Recently a friend of my husband’s in San Diego had a mammogram that showed some suspicious microcalcifications in her right breast.  She underwent a stereotactic biopsy which revealed ductal carcinoma in situ, the earliest form of breast cancer also known as stage 0 breast cancer.  This type of cancer is non-invasive and does not metastasize, however, if untreated it can progress or recur as a more serious type of breast ...

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When babies are born prematurely, they often lack surfactant: a soapy substance produced in the lungs that helps to keep the air sacs open. Without surfactant, these tiny babies fight to breathe, a condition known as infant respiratory distress syndrome. Within the past 50 years, the delivery of artificial surfactant therapy has revolutionized neonatal care, saving many lives that previously would have had no chance at survival. As a neonatal intensive ...

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I see patients with abdominal pain every day. Over my career, I’ve sat across the desk facing thousands of folks with every variety of stomach ache imaginable. I’ve listened to them, palpated them, scanned them, scoped them and at times referred them elsewhere for another opinion. With this level of experience, one would suspect that I have become a virtual sleuth at determining the obvious and stealth causes of abdominal ...

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shutterstock_205278607 Everyone yells at their kids. Oh, I'm sure there are some truly perfect parents out there who don't (and some who don't because they are physically unable to yell), but the rest of us do. Parents are human; we all get frustrated, angry, exhausted and scared and, well, yell. But yelling rarely helps. It usually makes things worse. And it makes us ...

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asco-logo A friend of mine died after outliving her prognosis for more than a year. I was with her at almost all her appointments with various oncologists. She had asked me to be the note taker for these appointments so that she could focus on the discussion as it happened and then have the notes to review afterwards. Her treatment course was ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 25-year-old woman comes for a preconception evaluation. She has a history of hypertension that is well controlled with lisinopril. Medical history is otherwise unremarkable. On physical examination, blood pressure is 134/86 mm Hg in both upper extremities; other vital signs are normal. Results of the cardiovascular examination are unremarkable. There is no ...

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The life cycle of a medical advance usually goes something like this: from discovery at the research bench and replication of findings to translational research and clinical trials, to implementation. The bottleneck can be at any one of these stages, and often it is in the discovery one; we just haven’t yet found the thing that works. But other times, we have -- the intervention works, we have shown and confirmed ...

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When I was in nursing school there was always a lot of eye-rolling when it came time to discuss nursing diagnoses.  This was mostly because nursing diagnoses were followed by book-length nursing care plans that we had to produce for various imaginary patients. There was also a faction, including myself, who thought a medical diagnosis was just fine, thank you, no need to reinvent the proverbial wheel. For example, for a ...

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We have a problem in this country with how precious organs for transplant are allocated. The problem has been brewing for years, and is well recognized in the transplant community, the physicians and institutions that perform them. Two recent opinion pieces review the issue well: "Very Complicated Math — Reconfiguring Organ Allocation," and, "Transplantation Traffic -- Geography as Destiny for Transplant Candidates." Since PICUs such as mine are ...

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The Lumberjack World Championships, coming up for those interested in Hayward, Wisconsin in late July 2015, appear to be very impressive. Contestants are judged on a diverse array of aptitudes, from chopping and sawing to pole climbing and log rolling. One presumes the criteria for winning each of these are clear and as objective as possible. There is a panel of master lumberjacks to help oversee the judging. In short, as a ...

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