Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 36-year-old woman is evaluated for a 1-week history of recurrent episodes of facial pain that are 1 to 3 seconds in duration and occur spontaneously dozens of times throughout the day. The pain is sharp, severe, and located in the right infraorbital area. During this same ...

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There is enthusiasm in politics about reducing regulation to stimulate creativity and economic growth. Maybe. But reduction in oversight of medication and medical devices by the Food and Drug Administration (FDA) will probably lead to a proliferation of expensive potions and gadgets that don't actually help. The New England Journal of Medicine published an article detailing the near miss associated with an injectable monoclonal antibody for Alzheimer's disease. ...

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Why does the universe have conscious beings? The physical and biological laws of nature do not seem to explain the existence of conscious creatures such as humans. Neuroscience has done well to explain many of our behaviors, illnesses and medical therapies based on purely physical and observable rules. But no one has ever measured consciousness. And yet it appears fundamental to whether my patient will recover from their disease. After 15 ...

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From time to time, friends, patients, and relatives ask my advice on participating in a medical experiment.  My response has been no.  More accurately, once I explain to them the realities of research, they don’t need to be persuaded.  They back away. Here’s the key point.   When an individual volunteers to join a research project, the medical study is not designed to benefit the individual patient.  This point is sorely misunderstood ...

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STAT_Logo The publication of Andrew Wakefield’s notorious and now discredited research on autism and vaccines in 1998 triggered a surge of worry about vaccine safety. Since then, questions about a purported connection between autism and vaccines have been asked and definitively answered: There is no link. But there are other factors linked to the development of autism that have ...

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american society of anesthesiologistsA guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. During the course of our careers as physicians, we have cared for or are aware of an elderly patient in the intensive care unit or ward who has exhibited delirium, or an acute confused state. This is particularly common after surgery and anesthesia. While simply being ...

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With all this talk about medical student, resident, and fellow burnout, I thought we might take a break to discuss the small delights that sprinkle throughout medical training. This is not a “You should publish as a trainee” manifesto. It’s more of a DIY guide for those who are interested but can’t find the time or the mentor. And after a decade of rejected manuscripts, unfortunately, I’ve got ...

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A concussion is a brain injury. A mild one, yes, but one that can lead to longstanding symptoms. What you do after a concussion, immediately and in the weeks that follow, can make a big difference in how your child recovers. Though it’s a mild injury -- there’s nothing to see on a CT, X-ray, or MRI -- the effects of a concussion can be significant and uncomfortable for a child ...

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Should school boards discontinue support for high school football? That’s the provocative title of a recent article in Pediatrics, the journal of the American Academy of Pediatrics. The background to this controversy is the increasing recognition that chronic traumatic encephalopathy (CTE), a severe and debilitating brain problem first identified in former professional football players, can have its beginnings in college or even high school football ...

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Seconds after I arrive at the ER on a Sunday afternoon, I'm called to see an elderly woman who can't breathe. She's ninety-four, and gurgling for air. On my way, I pass two middle-aged women. They are hovering outside a nearby room, trying to get my attention. One gestures like a traffic guard as she tries to wave me into the room. The other throws up her hands as I ...

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