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Health News Updated Daily by Internist and Allergist at Cleveland Clinic Florida

Last Build Date: Wed, 24 May 2017 02:26:46 PDT


Even short term use of oral steroids (less than 30 days) linked to increased risk of severe infection (sepsis), blood clots and fracture

Mon, 08 May 2017 06:45:00 PDT

One in five American adults in a commercially insured plan were given prescriptions for short term use of oral corticosteroids during a three year period, with an associated increased risk of adverse events. Of 1.5 million adults, 21% received at least 1 prescription for oral corticosteroids over 3 period.

The most common indications for use were:

- upper respiratory tract infections
- spinal conditions
- allergies.

Within 30 days of drug initiation, there was an increase in rates of:

- sepsis
- venous thromboembolism
- fracture

Risk over the subsequent 31–90 days.

The increased risk persisted at prednisone equivalent doses of less than 20 mg/day.


Short Term Use of Oral Corticosteroids and Related Harms

Eurovision 2017 - what are your favorite songs?

Wed, 29 Mar 2017 04:00:05 PDT

Here are some of the more popular ones:

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The full list is here:

Eurovision 2017 - Official Music Videos(image)

How to be happier at your workplace: from employee, and from employer, perspective

Wed, 22 Mar 2017 05:30:17 PDT

Robert Steven Kaplan has addressed these 2 topics in 2 Google talks and 2 books, they are linked below. I developed 2 sheets based on the ideas from the talks, embedded below.

How to be happier at your workplace: from employee perspective:

Robert Steven Kaplan: "What You're Really Meant to Do" | Talks at Google:

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How to be happier at your workplace: from employer perspective:

Robert Steven Kaplan | What to Ask the Person in the Mirror: Critical Questions for Becoming a More Effective Leader and Reaching Your Potential:

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Kaplan was vice chairman of The Goldman Sachs Group, he worked there for 23 years, then he had a change of heart, and became a Professor of Management Practice at Harvard Business School. He wrote the 3 books above in his second role, but that was not the end of road for him. In 2015, Kaplan was appointed as president and CEO of the Federal Reserve Bank of Dallas.


Robert Steven Kaplan - Wikipedia
Federal Reserve Bank of Dallas
Who Is Robert Steven Kaplan? The Next Dallas Fed President at a Glance

Indoor Tanning is Out - video message from the American Academy of Dermatology

Fri, 03 Mar 2017 04:00:32 PST

American Academy of Dermatology: Not only can the ultraviolet radiation from indoor tanning beds lead to wrinkles, it also increases the risk of skin cancer, including melanoma, the deadliest form of skin cancer. On an average day, more than 1 million Americans tan in tanning salons. Research shows that nearly 70 percent of indoor tanners are female, primarily 16 to 29 years old.

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"Bodies have a way of not keeping up with your brain or your career" - Glover from Deep Purple on approaching retirement

Thu, 02 Mar 2017 05:00:17 PST

Roger Glover from Deep Purple:

"We're all about late 60s, early 70s, and bodies have a way of not keeping up with your brain or your career. The time is approaching when it will end, but we don't want to face that. We don't actually want to make a date or a final tour or anything. We just want to carry on as long as nature allows or is kind of dignified. If we can't do what we do anymore, then yes, it's time to stop. But we're still doing it, and we're still enjoying it very much. So all we're saying is the door is closing, but it's not closed yet."

Glover and Paice's Rock Antenne interview:

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Photo Shoot for Deep Purple's 'Infinite': Exclusive Behind-the-Scenes Footage

"Everything changes and nothing remains still, you cannot step twice into the same stream" vs. Occidentali's Karma

Tue, 21 Feb 2017 04:00:17 PST

Francesco Gabbani won Festival di Sanremo 2017 with his catchy song “Occidentali’s Karma” (“Westerners’ Karma”) and will represent Italy during Eurovison 2017 song contest. You don't often hear quotes from William Shakespeare and Erich Fromm in the the first two lines of a song:

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Excerpts from the lyrics:

"Internet experts,
Honorary members of the selfie-addicted anonymous
Cleverness is out of fashion,
Easy answers,
Pointless dilemmas.

Whatever happens, panta rhei
And 'Singing in The Rain'."

The phrase panta rhei, "everything flows" either was spoken by Heraclitus or survived as a quotation of his. This famous aphorism used to characterize Heraclitus' thought comes from Simplicius, a neoplatonist, and from Plato's Cratylus. The word rhei is the Greek word for "to stream", and is etymologically related to Rhea according to Plato's Cratylus.

The philosophy of Heraclitus is summed up in his cryptic utterance:

"Ever-newer waters flow on those who step into the same rivers."

The quote from Heraclitus appears in Plato's Cratylus twice:

"All entities move and nothing remains still"


"Everything changes and nothing remains still ... and ... you cannot step twice into the same stream".

More from his YouTube channel:

Another clip of the song:

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Italy sends rising star Francesco Gabbani - and an ape - to win Eurovision 2017
"Occidentali's Karma" lyrics - Francesco Gabbani (Italy, Eurovision 2017)

The Corrs are back with a new album

Sat, 18 Feb 2017 05:00:00 PST

The Corrs are back with a new album, here is one of the singles: The Corrs - I Do What I Like - recorded at Church Studios:

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The first single from the album: The Corrs - Bring On The Night - recorded at Church Studios:

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The freak accident that changed Charles Krauthammer's life

Fri, 17 Feb 2017 04:00:22 PST

From Wikipedia: Charles Krauthammer is an American syndicated columnist, author, political commentator, and non-practicing physician whose weekly column is syndicated to more than 400 publications worldwide. Krauthammer became permanently paralyzed after a diving accident while in his first year studying at Harvard Medical School. After spending 14 months recovering in a hospital, and although wheelchair-bound, he returned to medical school, graduating to become a psychiatrist involved in the creation of the Diagnostic and Statistical Manual of Mental Disorders III, and later developing a career as a Pulitzer prize-winning writer.

Fox TV interview:

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Charles Krauthammer - Wikipedia

What happens when you have lunch with Chuck Norris

Wed, 15 Feb 2017 16:23:15 PST

"I heard medicine takes Chuck Norris to feel better", and more in this commercial by UnitedHealthcare (US insurance company):

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The whole playlist is here:

Plan-based Diet and Uprooting the Leading Causes of Death - by Michael Greger, M.D. (video)

Mon, 23 Jan 2017 05:00:17 PST

Plan-based Diet and Uprooting the Leading Causes of Death - by Michael Greger, M.D. (video), a lecture and Q&A session at Tompkins County Public Library, Ithaca, NY:

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Patient-centered communication: what are the basic skills?

Tue, 17 Jan 2017 05:26:06 PST

Communication skills needed for patient-centered care include:

- eliciting the patient's agenda with open-ended questions, especially early on
- not interrupting the patient
- engaging in focused active listening

Practice this at least in the first 60-seconds, the so-called "golden minute".

Understand patient's perspective

Understanding the patient's perspective of the illness and expressing empathy are key features of patient-centered communication.

Understanding the patient's perspective entails exploring the patient's:

- feelings
- ideas
- concerns
- experience regarding the impact of the illness
- expectations from the physician


Patient-centered communication - basic skills (click here to enlarge the image).


Empathy can be expressed by:

- naming the feeling
- communicating understanding, respect, and support
- exploring the patient's illness experience and emotions

Before and after a diagnosis

Before revealing a new diagnosis, the patient's prior knowledge and preferences for the depth of information desired should be assessed.

After disclosing a diagnosis, physicians should explore the patient's emotional response.

Treatment options

Shared decision making empowers patients by inviting them to consider:

- pros and cons of different treatment options
- no treatment

Instead of overwhelming the patient with medical information, small chunks of data should be provided using repeated cycles of the "ask-tell-ask" approach. Using "tell-tell-tell" does not engage patients.


1. Ask permission to start a conversation
3. Ask what the patient thinks about their health
4. Ask questions to find out what the patient already knows
5. Tell the patient information in a way that is easy to understand
6. Gauge the patient’s understanding by asking questions after you tell

What Is “Ask, Tell, Ask”? video:

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Patient-Centered Communication: Basic Skills. Hashim MJ. Am Fam Physician. 2017 Jan 1;95(1):29-34.
The 10 Building Blocks of Primary Care - “Ask Tell Ask” Sample Curriculum - UCSF
Ask-Tell-Ask: Simple Technique Can Help Hospitalists Communicate Difficult Messages

Media Files:

Percentage of U.S. residents with up-to-date screening for colorectal cancer remains at 60% - what options, other than colonoscopy, do we have?

Mon, 16 Jan 2017 05:24:02 PST

From the NEJM:

The percentage of U.S. residents with up-to-date screening for colorectal cancer has not increased appreciably since 2010 and remains at approximately 60%. To achieve the highest level of adherence to colorectal cancer screening, it may be best to provide participants a choice, because the “best” strategy is the one that they will adhere to consistently.

The NEJM reviews all the options in this table:

Full article is here:

Screening for Colorectal Neoplasia - Now@NEJM

Physician ratings at Cleveland Clinic (video)

Tue, 10 Jan 2017 05:00:09 PST

The CEO and the Chief Experience Officer explain the rationale behind the physician ratings at Cleveland Clinic:

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Disclaimer: I am an allergist at Cleveland Clinic Florida.(image)

Problem solver

Sun, 08 Jan 2017 20:22:53 PST

From Italian: Pedro and Domenico jump, but Oreste thinks about it a bit... and finds another solution.
#donkey #problemsolving

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This little video even made it to Daily Mail: Donkey shows off his brains by using his TEETH to remove a fence

Gadgets Galore - Best of CES 2017

Fri, 06 Jan 2017 05:39:55 PST

From WSJ: As the tech world reveals the products that will impact the year ahead, Personal Tech columnists Geoffrey A. Fowler and Joanna Stern hunt for the most exciting and unusual, from AR glasses to breast pumps (video is below):

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Minutes Count in the Cleveland Clinic Florida Emergency Room: Patient Story

Fri, 16 Dec 2016 05:00:07 PST

"A Florida woman is rushed to the emergency room with life-threatening injuries and only minutes to live. Experience her story as the Cleveland Clinic Florida Emergency Department team springs into action to save her":

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Disclaimer: I work at Cleveland Clinic Florida, but I am not paid for this post.


“99 percent of all claims of being 115 or older are false.”

Fri, 18 Nov 2016 04:00:01 PST

(image) An engaging story from the NYTimes about runners older than 90, and more.

Among the quotes:

“99 percent of all claims of being 115 or older are false.”

“Old age always wins. It’s shocking. No matter how hard you try, it beats you.”

Apart from that, nothing would stop him, not even a colostomy bag:

"The oldest competitor would be an Australian legend, John Gilmour, 97, a World War II veteran who was captured by the Japanese and put into forced labor. Malnutrition and the harsh conditions permanently shrouded his vision. Still, he resumed his running career after the war. He knew what a body could withstand. The pain of sport was nothing compared with the pain of capture.

In his mid-60s, he could still run a marathon under three hours."

Read the full story here:

Image source:, public domain.(image)

7 classical virtues of trust, justice, hope, temperance, wisdom, courage and compassion - and how this applies to medicine

Fri, 04 Nov 2016 06:45:13 PDT


We often receive an email from the Chief of Staff on Wednesdays. The email is meant to unite the physicians at Cleveland Clinic around a common idea/topic/thought for that week.

One of the emails mentioned "A virtuous culture built on the seven classical virtues of trust, justice, hope, temperance, wisdom, courage and compassion. These virtues offer us 25 centuries of wisdom about human conduct at its best."

As a simple exercise, try thinking about one of those each day of the week, make it the "theme of the day":

Monday - Trust
Tuesday - Justice
Wednesday - Hope
Thursday - Temperance
Friday - Wisdom
Saturday - Courage
Sunday - Compassion

These concepts are not new, of course. There have been multiple different variations proposed throughout the centuries. Some examples are references below. If you feel adventurous, don't limit yourself to 7 virtues but consider the 24 Prussian virtues below:

"Bottle-flipping" is the latest fad, see why schools are banning it - WSJ video

Mon, 31 Oct 2016 10:59:19 PDT

From WSJ: Bottle-flipping has become a worldwide phenomenon. But some schools are trying to ban the flippers:

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Easier schedule for HPV vaccine: 2 doses instead of previously recommended 3

Fri, 28 Oct 2016 05:04:34 PDT

From Mayo Clinic: To protect against cervical cancer and other cancers caused by HPV infection, the Centers for Disease Control (CDC) is now recommending that 11- and 12-year-olds receive two doses of HPV vaccine at least six months apart. This is a change from the previously recommended three-dose series.

The CDC says adolescents ages 13–14 also can receive the HPV vaccine on the new two-dose schedule. However, those who start the series later will continue to need three doses.

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Self-administered HPV Test is one of the Top 10 Medical Innovations 2017, selected by the Cleveland Clinic:

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How to administer "Emotional First Aid"

Wed, 12 Oct 2016 03:30:10 PDT

Do you know that feeling lonely impacts your ability to build up an immunity after getting the flu vaccine?

From the Google Talks lecture series: "Although we have bandages for cuts, chicken soup for colds, and ice packs for bruises, most of us have no idea how to treat day-to-day emotional injuries such as failure, rejection, and loss. But, as Guy Winch, Ph.D., points out, these kinds of emotional injuries often get worse when left untreated and can significantly impact our quality of life. In this fascinating and highly practical book he provides the emotional first aid treatments we have been lacking."

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Have you tried some chair yoga today?

Wed, 14 Sep 2016 06:00:16 PDT

Here is a list of sample exercises from the Costco magazine, which means chair yoga is hitting the mainstream:

Chair yoga is a gentle form of yoga that is practiced sitting on a chair, or standing using a chair for support. The poses, called Asanas, are often adaptations of standard Hatha yoga poses.

Chair yoga is especially suitable for busy people stuck at their desks at work, or those unable to participate in a traditional yoga class due to the effects of aging or disabilities.

Chair Yoga is one of the gentlest forms of yoga available. Complicated maneuvers and complex movements are typically not included.

Related reading:

Chair Yoga - Wikipedia, the free encyclopedia

Drummer Leonard Haze's thoughts on old age and dying

Tue, 13 Sep 2016 04:18:41 PDT

Leonard Haze was a great drummer. He passed away in his sleep last weekend at age 61. I saw him on tour with Ian Gillan in 1992 and the whole band was amazing. He had this humongous Ludwig drum kit and was a powerful drummer. Lenny Haze recorded the Toolbox album with Gillan, one of the songs from the album, Don't hold me back, is linked below:

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Considering the recent deaths of many rock and roll greats, this Facebook post by Lenny from January seems very relevant:

Leonard Haze, thinking about a lot of things.
January 2:

"That's enough. Why is it so hard to get old ? You loose friends as you go. With Bill F rates today that's for me since Christmas a total of 4 people I know passing away. Christmas eve my step daughter Danielle Galvin ' s Aunt & best friend at 36. From something she didn't know about. Lemmy two days after Christmas something he just discovered. Bill Frates today. I heard he was very I'll but still. You add on Mark Weaver & I am sorry but now I know why granny didn't want to play bingo.
I asked her if " you want a ride to the church to play bingo" ?" No " she snapped. Why ? Too many old people was the response. She explained that the last ladies she had become friends with all had died & she had lost all her friends. She was about 92 at the time & an uncle my mom & I took care of her and her older sister my greatest Aunt Mary. I can't explain how funny those two old ladies were. Best thing I ever did was 3 days a week with them.
But now granny I understand why you said more pain comes from loosing others than your body gives you getting old. Now I get it."

Lenny had moderate to severe COPD, according to news reports.


"We'll just go in and do some work."

Fri, 09 Sep 2016 04:00:31 PDT

Angus Young from AC/DC in Rolling Stone:

"Malcolm was always one to battle through. He would look at me in times of crisis and go, "We'll just go in and do some work. We'll sit and write some songs." He had that drive, and I feel obligated to keep it going, maybe because I was there in the beginning with him.

When you sign on and say, "I'm gonna do this and that," it's always good to say at the end of it, "I've done all I said I would do." That was always the idea, especially when we were younger – me, Malcolm, Bon. You had to show up and be on time."

It's a long way to the top if you wanna rock 'n' roll, AC/DC:

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Read more here:

AC/DC's Angus Young Talks Retirement, Malcolm Young Health Update

It Pays to Be Human: communicate clearly, take initiative, problem-solve, get along with people

Thu, 01 Sep 2016 04:00:01 PDT

From WSJ:

It Pays to Be Human - The job market’s most sought-after skills can be tough to spot on a résumé. Companies across the U.S. say it is becoming increasingly difficult to find applicants who can communicate clearly, take initiative, problem-solve and get along with co-workers. Those traits, called soft skills, can make the difference between a standout employee and one who just gets by.

"Soft skills" are needed in medicine too. It is always great to be human. After all, we can't be anything else.

The top 10 in-demand soft skills are listed by LinkedIn here:

Looking at the top 10 least in-demand skills is an eye opening experience. Apparently, employers are not interested anymore in: "emotional intelligence", and some teams skills such as leadership and team building.


The ‘Soft Skills’ Employers Are Looking For
Data Reveals The Most In-demand Soft Skills Among Candidates