Sympathy is the missing art in medicine
I still remember when my phone rang with an eerie sound, early in December 2013. The oncologist I had seen a couple of days earlier was on the other end asking me to return to the hospital ASAP because my bone marrow biopsy results was consistent with acute leukemia and I was at risk if bleeding. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - March 9, 2014 Category: Family Physicians Tags: Physician Cancer Medical school Source Type: blogs

Strike 3 Your'e Ou......Take A Walk?!?
I'm a baseball fan. No doubt about it. GO SOX! As I was walking or limping home last night I got to thinking about my general overall health over the years. It was a lot to take in on a 10 minute walk. But what got me to thinking was how many times I have fought and ultimately one against the odds. In 2001, I took an overdose of antidepressants, and spent days in a coma. Just when the doctors told my friends and family they were no longer going to try and bring me out of the coma because the seizures were too intense, I beat the odds and opened my eyes. Despite their concerns of having permanent brain damage, havin...
Source: Still arriving. - February 14, 2014 Category: HIV AIDS Source Type: blogs

Answer to Case 285
Answer:  leishmaniasis, presenting as atypical perianal and rectal wart-like lesions (see below for patient follow up)As Anon and Florida Fan mention, the differential of small intracellular objects in the 2-5 micron range includes leishmania amastigotes, small yeasts (primarily Histoplasma capsulatum), microsporidia spores, and Toxoplasma gondii tachyzoites. We can exclude Histoplasma capsulatum, other yeasts, and microsporidia based on the negative GMS stain, thereby leaving Toxoplasma and Leishmania  in our differential.  These two organisms are differentiated by morphologic features: Toxoplasma...
Source: Creepy Dreadful Wonderful Parasites - December 8, 2013 Category: Pathologists Source Type: blogs

Jessica L.
Jessica’s story is truly inspiring. Her battle back to better health is the kind of empowerment I hope to facilitate with Grain Brain. Adopting a Grain Brain-friendly lifestyle not only gave Jessica back control of her health, but her entire life. – Dr. Perlmutter As a travel writer with a somewhat unusual story of having sold everything my husband and I valued and owned, with no storage, on Halloween, one year ago, we left our lifetime home, family, and friends to travel the world and write about our daily adventures and share photos. Just one year prior to that, I wasn’t able to go to any of our grandch...
Source: Renegade Neurologist - A Blog by David Perlmutter, MD, FACN - November 1, 2013 Category: Neurologists Authors: gbadmin Tags: Success Alzheimer’s gluten free Grain Brain low-carb Spinal degeneration sugar travel Source Type: blogs

MKSAP: 56-year-old woman with Sjögren syndrome
A 56-year-old woman is evaluated during a follow-up visit for a 6-year history of Sjögren syndrome treated with low-dose hydroxychloroquine and cyclosporine eyedrops. She has had two episodes of cutaneous vasculitis, which resolved with corticosteroids. On physical examination, temperature is 36.4 °C (97.6 °F), blood pressure is 116/64 mm Hg, pulse rate is 72/min, and respiration rate is 18/min. Oral mucous membranes are dry. There is a new firm, left parotid gland enlargement without tenderness or warmth, reported by the patient to be progressive over several months, with asymmetry of the parotid glands. Laboratory stu...
Source: Kevin, M.D. - Medical Weblog - October 5, 2013 Category: Family Physicians Tags: Conditions Cancer Rheumatology Source Type: blogs

2-Midnight Rule: Medicare's New 2013 Inpatient Hospital Payment Policy Explained (CMS 1599-P Now 1599-F).
UPDATE August 4th, 2013.  The CMS 2-Midnight rule is official.  On August 2, 2013 the Centers for Medicare & Medicaid Services (CMS) issued a final rule [CMS-1599-F] updating fiscal year (FY) 2014 Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital Prospective Payment System (LTCH PPS).  As part of this ruling the 2-Midnight rule was codified into law. The final rule modifies and clarifies CMS’s longstanding policy on how Medicare contractors review inpatient hospital admissions for payment purposes. Under this final rule, in additi...
Source: The Happy Hospitalist - May 6, 2013 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs

2-Midnight Rule: Medicare's New 2013 Inpatient Hospital Payment Policy Explained (CMS 1599-P).
Hospitalists have risen to the challenge of only providing medically reasonable and necessary inpatient hospital care under the rules of three-midnight medicine.  They have refused to delay patient discharges just so patients could enjoy  high quality care in the nursing home of their choice that is paid for by our Medicare National Bank.  They are willing to accept discharge to home and face the music of bad patient satisfaction survey scores filled out by angry family members who are upset their hospitalist wouldn't commit Medicare fraud to get grandma to a Medicare paid nursing home for the next...
Source: The Happy Hospitalist - May 6, 2013 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs

Still alive and kicking!
Hello out there! Well A LOT A LOT A LOT has occured as you can possibly imagine since June of 2011. And we've a lot to cover. First of all I have kept up and checked on occassion in regards to old blog comments and what other bloggers have said. So in that regards I have been around. This blog was/is a wonderful outlet for me to come to especially when I am sick. I get to have random and crazy rants and say things that I WOULD never never say in public because for some reason it's just more acceptable in writing. It has it's purpose and it's time. I have found my true calling in life. No, it's not being a porn s...
Source: Still arriving. - May 5, 2013 Category: HIV AIDS Source Type: blogs

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Protocol for Synpotic reporting of Breast  excision specimen with diagnosis of Ductal Carcinoma In Situ (DCIS) of the BreastProtocol applies to DCIS without invasive carcinoma or microinvasion.The complete pathology report should include following parameters.Specimen type.___ Partial breast___ Total breast (including nipple and skin)___ Other (specify): ___ Not specified Procedure ___ Excision without wire-guided localization___ Excision with wire-guided localization___ Total mastectomy (including nipple and skin)___ Other (specify): _______________________________ Not specified Lymph Nod...
Source: Oncopathology - August 25, 2011 Category: Cancer & Oncology Tags: Protocol for Synpotic reporting of Breast excision specimen with diagnosis of Ductal Carcinoma In Situ (DCIS) of the Breast Source Type: blogs