Medical webwatch.

When you visit Reactome http://www.reactome.org/cgi-bin/frontpage?DB=gk_current, select "Hemostasis" from the matrix of 23 pathways to view the amazing clotting cascade. The cascade opens as a hierarchy of events with each base item presenting details of a section of the pathway with associated biochemical input and output sequences, participating molecules, preceding and following events, etc. The technique of reducing the cascade into manageable bits works well and is supported by a user guide on the top menu. The website is from a coalition of Cold Spring Harbor Laboratory, European Bioinformatics Institute, and the Gene Ontology Consortium, and describes itself as "A curated knowledgebase of biochemical pathways ... authored by biologic researchers with expertise in their field, maintained by the Reactome editorial staff." Pathways are available for to up to 14 species, including good old Homo sapiens.

At GeneTests http://www.genetests.org, click "GENE Reviews" on the menu bar and scroll to "Titles" for a huge A to Z index of diseases that have a genetic-based etiology. Each is considered under: "Summary," "Diagnosis," "Testing," "Molecular Genetics Testing," "Physical Abnormalities," "Diagnosis and Differential Diagnosis," "Prevalence," "Management," "Treatment & Therapies," and "Genetics Counseling." A very necessary keyword-driven glossary appears in a small window below the scrolling text. Although some of the molecular genetics tests are quite esoteric, each overview is balanced by more clinical considerations ending with a collection of outsourced help and support references. Sponsored by the University of Washington, Seattle, it describes its mission as: "By providing current, authoritative information on genetic testing and its use in diagnosis, management, and genetic counseling, GeneTests promotes the appropriate use of genetic services inpatient care and personal decision making."

The author of Differential Diagnosis in Musculoskeletal Imaging http://www.rad.washington.edu/mskbook, Michael L. Richardson, MD, from the University of Washington School of Medicine, says: "There are already plenty of good books out there on introductory musculoskeletal radiology. Why did I write this syllabus? Because, it seemed to me that most of these books were doing a great job of telling one about diseases, but not how to approach their diagnosis." This is a light and easily assimilated synopsis in 16 medium length chapters with loads of diagrams and x-rays.

Also from Michael L. Richardson, MD, Radiologic Anatomy Teaching Modules http://www.rad.washington.edu/anatomy presents annotated CT and MRI scans accompanied by mpegs that scroll through the CT sections. Menu option "6" offers a "Radiographic Anatomy of Skeleton" that has exquisite x-rays images with unambiguous annotation.

Literature Arts and Medicine Database http://endeavor. med.nyu.edu/lit-med/lit-med-db/poems.audio.html is "a bibliography of prose, poetry, film, video, and art which was developed to be a dynamic, accessible, comprehensive resource in medical humanities, for use in health/prehealth and liberal arts settings." It is produced and maintained by the Hippocrates Project, the multidisciplinary development laboratory for application of information technologies to medical education at New York University School of Medicine. From the list of writers click through to a summary their work and to listen to audio presentations. The menu also offers "Art" and the "Performing Arts." This website offers a deep and reflective oasis in your busy day.

Hardin MD http://www.lib.uiowa.edu/hardin/md/index.html is a readily accessible source for medical illustrations that can be searched via the 15 subject clusters on the front page or via an alphabetical listing. Progressing through the subcategories will deliver a short list of information providers and a list of resources for the images sought. Of necessity such an eclectic resource returns a number of sources for a given image, but browsing through these is an interesting pass-time in itself.

Free registration at Websurg http://www.websurg.com/homepage/index.php will open a busy front page presenting surgical videos, audio visual lectures, and operative techniques. The WebSurg concept was launched by Professor Jacques Marescaux and his team at the European Institute of TeleSurgery in Strasbourg, France. They say: "Our goal is to provide the surgical community, scientific societies, medical teaching centers, and industries with the first, worldwide, online training in surgery, information on the latest surgical breakthroughs and the possibility to chat with surgeons and experts from all over the world." Registration for CME credited courses is available. The virtual university tab on the top menu bar lists surgical videos by category, while the "Surgery Updates" tab offers the latest videos, lectures, expert interviews, and editorials. Cut!

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