geoffrey modest medical blogs

as many as you know, several of the medical professional organizations have submitted a list of 5 suggestions which they feel would decrease the use of unnecessary tests or treatments.  the most recent addition is from the American Society of Hematology, which I am circulating even though I'm not sure it's really helpful (they are focusing on very low hanging fruit).  see  choosing wisely hematology 2013  in dropbox, or  http://bloodjournal.hematologylibrary.org/content/122/24/3879.full.pdf+html . in brief, --In situations where RBC transfusions are necessary, transfuse the minimum number of units required to relieve symptoms of anemia or return the patient to a safe hemoglobin range (7-8 g/dL in stable noncardiac in-patients)  -- [transfusing more than is necessary does not improve outcomes and increases the potential risk] --do not test for thrombophilia in adult patients with venous thromboembolism occurring in the setting of major transient ris...

piece in new york times today (see  http://well.blogs.nytimes.com/2013/08/07/how-exercise-can-help-us-learn/?hpw ) which suggests that studying while doing low-level exercise improves memory.  there was also an article in one of malcolm gladwell's books finding that, in a crossover study, kids that exercised before an exam had a dramatic improvement in their scores, as compared to no exercise. unfortunately, the trend in society is to cut out exercise as part of the school curriculum, and it continues to be very difficult for many of us (including my patients) to fit exercise into our over-determined/overcommitted daily schedules