american society of anesthesiologistsA guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Before undergoing surgery, you should carefully discuss your medications with your surgeon and physician anesthesiologist. You may fare better during the operation and the early recovery phase if you continue required medications, but you might need to avoid some medications that could interfere with your anesthesia. Three ...

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Millions of people are diagnosed with irritable bowel syndrome (IBS) every year making it one of the most common gastrointestinal (GI) conditions. Despite its prevalence, there remain many misconceptions about IBS among both patients and doctors. Here we review some basic concepts in hopes of demystifying this nebulous syndrome. What is IBS? Irritable bowel syndrome is defined by a constellation of symptoms including abdominal pain and altered bowel habits (diarrhea or constipation) ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 58-year-old woman is seen for a follow-up evaluation of Parkinson disease, which she has had for 12 years. She was initially treated with ropinirole to which levodopa-carbidopa was added as the disease progressed. After 5 years of good control on medication, she began to experience involuntary generalized twisting and writhing movements ...

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Disneyland is in the news, and not because it is the most magical place on earth.   It also is the origin of the most recent rubeola measles outbreak, now spread to seven states and Mexico with over eighty cases diagnosed so far.  Unvaccinated children are being kept home from school in some California districts and vaccination requirements once again have become a battleground between  public health agencies and the “right ...

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This past Christmas holiday, an as-yet-unidentified “index case” -- the first person to start an epidemic -- visited Disneyland in California. Five employees became infected, along with dozens of visitors to the park. Since then, the outbreak has spread to about 80 people, including people who’ve caught it not directly from visiting Disney, but by coming in contact with Disney cases. These “secondary” cases will soon lead to “tertiary” cases ...

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I saw the movie Cake tonight. I felt it was my duty. I am, after all, a pain specialist. I’d read that it was gritty, honest, and accurate, and that Jennifer Aniston was very convincing. I found all that to be true. It’s the show’s first weekend in Louisville theatres, and the crowd at this 5:30 p.m. showing was decidedly mature, reverently attentive, and noticeably equipped with more walkers and canes than ...

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The big medical news recently was that sitting hours a day is taking years from our lives, whether we exercise or not. We have heard similar things before, so the now reiterated message is: Yes, we are sitting on a major health risk. Sitting is the major health risk! The new study, a meta-analysis in the Annals of Internal Medicine, purportedly adds precision to the estimate of risk. There ...

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“Hefur þú lært um Staphylococcus aureus?” I almost don’t recognize the bacteria name because my grandmother pronounces it differently in Icelandic. “Já–” I’m about to translate my microbiology flashcard for her when she interrupts, her hands busy kneading the cookie dough and her eyes on my little sister near the oven. That’s the bacteria that almost killed her eleven years ago, she tells me. I can hear her words building up. This ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 72-year-old man is evaluated for dyspnea at rest. He has end-stage COPD and is on a home hospice program. He has weight loss, reduced functional capacity, and muscle atrophy. His medications are ipratropium, salmeterol, fluticasone, albuterol as needed, and prednisone. He is uncomfortable, with chronic air hunger that has gradually increased ...

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The really incredible advances in the treatment of hepatitis C bring to life several relevant questions as we move forward into 2015. First, who should be treating hepatitis C patients (primary care providers, gastroenterologists, infectious disease specialists)? Second, can we really afford to use these new treatments? I recently discussed this topic with my GI and hepatology colleagues in AGA Perspectives, the bi-monthly opinion magazine of the
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