I am going to confess that I am my children’s pediatrician.  I have given them every vaccination they have ever had and probably would not trust another provider to do it.   I endorse the vaccination schedule recommended by the American Academy of Pediatrics; I believe it is safe and prevents disease.  I completed medical school and three years of pediatric training that helped shape this belief.  I have seen death ...

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The cancer moonshot initiative raised skepticism because of the limited funding to end cancer. Unfortunately the recently announced panel membership confirms that while the project may launch, skewed representation may tilt the mission off course. It is no surprise that the panel heavily tilts toward immunology, medical oncology, surgery and big science. But three core specialties you would find at any tumor board are missing: pathology, radiology, and radiation ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 55-year-old man is evaluated following a screening for type 2 diabetes mellitus. He is asymptomatic. He has a history of hypertension and hyperlipidemia. There is no history of anemia, liver disease, or kidney disease. Medications are lisinopril and rosuvastatin. On physical examination, blood pressure is 123/76 mm Hg and pulse rate ...

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When I think back about what I learned about drug addiction in medical school in the 1980s, I can’t think of much. Sure, I talked to plenty of patients who had been snorting coke and injecting heroine. One man with AIDS promised to teach me how to draw blood, if I’d sit by his side and keep him company. He didn’t have any other visitors. Maximum security prison where he was ...

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This post is purposely controversial.  I write it because I believe that mounting evidence suggests that we should encourage “out of the box” thinking about this issue.  This post is hypothesis challenging.  I may be right, or I may be wrong.  I hope we get some debate on my speculations. The latest blow to the cholesterol hypothesis: "Dashing Hopes, Study Shows a Cholesterol Drug Had No Effect on Heart ...

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Over the past few months, the federal government has mobilized against what is being called "the opioid crisis": a national epidemic of fatal overdoses that in 2014 claimed more than 14,000 lives, the most ever recorded. Since most of these opioids were originally prescribed by physicians to treat pain, the Centers for Disease Control and Prevention recently finalized a guideline containing recommendations for appropriate opioid ...

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“One can dream.” That’s often a quote we hear when we talk about winning the lottery or landing a job that lets us do something great like being a taster of new ice cream flavors for a living (I wish). However, what’s sad is that many American moms utter those same words when they think about life after baby. A year of paid maternity leave. Access to a good lactation consultant. Family members who ...

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Today’s restless society has taken its toll on modern medicine. Among all the strategies for protocol optimization and health insurance improvements, doctors get to spend less and less time actually talking to their patients. Each check-up needs to be performed in a certain amount of time, and every procedure needs to be completed as quickly as possible so that hospitals are efficient and profitable. While this makes perfect financial sense, it ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 77-year-old woman is evaluated 4 months following a left middle cerebral artery ischemic stroke. The severity of her stroke required prolonged initial hospitalization and a 3-month stay in a rehabilitation center before returning home. Residual deficits include dense right-sided hemiparesis and dysphagia requiring oral feeding with thickened liquids. Medical history is ...

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We are born with arms wide open, and we die in much the same way.  It is that which we carry, in the time between, that defines us. The newborn, caught in the primordial stew of beginnings, is unable to recognize the difference between self and other.  She grasps and roots at inanimate objects with the same voracity she reaches for her mother.  It is a time of differentiation, a time ...

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