I recently read a very good article in the New York Times about a patient found to have the classic incidentaloma, a small mass in the adrenal gland.  This is estimated to be seen in 4% of abdominal CT scans, and is rarely serious but typically leads to recommendations for additional testing and follow up CT scans to assure that it is not either a metastatic cancer from ...

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For as long as I can remember I have tended to develop a bad cough nearly every time I get sick in the cold and flu season. I’m not sure if I have a minor tendency to bronchospasm or if my years of passive smoke exposure as a child somehow damaged my lungs. Who knows, but I seem to have the tendency for every URI become a lingering brohchitic cough. In ...

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Sports fans have heard a lot about football players with Lisfranc injuries recently. Maurice Drew-Jones, running back for the Jacksonville Jaguars and Santonio Holmes, receiver for the New York Jets, have been in the news.  Matt Schuab, QB for the Houston Texans missed last  season from a Lisfranc injury. Many of you may know that a Lisfranc injury is a type of foot injury and that it can sometimes be very serious ...

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Moving from paper death certificates to an online process called the Washington State Electronic Death Registry System, or EDRS. Sounds like a simple 21st century process that should make the process of completing a death certificate faster and easier right?  Oh, the government designed the system.  Oops. I’ve been so frustrated by the unintended consequences of a new state governmental process for completing death certificates. Beginning in early 2012 Washington state started ...

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Linzess is a new drug that received FDA approval by Forest Laboratories for use in irritable bowel syndrome (IBS) with constipation and in chronic idiopathic constipation.  It got my attention because of its biochemistry. Learning about the mechanism of action of new drugs like Linzess reminds me how much more is understood about the molecular biological level of physiologic function of the human body than when I was in med school.  Linzess ...

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E-cigarettes seem to be a very popular product these days, so I thought I’d do a bit of research to figure out what the heck an e-cigarette is and to try to answer the question, “Are e-cigarettes safe?” It appears that the primary reason people use e-cigarettes is to avoid smoking, either as a way to get their nicotine in areas where smoking is prohibited, or as a means to try ...

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I am acutely aware of the obesity epidemic in this country.  I’ve posted previously about how obesity may have surpassed smoking as the #1 preventabe cause of death in the U.S.  Still the FDA approval today of Belviq, a sertonergic drug that brings back memories of Fen-Phen, Meridia and Redux (dexfenfluoramine) over concerns with their association with valvular heart disease, pulmonary hypertension ...

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It seems like every day in the office I see at least one man concerned about testosterone deficiency.  If you look at the symptoms of testosterone deficiency most of us have one or more of these symptoms at least some of the time.  Fatigue, depression, weight gain, lack of energy, reduced sex drive, loss of physical strength, and moodiness are all described as symptoms typical of testosterone deficiency. Making the ...

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Hydrocodone as it is currently prescribed in the U.S. is a schedule 3 drug.  The FDA puts rules and regulations on the prescribing of medications that have a significant potential for abuse, diversion or addiction, and the lower the schedule number, the more the restrictions. Schedule 1 drugs are illegal in the U. S.  They are deemed to have no legitimate medical purpose.  Examples are heroin, LDS, methamphetamine, marijuana (strange but ...

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Does muscle weakness improve after disc surgery? For an NFL fan arguably the best thing that could happen to your team is to sign Peyton Manning and have him perform at or near his pre-injury level.  The corollary is that one of the worst things to happen to your team would be to take a huge salary cap hit to get a Peyton Manning with such weak throwing arm that even ...

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