Recently, I was challenged by the mother of a trauma patient. She had read about traumatic spleen injuries online and was concerned about the risk a hematoma presented and wanted the ultrasound to look at the hematoma. I found myself floundering around trying to explain how this study was unnecessary. In frustration, I turned to my nurse practitioner and said, “Heather, can you translate for me?” This is a common problem. ...

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Part of a series. Cognitive decline is a normal process of aging; Alzheimer’s is a disease. Cognitive decline due to aging can be slowed but not halted with appropriate lifestyle approaches. The "big four" are equally important to slow cognitive decline: Don’t smoke. Reduce stress. Exercise often. And eat a quality diet in moderation. Good sleep and brain stimulation need to be added for maintaining good cognition. Some form of ...

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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 seen for follow-up evaluation of Parkinson disease, which was diagnosed 10 years ago. Although his symptoms initially were well controlled with medications, he has experienced increasing fluctuations in motor symptoms, specifically tremor at rest and slowness, within the past 3 years. Medications are ...

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Two months into my pediatric residency, while working on an overnight call, I encountered my first medical mistake. We, fortunately, had had a very good night, and all patients had remained stable. It was an hour before sign-out to the morning team, that I received a page. I quickly held my pager and dialed the 4-digit number, only to find a busy dial tone. I was a little surprised and ...

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I am not a doctor.  (Yet.)  I am a novice third-year medical student, somewhat able to perform and document a physical exam on a sleeping child, to dial the correct number to call a consult and to make wild guesses about chest X-rays (“I see a consolidation?”). I write about medicine not from a position of experience, but of malleability.  I want to become like the best doctors I see. Towards ...

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For American conservatives, Britain’s NHS is an antiquated Orwellian dystopia. For Brits, even those who don’t love the NHS, American conservatives are better suited to spaghetti westerns, such as Fistful of Dollars, than reality. The twain are unlikely to meet after the recent press surrounding Charlie Gard, the infant, now deceased, with a rare, fatal mitochondrial disorder in which mitochondrial DNA is depleted — mitochondrial depletion disorder (MDD). In this condition, ...

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Part of a series. Can we slow the aging process? The answer is a definite yes. It’s not easy and requires some real diligence, but aging can be slowed. When thinking about a car we all know “old parts were out.” It is equally true for the human body. But less appreciated is the fact that we can either slow or speed up the process, just as good preventive ...

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A study published in JAMA looking at the brains of former football players donated to a brain bank, a highly selective sample, found signs of chronic traumatic encephalopathy (CTE) — a degenerative neurological disease — in nearly all deceased players examined. The mainstream media converged towards numerical consensus.

Patient psychology is increasingly recognized as an important contributor to health outcomes. What patients believe about their health and their providers can significantly affect their initiative and their adherence. It is important to recognize that factors that appear to be unrelated to medical care can influence feelings about that care, as well as outcomes. The reason this occurs is that the brain is not designed to parse out each element of ...

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For many, American football is a beautiful game that is simple to enjoy but complex to master. Choreographed with a mixture of artistry and brutality, it features the occasional “big hit” or bone-jarring tackle, forcing a fumble and turning the tide of the game. But with this part of football comes justified concern about the long-term health effects of engaging in this type of activity over time, concerns that abound in ...

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