I donated blood today. I'm one of those people who doesn't shudder at the thought of needles piercing my skin, or get queasy as I watch the blood drain from my vein into the collection bag. It's no big deal. I eat the cookies and drink the juice afterward, and I kind of enjoy talking with the elderly volunteers. I think I'm lucky. I know so many people who are sickened ...

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I walk into the exam room on a Friday afternoon to find a 16-year-old female who is coming in to see me for a sport physical. On paper, everything looks great: Her vital signs are on point, she’s a straight A student, vaccines are up to date, she eats healthy and exercises regularly, Mom and Dad are still happily married and she’s not dating an abusive senior who is pressuring her into ...

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Today, I talked at length with that lady whose husband has Creutzfeldt–Jakob disease (CJD). That patient -- the one with arbitrary myoclonic jerks, always naked and uncovered by blankets due to uncontrolled flailing, his penis and Foley catheter exposed. That one with overgrown mycotic toenails and eyes that are always only half-open, his gaze drifting everywhere. He was until now just a patient for me -- the CJD patient. Yet today ...

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Because of their beauty, their amazing biology, and their use in developing medicines, venomous animals are found in captive collections far beyond their native ranges. Fortunately, accidents involving them are rare. But people who take care of such animals need to be prepared for an emergency, and if they wait until the last minute things can go very wrong. Speaking as one who receives emergency calls, I offer the following ...

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In my first quarter of medical school, I learned about prenatal screening for cystic fibrosis (CF), a progressive multisystem disease caused by an autosomal recessive mutation in the CF transmembrane regulator gene. We also learned about bronchiectasis, a common pathology of CF that consists of the irreversible enlargement of airways, promoting continuous low-grade bacterial infection and causing deadly respiratory failure. But despite my hours of studying and memorization, these clinical facts ...

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Yet again, the topic of breastfeeding has been discussed in the mainstream media and -- not surprisingly -- was depicted in a less-than-factual way. It seems every few weeks these stories surface, and usually it’s a mom who’s been shamed for nursing in public. It happens so often I have almost stopped paying attention because they are so equally infuriating and repetitive. This time, however, it was the ...

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Medical literature is full of studies showing that most diets don’t encourage long-term weight loss. In fact, the majority of diets lead to weight gain. Most people end up gaining back the few pounds they’ve lost within a year of dieting -- plus a few extra pounds on top of that. There are many theories for why this happens. An article from the New England Journal of ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 54-year-old man is seen for follow-up evaluation of a tremor in his upper extremities that has been present since age 20 years. The tremor was mild for many years and did not interfere with his work but has become more prominent in recent years. He has difficulty writing and using utensils ...

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Spend spend spend -- that’s the push by marketers and websites this time of year. Except from me. Here are three holiday gift things nobody needs. Save your money, or buy something else if you must, but stay away from today’s featured items: 1. Crib bumpers. The American Academy of Pediatrics has called for banning these things since 2007, but they’re still sold. And they’re still killing babies. A November ...

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The clues are usually there, even in the hardest of cases. They just aren’t presented to you on a silver platter. Gwen Stephenson had an ill-defined polyarthritis and had been on methotrexate for some time. Her rheumatologist, Norm Fahler, had tapered her off the medication while keeping an eye on her inflammatory markers and they had leveled off at just above the normal range. Seven or eight years ago, Gwen had suffered ...

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