medpagetodayFrom MedPage Today:

  1. Time to Retire Lithotripsy for Kidney Stones? More than 30 years ago, extracorporeal shock wave lithotripsy (ESWL) had a highly anticipated, much-ballyhooed introduction as a nonsurgical therapy for kidney stones. Obviating the need to cut the skin or insert a device into the body, ESWL would use acoustic shock waves to ...

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medpagetodayFrom MedPage Today:

  1. Sleep Apnea Linked to Depression in Men. Obstructive sleep apnea (OSA) is associated with an increased risk of depression in men.
  2. Tapering Asthma Meds Saves Money in Stable Patients. Reducing asthma medications in stable patients led to cost savings without increasing utilization of other asthma resources.
  3. Poor ...

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I see some odd things in my clinic. One recent diagnostic dilemma was a man in his late fifties with shortness of breath. He had been born with a ventricular septal defect and had undergone surgery for this in his infancy. During his lifetime, he had seldom gone to doctors and always thought he was in fairly good health, maybe just of a weak constitution. A smoker since age 13, he ...

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medpagetodayFrom MedPage Today:

  1. Is This 'Meaningful Use'? Docs Say Yes, Patients Unsure. Proposed changes to patient engagement requirements under the federal government's Meaningful Use program are drawing praise from physician groups but are disappointing patient advocates.
  2. Point: Does the Risk of E-Cigarettes Exceed Potential Benefits? Yes. The use of e-cigarettes continues to ...

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Alright, we need to talk. Those of you who follow my blog know that I don’t shy away from controversial topics and that I don’t have a problem speaking my mind. I try to do it in a respectful, informative, and somewhat humorous way. But I saw something this morning that needs to be addressed, and it’s not funny at all. As I was eating breakfast before work, I saw a ...

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shutterstock_50580199 As a sleep physician, I spend a lot of time educating patients about what sleep is and how it works. Sleep, as I often explain, is not simply the lack of being awake; any more than landing a plane is simply the lack of flying. It’s becoming increasingly understood that sleep is an actively generated state, created by a series of ...

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medpagetodayFrom MedPage Today:

  1. Helmet Bests Mask for Infant CPAP. Infants with bronchiolitis who were treated with a continuous positive airway pressure (CPAP) helmet did not need to be intubated as often compared with those who used a CPAP facial mask.
  2. Negotiations Heat Up on Permanent SGR Fix. As a deadline looms, Congressional ...

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medpagetodayFrom MedPage Today:

  1. Kid's Asthma Not Linked to Maternal SSRIs in Pregnancy. Children whose depressed mothers took newer antidepressants while pregnant were not at increased risk of childhood asthma.
  2. Menopausal HT Not Tied to Greater Death Risk. Hormone therapy in postmenopausal women was not linked to a significant effect on all-cause mortality, ...

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medpagetodayFrom MedPage Today:

  1. Mom's, Kid's Fructose Intake Linked to Asthma. A child's risk of asthma increased significantly with maternal fructose intake during pregnancy.
  2. Mixed Outcomes in Pregnancy After Weight-Loss Surgery. Women with a history of bariatric surgery who later gave birth faced both benefits and risks including a lower risk for gestational ...

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The high cost of health care in the United States in part relates to how clinicians are paid. Performing expensive and often risky procedures simply pays better than engaging patients in a shared decision-making conversation. Shared decision-making (SDM) is a process where clinicians and patients educate each other about treatment options, risks and benefits, and preferences, and then they decide on the best approach together. Patient decision aids can assist ...

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