Issue #15 (December 2020)


Dear Reader,

When we think of the COVID-19 pandemic, we often view it from a clinical perspective: an infectious disease causing bodily chaos that must be treated.
Yet as MJ’s “ops guy” (accountable for areas such as finance, HR, and customer success), I view it differently: COVID-19 is a societal problem that must be addressed from a systems perspective.

The institutions helping run our communities, the protocols determining our interactions, the logistics networks allocating our resources, the cultural habits guiding our relationships: all are affected; and all should be treated.

Perhaps this is an opportunity to bravely rethink what our civilization has built; and deconstruct the old to build something more robust. It may seem daunting, but take it from us: these challenges are thrilling and worthwhile.

Start with one small piece of the system, and then take it from there.

Miguel Angel Molina
Chief Operating Officer
Medical Joyworks, LLC


The latest from MJ

  • Ever wonder what a camel has to do with tropical diseases? In this month's edition of Meet an IMB Member, Dr. Ludovico Cobuccio, guest scientist at the Medicine Department of the Swiss Tropical and Public Health Institute (SwissTPH) and a physician-scientist at the Digital and Global Health Unit of Unisanté in Lausanne, Switzerland, tells us about his adventures in confronting infectious tropical diseases.
  • We continue to seek specialists to join as peer-reviewers under our MJ International Medical Board. If you want to get involved and are a specialist (or specialist in training), click here. The specialties we most need help with are: orthopedic surgery; pediatrics; obstetrics and gynaecology; neurosurgery; intensive care/critical care; psychiatry; urology; ear, nose and throat surgery; and dermatology.
  • Christmas, Bodhi Day, Hanukkah, New Years, and other important celebrations are all just around the corner. Despite these challenging times, we hope that you have an opportunity to enjoy them with loved ones safely.
  • Thank you for being a part of our community throughout 2020. It has been a remarkable year, with great challenges but even greater accomplishments (not just for us but for everyone, we believe). May 2021 continue this positive trend, with many blessings for all. Seasons Greetings!


International Medical Board Members

Name: Dr. Ludovico Cobuccio
Speciality: Internal Medicine and Tropical Medicine
Designation: Physician-Scientist
Work institute:
  • Swiss Tropical and Public Health Institute, Basel University, Switzerland
  • Digital and Global Health Unit, Centre for Primary Care and Public Health, Lausanne University, Switzerland.
Graduated from: Insubria University (Varese), Italy.
Twitter: @DrLuCob
What attracted you to your specialty?
I had always found infectious diseases (and tropical diseases in particular) fascinating. Infectious diseases is an extremely broad speciality, covering all organ systems; and has links to all specialities. Moreover, I truly enjoy the detective-like approach required for solving the complex cases one often finds in this specialty.

What have you learned about your specialty solely from experience?
I’ve learned that, when dealing with returning travellers who present a bizarre clinical picture, a thorough patient history is essential. I’ve learned to ask questions that may be considered weird at first sight. Questions such as: "did you help any camel to give birth?" can help you solve the mystery.

What is a common misconception associated with your field of study?
I’m subspecialising in tropical infectious diseases. So, naturally that means: sunshine, floral shirts, and the occasional clinic under the shade of a palm tree... Right?

What is your biggest research interest today?
Clinical decision support algorithms (also known as clinical decision support systems), technologies used to help improve patient care. I find them particularly interesting as when applied to mitigate antibiotic resistance in low and middle income countries.

What publication/research are you most proud of?
Well, I haven’t published much - yet. My career as a clinical researcher started just recently. I guess I could say that I’m very proud of what will be my next publication (coming soon)!

In your opinion, what is the greatest challenge in your field today?
Tropical infectious diseases still represent a great burden for the healthcare systems of low and middle income countries. Despite this reality, research in the field is heavily underfunded. I think that being able to do good quality research with limited resources was - and remains - the greatest challenge.

What will be a game-changer innovation in your field?
Host transciptomic point of care tests (where one can reliably study the complete set of RNA transcripts that are produced by the genome), integrated with digital tools to circumvent current limitations of pathogen-based assays, is certainly one of those game-changes. Being able to measure global patterns of host responses to infections represents a new paradigm for the diagnosis of infectious diseases at any scale.

How has MJ helped advance your professional objectives (in terms of teaching, research, management, personal development, etc.)?
I started using Prognosis while in university. I remember it being rather amusing, and it also provided a great way to test my knowledge. Later, I began reviewing clinical cases for Medical Joyworks as an IMB member. My IMB work requires careful attention to detail, plus the ability to convey a clear message to the end user (or reader). It’s been a great opportunity to practice skills that are essential for my day-to-day life as a clinical researcher.


Recently released stories

Stretched - Play it free online
Lumpy - Play it in Clinical Odyssey
Confused - Play it in Clinical Odyssey
Fearsome - Play it free online
Insidious - Play it in Clinical Odyssey
Even More Weakness - Play it in Clinical Odyssey
Croup - Read it free online
... and more.


Q&As from our user community

Clinical Sense: Heated (Heat Stroke)

Q: I'm confused. You've listed both internal and external cooling methods to manage this patient with heat stroke. Which should we use in practice?
A: In practice, you'd want to use a combination of both external (e.g., evaporative cooling or immersion) and internal (e.g., gastric, rectal, or bladder lavage) cooling. The following article covers these approaches in detail:
If you would like to play this scenario or join the conversation, go to the Clinical Sense app in your mobile device.

Prognosis: Your Diagnosis: Failing (Myelofibrosis)

Q: This patient has myelofibrosis. His serum EPO is already high. Is there a point in giving additional synthetic EPO?
A: Yes, this patient has a high serum EPO level. However, this is still an inadequate response. Current evidence supports treatment with an erythropoiesis stimulating agent, given that he has low risk disease. The following guideline from the NHS explains this in more detail:
If you would like to play this scenario or join the conversation, go to the Prognosis: Your Diagnosis app in your mobile device.
That's all for now!

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