STAT_LogoDear Doctor, Please help me understand why so few of you have chosen to treat people with opioid addictions. I’ve been following the topic of opioid addiction for years. It is one of the most common themes for First Opinion submissions. Authors routinely point to the importance of medication-assisted therapy, the standard of care for individuals ...

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I loved my endocrinology block in medical school. It was one of my favorite units. One hormone acts on another gland, which either induces a positive feedback releasing its successor hormone or a negative feedback blocking its predecessor. It was step-by-step. It was straightforward. I loved the material so much that I reached out to an endocrinologist to shadow her. I wanted to see the power of what we were learning ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 24-year-old woman with longstanding atopic dermatitis is evaluated for an acute worsening of her disease in the past week. She has had increased pruritus and now has multiple painful areas within the involved skin. She has been applying petrolatum jelly and triamcinolone ointment and washing with gentle cleansers without improvement. ...

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I recently listened to DDx, a new podcast from Figure1. In their third episode, a 37-year-old man presents to the emergency department in the middle of the night with persistent vomiting and retching. He is highly vocal and agitated. Upon questioning, he reveals that he experiences these episodes frequently and previous investigations have all been inconclusive. His skin is noted to be flushed and his father ...

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Several years ago, a colleague of mine did a procedure on my daughter. What was supposed to be routine has become a nightmare for her.  When he saw her post-op, he told her she was fine.  Because of this obfuscation, years went by before she really understood how damaged she was. By then, the statute of limitations had lapsed and she had no recourse. Still seeking closure on this disaster, my daughter ...

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The keto diet has recently garnered much fame for its apparent ability to improve diabetes and obesity – results so impressive the Journal of the American Medical Association recently highlighted the diet and thereby christened it as something more than a low-carb craze. However, not all the evidence supports such a positive outlook, leading the diet to straddle the increasingly blurred lines between faddist snake ...

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Recently, a journalist with NPR asked her audience if sleeping with your baby is as dangerous as doctors say.  In short, yes, it is very dangerous. In the article, Michaeleen Doucleff repeatedly trivializes the danger of parents co-sleeping with their baby.  She uses anthropological evidence to reassure parents that sleeping with their infant is safe if parents don’t drink, smoke, or use illicit drugs.   She makes light of ...

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People with liver failure and cirrhosis die every year because there are not enough livers available. Who should receive the treasured life-saving organ? There is an organ allocation system in place, which has evolved over time, which ranks patients who need liver transplants. Without such a system, there would be confusion and chaos. How can we fairly determine who should receive the next available liver? What criteria should move a ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 68-year-old man is evaluated at a follow-up appointment. He has a 7-year history of heart failure secondary to ischemic cardiomyopathy. Over the past 6 months, he has had three hospitalizations for exacerbations of his heart failure. He currently has exertional dyspnea while getting dressed, and his maximal activity level is ...

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Kate Spade. Anthony Bourdain. Two celebrity icons splashed the headlines recently as both figures committed the unthinkable act of suicide. Both left behind young daughters and significant others reeling in the background wondering what had just happened. Kate Spade was the colorful fashionista of purses and dresses. Anthony Bourdain was the connoisseur of delectable eats traveling the world. How could such successful personas mask the pain hidden within? Even Robin ...

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