Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 23-year-old woman is evaluated for a 1-year history of morning stiffness and achiness of the hands as well as Raynaud phenomenon. Two months ago, she experienced a sun-induced rash on the chest and back and patches of discoloration on the hands. On physical examination, temperature is 36.4 °C (97.5 °F), blood pressure ...

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Cancer patients depend on denial.  Without its protection, we would be overwhelmed by terror.  Denial filters and slows bad news, so we can digest reality in the merciful morsels; thus, we cope.  Without denial, we would shut down, withdraw, and lose hope; healing would not be possible.  However, if we do not move beyond denial, accept the diagnosis and loss, make a plan, we die. Allen, a 43-year-old man, came to ...

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blueandblackdress2-770x457 My mother-in-law texted me about The Dress, random friends are blowing up my inbox, and the nurses in the emergency department were huddled around the computer at 2 a.m. debating the color of the dress. Everyone in the world seems to be wondering what color the dress really is and why. The best way to find the answer to such questions is to find ...

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Some people who argue against vaccinations claim that vaccine policies infringe on their “rights” -- their rights, as parents, to make medical decisions for their children. It’s a scary, misleading, and chilling message. We need to be careful about where one person’s rights end and the next person’s rights begin. We need to remember that children (their children, and your children too) have rights of their own. For example, Dr. Bob ...

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Recently, Ohio became the 20th state to pass a law mandating that hospitals and clinics performing mammography screening to notify a patient in writing if results suggest something known as "dense breast tissue."   Standard mammography creates a 2-D image of breast tissue.  In general, this is sufficient for screening purposes.  However, especially in younger patients, the presence of dense breast parenchyma can lead to higher false negative readings and ...

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The high cost of health care in the United States in part relates to how clinicians are paid. Performing expensive and often risky procedures simply pays better than engaging patients in a shared decision-making conversation. Shared decision-making (SDM) is a process where clinicians and patients educate each other about treatment options, risks and benefits, and preferences, and then they decide on the best approach together. Patient decision aids can assist ...

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As medical librarians, we’re certainly the first to say that PubMed is a superb database, elegantly crafted at the National Library of Medicine to do fast and efficient searches for almost all medical and health subjects. Much of the power of PubMed is that it makes it possible to search broad subjects easily. When the user searches “cancer,” for example, PubMed quickly finds thousands of citations on all types of ...

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I sometimes think doctors forget what it’s like to be patients. But I’ve been there, and I know how frustrating and scary it can be. I remember one night, I was lying in a hospital bed, resting peacefully. I heard a noise and opened my eyes to a room full of chaos. Nurses everywhere. A crash cart. Someone holding paddles. I tried to speak, but couldn’t. And then I got it out: “Please don’t.” Here’s my story: Before ...

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“I had no idea how much cancer sucks.” My patient’s observation seems silly, basic.  Of course, cancer sucks.  It maims, humiliates and kills.  It takes.  What made the statement remarkable was its source.  This is not a medically naïve person, waiting to die. Rather it was spoken by a patient in complete remission, likely cured, who is an expert in cancer care.   To her amazement, it changed life forever. I think that ...

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The president's proposed Precision Medicine Initiative, as mentioned in his recent State of the Union address suggests it's probably time to get ready for some changes in our daily routines as health professionals. I'm not talking about the incredible information that has already been produced by researchers examining the human genome. Nor am I referring to the work that is going on in major cancer centers and elsewhere exploring how to better ...

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