November 2005

Medical instincts – the denouement

November 30, 2005

As many readers surmised, the bicarbonate was elevated secondary to hypoventilation. This patient’s ABGs (on 4 L) revealed a pH of 7.3, pCO2 74, pO2 66. He has the classic Pickwickian syndrome. To flesh out the story, the patient suffers with PTSD. He had CPAP prescribed, but he was unable to tolerate it psychologically. He [...]

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Concerns about professionalism in the UK

November 30, 2005

Student doctors say many may quit A loss of medical professionalism will lead more doctors to quit the career entirely, according to trainee medics. A poll of more than 2,000 future doctors found eight out of 10 shared this concern. They said factors outside medicine, such as public expectations, may undermine a good relationship between [...]

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Increasing the number of medical school graduates

November 30, 2005

Dr. Jordan Cohen, outgoing president of AAMC, understands. In his last presidential address – “The Work Ahead” he calls for a major increase in US medical school graduates. Challenge number 5 is to enlarge the capacity of LCME-accredited medical schools. As Yogi Berra is famously credited with saying, ‘prediction is a risky business, especially about [...]

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Medical instincts

November 29, 2005

Today I present a puzzle from my current inpatient service. The patient is a 60 yo veteran who comes in for increasing dyspnea. He carries a diagnosis of obstructive sleep apnea, has CPAP prescribed but does not take it. A recent echocardiogram showed normal left ventricular function. Previous pulmonary function studies showed no obstructive or [...]

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Grand Rounds 2.10

November 29, 2005

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More on olive oil

November 28, 2005

Whenever I go to a restaurant, I ask for olive oil instead of butter. While I like the taste better, it is also nice to know that olive oil likely has health benefits. Olive oil’s heart effect located viagra free viagra buy viagra online generic viagra how does viagra work cheap viagra buy viagra buy [...]

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2 bits, 4 bits

November 28, 2005

Gimme an Rx! Cheerleaders Pep Up Drug Sales As an ambitious college student, Cassie Napier had all the right moves – flips, tumbles, an ever-flashing America’s sweetheart smile – to prepare for her job after graduation. She became a drug saleswoman. At game time, Onya cheers on the Washington Redskins. But she saves some of [...]

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A nice story – the war on TB

November 25, 2005

Health Officials Hail Battle Against TB Health officials hailed a global partnership against tuberculosis on Thursday that is providing developing countries with $70 million in investments and technology to help them produce low-cost drugs to fight the disease. The project, led by the World Health Organization, pools the resources of drug companies, universities and international [...]

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A question about sudden death

November 23, 2005

A reader writes: I’m curious about why you put Torsades des Pointes as one of the possible culprits. From what I gathered from my ACLS certification class earlier this year, that was a big finger pointing toward a pharmacological cause of the arrhythmia. Am I remembering incorrectly? Most Torsades is caused by pharmaceuticals. However, the [...]

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An athlete almost dies

November 23, 2005

Eric McErlain of Off Wing Opinion (my favorite sports blog) occasionally asks me to write about sports related medical issues. Today I wrote about the near sudden death of Jrir Fischer, a professional hockey player. For those interested: Jrir Fischer – medical speculations I mostly write about why athletes might suddenly die, speculating on what [...]

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