A recent issue of Pediatrics includes a new report detailing the need for doctors to improve patient teaching about fever and fever-reducing drugs.
Many parents fear their child getting a fever or have “fever phobia.” I certainly can understand why. Kids can do crazy things when they get fevers. They don’t sleep well, eat poorly, and behave strangely. Some children …
Fever in children: 5 facts you must know
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 76-year-old woman is reevaluated after results of thyroid function tests performed 2 weeks ago are abnormal. The patient otherwise feels well. She has a history of hypertension, atrial fibrillation, gastroesophageal reflux disease, and depression. Current medications are metoprolol, amiodarone, warfarin, omeprazole, and sertraline.
On physical examination, …
MKSAP: 76-year-old woman with abnormal thyroid function tests
When you and your gynecologist have decided on hysterectomy as the treatment of choice for your gynecologic diagnosis, there are several routes by which a hysterectomy may be accomplished. A total hysterectomy is the surgical removal of the uterus, and when indicated, the additional removal of the fallopian tubes and ovaries (termed salpingoophorectomy) may be recommended.
There are several routes by which a hysterectomy can be performed. You and your gynecologist …
The different ways hysterectomy can be performed
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 33-year-old man is evaluated because of the recent appearance of stretch marks in his groin that extend to his thighs. He has a history of long-standing psoriasis that at times has involved much of his body, including his intertriginous areas. His topical treatments include tar-containing …
MKSAP: 33-year-old man with stretch marks in his groin
To do nothing is sometimes a good remedy.
-Hippocrates
Edna Frost is 88 years old, a slender, slow-talking woman with a dry sense of humor and a blood pressure that’s all over the place. At best, she runs ten points higher than any of her previous doctors wanted to put up with. At worst, she flirts with systolics over 200, but that doesn’t seem to be a common occurrence.
Edna has been my …
Sometimes the treatment is worse than the disease
What is an EKG?
EKG stands for electrocardiogram. It should probably and sometimes is abreviated ECG, but EKG seems to have stuck as more popular.
Scientists have known for over 120 years that the heart gives off electrical currents when it beats, but it was the Dutch scientist Willem Einthoven in the early 20th century who discovered the nature of this phenomenon and who developed the electrocardiogram as a tool to …
How and when do new medical technologies become the standard of care?
A recent study showed that the use of CT scans in hospital emergency departments rose sixteen percent between 1995 and 2007.
Looks a bit like a medieval torture doughnut.
The only thing that surprises me about this is that it’s not more.
Way more.
I remember the first time I actually ordered a CT scan on a patient all by myself, in …
Before getting a CT scan, ask your doctor if its really needed
This past Presidents’ Day, I thought it would be a good idea to talk briefly about the role that smallpox played in the life of our first president and it’s important role in the American Revolution. For those who would like to learn about this in greater detail, I would highly recommend the book, Pox Americana: The Great Smallpox Epidemic of 1775-82, written by Elizabeth A. Fenn.
In 1751, when George …
A history of smallpox in America
If you develop a swollen knee, please don’t consider it a normal occurrence.
If there was a clear cause, such as a fall to the knee, or some twisting injury to the knee, it’s likely that the cause is due to some mechanical damage. An easily recognized example would be a football or rugby player sustaining such an injury on the playing field. In that case, its typically serious and when …
Why you shouldn’t ignore a swollen knee
by Joe F. Lau, MD and Jeffrey W. Olin, MD
Physicians who perform percutaneous endovascular procedures encounter a multitude of vascular diseases that may masquerade as obstructive atherosclerotic arterial disease. While atherosclerosis is clearly the most common condition seen, complex inflammatory, genetic or structural processes may either not be amenable to an endovascular approach or actually be harmful and thus lead to outcomes that are not …
Vascular diseases that present as obstructive atherosclerotic arterial disease
Most of us are uncomfortable talking about our waste products, urine and feces. However, changes in the color and odor may signify disease that can be treated or prevented. This article will review causes of discoloration of urine and when there is a change in the odor of urine.
For hundreds of years doctors have looked at urine as a barometer of what is happening in the body. The urine can …
Pay attention to the color and smell of your urine
As 30-year-old New Yorker Carrie Donnelly began her bachelorette party in her new black open-toe five-inch heels, she fell, her foot going one way and her ankle the other.
“When I woke up the next day, my ankle was throbbing and had become extremely swollen,” she said. It was a month before her wedding—the last thing she wanted to do was to walk down the aisle in a cast.
Super-high heels like …
Prevent foot fractures while wearing heels
Your current thought patterns are likely what keep you trapped in the prison of social anxiety.
To unlock yourself from this prison, you will likely need to have to rewire your brain with new thoughts that take time to cement in the brain, but if you try this as a start, it will lead you up the correct path.
1. The change cannot happen …
How to escape the prison of social anxiety
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What links belief in tarot cards, UFOs and vaccine rejectionism? Yes, they are all forms of superstitious or magical thinking, but are there characteristics that predict who will believe in such nonsense? That’s one of the questions that psychologists Marjaana Lindeman and Kia Aarnio seek to answer in their paper, Superstitious, magical, and paranormal beliefs: An integrative model.
Lindeman and Aarnio postulate that believers in superstition, paranormal phenomena and pseudoscience make …
Explaining why belief in pseudoscience is often evidence resistant
I must have missed the declaration of war on pubic hair.
It must have happened sometime in the last decade because the amount of time, energy, money and emotion both genders spend on abolishing every hair from their genitals is astronomical. The genital hair removal industry, including medical professionals who advertise their specialty services to those seeking the “clean and bare” look, …
The war on pubic hair must end
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 28-year-old woman has a 3-month history of easy bruising and bleeding gums. She feels otherwise well. Medical and family histories are unremarkable, and she takes no medications.
On physical examination, temperature is normal, blood pressure is 110/70 mm Hg, pulse rate is 64/min, and respiration rate …
MKSAP: 28 year old woman with easy bruising and bleeding gums
I see a lot of patients who are sent to me for evaluation of dizziness. On the surface you wouldn’t think a cardiologist would have much to do with a symptom that relates more to the head than the heart, but there is some logic to it—poor blood flow to the brain could lead to dizziness and, since blood flow starts in …
Evaluating dizziness in the cardiologist’s office
Here are ways doctors can help autistic or delayed children behave and learn.
I certainly do not mean to trivialize the behavior issues that erupt as typical children develop, but the problems of atypical kids are more difficult and less likely to be fully addressed by general pediatricians and society at large.
1. Understand the ABCs of behavior. Antecedent = What happened immediately before the behavior? Behavior = A description of the …
How to help autistic or delayed children behave and learn
For Christmas Eve dinner, our family congregated at Café Opera, in the Intercontinental Hotel for a scrumptious seafood buffet. Going to a buffet is a little bit evil, as you know that you’re about to commit the sin of gluttony.
I usually tell my patients who suffer with gout to avoid buffets. That 3rd mountain of prawns may precipitate an acute episode of gout. Christmas party season is a dangerous time.
Overindulgence …
Gout is a common cause for episodic joint pain and swelling
Prostate enlargement, or benign prostate hyperplasia (BPH), is a common, non-cancerous condition affecting nearly 14 million men over the age of 50.
The symptoms of prostate gland enlargement include a decrease in the force and caliber of the urinary stream, frequency of urination, urgency, a feeling of not emptying the bladder despite urination and nocturia, or the need to get up at night to urinate. Although lifestyle changes will not cure …
Lifestyle changes to control the symptoms of prostate enlargement
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