I was working in a rural health clinic when I went into to see a new patient.  Amy was 18 years old, with her 6 day old newborn son by her side. I introduced myself and then asked, "what brings you into the clinic?" Amy responded, "Shortly after giving birth, I started having problems with shortness of breath, ankle swelling, and high blood pressure.  I told the OB residents and they brushed ...

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One interesting therapy for headaches, which generates a lot of questions from patients, is acupuncture.  Acupuncture is a traditional Chinese therapy which has been around for centuries but only came around to wide spread use in the West (United States and Europe) in the 20th Century. There are many misconceptions about acupuncture.  One question I get regularly is “Do you think acupuncture works?”  This is a difficult question to answer because ...

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With the advancement in healthcare and technology we are able to greatly extend the life expectancy of the population. For the healthcare provider that means that more elderly patients and patients with multiple chronic medical conditions are being admitted to the hospital. Some “complex” patients require a multidisciplinary approach with the involvement of multiple consultants. As a primary attending physician for the patient you often have to deal with contradictory ...

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An article recently published in the Journal of the American Medical Association reported on a study that showed elderly women (mean age 82) who had sleep apnea were more likely to develop cognitive deficits than a similar group of women who did not have sleep apnea.  The study followed these women over a period of several years.  Although this study received a lot of press, the finding – one of ...

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If you don’t know there is a problem how can you fix it?  Checking blood sugar for a diabetic is mandatory.  This applies to both Type I and II diabetics.  I check my blood sugar at least 8 times per day. I do this to allow me to closely monitor my blood sugar level.  As a disciplined diabetic, I run the risk of low blood sugar episodes more frequently ...

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Each year, biologically based disorders of brain development – autism, attention deficit/hyperactivity disorder (ADHD), mental retardation, dyslexia, and subclinical neurodevelopmental disabilities – affect between 400,000 and 600,000 of the four million babies born in the United States. This means that between 10% and 15% of American children have some kind of learning disability. Reported rates of autism spectrum disorder (ASD) are sharply increasing.  The CDC reports that the rates of ASD increased ...

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After seeing the NBC Nightly News last night, a physician urged me to write about what he saw: a story about a "simple blood test that could save women's lives." Readers - and maybe especially TV viewers - beware whenever you hear a story about "a simple blood test." And this is a good case in point. Brian Williams led into the story stating: "Two of three women who die suddenly of cardiac heart ...

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The science of nutrition is changing and not in the way you might expect. After years of "reductionist" thinking — where food has been viewed as the sum of its parts – a call to treat food as food has been sounded. No more poring over nutrition labels to calculate grams of fat or chasing down the latest go-to chemical – be it vitamin E, fish oil or omega-3. ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. An 89-year-old woman is evaluated for dizziness that she has had for the past year, mainly while standing and ambulating. The dizziness is described as a sense of unsteadiness. The symptoms can last for minutes to hours, and she has at least 4 to 5 ...

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There are some important new recommendations about tonsillectomy — taking out the tonsils — as a treatment for recurrent strep throats. Some of us can recall a time when getting your tonsils out was one of the rites of passage of childhood. Usually a related procedure is added — an adenoidectomy, removing the adenoids as well. It’s called a T&A in the medical world, and it’s one of the ...

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