The Medical Joyworks Monthly


Connect to MJ's thriving community

Issue #24 (September 2021)


Dear Reader,

If August was a quiet month, September has been the complete opposite.

Perhaps because everyone is back from their well-earned holidays, we have seen a dramatic increase in Clinical Odyssey subscriptions, inquiries from customers, and even more business through our institutional partners.
Take our Clinical Odyssey subscriptions, for example. 

Since introducing the Free Subscriptions option in late May, we have witnessed this customer group grow by almost 4,000 percent. Even more outstanding is that 99% of these free subscribers are still using the product; more than 2% of them upgrade to a paid subscription; and roughly 40% those who upgrade do so within 48 hours of having opened a free subscription!

Naturally, this is great news for us—and more work; and we trust that it will translate into better and more products for our customers worldwide. It also means more opportunities for our writers, IMB members, and other partners to get involved.

So, let us rejoice for the start of the academic year in many parts of the world. And thank you—to you and to all of our customers—for this continued trust in what we do.

That is all for now. Have a great month!

Miguel Angel Molina
Chief Operating Officer
Medical Joyworks


The latest from MJ

  • Are you up for a writing challenge? We are seeking new freelance writing contributors to join our learning module creation activities. If you are soon to graduate or have already graduated from medical school, and have clinical experience, contact our editor, Dr. Stanley Sack at
  • To help us peer review learning modules, we need specialists in: general surgery, orthopedic surgery, pediatrics, obstetrics and gynecology, neurosurgery, intensive care, critical care, psychiatry, urology, neurology, nephrology, endocrinology, and pulmonology. If you are a specialist (or specialist in training), or know of someone who fits the part, have them contact Julia Botija at julia@medicaljoyworks.
  • That's it for now. Stay healthy, and curious!


International Medical Board Members

Name: Dr. Steven Zuckerman MD
Speciality: Neurology
Designation: Consultant Neurologist
Work institute: Baton Rouge General Hospital, Baton Rouge, Louisiana, USA.
Graduated from: Robert Wood Johnson Medical School of Rutgers University, New Jersey, USA.
What attracted you to your specialty?
I was intellectually challenged by the complexity of the nervous system. It seemed like an interesting field, where you could localize a lesion using a detailed exam. I had completed a residency in Internal Medicine, but my fascination for Neurology remained. So I then decided to start a second residency, this time in Neurology.

What have you learned about your specialty solely from experience?
The limitations of the neurological exam! I know that I am supposed to be old school and tout the benefits (and importance) of conducting thorough and detailed exams, but I often tell students to "never let a great neuro exam get in the way of a crummy MRI scan." (tongue somewhat in cheek—or with some sarcasm).

What is a common misconception associated with your field of study?
I used to have the saying that “Neurology is a field of diagnose and adios (goodbye in Spanish)," meaning that there were very limited therapeutic options available for treating the conditions we encountered. This is certainly not the case today. We now have very effective acute stroke interventions. The field of Multiple Sclerosis has exploded with treatment options. There are new antiseizure medications and surgical possibilities for patients with Epilepsy. The same is true for Parkinson's Disease. There has been a dramatic shift in emphasis, from being an obscure diagnostician to having effective interventions in our field. 

What is your biggest research interest today?
I do not have a research interest at this time. I am just a practicing neurologist.

In your opinion, what is the greatest challenge in your field today?
There are still several neurological conditions for which there are no effective treatments. Take, for instance, Alzheimer's Disease. Despite the U.S. Food and Drug Administration’s recent approval of Aducanumab, a new medication to treat Alzheimer’s, there still is a desperate need for useful interventions that can help treat this terrible condition. The same thing holds true for other neurodegenerative diseases.

What will be a game-changer innovation in your field?
I think that further interventions for diseases such as Amyotrophic lateral sclerosis (ALS), Parkinson's Disease, muscle and nerve disorders will be very important. I also believe that whole exome sequencing (WES), a technique for identifying the sequence of DNA nucleotides in a subject’s genes, will be a big game changer for previously unrecognized genetic / inherited diseases.

How has MJ helped advance your professional objectives (in terms of teaching, research, management, personal development, etc.)?
Medical Joyworks is enabling me to present important neurological information to a large group of students. I appreciate the opportunity to review these topics and ensure that I am providing the most up to date and accurate information to students. Moreover, teaching has been my passion and I derive personal satisfaction knowing that I am facilitating next generation physicians in the care of neurological disorders. To my mind, the concise and well-directed learning modules presented by Medical Joyworks are just what the doctor would order to help any student remember practical clinical information.


Q&As from our user community

Clinical Sense: Complicated (Statin Myopathy)

Q: You've suggested  atorvastatin 40 mg QD—i.e., 40 mg four times a day = 160 mg. That's twice the maximum daily dose! Did you mean 40 mg OD?
A: You highlight the peril of using abbreviations. “QD” (Latin: “quaque die”) means “once daily”; this is easily confused with, “QID” (Latin: “quater in die”) which means “four times a day.” On the other hand, “OD” (“once daily”) can be confused with “oculus dexter” (the right eye) in ophthalmological settings. The best solution is to explicitly state “once daily”, “daily”, or “q24h”—and this is what we will do ourselves in the future!
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: Totally Confused (Neuroleptic Malignant Syndrome)

Q: This patient with schizophrenia developed neuroleptic malignant syndrome (NMS) following olanzapine therapy. He will need antipsychotic therapy once more, after he recovers from NMS. Which antipsychotics can we consider? And how long should we wait before starting treatment?
A: Recommencing antipsychotic therapy after an episode of NMS carries the risk of causing a second episode of NMS. Hence, this should always occur in consultation with a trained psychiatrist; and in a setting in which the patient can be carefully monitored. A large part of this process is reviewing the indications for antipsychotic treatment, and counseling the patient and their family on the relevant risks and benefits.

Reintroduction of antipsychotic therapy should not occur for at least two weeks after resolution of NMS. Any potential risk factors should be minimized prior to recommencement. A low-potency, atypical antipsychotic with a low propensity to cause NMS should be chosen; and dose titration should be very gradual. Patients should be carefully monitored for early signs of NMS. For more information, see:
If you would like to play this scenario or join the conversation, go to the Prognosis: Your Diagnosis app in your mobile device.


Recently released stories

Stoned I - Play it free online
Heated - Play it in Clinical Odyssey
Adam I: sore throat - Play it in Clinical Odyssey
Another Lump - Play it free online
Dropped - Play it in Clinical Odyssey
Concealed - Play it in Clinical Odyssey
Croup - Read it free online
... and more.
That's all for now!

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