Friday, June 25, 2010

Marathon meeting week

I'm sitting at Logan airport in Boston, waiting for my flight home. I'll be waiting for another 5 hours, been here for two hours already. I honestly cannot remember when I was last this worn down. I'm zoning out while the poor waiter at DINE Boston Bar & Grill tries desperately to get me to order.

The week started last Thursday with the Nordic PhD-course on Hypertension arranged as a satellite meeting to the European Society of Hypertension annual meeting in Oslo by the Hypertension Societies of the Nordic countries. A selection of, mostly clinical, hypertension scientists crammed as much teaching as possible in to a day-and-a-half course. The fare was a little lop-sided towards diagnosis, prognosis and treatment, a.k.a. clinical science, with rather less basic science and proper mechanistic research.

Then the actual ESH2010 meeting started Friday evening. The meeting was similarly lop-sided, but provided some really interesting sessions with for example Hans Ibsen on the prognostic importance of changes in albuminuria/proteinuria status. An important happening at the meeting was the ESH answer to the recent findings of an association between ARB-use and cancer. In a meta-analysis of several of the recent mega-trials an increased risk for newly diagnosed cancer of about 0.8% was identified in the treated cohort. This was obviously taken up by the daily press with the usual glee. It is a small difference and it is not something the studies were designed to look for. Indeed when the VALUE trial data was added to the cohort the association disappeard. In short, there is with all probability no association between ARB-use and cancer.

I had the honor of co-chairing a poster session providing important new information on renin release, Angiotensin-A (a new AngII like peptide) and how AngII modulates the interaction between beta-arrestin and nephrin possibly underlying part of the proteinuria in high AngII states. I honestly didn't like the poster session format. There was a guided poster session, which is an ok idea, but they were all at the same time and didn't cover all the posters in each session. This meant that most authors weren't at their posters, giving very little room for discussion. Since the discussions during the poster sessions is usually the best part of these conferences I have to count this as a major fail.

I had my presentation on Monday morning and actually managed to be snared by a new possible collaborator before catching the airport express out of Lillestrøm and jumped on to the Iceland Air flight to Reykjavik and further on to Boston. All in all a very good meeting.

The flights and waiting times afforded me just enough time to put together my talk for Tuesday morning. From Logan I continued by car to Vermont Academy outside Saxtons River. That's about three hours worth. Luckily the bar hadn't closed when I arrived slightly after eleven - neither had the registration desk (although he was packing up). I had a beer, said hello to my colleagues in the APS renal section, got a glass of Bourbon pressed into my hand and woke up at four in the morning, thinking I had overslept. I had a shower, practiced and shortened my talk a couple of times before breakfast, and then the meeting, FASEB Summer Research Conference on Renal Hemodynamics, was suddenly in full swing.

My presentation went over well, and we continued with sessions between 8.30am and 10pm with a long lunch break and a long bar break every day. The best presentation of the conference was Dr. Schnermanns "Musings on Tubuloglomerular Feedback" (that wasn't the title he was given, but I guess that is how it goes). His most convincing slide was the linear relationship between the chance of being wrong or "Ch-bong" and the "Technical Pain Index". I'll have to try to get a copy of his slides, very educational. Today we wrapped up at lunch time and were bussed to Logan.

So, here I am, now with only about 3 hours until boarding. Thanks everyone for a really productive scientific week (If slightly hard on my liver). Now I am going to silently slip into a coma and possibly come out for my defense in August.


Sunday, June 13, 2010

Science is mean

Thad Guy has quit. Years ago. He did leave some immortal insights for posterity.

That is why science is evil, and the scientific method is the work of the Devil.


Tuesday, June 08, 2010

A spotted purple zebra

In medical school you learn that you should keep a weather eye for horses, not zebras (unless you live in Africa, possibly). The question is: How do you catch a zebra when one unexpectedly but inevitably shows up?

Zebra trying to hide, pretending to be a urinary tract infection.

Luckily, you do exactly what you usually do. When on the savannah, you shoot everything. What kind of wall trophies you get depends on whether you bring a gun or a camera. If there was a zebra there, even if it tried to hide, you'll have a zebra on the wall when you get home. When in the coal mine that is the ER, or the peat bog of general practice, you exclude the dangerous and the common and then you start excluding the less common (or refer for that purpose). The trick is to not fall for the obvious, common and dangerous diagnosis, and to remember to ask yourself how you account for the unexpected finding that doesn't fit.

So, why this sudden elaboration? Well, we just spotted a zebra, and not just any zebra, but a purple spotted zebra.

Wish us luck.