If another case of Ebola emanates from the unfortunate Texas Health Presbyterian Hospital, the root cause analysts might mount their horses, the Six Sigma black belts will skydive and the safety champions will tunnel their way clandestinely to rendezvous at the sentinel place. What might be their unique insights? What will be their prescriptions? One never knows what pearls one will encounter from after-the-fact risk managers. I can imagine Caesar consulting a Sybil ...

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Did you know that your digestive tract contains over 400 different types of bacteria? This complex ecosystem is called intestinal microflora. The concentration of bacteria in the gastrointestinal tract increases dramatically moving from the stomach towards the colon. In humans, the intestinal microflora is vital in many important functions including digestion of nutrients and prevention of infection. Disruption of the “normal flora” can lead to many problems including diarrhea, bloating, ...

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Ebola is everywhere. Turn on the television, and you will see the headlines. “Ebola in America.” Or, “Hospital worker who handled Ebola is on cruise.” And then there is the “Ebola fears prompt parents to keep children home from school.” The headlines go on. Go onto Facebook or Twitter, and you will see Ebola as the most viewed article, or the most tweeted topic. Ebola is everywhere. Ebola is incredibly infectious. Ebola is ...

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A recent case that I saw in consultation at the patient’s request highlights the pervasive problem of overdiagnosis and overtreatment of endometrial hyperplasia. This 46-year-old woman was diagnosed with simple hyperplasia without atypia within an excised endometrial polyp, for which both her gynecologist and pathologist recommended hysterectomy. The basis for this recommendation was a perceived increased risk of endometrial cancer, either currently lurking within her uterus or to be developed ...

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Ebola: Whos looking out for the nurses? Being a nurse is a risky job.  Needle-stick injuries, violence, back injuries, and infectious disease are all potential threats.  But until recently, nursing was not usually viewed, like police work, or commercial fishing, as a life-endangering career choice. Those who risk their lives for their work go into it knowing the risks, and receive intensive training and protective gear. Not so the ...

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Nancy Snyderman shows indifference for her role as a medical communicator I wish Dr. Nancy Snyderman the best of health. I'm happy that she remains free from the deadly Ebola virus, and hopefully it will stay that way. It must have been extremely difficult for her to be under quarantine, especially since she was feeling healthy. It's simple: When you feel good, you want to be active. In Dr. Snyderman's case, she ...

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With all the news about enterovirus 68 sending hundreds of children to hospitals, it's easy to panic when you hear about a case in your neighborhood -- or, even worse, if your child starts coughing. But please, don't panic. This virus has certainly caused trouble and tragedy. But enteroviruses are incredibly common, causing 10-15 million illnesses a year -- and usually, those illnesses are minor. This one, for reasons we ...

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Polypharmacy, or use of multiple psychiatric drugs, for treatment of attention deficit hyperactivity disorder (ADHD) is on the rise. A recent study compared treatment with basic therapy (stimulants plus parent training) with augmented therapy (those two plus risperidone, an atypical antipsychotic). The study concluded that treatment with risperidone was superior. When children show dramatic improvements in behavior on risperidone, now being prescribed with increasing frequency for ADHD and a range ...

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Josh Green’s novel -- and recent film -- The Fault In Our Stars (TFIOS) is a new classic of young adult fiction, deservedly famous, and it’s easy to see why. The story is simultaneously deeply sad and really funny, mostly due to the narrator, Hazel. She is an intensely likable 16-year-old, who charms you even while she explains, stoically, that she is dying of thyroid cancer that has spread to ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 30-year-old woman is evaluated for episodic migraine without aura that first presented in high school and has persisted into the third trimester of her current pregnancy. The headache attacks occur two to four times monthly and last 12 to 24 hours. She experiences moderately severe pain, significant nausea, no vomiting, and ...

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