MKSAP: 60-year-old woman with substernal chest pain
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 60-year-old woman is evaluated for a 3-week history of substernal chest pain. The pain is dull, nonradiating, and unrelated to activities. Sometimes the pain is worse after eating spicy foods and can be occasionally triggered by emotional stress. She has not had shortness of breath or weakness. She is moderately active, walking a mile each day. She generally eats a “healthy heart” diet but has never had her lipid levels evaluated. She has never smoked cigarettes. There is no family history of heart disease...
Source: Kevin, M.D. - Medical Weblog - July 8, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Heart Source Type: blogs
What if I feel fine eating grains?
Many health problems from grain consumption are overt–you can feel it or see it, such as fibromyalgia or skin rashes.
But many consequences of grain consumption are silent and can only be seen with lab tests or other investigative tools such as endoscopy. But the lack of current symptoms does not mean that there is not a future of health problems from grain consumption.
Understand this basic fact and you can be enormously empowered in diet and health.
About Undoctored:
We are entering a new age in which the individual has astounding power over health–but don’t count on the doctor or healthcare system t...
Source: Wheat Belly Blog - June 29, 2017 Category: Cardiology Authors: Dr. Davis Tags: Undoctored Wheat Belly Lifestyle autoimmune gluten gluten-free grain-free grains heart disease Inflammation lipoproteins Source Type: blogs
Celiac Disease: A Serious, Life-Changing Condition
I met Paul Graham courtesy of one of his essays. Then, we talked by phone and I read – no devoured – his book, In Memory of Bread: A Memoir. Pardon the pun. Paul is a professor of English Department at St. Lawrence University in Canton, NY and on July 1 becomes Department Chair. He focuses on fiction and non-fiction creative writing and lives with his wife, Bec and their German shepherds.
Paul, your book is the best description I’ve read about the challenges of being diagnosed with celiac. Can you summarize what happened? Given your experience, what recommendations would you have for clinicians? Should celiac be su...
Source: Disruptive Women in Health Care - June 5, 2017 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Uncategorized Source Type: blogs
Revamp health regulations to reduce cost and improve patient safety
Johns Hopkins ophthalmologist Oliver Schein has found a simple way to save a half a billion dollars a year from our country’s health care bill, with no negative effect on patient health. The only thing standing in the way is a stubborn government requirement.
Seventeen years ago, Dr. Schein and colleagues published a study finding that cataract surgery patients who underwent routine preoperative testing — such as an electrocardiogram, blood tests, and imaging studies — had no fewer complications than those with zero testing. The risks of this surgery are so small that they can typically be identified and ...
Source: Kevin, M.D. - Medical Weblog - May 17, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/peter-pronovost" rel="tag" > Peter Pronovost, MD, PhD < /a > Tags: Policy Health reform Source Type: blogs
Bob Wachter ’ s 2017 Penn Med Commencement Address “ Go to Radiology ”
By ROBERT WACHTER, MD
Dean Jameson, Trustees, Faculty, Family and Friends, and most of all, Graduates of the Class of 2017:
Standing before you on this wonderful day, seeing all the proud parents and significant others, I can’t help but think about my father. My dad didn’t go to college; he joined the Air Force right after high school, then entered the family business, which manufactured women’s clothing. He did reasonably well, and my folks ended up moving to a New York City suburb, where I grew up.
There were a lot of professionals in the neighborhood, but my dad admired the doctors the most. He was even a little e...
Source: The Health Care Blog - May 17, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Penn Radiology Robert Wachter Speeches UCSF Source Type: blogs
Flex Robotic System, a Snake to Navigate Colon for Transanal Endoscopic Procedures
Medrobotics out of Raynham, Massachusetts won FDA 510(k) clearance to introduce its Flex Robotic System for performing colorectal endoscopic procedures. Heralding the future we live in, the robotic snake is inserted transannally and is then steered using a 3D joystick to the treatment site. It can take on different shapes, depending on the path it took to reach the target. Once in place, it will remain rigid to permit the introduction of instruments, such as graspers and needle drivers, to perform whatever procedure is necessary.
Rigid instrumentation limits the reach of the physician, particularly through anatomical lume...
Source: Medgadget - May 15, 2017 Category: Medical Devices Authors: Editors Tags: GI Surgery Source Type: blogs
LITFL Review 279
LITFL: Life in the Fast Lane Medical Blog
LITFL: Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog
Welcome to the 279th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM.
The Most Fair Dinkum Ripper Beauts of the Week
An incredible talk from Tom Evens discussing how we train for the long game with a focus on margin...
Source: Life in the Fast Lane - April 23, 2017 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review LITFL R/V Source Type: blogs
April in Paris: Voyager Avec Enfants (Day Five)
" A touts les glories de la France. "Coming into this trip, I scheduled two guided tours, and deliberately put them at the end of the trip. I wanted to leave things a little open-ended and less time-pressured at the start of the week, just to allow for jet lag and child recalcitrance and the general unpredictability of kid life. However, Idid have two organized excursions I wanted for us to do, the first of which was a bike tour of the grounds at the Palace of Versailles.Generally speaking, there ' s enough in the city of Paris to do with kids, particularly if you ' re only planning to be here for less than a week, as we a...
Source: the underwear drawer - April 7, 2017 Category: Anesthesiology Authors: Michelle Au Source Type: blogs
H. pylori, a true stomach “bug”: Who should doctors test and treat?
In 1982, two Australian scientists discovered that a certain bacterium, Helicobacter pylori, was a common cause of persistent stomach inflammation and stomach ulcers. This realization revolutionized ulcer treatment.
While fairly common, this infection usually causes no symptoms, but it can sometimes lead to ulcers in the stomach or the very first part of the small intestine (duodenum), and to certain types of stomach cancer. There is also evidence linking H. pylori infection to other conditions like iron-deficiency anemia and vitamin B12 deficiency. The bacteria are thought to spread through contaminated water, vomit, or f...
Source: Harvard Health Blog - April 5, 2017 Category: Consumer Health News Authors: Wynne Armand, MD Tags: Digestive Disorders Health Infectious diseases Tests and procedures Source Type: blogs
This 2-minute video shows you why you need a colonoscopy
March is colon cancer awareness month.
Created by gastroenterologist Amit Sachdev, this video was selected by the American Society of Gastrointestinal Endoscopy as part of their colorectal cancer screening campaign. Enjoy.
Image credit: Shutterstock.com
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 24, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/admin" rel="tag" > Admin < /a > Tags: Video Cancer GI Source Type: blogs
Gastrointestinal endoscopy and sonography workforce supply review
Department of Health (DH) - These reports present a summary of surveys of the ultrasound and endoscopy workforce in England. The reviews aim to inform the commissioning of education, training and resourcing of these sections of the workforce as well as help with short- and long-term workforce planning.Endoscopy reviewSonography review (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - March 9, 2017 Category: UK Health Authors: The King ' s Fund Information & Knowledge Service Tags: Workforce and employment Source Type: blogs
Case of the Week 436
This week ' s case was generously donated by Dr. Sabarinathan from Madras Medical College in Chennai, India. The patient is a young man with a 2-week history of epigastric pain and vomiting. Physical examination was normal, and a complete blood count showed only a mild anemia (hemoglobin of 9.8 g/dL). An ultrasound of the abdomen was normal and so an upper gastrointestinal endoscopy was performed. This is what was seen:Identification? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - March 1, 2017 Category: Parasitology Source Type: blogs
Answer to Case 436
Answer:Ascaris lumbricoidesAlthough we don ' t have the worms to examine in this case, the presence of multiple large tan-white worms with a smooth outer cuticle within the lumen of the intestine is strongly consistent withA. lumbricoides.The femaleA. lumbricoidescan get quite large, reaching lengths of 35 cm!One reader also raised the possibility of anisakiasis given that these worms were found on an upper endoscopy. However, the large size would exclude anisakid larvae given that they only reach a few centimeters in length. Also, the presence of multiple worms would be unlikely for anisakiasis, since usually only 1 ...
Source: Creepy Dreadful Wonderful Parasites - February 27, 2017 Category: Parasitology Source Type: blogs
Over-the-Counter FIT Test for Colonic Cancer Looks Effective
A large very number of colonoscopies are performed yearly in the U.S. for cancer screening. For older male non-smokers, colonic cancer ranks with prostate cancer as a major cancer threat (see:Men and Cancer Risk). Here are some specific numbers about the frequency of gastroentestinal endoscopy (see:$4.4 Billion Gastrointestinal Endoscopic Market in the U.S. and Europe Projected for 2020):Gastrointestinal endoscopy is one of the most widely performed medical procedures in the world.It is projected that there will be over 75 million gastrointestinal endoscopic procedures performed in the U.S. and Europe com...
Source: Lab Soft News - January 24, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Cost of Healthcare Laboratory Industry Trends Medical Consumerism Medical Research Point-of-Care Testing Test Kits and Home Testing Source Type: blogs
More Ailments
So yesterday I blogged about my stupid sleep test, CPAP machines, and other whininess. I wrote that I have a new ailment, and what ' s another ailment. But seriously, another ailment? I don ' t really want another ailment. In fact, I am kind of sick of being sick and having ailments and more ailments.Honestly I just want to stop having ailments, be a healthy person, and and have a life. I mean what do I do now? I go to the gym three times a week. I go to doctor appointments and PT now. I don ' t go to work. The only other places I go regularly are the library, grocery store, and knitting group.I would prefer to do thinks l...
Source: Caroline's Breast Cancer Blog - December 5, 2016 Category: Cancer & Oncology Tags: apnea CPAP lack of sleep whininess Source Type: blogs
