When I was a little, I used to love puzzles. You could find me with pen in hand, sprawled out on my bedroom floor, nose buried deep in word searches or my Highlights magazine. I wanted to know how things worked. I loved building block sets and making up games with my older brother during summer vacations. Over the years, that curiosity eventually morphed into my current profession as a ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 57-year-old man is evaluated for a diagnosis of acute kidney injury. He was diagnosed with gastroesophageal reflux disease 3 weeks ago and was prescribed omeprazole. Several days ago he noticed lower extremity swelling and decreased frequency of urination. Laboratory evaluation showed a serum creatinine level of 2.2 mg/dL (194.5 µmol/L). ...

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When it comes to our health and our health care, we love the numbers. Sometimes, we even fall in love with the numbers, assuming that the numbers tell us the whole story when, in fact, that may not be the case. Cholesterol numbers, blood pressure numbers, body mass index, whatever. As patients and consumers, we are frequently defined by our numbers. But what happens when those numbers and other medical tests, ...

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Vaginal yeast infections are common, up to 75 percent of women will have at least one and 5 percent of women suffer from chronic yeast infections (meaning four or more a year). Many women out of frustration with allopathic medicine (preventing recurrent yeast infections can be challenging) or because of their beliefs turn to alternative medicine options. More and more I am hearing about vaginal garlic. The problem with many alternative ...

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How many calories are in a pound? This seemingly simple question stumped me on my family medicine board recertification exam seven years ago — twice. (I think they asked the question in two different ways. I hoped they were experimental questions that didn’t count.) Later that day, I found the answer: 3,500 calories equals one pound. I don’t remember which multiple-choice answer I chose, but I do remember choosing the same answer ...

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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 e-mails her internist from Mexico with a report of diarrhea for 2 days. She is traveling and reports three to four loose bowel movements per day. She has been dining in the hotel restaurants but has also consumed foods and bottled soft drinks served with ice from local ...

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Several years ago, I was meeting a young woman in my clinic for the first time. She was healthy but had been obese most of her adult life, even though she had tried many methods of losing weight. We spoke for a few minutes about diet and exercise, and she agreed to see the nutritionist. A few months later, she came back to check her progress. She had lost weight, about ...

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Perhaps, doctors struggle more than most with memories that mark sad moments in their careers. For me, one of the most indelible was of a wonderful young man with chronic myeloid leukemia (CML). When I started my oncology career in the early 1970s, CML was almost always fatal. It would start with a chronic phase, which was treated with pretty simple medications. But those medications didn’t cure the disease. The “almost always” ...

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Liver transplantation for alcoholic liver disease has been controversial since the advent of the procedure. The perception that alcohol-related liver disease is self-inflicted combined with concerns of a high risk of recidivism to alcohol use, recurrent alcoholic liver disease, and non-compliance post-transplant has led a lack of support for transplantation for alcoholic patients in the public and among physicians. After initially avoiding transplants in this group of patients, the majority ...

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A recent study of men with early-stage prostate cancer found no difference in 10-year death rates, regardless of whether their doctors actively monitored the cancers for signs of growth or eradicated the men’s cancers with surgery or radiation. What does this study mean for patients? Based on research we have conducted on prostate cancer decision-making, the implications are clear: Patients need to find physicians who will interact with ...

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