It is well known that Medicare expenditures threaten the financial solvency of the U.S. government. And it is pretty well agreed upon that some of our Medicare spending goes towards wasteful medical care. But which medical care is wasteful and how much is such care costing us?  A study in JAMA Internal Medicine provides a sneak peek at answers to these important questions. The research, led by Aaron Schwartz, a graduate student ...

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The term "Golden Age" seemed to permeate multiple domains in the 1950s, almost to the point of triteness. The field of cardiac surgery, however, deservedly earned the term as pioneer after pioneer introduced innovation after innovation that advanced the specialty. Walter Lillehei in Minnesotta, Wilfred Gordon Bigelow in Toronto, William Chardack in Buffalo, and Ake Senning in Stockholm were just some of the trailblazers of that era. The four surgeons also shared ...

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Last year, Dean Dupuy, 46, an engineer at Apple, suddenly died of a heart attack while playing hockey. He experienced no warning symptoms and, with a healthy, active lifestyle, did not fit the profile of someone at risk. Too late to save him, Dupuy’s wife Victoria discovered that early coronary disease can be identified by simple CT scans. She recently launched a nonprofit organization, No More Broken Hearts, in San Jose ...

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medpagetodayFrom MedPage Today:

  1. No Benefit to CABG, Mitral Valve Repair Combo. A year after coronary artery bypass graft surgery (CABG) and mitral valve repair, patients with moderate ischemic mitral regurgitation did not seem to benefit from having the two procedures versus having only CABG.
  2. Watchman Proves Long-Term Mettle in AFib. Left atrial ...

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I’m getting to the point where I think it might be time to stop or at least decelerate the pace of my writing on medicine. When I retired from medical practice almost a year ago there were a lot of pent up experiences that I felt a need write about. But now I have already written about almost everything that I wanted to and, as I am no longer a practicing physician, ...

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medpagetodayFrom MedPage Today:

  1. IMPROVE-IT Results Turn Up Volume on Guideline Debate. The long-awaited results of the IMPROVE-IT study comparing Vytorin (ezetimibe/simvastatin) to simvastatin in high-risk patients revealed a small but significant benefit, and a large -- and possibly equally significant -- rift regarding the cardiovascular prevention guidelines.
  2. State Exchange Situations Vary at ...

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medpagetodayFrom MedPage Today:

  1. Weight Loss Relieves Symptoms in Knee OA. Obese patients with knee osteoarthritis (OA) who maintain an initial weight loss report fewer symptoms compared with their baseline level of symptoms.
  2. Age and Sex May Distort Biomarkers in Early RA. Age and sex are independently associated with levels of erythrocyte sedimentation ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 55-year-old man is evaluated during a routine examination. He has a 2-year history of nonischemic cardiomyopathy. (Echocardiogram 2 years ago demonstrated a left ventricular ejection fraction of 35%.) He is feeling well and reports no shortness of breath; he walks 2 miles daily without symptoms. Medical history is remarkable for hypertension. ...

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Another day, another pacemaker, at least so it seemed at first. The usual greeting the patient, answering the last questions, consent signing, placement of the IV, EKG leads, prepping of the surgical site and initiation of the preoperative antibiotics were all recent memories.  He laid there, smiling, knowing he'd made the right decision after years of struggling with his arrhythmia in other ways.  His heart was showing signs of slight weakening and ...

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the_good__the_bad_and_the_ugly_by_kwad_rat-d5id914 I had a recent conversation with an old friend about her elderly father that encapsulates a lot of what is both great and terribly wrong with health care in America today. Here are the basic facts: the man is in his mid-80s, retired from teaching school, and is active and vigorous, living in the community; he is cognitively intact. He has a ...

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