medpagetodayFrom MedPage Today:

  1. Statin Therapy Suppresses Coronary Plaques in HIV Patients. Treatment with potent statin medication appears to reduce plaque burden in coronary arteries of patients infected with human immunodeficiency virus (HIV) while untreated patients experienced expansion of plaques.
  2. Few Women Qualify for 3-Person IVF. Close to 800 women of childbearing age ...

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Come, let us build ourselves a city, with a tower that reaches to the heavens, so that we may make a name for ourselves.  – Genesis 11:4 With these words, so begins the biblical story of The Tower of Babel. The tale was written, at least in part, to explain the origin of different languages. Essentially, a group of earth’s early inhabitants started to build a tower to the sky in order ...

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Jimmy Kimmel gets doctors to say how they really feel about the anti-vaccine movement.  It's about f'n time.  

There has been an outbreak of measles, a vaccine preventable disease, along with an outbreak of people yelling at each other. There have been angry exchanges between people who would like all children vaccinated according to the recommended guidelines and people who support the rights of parents to choose which vaccines to give their children, if any, and when to give them. There has been much focus on the assertion, ...

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I awoke one Saturday morning to a terribly familiar feeling -- a tight, barky cough, fast breathing, severe shortness of breath and burning in my chest. Another severe asthma attack. I knew I was in trouble. Twenty-three years ago, when I was an internal medicine resident, I went to be evaluated for recurrent pneumonia. I wound up being diagnosed with cough variant asthma. Most asthmatic patients wheeze; when my asthma is ...

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Abuse-Schedule-476x640 A physician in Texas posts this photo on Facebook. Caption: “My schedule one morning in January 2014. Never again ...” Yay! Another physician breaks free from assembly-line medicine. High-overhead, high-volume offices sacrifice the sacred physicians-patient relationship and perpetuate a disease-billing management system. This is not health care. It’s abuse. Patients: Avoid clinics with 10-minute slots. Go for docs who offer 30 to 60-minute appointments. Physicians: ...

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Recently, as I juggled work, family and shoveling, I prepared a lecture on promoting equity in health delivery. My first slide is a picture of the Ebola virus, and as of this morning, my last slide is a map of the ongoing measles outbreak. That’s because this week, we’ve heard a clear public health message from both President Obama and Surgeon General Vivek Murthy: Vaccines are safe and effective. Why is this ...

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The other day I ordered a CT scan with contrast on a patient with an apparent mass on his neck. I explained about the need to get a blood test to make sure his kidneys could handle the iodine contrast. Because our lab was closed, I had to print a requisition for him to bring to the hospital lab. Printing a requisition from our EMR is a multi-step process that involves ...

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shutterstock_140803288 gomerblog A local hospital is trying a new, controversial but more efficient approach to medical care. “We have changed our guidelines, if you want Dilaudid you get Dilaudid, if you want Valium, you get Valium. No questions asked,” CEO Michael Shoemaker told reporters Wednesday. In what experts are calling pure genius, emergency ...

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Many of my patients are taking herbal supplements, or so they think.  This herbal and health supplements industry likely is envied by traditional pharmaceutical companies.  The latter has to spend zillions of dollars proving safety and efficacy to the Food and Drug Administration (FDA).  Many of these drugs are cast aside during the approval process or afterwards when serious side effects become known, or a new medicine is proved safer ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 23-year-old woman is evaluated for a 1-year history of morning stiffness and achiness of the hands as well as Raynaud phenomenon. Two months ago, she experienced a sun-induced rash on the chest and back and patches of discoloration on the hands. On physical examination, temperature is 36.4 °C (97.5 °F), blood pressure ...

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As a medical student, I strongly support vaccination.  It works, it's safe, and it doesn't cause autism.  But I also understand why many parents don't believe me and the medical community when we beg them to vaccinate their kids. Medicine has come a long way from "do no harm."  Now we talk about risks and benefits: and none of our tests, medicines, or procedures are without risks.  Increasingly, pharmaceutical companies have ...

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I grew up most of my life avoiding doctors and hospital visits. I never fancied getting shots or blood draws as a child, and without health insurance; I didn’t have much of a choice.  This lack of access is what drew me to volunteer at the county hospital I was born at. Every Wednesday morning, I would report to the pediatric asthma allergy clinic at San Francisco General Hospital. Most ...

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Cancer patients depend on denial.  Without its protection, we would be overwhelmed by terror.  Denial filters and slows bad news, so we can digest reality in the merciful morsels; thus, we cope.  Without denial, we would shut down, withdraw, and lose hope; healing would not be possible.  However, if we do not move beyond denial, accept the diagnosis and loss, make a plan, we die. Allen, a 43-year-old man, came to ...

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blueandblackdress2-770x457 My mother-in-law texted me about The Dress, random friends are blowing up my inbox, and the nurses in the emergency department were huddled around the computer at 2 a.m. debating the color of the dress. Everyone in the world seems to be wondering what color the dress really is and why. The best way to find the answer to such questions is to find ...

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Some people who argue against vaccinations claim that vaccine policies infringe on their “rights” -- their rights, as parents, to make medical decisions for their children. It’s a scary, misleading, and chilling message. We need to be careful about where one person’s rights end and the next person’s rights begin. We need to remember that children (their children, and your children too) have rights of their own. For example, Dr. Bob ...

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shutterstock_127360631 I’ve been thinking about this post for awhile, and finally, am going to spill some “secrets” about me and my colleagues. We are in debt. I mean, real debt. We are in debt. I mean, real debt. It actually costs most of us almost 1 million dollars to become your doctor. It has taken us a long time to get here. Let’s do some ...

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shutterstock_178434308 Recently I wrote about the problems with maintenance of certification requirements.  One of the phrases I repeatedly read when I was researching the piece was “the patient as customer.”  Here’s a quote from the online journal produced by Accenture, the management consulting company:

Patients are less forgiving of poor service than they once were, and the bar keeps being raised higher because ...

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medpagetodayFrom MedPage Today:

  1. Mom's, Kid's Fructose Intake Linked to Asthma. A child's risk of asthma increased significantly with maternal fructose intake during pregnancy.
  2. Mixed Outcomes in Pregnancy After Weight-Loss Surgery. Women with a history of bariatric surgery who later gave birth faced both benefits and risks including a lower risk for gestational ...

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Assigning patients to doctors. Who still does this? We don’t assign hungry people to restaurants, hairy people to barbers, or passengers to airlines. Even State Farm allows me to choose between Maaco or my local chop shop every time I crash my car. We do assign kids to teachers, but still, I don’t need too many analogies to tell me that assigning patients to doctors is a bad idea! The average U.S. ...

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