Most men diagnosed with prostate cancer don’t die of the disease. Between 2011 and 2015, 112.6 per 100,000 men per year were diagnosed with prostate cancer in the U.S., but only 19.5 per 100,000 men per year died of the disease over that same period of time. That is still far too many deaths. But the huge disparity between deaths and diagnoses arises in large part from overdiagnosis of prostate ...

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Like many pediatric intensivists, I care from time to time for victims of child abuse in the form of what is often called “shaken baby syndrome.” This syndrome is a characteristic constellation of finds that happen when a strong person grasps a child around the chest and aggressively shakes the infant. It was first described by Caffey, a pediatric radiologist, fifty years ago. The baby may have ...

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The New York Times is interested in fecal transplants. This is the euphemistic term for taking feces, poop, crap, sh*t, bowel contents from one person and putting it into another person. There are various procedures for doing this, from drying it and putting it into capsules to making it liquid and introducing it by enema, nasogastric tube or colonoscopy. It is a remarkably effective treatment for a wide range of ...

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When it comes to plastic surgery, I have found that many people -- doctors included -- expect post-surgical pain, so they plan for that assumption. This means preparing for days, weeks, or months of narcotics use. This mode of thinking begins long before any incisions are made, virtually guaranteeing a patient will be taking opioids. Instead, I advocate for pain prevention. This approach requires strategizing ahead of any procedure, making use ...

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acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. In the run-up to the Academy Awards this year, like many people I made a concerted effort to see most of the top-nominated pictures.  Of particular interest was Bohemian Rhapsody, the biographical film about the lead singer of the rock band Queen, Freddie ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 52-year-old woman is evaluated during a follow-up visit. She was discharged from the hospital 3 weeks ago following a small non–ST-elevation myocardial infarction treated with drug-eluting stent placement in the right coronary artery. An echocardiogram obtained during hospitalization showed normal left ventricular function and normal valvular function. Her ...

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I became a nurse at the age of 23. I was pregnant with my first son and dove into nursing headfirst, accepting a job in the pediatric ICU of the hospital where I worked. I still remember the call when I received the job offer. I hung up and jumped up and down, screaming in excitement. I couldn’t believe that I got my dream job, the job that wove my ...

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I was working a few days ago and pulled a tooth.  Mind you, it’s not something I do with any regularity.  However, it was a very sweet little lady who was too weak and ill to get to the dentist and had other issues.  That lower incisor was loose, and constantly in the way. Furthermore, it was painful. I had seen her for something else in the emergency department.  I took ...

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What if I told you our children were being exposed to a known carcinogen, and it was increasing with successively younger kids? If that carcinogen were a preservative in packaging or chemicals from industrial waste, there would be widespread outcry. But it’s neither of those things. It’s something far more dangerous, but that we’ve somehow accepted as no big deal. But the risk is very real. The carcinogen is excess ...

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During my time in practice, I had at least eight patients who came to me sure they had systemic lupus erythematosus, also commonly called SLE or lupus. This is an autoimmune disease, characterized by joint pain, that can affect almost any organ, including skin, kidneys, brain, and heart, and can even be fatal. In every case, they had been given this diagnosis because of a blood test called an ANA, ...

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