Things I've Learned: Freezing Rain, Brownie Edge Pans, and The President Tree

Oh my, I've missed posting "Things I've Learned" for the past four Thursdays. I'll have to do better. This week has been my first one back from winter break and I knew that I'd have to get right back into the swing of things -- new hospital, new rotation, and plenty of call. My first full day off is January 31. Fortunately my staff consultant is wonderful and I've been learning plenty. Here is one medical thing and three other things that I've learned in the past seven days:

1. PRES -- This week I saw a patient who had had posterior reversible encephalopathy syndrome (PRES), something I had never heard of. It is a syndrome of headaches, confusion, seizures, and visual loss, secondary to brain edema (evident on MRI). It has a variety of contributing causes, including malignant hypertension, eclampsia, immunosuppressive therapy, lupus, and renal failure. It is diagnosed clinically, with supportive MRI findings, and is managed by treatment of its underlying cause.

   

   (http://en.wikipedia.org/wiki/Posterior_reversible_encephalopathy_syndrome)

2. freezing rain -- Yesterday I learned first-hand what freezing rain is. As I walked from my car from the grocery store, it started raining -- which I found odd considering it was -18 °C. When I returned to my car ten minutes later, it was coated with a thick glaze of ice. It was then that I understood that freezing rain is not, as I had previously thought, ice falling from the clouds, but rather supercooled liquid rain drops that freeze immediately upon impact with a surface. I had a tough time scraping the thick ice glaze off of my car windows. I don't know what I would have done had I been driving... No wonder it's such a hazard!
   
3. brownie edge pan -- For fans of brownie edge pieces (not really me -- any brownie piece will do!) I happened upon this innovative baking pan:

   

   (http://www.amazon.ca/Bakers-Edge-Brownie-Pan/dp/B000MMK448)

4. The President -- The President is a giant sequoia (redwood) tree located in California's Sequoia National Park. At 247 feet (75 m) high and 27 feet (8.2 m) wide, it is the third largest tree in the world. It is also the oldest known living sequoia, with an estimated age of 3200 years! The tree is so large that it took a team of National Geographic photographers and scientists 32 days to scale and photograph it, then stitch 126 separate photos together to, for the first time, showcase the tree in its entirety:

   

   The President
   (http://news.distractify.com/geek/science/after-126-separate-photos-scientists-have-captured-this-incredibly-tall-tree-in-a-single-image/)

What is something that you learned this week?