We tell ourselves many things about our health each day, every day, all day long. The vast majority are unintentional, uninspired and blunt. A particularly sinful dessert brings admonishment, “You should not have eaten that.” Panting after two flights of stairs call for an exasperated, “I am out of shape!” Receiving a diagnosis prompts mental overdrive of “What if I don’t survive this?” thoughts. Learning my diagnosis of chronic kidney disease ...

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Top stories in health and medicine, June 4, 2014From MedPage Today:

  1. Advice to Docs Might Not Come From a Fellow Human. Long Island dermatologist Kavita Mariwalla knows well how to treat acne, burns, and rashes. But when a patient came in with a potentially disfiguring case of bullous pemphigoid -- a rare skin condition that causes large, watery blisters -- she was ...

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I wish I could share the photo of my 4mm boomerang shaped kidney stone.  I labored for 2 months, back in early 2009 to pass it, the second stone in 5 years. During my ordeal with these stones, I had the following health care encounters, tests, medicines, lab and imaging tests.

  1. at least 5 sets of blood work, with CBC and chemical profiles, parathyroid studies
  2. several urine tests, including urinalysis and urine culture, ...

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From MedPage Today:

  1. No Benefit for Testing ICD at Implant. Even though testing at the time of implantation of an implantable cardioverter-defibrillator (ICD) is safe, it doesn't add any benefits.
  2. Nephrologists Take Fistulas Into Their Own Hands. Every year, Rick Mishler creates about 250 fistulas in patients' arms, stitching artery to vein so they can have a chance at successful dialysis.
  3. Lack ...

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From MedPage Today:

  1. Sudden Cardiac Death Robs Many Years of Life. The burden of sudden cardiac death in terms of years of potential life lost is high compared with other leading causes of death in the U.S.
  2. HTN Guidance Takes Center Stage at NKF. Guidelines on hypertension management, particularly the JNC8 recommendations released last December, will be a major talking point at this year's ...

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Given all the complaining I and my colleagues do about the problems with the EMR, I figured I’d take the opportunity to tell you about something good that came from having my practice online. A patient came to see me last week for a check up and requested a prescription for birth control pills.  She’d used them in the past without problems. I wrote the script and sent her on her ...

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NephMadness 2014: Lets reinvigorate nephrologyThe field of nephrology is in a workforce crisis. We as a subspecialty have witnessed a steady decline in the number of applicants perusing nephrology fellowship over the last several years. In fact, fewer than 100 US medical school applicants participated in the 2014 nephrology fellowship match. This is a sobering statistic as 403 nephrology slots were available in this year’s ...

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From MedPage Today:

  1. Can the Health App Wild West Be Tamed? Mobile health applications can have a big impact on people's health and lifestyle habits and gather vast amounts of personal data -- all without any oversight. Is this a problem?
  2. Hypertension, Obesity Tied to Kidney Cancer. Increases in blood pressure and body mass were associated with greater risks of kidney cancer in U.S. ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 59-year-old woman is evaluated during a routine follow-up visit. She was recently diagnosed with type 2 diabetes mellitus and hyperlipidemia. She feels well. Medications are metformin, atorvastatin, and aspirin. Physical examination findings and vital signs are normal. BMI is 27. Laboratory studies reveal a serum creatinine level of 0.9 mg/dL (79.6 µmol/L), an ...

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I have been doing admitting shifts at a large hospital, as hospitalist. It is flu season, so volumes are large. Even people without the flu are sick. It often happens that way. And they are so very sick! The thing about the very sick patients I see is that they are generally what might be called medical "train wrecks." They are very sick because they have had interventions over the years ...

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