I have a love-hate relationship with practice guidelines. Love because it is often helpful to refer to a set of evidence-based recommendations as part of clinical decision-making; hate because of all of the shortcomings of the guidelines themselves, as well as the evidence upon which they are based. A recent piece in JAMA and the editorial that 
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Top stories in health and medicine, June 27, 2014From MedPage Today:

  1. Shortage of Saline Has Hospitals on Edge. Hospitals across the country are struggling to deal with a shortage of one of their essential medical supplies. Manufacturers are rationing saline -- a product used all over the hospital to clean wounds, mix medications, and treat dehydration. Now drug companies say they won't ...

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It was a sunny spring day as the bus turned the corner. It was a yellow school bus filled with young children jumping up and down in their seats. It was an average day in an average school year. Nothing about it stood out. Let’s take a closer look. The boy sitting in the front of the bus holding tightly to his lunch box is named William. His clothes are tattered ...

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Top stories in health and medicine, June 26, 2014From MedPage Today:

  1. Drug Discounts Have Pharma Crying Foul. In 1992, the federal government told drug manufacturers they had to give steep discounts to hospitals that treat a large percentage of poor patients.
  2. Quitting Snus After MI May Lower Death Risk. Stopping the use of smokeless tobacco after a myocardial infarction (MI) ...

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This story has become all too familiar. The patient enters the ER with crushing chest pain and their EKG shows an acute MI, (known today in the colloquial as STEMI, for ST-elevation myocardial infarction). The interventional cardiologist is summoned quickly and in less than 90 minutes from the patient's arrival across the ER door threshold, he or she is on a cardiac cath lab table, where a coronary stent is ...

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Top stories in health and medicine, June 25, 2014From MedPage Today:

  1. Obesity, T2D May Alter Gut Bacteria. The portfolio of gut bacteria in patients with obesity and type 2 diabetes may look different from that of healthy people.
  2. Ohio Amish Rethink Vaccines in Measles Outbreak. The Amish countryside in central Ohio looks like it has for a hundred years. There ...

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

  1. FDA: Testosterone Carries VTE Risk. Testosterone products can cause venous thromboembolism (VTE) even in patients without polycythemia, the FDA warned amidst ongoing cardiovascular risk assessment.
  2. Safety Foul-Up Exposes CDC Staff to Anthrax. A breakdown in safety procedures has exposed 84 CDC staffers in Atlanta to live anthrax.

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Top stories in health and medicine, June 20, 2014From MedPage Today:

  1. The Uninsured: 33 Million and Counting. In the last full year before the Affordable Care Act went into effect, more than 33 million Americans had been without health insurance for more than a year, according to CDC survey.
  2. Gross Anatomy: A Real Twisted Heart. It's nothing but heartache for ...

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Top stories in health and medicine, June 19, 2014From MedPage Today:

  1. Do Thiazides Trigger Metabolic Side Effects in Older Adults? Metabolic adverse events were relatively common among older, predominantly male veterans who started taking a thiazide diuretic for hypertension.
  2. Insurers Push Back Against Growing Cost of Cancer Tx. Some cancer patients and their insurers are seeing their bills for chemotherapy ...

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After I left my position as a staffer for the U.S. Preventive Services Task Force in November 2010, it was three years before I was tapped for another guideline post, this time at the American Academy of Family Physicians. Recently I joined the AAFP's Commission on Health of the Public and Science, which formulates guidance for family physicians on a variety of topics, including clinical preventive services. My appointment coincided ...

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