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Latest Posts

Imaging That Can Reliably Distinguish Between Benign And Malignant Pancreatic Cysts

Optical Coherence Tomography (OCT) has been demonstrated to be able to differentiate between benign and potentially malignant pancreatic cysts. Researchers from Massachusetts General Hospital, Physical Sciences, Inc., Brigham and Women’s Hospital, and Brandeis University have published their findings in Biomedical Optics Express. In their study they used surgically removed pancreas specimens of patients with pancreatic cysts to assess them with OCT and compare the results with histology examinations. OCT was able to reveal specific morphological characteristics used to differentiate between the low-risk and high-risk cysts. Read more »

*This blog post was originally published at Medgadget*

New Dietary Guidelines Give Little New Guidance

There isn’t much new in the latest iteration of the “Dietary Guidelines for Americans.” Three years in the making, the 2010 guidelines (released a tad late, on January 31, 2011) offer the usual advice about eating less of the bad stuff (salt; saturated fat, trans fats, and cholesterol; and refined grains) and more of the good stuff (fruits and vegetables; whole grains; seafood, beans, and other lean protein; and unsaturated fats). I’ve listed the 23 main recommendations below. You can also find them on the “Dietary Guidelines” website.

The guidelines do break some new ground. They state loudly and clearly that overweight and obesity are a leading nutrition problem in the United States, and that a healthy diet can help people achieve a healthy weight. They also ratchet down sodium intake to 1,500 milligrams per day (about two-thirds of a teaspoon of salt) for African Americans and people with high blood pressure or risk factors for it, such as kidney disease or diabetes. But the guidelines also leave the recommendation for sodium at 2,300 milligrams a day for everyone else, a move that the American Heart Association and others call “a step backward.”

Vague language spoils the message

One big problem with the guidelines is that they continue to use the same nebulous language that has made previous versions poor road maps for the average person wanting to adopt a healthier diet.

Here’s an example: The new guidelines urge Americans to eat less “solid fat.” What, exactly, does that mean — stop spooning up lard or Crisco? No. Solid fat is a catchphrase for red meat, butter, cheese, ice cream, and other full-fat dairy foods. But the guidelines can’t say that, since they are partly created by the U.S. Department of Agriculture USDA), the agency charged with promoting the products of American farmers and ranchers, which includes red meat and dairy products. “Added sugars” is another circumlocution, a stand-in for sugar-sweetened sodas, many breakfast cereals, and other foods that provide huge doses of sugar and few, or no, nutrients. Read more »

*This blog post was originally published at Harvard Health Blog*

Eat More Calcium To Prevent Calcium-Containing Kidney Stones?

Over the years I have had a number of patients with painful kidney stones and once they have passed (or been removed) I have felt at a loss to helping them prevent them. ”Stay hydrated” somehow didn’t seem adequate, although we know fluid intake can help stave off recurrent kidney stone attacks.

Some textbooks said “avoid calcium” since most stones are made of calcium oxylate. High oxylate levels can be found in some fruits and vegetables, as well as in nuts and chocolate. Yet there was no real scientific evidence that these foods caused stones. The evidence for who got kidney stones was all over the ballpark and for a physician, that means no prevention advice is really proven.

A new study published in the Clinical Journal of the American Society of Nephrology says that calcium rich foods such as low-fat milk and yogurt can be protective. What? Eat more calcium to prevent calcium-containing stones? It seems that higher intakes of calcium are actually associated with a reduction in kidney stone risk. Read more »

*This blog post was originally published at EverythingHealth*

Young Doctors Who Lie

This is something: A study published in the July 20, 2010 Annals of Internal Medicine finds that 5 percent of residency applications contain plagiarized content. The study from Boston’s Brigham & Woman’s Hospital is based on the personal statements of nearly 5,000 residency applicants that were matched against a database of published content.

The authors comment that the study is limited, among other things, by the fact that it was done in just one institution. It makes me wonder if the number is artificially high or potentially too low.

So why would medical students lie? Read more »

*This blog post was originally published at 33 Charts*

The Problem With The Newly-Launched “”

If a website touted misleading healthcare information, you’d hope the government would do something about it. But what do you do when the government is the one feeding the public bad information?

Last week the Obama administration launched the new It’s mostly an online insurance shopping website. It’s very much a federal government version of sites like or Massachsetts’ HealthConnector site, which have been around for years.

So when HHS Secretary Kathleen Sebelius, in announcing the new site, claims it gives consumers “unprecedented transparency” into the healthcare marketplace, you should wonder what she means. But that’s not the big problem with this site. Read more »

*This blog post was originally published at See First Blog*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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