please note, due to a high volume of attendees, there may be a short wait. Follow Himmelfarb Library on Social Media
GW Weekly Poker Session Date: March 24, 2023 (Every Friday) Time: 2:00 pm - 3:00 pm Location: District House, 2121 H St., NW Room B205
Come and join the Poker Club for their spring 2023 weekly session! Anyone interested at any skill level is encouraged to join. The rule structure is Texas no limit hold’em. Everyone will receive a fictional cash bankroll upon registration, and that money stays with you throughout the semester. Any profits made during weekly play will accumulate, and players are ranked based on their bankroll value for end-of-semester tournament qualification.
2023 Cherry Blossom Kite Festival Date: March 25, 2023 Time: 10:00 am - 4:30 pm (Rain date: March 26, 2023) Location: Washington Monument Grounds Cost: Free
Spring on the fun at the Blossom Kite Festival with activities, music, competitions, performances, and more! Kite enthusiasts, beginners, families, and friends are all welcome. Bring your own kite, purchase one onsite, or pick up a free kite kit that you can decorate onsite. This year’s festival will also feature a day-long celebration of dynamic traditional Japanese drumming, showcasing of kites by Mr. Mikio Toki, a master of traditional Edo-style kites, and performances and demonstrations by the local Wings Over Washington Kite Club.
Washington Jazz Arts Institute Concert Date: Friday, March 31, 2023. 6:00 pm Online reservation starts Wednesday, March 15, 2023, at 10:00 am Location: Kennedy Center MILLENNIUM STAGE Cost: Free
The Washington Jazz Arts Institute (WJAI) is committed to the education, documentation, preservation, promotion, and preparation of the future of Jazz in and for the Washington, DC community. The Institute has developed a jazz orchestra in support of city-wide musical outreach and education which will expand opportunities for the appreciation of live jazz, training, and performance for young musicians.
