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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Top stories in health and medicine, July 24, 2014From MedPage Today:

  1. Weight Watchers Tops in Efficacy Vs. Cost. Among the most popular diet programs and drugs, Weight Watchers trims the most bulge for the buck, according to a new cost-effectiveness analysis.
  2. Probiotics: Moderate Impact on BP? Probiotics cut blood pressure by roughly 4 mm Hg systolic and 2 mm Hg ...

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Top stories in health and medicine, July 23, 2014From MedPage Today:

  1. Salt Consumption Tied to Heart Risk in T2D. Higher salt intake was associated with a greater risk of cardiovascular disease in patients with type 2 diabetes.
  2. Three-Drug Cocktail Has Promise in TB. An experimental, three-drug tuberculosis (TB) treatment regimen demonstrated bactericidal activity in patients with drug-sensitive or multidrug-resistant disease.

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Most physicians recall the medical school ritual of unboxing our first stethoscope. From the first physical diagnosis course, we were all solemnly instructed as to the importance of the physical examination in the diagnosis and of management of illness. Given that perhaps the most notable use of the stethoscope is cardiac auscultation, it would seem that this should hold particularly true for cardiology. And yet, on moving from classroom to bedside, ...

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The world is asunder.  Iraq is sinking into a sectarian abyss.  ISIS, a terrorist group, now controls a larger territory than many actual countries.  Russia has swallowed Crimea and has her paw prints all over eastern Ukraine.  China is claiming airspace and territories in Southeast Asia increasing tensions with Japan, Vietnam and the Philippines.  The Israeli-Palestinian peace process is in another deep freeze.  Terrorists in Sudan and Nigeria are kidnapping ...

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To paraphrase General MacArthur, old doctors never retire, they just fade away. Despite having greater than average financial resources and more burdensome than average work load, many doctors seem to have a hard time knowing when it is time to call it quits. I know doctors who continue to practice into their 70s and 80s. Some continue to work until the day they die. Why is this? I think that some ...

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A health research company just released a list of the 100 top drugs in America according to sales. 29th on the list, with sales of over $1.8 billion, is the cholesterol lowering drug ezetimibe, brand name Zetia. This drug was released over 10 years ago because it worked really well in combination with statin drugs such as Zocor (simvastatin) to lower LDL cholesterol levels. It was released as a single agent and combined ...

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Top stories in health and medicine, July 3, 2014From MedPage Today:

  1. Proposal To Add 'Copper' Plans to Marketplace Raises Concerns. If you offer it, will they come? Insurers and some U.S. senators have proposed offering cheaper, skimpier "copper" plans on the health insurance marketplaces to encourage uninsured stragglers to buy.
  2. Childhood Malnutrition May Raise HTN Risk. Young adults who survived ...

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Should doctors be paid overtime for taking call? Taking call is the worst thing about being a doctor. There, I said it. But wait! What about medical malpractice lawsuits? What about dealing with patients’ suffering or dying either from their illness, or far worse, relating to decisions you made or procedures your performed? Certainly these are far worse events than being on call. Granted. However, these awful events are part of ...

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Top stories in health and medicine, June 30, 2014From MedPage Today:

  1. FDA Finally OKs Inhaled Insulin. After several denials, the FDA announced Friday that it had approved inhaled insulin (Afrezza) to be used for improving glycemic control in adult patients with diabetes.
  2. ADHD Meds Tied to Cardio Risk. Danish children taking stimulant drugs for attention deficit-hyperactivity disorder (ADHD) had roughly ...

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