Top stories in health and medicine, November 26, 2014From MedPage Today:

  1. USPSTF: Routine Vitamin D Screening Unsupported. There is not enough evidence that vitamin D screening is beneficial in routine practice and therefore it can't be recommended, according to the U.S. Preventive Services Task Force.
  2. SLE Patients See Good Outcomes in Blood Cancers. Risk of hematologic malignancy may be increased ...

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Top stories in health and medicine, November 24, 2014From MedPage Today:

  1. Does an IUD and Family History Boost RA Risk? Current use of an intrauterine device (IUD) was associated with an important biomarker of future rheumatoid arthritis risk among women with a family history of the disease.
  2. Pricey Generics Draw Senate Scrutiny. Robert Frankil, RPh, was dismayed when a customer ...

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Top stories in health and medicine, November 21, 2014From MedPage Today:

  1. Clinical Focus in MS: Novel Approaches to Progressive Disease. Although the drug development pipeline still contains numerous products intended for patients with relapsing-remitting multiple sclerosis (RRMS), the consensus among clinicians is that relapses can be effectively squelched in nearly all RRMS patients with the dozen or so currently approved therapies.

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Top stories in health and medicine, November 18, 2014From MedPage Today:

  1. Weight Loss Relieves Symptoms in Knee OA. Obese patients with knee osteoarthritis (OA) who maintain an initial weight loss report fewer symptoms compared with their baseline level of symptoms.
  2. Age and Sex May Distort Biomarkers in Early RA. Age and sex are independently associated with levels of erythrocyte sedimentation ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 66-year-old man comes for a preoperative evaluation before total joint arthroplasty of the left knee. He has a 25-year history of rheumatoid arthritis. He has had progressive pain in his left knee with activity, which limits his ability to hike. The patient has similar pain in the right knee, but it ...

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I almost died today. I was driving from one clinic to another, on a busy highway in the rain, when my car hit a standing body of water and hydroplaned. I lost control of the car, spun counterclockwise across three or more lanes, and slammed into the dividing median. I remember screaming “NO!” internally right before impact. I couldn’t believe what was happening as it happened.We should all be anonymous Samaritans
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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 64-year-old man is evaluated for a 2-year history of knee osteoarthritis. He has bilateral knee pain that worsens with walking. He has tried topical therapies, physical therapy, and acetaminophen, none of which has provided relief. The patient also has peripheral vascular disease, hyperlipidemia, and hypertension. Medications are hydrochlorothiazide, pravastatin, and a ...

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Recently, an international research team led by Xavier Rodó published a fascinating study in PNAS suggesting that Kawasaki disease is caused by an agent transported by wind from farms in Northeast China.  This agent, possibly a fungal toxin, is responsible for triggering an exuberant immune response in children, causing the typical manifestation of the disease: fevers, rash, conjunctivitis, “strawberry tongue,” enlarged lymph nodes, and swelling of the extremities.  Untreated, Kawasaki disease can cause aneurysms of the coronary arteries, ...

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It is noteworthy how certain vital and effective generic drugs for common diseases have become exorbitantly expensive. We are use to new pharmaceutical brands costing a small fortune. But generics, one of which goes back to use in Egyptian times? Really? Allopurinol and asthma inhalers that are cheap but effective medications have become unaffordable to those that need it the most: Simply stated, those that can't breathe and those that ...

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During our weekly physician conference,  I discussed a patient with a suspected autoinflammatory disease.  An elderly male, he had a history of recurrent fevers, hives, and elevated inflammatory markers, which had gone untreated for many years.  Eventually, he developed renal amyloidosis, and was finally referred to rheumatology clinic for further evaluation.  Although he had many of the classic signs and symptoms of an autoinflammatory disease, his physicians had not recognized ...

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