Saturday, 14 November 2015

Apple Music

Date: 14 November 2015 at 18:13

Apple Music. Right so I've had nearly two months with this now. It's £15 a month. I have Apple Match. That's £25 a year…

However, family price… it seems to work for me!

I think...

Saturday, 5 September 2015

Vascular Training…

Vascular Training…

It's interesting to see how that even in an ideal situation it's still very very hard!

Thursday, 11 June 2015

To be better...

5 ways to become better - Atul Gawande

From his book "Better" here are 5 ways to become a "positive deviant" and better doctor:

1. Ask an unscripted question - in other words take a human interest in the often inhumane world of medicine.

2. Don't complain" - in other words suck it up and try and keep cheerful.

3. Count something - audit/research - take an interest in the science no matter how rough and ready.

4. Write something - explain your findings/thoughts to yourself and others.

5. Change - adopt new techniques. Avoid dogma. Then assess the change.

It's a good book. Very american. But good. Get it here

14° Partly Cloudy

Software to write Manuscripts With

#Software to write manuscripts with…
  • Scrivener
    Amazingly useful. Doesn't choke on documents longer than 1 page like Word does. You can move anything anywhere. Designed for writing a thesis. Not a word processor but a writer.
  • Nisus Writer Pro
    An oldie but a goodie. This is word processing for those who like the Mac way. Clear. Concise. Can do anything. Also saves in RTF nicely.
  • Manuscripts
    A newbie. In beta. Designed to take a template and make it almost automagical. Kinda like Overleaf but made for Mac and made to look good too.
  • Word
    Old reliable. Ish. De facto standard sadly. Not as good as people think it is.n especially with big documents. Could be worse of course. Very flexible. Just be careful of unseen formatting!
  • Overleaf
    Online latex writer. You write in standard, it converts. Output is beautiful. Designed for collaboration. Just slightly clunky. Improving rapidly.
  • Papers
    My library of papers is now >7000. Only way I can manage this and cite as I wish. Endnote didn't work for me (and continually crashed word). Try - its good.

Friday, 1 May 2015

OASIS - Survival analysis for the rest of us…

OASIS - Survival analysis for the rest of us…

try it - online, free kaplan meier etc


Monday, 27 April 2015

Friday, 24 April 2015

Software for Vascular Trainees

Software for Vascular Trainees

As a vascular trainee, nowadays you need to be endovascular trained. In other words, you need to encompass all that an interventional radiologist is (minus the diagnostics obviously) and an old school vascular surgeon was.
This means learning how to reconstruct CTs and plan EVARs as well as putting the dratted things in.
To help with this software is available…
Osirix - Open Source PACS software - fully featured PACS suite, has a (non CE and non FDA) free version which is on a par if not better than all commercial PACS. You can size off this easily, but it does require you manually creating the centre line. Price? £500ish for CE/FDA approved. Mac only.
Sova.EVAR - An Osirix plugin, currently in some form of commercial re-organisation. Originally a university project. Excellent and has a free 30 day trial. Full integration with stent catalogues. Price unknown. Mac only.
Endosize - A standalone sizing software (university spin off), with excellent sizing capabilities. Great output and easy to use. Very quick. Works on Mac, PC and Tablet. Free demo. Price €2990 for a year licence and €7900 for a perpetual licence.
3Mensio - A university spin off. Excellent, full featured sizing suite. Expensive though! PC only. Free Demo. Price… Not yet sure…
TeraRecon - Essentially the industry leader in standalone sizing. Has multiple options for use including thin client cloud service. Excellent tools and rendering. Good support. Most common hospital solution. Works on PC only. Price £10000 ish for a perpetual licence.
Aycan Osirix Pro - Built on modified Osirix code base allows vessel analysis. I found it exceedingly difficult and gave up. Works on Mac. Price about €2000+
Other suites are available obviously and many supplied PACS in hospitals now do this on their own.

Saturday, 21 March 2015

Do No Harm, Tales of Life, Death and Brain Surgery - Ponderings

I've been thinking about current medical care in the NHS. This was prompted by the good but extremely irritating and smug book "Do No Harm, Tales of Life, Death and Brain Surgery" by Henry Marsh (, a recently retired and exceptionally eccentric neurosurgeon, who worked at St Georges.
During his case presentations/anecdotes (classic medical fodder) he reveals his inner torment at the current state of medical practice in the NHS and how it impinges on what he wants to do. Now there is significant insight as he does portray his errors at length. However, he is exceptionally critical of others and himself, to the point of disservice. His main ire is of course aimed at the bureaucrats and managers, who get in the way of his service. He complains about the nanny state and training, and the inconceivable lack of clinical input into the construction and development of hospitals and care pathways.
What he fails to explain or to accept is that it is actually his role as the senior to look after these aspects. He is the senior after all. Who else has the expertise and the experience to help guide? Maybe he did but did not feel he was of use… He bemoans training, but refuses to have trainees or students in his clinic rooms. He bemoans the lack of beds, but all his patients were admitted the night before - this is highly unusual nowadays. Is it beneficial? Perhaps, perhaps not, but there is not the bed capacity to support this routinely, especially not in a tertiary referral unit which is always full. Of course if there were medications required pre-op then it's understandable, but maybe work should look into the rationale. He bemoans the encroachment of managers into his kingdom, but it is his antipathy to engage that is the cause.
Fundamentally, his regrets are common - mistakes made, both clinically and in life. However, sadly this book does not cover how he has changed or grown to improve. He enters as he leaves and there is no idea of how he affected his trainees, which is sad.