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Patients are often exposed to cancer-causing radiation for little medical reason, a Consumer Reports investigation finds.

When James Duncan, M.D., a radiologist at Washington University in St. Louis, experienced intense pain in his abdomen in 2010, he rushed to a local emergency room. His doctors suspected kidney stones, but they wanted to be sure, so they ordered a CT scan. Duncan remained motionless as the machine captured a detailed, 3D image of his abdomen. He knew that the test was done when the machine stopped whirring. So he was surprised when the scanner kicked back on after a few seconds.

“I later learned that the technician running the CT mistakenly believed that the first scan didn’t include the top of my kidneys, and decided to acquire more images ‘just to be sure,’ ” Duncan says. “The irony: I was getting ready to give a lecture on reducing radiation exposure from medical imaging. And there I was, reluctantly agreeing to a CT scan and then getting overexposed.”

Duncan will never know whether that specific scan caused any long-term harm, because it’s almost impossible to link radiation exposure from any one medical test to a future illness. But like other researchers, he knows that doctors today order millions of radiation-based imaging tests each year, that many of them are unnecessary, and that the more radiation people are exposed to, the greater their lifetime risk of cancer.

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Read The Full Article - On The Wall Street Journal By Ron Winslow Nov. 16, 2014

CHICAGO—Millions of heart patients whose disease has been treated with tiny devices called stents may need to stay on an aggressive course of blood-thinning drugs longer than current practice to get the most protection against future heart attacks, a major study presented Sunday suggests.

In the study, which involved nearly 10,000 patients, those treated with aspirin plus a second anticlotting drug for 30 months had a sharp reduction in the risk of heart attacks and other complications compared with those who stopped one of the blood thinners after a year.

But prolonged use of a dual-agent strategy comes with increased risk of significant bleeding problems. Some patients experience annoying side effects such as nose bleeds and bruising. Experts said the challenge for doctors and patients alike is weighing the benefits versus risks in determining how long to remain on the therapy.

Current U.S. guidelines call for doctors to prescribe what is called dual-antiplatelet therapy for 12 months, and some cardiologists have urged even shorter treatment.

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The Wall Street Journal - January 14, 2013

Stomach, Back or Side? How You Slumber Can Aggravate Pain, Prevent the Body From Bouncing Back

Tossing and turning all night to find that perfect sleeping position? WSJ's Sumathi Reddy joins Lunch Break with new findings on which positions could help you rest up more efficiently. Photo: Getty Images.

Tossing and turning all night to find that perfect sleeping position?

Experts say there is no one right way to sleep. But for people with certain types of pain and medical conditions, there are positions that can help keep problems from getting worse and may even alleviate them. In some cases, sleeping in the same position night after night can itself create pain, such as neck or shoulder problems.

"It's important that people take time to think about how they position themselves when they sleep," said Peggy Brill, a Manhattan orthopedic physical therapist. "Rest is important for the muscular skeletal system to recover" from the day's stresses, she said. "The proteins get back into the muscles, there's rejuvenation of the body, so you want to be in a healthy anatomical position when you sleep."

The most common sleeping position is on the side—57% of us at least start the night in that position, according to a nationwide survey of more than 2,000 people performed for mattress maker Tempur-Pedic TPX +6.36%North America. That's followed by the back—17% of people opt for this position—and the stomach, 11%. Most of the remaining respondents said their position when they first go to bed varies each night.

Moving around during the night is common. Videotaped sleep studies have found that adults might change their position between three and 36 times a night, with the average person switching about a dozen times. The tendency to shift in one's sleep decreases with age.

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From the January ACP Internist, copyright © 2013 by the American College of Physicians.
By Kathy Holliman

When it comes to patients' alcohol consumption, the "who" and "how much" are important, but the "what" is probably not.

Research on alcohol's health benefits and risks has shown that ethanol works the same whether it is consumed in a glass of red wine, a bottle of beer or a gin and tonic. The amount and frequency of consumption, along with the drinker's gender, age, medical condition and history, family history, and medications, are all linked with the effect of ethanol over time.

Patrick G. O'Connor, MD, MPH, FACP, professor of medicine and chief of internal medicine at Yale School of Medicine, advises primary care physicians to routinely screen every patient about daily and weekly alcohol consumption.

"It is such a common and fundamental issue that if you don't ask all patients, you are going to be missing many who could benefit from what you have to offer in terms of improving your patients' health," he said.

Long-term observational studies have highlighted a few key points about alcohol consumption: Benefit seems limited to the cardiovascular system in people over age 50 if they do not exceed the recommended number of servings per week. Risk includes development of breast cancer in women, particularly those who consume more than a few servings a week. Heavy drinking imposes significant risks for osteoporosis, many types of cancer, liver disease, hypertension, atrial fibrillation, stroke and multiple social and behavioral problems.

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