shutterstock_150037820 Lately I've had the opportunity to work in an outpatient clinic where the regular doctor is out sick for a prolonged period of time. It is a breathtakingly beautiful little community, with green hills and a crystal clear river. It is also troubled by methamphetamine and prescription drug abuse. The little clinic in town is unwittingly a partner in this crime. Like ...

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I recently read a discussion by three hypertension specialists, Drs. Jan Basile, Dominic Sica and David Kountz, on how to treat resistant hypertension. Resistant hypertension is blood pressure that remains above goal despite treatment with three drugs, from different classes, one of which must be a diuretic. 10 to 15 percent of patients with high blood pressure will have resistant hypertension. These are the people who always seem to have ...

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Physicians need to complete about 50 hours of some kind of continuing medical education (CME) every year. The ideal kind of class is one that we actually attend in person, with teachers who are expert in the field being taught and are somewhere near the cutting edge. CME classes are especially nice when they include something hands-on rather than just a lecture format because much of medicine is hands on ...

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In the last year and a half, I've been able to go to Africa 4 times and Haiti once, for which I give thanks that the world still produces abundant fossil fuels. That much airplane travel does make me feel a bit guilty, even though I'm not actually vacationing. Going to far away places to practice medicine has always been something I hankered after, and it turns out that knowing how ...

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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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The flu season has really gotten into gear now with 46 of our 50 states reporting widespread influenza activity as of January 3, 2015. Influenza is a virus that infects the respiratory tract, causing sore throat, runny nose, fever, and cough. Rarely people with the flu will have nausea, vomiting and diarrhea, but this is not "stomach flu" which is a term some of us use to describe any one ...

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shutterstock_164594111 An article from the JAMA has been gnawing at my consciousness for the last couple of weeks. Dr. Prashant Kaul and colleagues out of the University of North Carolina reviewed records from hospitals in the state of California from 2008 through 2011, looking for patients who had been hospitalized with heart attacks. Specifically, they were looking for patients with ST elevation ...

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I am presently doing locum tenens shifts in a lovely community in Oregon as a hospitalist. I have been to this hospital before and was glad to return when they needed some help. I like this place and noticed on my first go around that patients got good care and that physicians and nurses all seemed to get along pretty well together. When I first worked here, 2 years ago, they ...

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shutterstock_190622306 Drug prices are a difficult issue to write about because real data about the workings of pharmaceutical companies is very difficult to uncover. Still, I came face to face with something that seemed extremely not right and so I feel I should at least make some comment. It started when I prescribed a patient sumatriptan for her recently more frequent migraines. ...

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Ebola virus has grabbed headlines since the epidemic started in West Africa nearly a year ago. The death toll is estimated at 4,500 people, and the epidemic continues to spread. One person infected in Liberia returned to Texas with the disease and died, infecting maybe 2 health care workers. Ebola is a nasty virus, surely, with a case fatality rate of 80 percent. Overall health and nutrition as well as living ...

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