News reports covering a prostate cancer study recently in the New England Journal of Medicine have all pretty much come out with the same message: men diagnosed with prostate cancer who had radical surgery did much better than men who were assigned to "watchful waiting" after they were diagnosed. But guess what? There's a critical fact that seemed to be missing in much of the coverage I saw. And that fact ...

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Having now lost more than 30 pounds, I am very close to declaring victory (maybe a few more pounds over the next few months).  A colleague has asked me to write my tips as a handout for patients.  This is a daunting task, but that has never stopped me! The weight loss formula is simple and well known.  Achieving lasting weight loss remains challenging.  The mathematical formula is simple.  Weight loss ...

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Adults are the ones who are supposed to be stressed, not kids. Childhood is supposed to be the stress-free part of life, right? Well, maybe not. At least not for teens. According to a recently released survey from the American Psychological Association, teens are actually more stressed than their parents. Researchers surveyed 1950 adults and 1,018 teens last summer and asked them a whole bunch of questions about the stress in their lives, and how ...

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Daylight saving time is approaching again. At first glance, it might seem enough to just remember to spring forward. But do you realize daylight saving time is one of the grandest social engineering experiments in America? Almost the entire country moves their schedule up one hour. Every meeting, romantic dinner, and heart transplant occurs one hour later. Every business, court appointment and movie showing is one hour later. In virtual lockstep, ...

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As a nation, we are constantly monitoring and appraising the economy and our financial health.  We gather a tremendous amount of information to assess this. The Census Bureau randomly selects 60,000 households each month, unleashing a swarm of 2,000 field representatives to track down the selected participants and assess their employment status. The Bureau of Labor Statistics surveys 500,000 businesses to estimate job creation.  Approximately 5,000 “consumers” are surveyed ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 43-year-old man is evaluated in the hospital for severe abdominal pain of 2 days' duration. He is otherwise healthy except for the recent finding of pancytopenia. Family history is noncontributory. His only medication is a daily multivitamin. Following a physical exam and lab results, what test is most likely to establish ...

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The media headlines attached to the major medical news story of the past week might have been: "Shocking but true: Nearly 1 in 10 US children under the age of 5 is obese!" Had that been the headline, it would indeed have been every bit as true as it is shocking. And the really shocking part is: that's the good news! Hold that thought, please. Some years ago, at the prompting ...

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Vaccine coverage rates, overall, remain very strong in the USA. Well over 90% of kids are well-vaccinated, and the rates of vaccine-preventable diseases remains very low. Newer vaccines have proven especially safe and effective, including immunizations against severe diarrheal illness and cancers of the cervix and throat. In many ways, we are staying ahead in our battle against vaccine-preventable disease. Yet: there are still pockets of intense resistance to vaccines, ...

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When it comes to high blood pressure treatment in the elderly, the plot continues to thicken. Last December, a minor controversy erupted when the JNC hypertension guidelines proposed a higher blood pressure (BP) treatment target (150/90) for adults aged 60+. And now this month, a study in JAMA Internal Medicine reports that over 3 years, among a cohort of 4961 community-dwelling Medicare patients aged 70+ and diagnosed with hypertension, those on blood pressure medication ...

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Physicians and patients collaborate to treat symptoms. This is not newsworthy and even sounds appropriate. Isn’t that what doctors are trained to do? It is but I’m not sure this should be a central focus of our healing mission. Treating a symptom is not the same as treating a disease. For example, if an individual is having abdominal discomfort, pain medicine should not be the first responder, even if this would ...

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