Top stories in health and medicine, October 29, 2014From MedPage Today:

  1. Add-on Tx Less Likely in T2D Patients on Metformin. Patients with type 2 diabetes who don't start out on metformin may be at higher risk for needing additional therapy.
  2. Lung Donation After Cardiac Death Shows Promise. Lung transplantation after cardiac death achieved key endpoints comparable to those attained with ...

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A friend of mine has been living well with lung cancer for five years -- working, running several miles a day, traveling, doing good stuff with his family, and generally enjoying the pleasures of everyday life. He knows the cancer will eventually kill him, but has been making the most of every remaining minute. Then, a month ago, things suddenly turned dramatically south. Severe shortness of breath, constant coughing, sleeplessness, fatigue, ...

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Respiratory syncytial virus infection, aka RSV, is a common infection in children. A key aspect of RSV is how poor a job our immune systems do in fighting it off. Virtually all children are infected with RSV during the first few years of life. Not only that, all of us are reinfected multiple times during our lives. Attempts at devising a vaccine for RSV have all been unsuccessful. In fact, ...

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88.2% of all statistics are made up on the spot. - Victor Reeves There’s a growing movement in medicine in general and imaging in particular which wishes to attach a number to everything. It no longer suffices to say, “You’re at moderate risk for pulmonary embolism (PE).” We must quantify our qualification. Either by an interval: “Your chances of PE are between 15 and 45%.” Or, preferably, a point estimate: “You have a 15% chance ...

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Top stories in health and medicine, September 11, 2014From MedPage Today:

  1. Azithromycin Linked to Belly Blockage in Infants. Infants who received azithromycin (Zithromax) in the early days of life were at an increased risk for developing infantile hypertrophic pyloric stenosis (IHPS).
  2. Singulair Doesn't Ease Wheeze in Most Kids. Intermittent montelukast (Singulair) didn't alleviate wheezing in children, except possibly for those ...

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Check out the prices for nebulizer solutions of albuterol and budesonide (generic Pulmicort). They are totally affordable. $4 for a month for albuterol. $14 for a month for budesonide respules. Pulmicort respules used to be very expensive. Now even the branded budesonide is  less than 10% of a monthly cable bill. Then check out the prices of inhaled steroids delivered through meter dose inhaler (MDI) or dry powder inhaler (DPI). These ...

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Earlier this year a child died following a surgical procedure in California for a condition called obstructive sleep apnea. The case generated a great deal of concern among parents about both this condition and the surgery often done to treat it. I wrote a post myself about it at the time. I still get questions about it because I care for quite a few children immediately after they have had ...

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Top stories in health and medicine, August 6, 2014From MedPage Today:

  1. Advocacy Groups Take Obesity Naysayers to Task. Two obesity advocacy groups took to the pages of the Archives of Internal Medicine this week to castigate a report that questioned the legitimacy of obesity as a disease and cast an unfavorable light on new weight-loss drugs.
  2. Shoulder Pain: PT Works ...

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Recently, a family physician colleague asked me to explain why the Affordable Care Act requires private health insurers to provide first-dollar coverage for preventive services that the U.S. Preventive Services Task Force assigns an "A" or "B" (recommended) rating, but allows public insurers (Medicare and Medicaid) to determine if and how they will cover these services. Until recently, the question hadn't come up, since Medicare has agreed to cover pretty much every ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 38-year-old man is evaluated for a 1-year history of cough with mucoid sputum and a 6-month history of mildly progressive dyspnea. He has a 12-pack-year history of smoking. He has no history of asthma, allergies, skin disease, or liver disease. On physical examination, vital signs are normal. Pulmonary examination discloses decreased breath ...

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