Chest pain and what we can learn from changing flat tires “Daddy, I think we have a flat tire.” I just rolled out of the garage with my 4th grade daughter. It was Tuesday morning. Usual daily routine. Drop her off at school then go to work. A little different today as I was to lead an important meeting. How could she possibly know what a flat tire sounds like? Now? Right now? She’s ...

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Top stories in health and medicine, August 14, 2014From MedPage Today:

  1. Beyond Asbestos: Autoimmunity, Pollution, and Particles. Recently, I wrote an article about some interesting research being done by Jean Pfau, PhD, of Idaho State University suggesting that workers who had been exposed to asbestos at the now-shuttered Zonolite mine in Montana were developing an as-yet undescribed autoimmune condition characterized by severe ...

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Top stories in health and medicine, August 12, 2014From MedPage Today:

  1. Low Obesity Risk Score Can Still Equal Major Health Problems. Young adults who scored slightly higher on an obesity risk assessment scale still had significantly worse dietary habits than those who were at lower risk.
  2. Feds' $10 Billion Search For Healthcare's Next Big Ideas. The Affordable Care Act was ...

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No medical resident looks forward to working night float. The initial glamour of doing chest compressions in the rising light comes up against a litany of administrative tasks. As the glamour wanes, the gulf between the objective curriculum and actual practice widens. On paper, residents learn how to manage acute emergencies and learn deeper clinical reasoning. Actual practice, or the “hidden curriculum” of training, can be a different experience, involving ...

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Top stories in health and medicine, August 7, 2014From MedPage Today:

  1. Return to Warfarin Okay After TBI? Restarting warfarin (Coumadin) after a traumatic brain injury (TBI) improved overall outcomes despite the bleeding risk.
  2. Dietitians Take Aim at Food Industry Sponsorships. Andy Bellatti has been troubled by some of the continuing education programs he's seen at the Academy of Nutrition and ...

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The scientific literature is replete with the failure of vitamins to support diseases.  Yet, the industry is booming and people's cabinets are filled with potentially harmful, poorly studied colorful bottles that make unsubstantiated magical claims. This year, we witnessed Dr. Mehmet Oz, a celebrity doctor who frequently extols weight loss products, supplements and vitamins on his syndicated television show come under fire from regulatory committees for false claims and poor outcomes. The ...

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Top stories in health and medicine, July 31, 2014From MedPage Today:

  1. Florida 'Gun Gag' Angers Medical Societies. Medical societies condemned the federal court decision allowing Florida to forbid physicians from asking patients if they keep firearms at home, with severe penalties for violators.
  2. Compromise Reached on Vets' Healthcare. Congressional leaders appear to have reached a compromise on a bill to ...

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Knowing what to do when faced with a sick patient is relatively straightforward. We learned a lot of it in medical school, picked more up by experience, and usually have the opportunity to look things up quickly on the Internet. Even when faced with a brand new situation, we can usually fall back on our general knowledge of science and medicine. But in today’s practice of medicine, that’s not enough. Physicians, ...

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Top stories in health and medicine, July 29, 2014From MedPage Today:

  1. Smoking Worsens Psoriatic Arthritis. Patients with psoriatic arthritis who smoke have worse patient-reported disease features at baseline and don't respond as well as nonsmokers to anti-tumor necrosis factor (TNF) treatment.
  2. Heart Defects Still Often Found Late. Prenatal diagnosis of critical heart defects has increased, but more than one in ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 68-year-old woman is assessed for a 6-month history of progressive exertional leg discomfort, described as a "heaviness" involving both calves. The symptoms are relieved within 5 to 10 minutes of rest. She has noted the same limiting heaviness with bicycling. Medical history is significant for hypertension, type 2 diabetes mellitus, and ...

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