One recent morning, my grandma awoke with abdominal pain. She was taken to a good, local community hospital and diagnosed with acute ischemic bowel. There are various causes of ischemic bowel, but regardless of cause, getting the right care quickly determines whether such patients live or die. After speaking with her physicians, I called some friends. A quick discussion with colleagues in radiology, surgery, and gastroenterology helped me know that the ...

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We heard from a patient during our dermatology week, who worked as a medical laboratory technician, running hundreds of blood samples every day, and frequently using her own blood as the negative control. Then she began to notice that the numbers stopped making sense. Her ANA had shot through the roof and her white blood cells started dropping. "I couldn’t use my blood as the negative control anymore," she said, shrugging ...

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Recently, a physician colleague asked me a question about a patient. The patient, who had already been seen by another allergist, was referred to another physician ("the consultant") for evaluation. The consultant was in the same healthcare system as my colleague, but the allergist was not. In evaluating the patient, a specific allergy question came up. The consultant asks my colleague about this question. What was interesting was that the consultant ...

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The vaccination debate has been raging over the last several years.  As I write this, it is important to know I do not write this blog to creat debate or ill feelings from either side.  I wish only to provide one health care provider’s view of the issues surrounding vaccinations.  From a mother standpoint, I have friends who choose to vaccinate their children, and those who do not.  Our friendships do not ...

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Just as posited in a prior article featured on KevinMD.com, where it was suggested that implementing an EMR/EHR has significant attraction to prospective physician candidates, I would like to also recommend that a similar stance can be adopted with respect your practice's your web presence. In other words, is your website putting your best foot forward for not only prospective patients, but also to prospective physicians and others who ...

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During our medical training we are taught to use evidence based medicine.  This means using the most up to date scientific research data that has been analyzed and accepted as fact.  But does this mean every patient we see fits into the evidence based medicine algorithm that we have been taught to use? I hope not.  For this would mean we would only be following half of medicine.  The art of ...

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Not many years ago it was assumed that most cancers were not caused by viruses. Today it is clear that many are and the list is growing. Head and neck cancers are either caused by the environment (especially tobacco) or by the human papilloma virus, the same virus that causes cervical cancer and some genital warts. The incidence of HPV-related head and neck cancer has been rising rapidly in the past ...

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My 64-year-old patient with terminal cancer and less than six months to live wanted to go to Oregon. He was contemplating assisted suicide, which is legal there. “My life has been long and good,” he said. “I believe it is my right. I want the ability to say it’s too much, I can’t do it anymore. A person should have a dignified quality of life.” Another one of my patients, an ...

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A nationwide system to collect adverse events from anesthesiaA guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Anesthesiologists have been at the forefront of the patient safety movement. Over the past 25 years, anesthesia-related deaths have declined from two deaths per 10,000 anesthetics administered to one death per 200,000 to 300,000 anesthetics administered, due to improvements in patient safety and innovative research ...

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I took my daughter to the orthodontist last week to get braces. There's a lot about the process that seems better than when I was a kid. Mostly, it's that instead of having to slide brackets around each of your teeth (yishk!) the orthodontist just paints a special glue on the enamel and places the brace on the front of each tooth. Kids get to pick the color of their braces ...

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