Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 60-year-old man is evaluated for a 5-month history of exertional chest discomfort that improves with rest. His symptoms have progressively worsened such that he has reduced his activity to a minimum. Medical history is significant for hypertension and hyperlipidemia. Medications are low-dose aspirin, losartan, hydrochlorothiazide, and atorvastatin. On physical ...

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A wise professor of medicine always told me as a young physician, “Eighty-year olds are to be revered and not messed with.”   This is especially true for those 90 or older.  Here in South Florida, there is always some senior citizen telling us today’s 80 is yesterday’s 60, and today’s 70 is yesterday’s 50.  It just isn’t so.  I see this erroneous belief of the elderly having the healing power ...

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I am healthy, a mom of two boys, a wife, and an emergency medicine PA for the past 12 years. I don't just say I'm healthy to say it, but I really am. I've never taken medications, until now. It's New Year's Eve, and I'm scheduled for my injection. I grab my sharpie and write injection on the 31st. I suddenly didn't know whether to laugh, cry, or be angry. ...

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All of us are aware of what has been termed our “obesity epidemic.” The current prevalence of obesity among adults in the U.S. is around 40 percent, a dramatic increase over the past 50 years; it was about 15 percent in 1970. Rates are also increasing across first world countries, so we are not alone in this. Obesity is defined as a body mass index (BMI) greater than 30. Values of ...

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The Somalian government should be ashamed of condoning the widespread occurrence of female genital mutilation. According to UNICEF, 98 percent of women from the ages 15 to 49 have undergone FGM in Somalia from 2005 to 2014. As defined by the World Health Organization, FGM is a procedure that removes or injures female genitalia for a non-medical purpose. This procedure has absolutely no health benefits for women. It ...

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One of the advantages of practicing clinical medicine, and seeing patients daily for many years, is you develop your own long-term study regarding certain medical health issues. In the area of hypertension, I have been taught by the best since my internship with pioneers such as Eliseo Perez Stable and Barry Materson at the University of Miami affiliated hospitals, Jackson Memorial Program, ensuring that their trainees were up to the ...

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The holidays bring friends and family together for celebrations and the chance to reconnect with people we may not see regularly during the rest of the year. But for people who are the caregivers for a parent, spouse, partner, or other family member who is living with Alzheimer’s disease or other forms of dementia, the holidays can be more complicated. Beyond the stress of continuing to provide care during an especially ...

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I first became John Dolan’s social worker following his colon surgery, surgery for removal of a very large cancerous tumor, the largest the experienced surgeon said he had ever seen.  John was told he had about three months to live. So much for predictions!  He lived another 16 months. To the chagrin of his very large Catholic family, he was one of thirteen children; he was all the time rejecting their ...

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The debate over the safety of giving birth at home, both for the mother and for the infant, has continued for years. I’ve written about the issue myself. From time immemorial until about 75 years ago or so, most babies were born at home. Now it’s around 1 percent in the USA, although it’s much higher than that in many Western European countries. The shift to hospital births ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 79-year-old man is evaluated for a 2-month history of progressive malaise and weakness, aching bilateral shoulders and hips, and stiffness for 2 hours in the morning and after immobility. He recently noted aching in his jaw when chewing. He also reports new left-sided headaches. Last week he had ...

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