From MedPage Today:

  1. Is There a Flaw in This Large Vitamin D Trial? A 57-year-old woman had her vitamin D level checked by her primary care physician based on her mix of risk factors, and the level was found to be low. Her doctor prescribed a high-dose vitamin D supplement of 50,000 IU administered once a week.
  2. ICUs Neglect UTI Prevention. Intensive care units ...

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'Tis the season to be coughing ... It no longer takes an epidemiologist looking at absenteeism rates in schools to predict the start of influenza season.  For several years now there have been sophisticated models using search engine terms to monitor increasing incidence of febrile cough illness in regions of the world. Or just ask a primary care clinic what its waiting room sounds like these days.   A chorus of coughs, high, ...

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Since prior to my entrance to medical school, common wisdom for treating sore throats involved the prevention of rheumatic fever.  Since group A strep pharyngitis is the cause of most acute rheumatic fever, all efforts have focused on treating group A strep.   Studies in the 1950s showed that penicillin treatment decreased the probability of patients developing rheumatic fever. The prevailing theory in the 50s and 60s, that we should diagnose group ...

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I’ve spent the past four weeks learning about primary care on my family medicine rotation. A significant portion of patient care in this setting is focused on health maintenance or disease prevention. Physicians can provide their patients with evidence-based recommendations for various screening tests and vaccinations, but it is ultimately up to the patient to decide what services he or she will receive. According to the Centers for Disease Control and ...

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The night before I was leaving for a three-week medical mission trip, I was called urgently to the ICU to see Rachel (name altered), a previously healthy woman in her late 40s, slightly overweight with dirty blonde hair. She had started a new job as a customer service agent. Rachel was the sickest patient I had seen in months, and I could not figure out what was going on. A week ...

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Case 1: You have a 94-year-old woman with multiple medical problems in hospice who develops a fever (subjectively hot to the touch), shortness of breath, and a cough producing yellow sputum.  Her daughter asks if she can be treated with antibiotics "to make her feel better."  The patient is not well enough to make decisions, but in earlier conversations had stated a goal of remaining comfortable at home, while also ...

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Gastroenteritis, often called “stomach flu,” is common in children. It has nothing to do with influenza, the “true flu,” which is caused by a respiratory virus. Gastroenteritis is caused by a different set of viruses. These viruses are generally transmitted by what physicians call the fecal-oral route, which sounds kind of gross. What we mean by that term is that the bug is in our intestinal tract and gets on our ...

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From MedPage Today:

  1. Low Melatonin May Up Risk of Prostate Cancer. Higher urinary melatonin levels had a significant inverse association with risk of aggressive prostate cancer.
  2. H7N9 Cases Spike in China. After a slow fall season, China has seen a recent wave of H7N9 avian influenza cases, according to the World Health Organization.
  3. Trials in Esophageal Ca, HCC Fall Short. Patients with ...

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I've made a huge mistake, I thought. The fever had come back. The fever had come back, and I was stuck on a bus. The first of five buses, actually... I am a fourth-year medical student, but right now I'm a long way from home. I am spending a year in South America, studying international public-health issues by working in emergency rooms, non-governmental organizations (NGOs), social projects and surgical suites. When this story ...

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From MedPage Today:

  1. Maryland's Bold Hospital Spending Plan Gets Feds' Blessing. Maryland officials have reached what analysts say is an unprecedented deal to limit medical spending and abandon decades of expensively paying hospitals for each extra procedure they perform.
  2. A Brain-Dead Mother, a Million-Dollar Baby. The case of a pregnant woman in Texas kept on life support against her family's wishes has captured the ...

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