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Head And Neck Cancer Surgeon Steps Out Of His Comfort Zone And Into Kenya

Traveling makes one modest – you see what a tiny place you occupy in the world.
-Gustave Flaubert

Tumor ImageWe have come to Kenya, expecting to work outside of our “comfort zones.”

Our patient has arrived from miles away, riding on the back of her husband’s bicycle. She has an enlarging, bleeding mass growing off of the side of her neck. There are no pathologists available, so we are uncertain what kind of tumor it is, although it appears to be a cancer. She has been wearing a scarf to hide the mass for the past year; her head covering is speckled with blood.

We are anxious. Unexpected things can happen in an operating room this far from home. We expect Read more »

Cerebral Vasculitis Occurring With A Corpus Callosum Infarction

Cerebral vasculitis is a known cause of ischemic and hemorrhagic strokes and has been described as one of the rare but important causes of corpus callosum infarction. Biopsy-proved giant cell arteritis causing callosal infarction is an exceedingly rare finding because a tissue specimen is usually not obtained and conclusions are drawn on the basis of clinical and radiologic findings alone. We present a case of callosal infarction, which evolved and eventually affected large portions of both cerebral hemispheres.

A 63-year-old woman presented to our hospital with left-sided numbness and neglect, cognitive changes, and apraxia. One month earlier, she was found to have a C-reactive protein level of 8.0 mg/dL (normal <0.5 mg/dL) and 75% stenosis in both femoral arteries. These results prompted Read more »

*This blog post was originally published at AJNR Blog*

More Bad News About The Obesity Epidemic In America

A report released recently by the Robert Wood Johnson Foundation and the Trust for America’s Health issued some grim warnings about the current and future state of the U.S.’s obesity epidemic.

Bluntly titled “F is for fat: How obesity threatens America’s future 2011,” the report found that obesity rates rose in 16 states since 2010 and that more than 30% of people are obese in 12 states, compared with one state just four years ago. The South is still the worst-faring region—nine out of 10 states with the highest obesity rates are located there.

The report compared today’s data with data from 20 years ago, when no state’s obesity rate exceeded 15%. Now, only one state—Colorado—has a rate below 20%. The report also points out that despite the increased attention paid to obesity by government (not to mention the media), no states posted a decrease in rates over the past year. Diabetes and hypertension rates have also risen sharply over the past two decades, the report said.

Recommendations to address the problem include preserving and in some cases restoring federal funding for obesity prevention and implementing legislation to improve nutrition in schools, among others.

Meanwhile, two researchers are making headlines for proposing a more extreme solution: Read more »

*This blog post was originally published at ACP Internist*

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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