asco-logo I run a dilator program for women with rectal or anal cancer where I educate patients about the need for and correct use of vaginal dilators to mitigate the effects of radiation on the vaginal wall. Many women don’t understand the need for dilators after radiation for this cancer, so I always start with a description of the anatomy and ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 68-year-old man is evaluated for a 3-year history of dyspnea on exertion. He experiences no headaches or blurred vision. Medical history is notable for a stroke 2 years ago. He is a smoker with an 80-pack-year smoking history. Medications are hydrochlorothiazide, lisinopril, aspirin, and simvastatin. On physical examination temperature is 36.7 °C ...

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Recently, new dietary guidelines were released, recommending reducing sugar intake overall, and reducing meat intake in growing boys.  Last year, as we remain in the throes of a nationwide obesity epidemic, the FDA changed the nutritional labels we’ve become all-too-familiar with. The emphasis is now on calorie count of an "appropriate" serving size. So much for my pretending that the "appropriately served" pint of ice cream I just downed had 350 ...

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Sometimes as a travel medicine doctor you feel like Red Riding Hood’s mother. Your patients come in asking for advice about upcoming travels. Much like Red’s mother you want to wrap your patients up in a protective cape and guide them on safe travels. You want to teach them to avoid any wolves that may be lurking out there. Like impetuous teenagers, your patients don’t always listen. And Zika virus just made it worse ...

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My son Acton is truly a miracle baby because he was not even supposed to be here. I had gone through four years of infertility with three miscarriages and an ectopic pregnancy (pregnancy in my fallopian tube), causing my left tube to be removed. After my last miscarriage, I was told I was in perimenopause and had less than 1 percent chance of ever getting pregnant again, let alone carrying ...

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“Hey mon, you alright?” “You have a blessed day.” “How is your morning walk pretty ladies?” “Yeah mon, no worries. Everything alright.” These "stock phrases" are just a few of the things I heard each and every day while staying in Negril, Jamaica. I travelled to the island to take a short vacation and also attend a destination wedding this past month. While on the island, I was pleasantly greeted by the local Jamaicans ...

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It was that time of the year at the cancer center -- with treats all around, chocolates, cookies and gingerbread houses, gifted from the patients to their doctors. Yes, it was the excess sugar holiday season. Most of these patients were follow-ups --  the already established patients of the cancer center, expressing their gratitude in taking care of them in the tough times earlier in the year. Among all the ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 50-year-old man is evaluated in follow-up after hospitalization 6 months ago for a large bleeding gastric ulcer. Tests performed for Helicobacter pylori infection at that time were negative. However, for the 3 months before hospitalization he had been taking ibuprofen for chronic back pain. He was discharged from the hospital on omeprazole, ...

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At the J.P. Morgan Healthcare Conference in San Francisco, Mr. Andrew Slavitt, acting administrator at the Centers for Medicare & Medicaid Services (CMS), announced on January 11th that, “The meaningful use program as it has existed will now effectively be over, and replaced with something better,” and later clarified on Twitter that, “In 2016, MU as it has existed-- with MACRA-- will now be effectively over and replaced ...

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Computed tomography (CT) is a powerful diagnostic tool that allows rapid diagnosis of disease.  CT is widely available in the U.S. and is a mainstay of medical diagnosis.  Estimates state that 85 million CT scans were performed in the U.S. in 2012.  To create images, CT scanners pass ionizing radiation (x-rays) through the body thereby exposing patients to radiation.  Patients who are imaged with CT have a theoretical ...

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