I first posted about this subject a couple of years ago but it’s so fascinating to me I’m writing about it again. I happened to run across this study containing some amazing information. It’s from a publication called The Journal of Voice. The link is to the abstract — the complete article is behind a paywall but I can get it for anybody who’s interested in reading the whole study in …
When babies cry, your tone matters
Fifty years ago, in a golden moment of television comedy shows, Rowan & Martin’s Laugh-In program regularly featured “The Flying Fickle Finger of Fate” award. Wikipedia says it “recognized actual dubious achievements by public individuals or institutions.” Do a Google search. You’ll quickly see how popular this award became.
Yes, I’m dating myself by going back 50 years. But mine is the generation that often becomes obsessed with being given “the …
Prostate cancer screening campaigns are giving men the finger
Depression is commonly linked to career disappointments, financial setbacks, and disruption of normal routines — especially sleep pattern — as well as social pressures and conflict in personal relationships. It is this last factor that has captured my attention in relation to depression. Personal relationships, in particular, the most personal, love partnerships, have a profound impact on our mood. In fact, researchers report that unhappy marital relationships are associated with …
Personal intimacy as an overlooked antidepressant
Teleneurology is the new and vastly expanding practice of neurology involving the use of technology and/or video chat to improve access to services. With an ever-increasing aging population there is and will continue to be a shortage of neurologists in the United States. Teleneurology has increased patient access to neurologists especially in rural areas but also in urban and suburban areas.
Practicing as a teleneurologist for the last two years I …
Teleneurology works. Here’s why.
Influenza is the leading cause of vaccine-preventable deaths in the United States. Influenza also tops the list of the burden of disease and disability-adjusted life years (DALYs) according to a Eurosurveillance article.
The flu is more likely to cause severe illness and harm pregnant women as compared to women who are not pregnant. Changes in the immune system, heart, and lungs during pregnancy make pregnant women (including …
Flu vaccination in pregnant women reduces risk of hospitalization
I spent the summer between the first and second years of medical school in the emergency department at Cincinnati’s major trauma hospital. More specifically, I spent summer nights there, studying the effects of interpersonal violence. Cincinnati is both a friendly city and a violent city. People say “Hello” when you pass in a corridor. At first, coming from Boston, this mid-West style of friendliness took me aback. At the same …
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 34-year-old man is evaluated for several slow-growing lesions on his penis. He first noticed the wart-like growths 3 years ago, and they have progressively enlarged. He was treated with topical cryotherapy six times and topical imiquimod over the past year without improvement; the lesions have continued to enlarge. Medical history is significant …
MKSAP: 34-year-old man with slow-growing lesions
You wake up one morning, and your shoulder hurts. You’re not sure why, and blame it on your sleeping position. Perhaps you bend down to pick something up, and when you stand up your knee hurts. These are very common stories heard from patients in an orthopedic surgeon’s office. The onset of joint pain without significant trauma is very common over the age of 40.
Perhaps you wait a …
My medical center recently cemented an agreement with the Veterans Administration to offer care to veterans who could not be accommodated at the VA. We need paying patients, they need doctors of our caliber — establishing mutual benefit. Military veterans have always been among our patients. During my professional lifetime that has included men of my father’s generation whose young adult years encompassed World War II’s widespread draft. World War …
We have to deal with the trauma in veterans early on
Here are a few thoughts about the latest chapter in the never-ending debate about antibiotics vs. surgery for the treatment of uncomplicated appendicitis.
You will recall the randomized controlled trial from Finland published in 2015 that found a 27% rate of failure of antibiotics within the first year.
Now that the patients have now been followed for five years, 100 (39%) of the 246 patients treated with antibiotics have experienced persistent …
Antibiotics vs. surgery for appendicitis: What one surgeon thinks
So much of life depends upon timing. Sure, we plan, but we know how much of our life’s events are unplanned and unexpected. So often, our jobs and our mates — two of our most defining accomplishments — are the result of a chance encounter or a random act. Life does not reliably proceed in an orderly manner.
This is often true in the medical profession. Here, physicians in our quest …
When diagnosing colon cancer isn’t in a patient’s best interest
Computed tomography, or CT scanning, is one of the most powerful diagnostic tools to emerge during my medical career. Just look at the detail in the brain images above, taken at 90-degree angles through the brain. And I was there at the beginning. I remember well when I was a medical student taking neurology, and the first CT scanner arrived at the Mayo Clinic. By today’s standards, it was incredibly …
Best practices in head CT imaging: How are we doing?
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 36-year-old woman is evaluated for a 12-year history of refractory constipation. Her symptoms began after a difficult childbirth. She has constipation marked by straining, bloating, and a constant sensation of incomplete emptying. She sometimes has 4 or more days between bowel movements. When she does have a bowel movement, the stool is …
MKSAP: 36-year-old woman with refractory constipation
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With the recent 10-year anniversary of the Mental Health Parity Act being signed into law, comes the reminder that we still have so much work to be done. Unfortunately, blatant discrimination in health insurance coverage for mental health and substance abuse has continued despite this legislation. The Parity Act required that dollar limits on mental health benefits be no lower than the dollar limits for medical and surgical benefits offered …
Is there parity in mental health or are we still dealing with a paucity?
An excerpt from Let Go of Emotional Overeating and Love Your Food: A Five-Point Plan for Success. Copyright © 2018 by Arlene B. Englander. Published by Rowman & Littlefield. All rights reserved.
Anyone who has ever tried to lose weight or keep weight off realizes that evening can be …
Evening eating: Are you a “light” eater?
Healers, scientists, leaders — these are all terms that we equate with being a physician. As we spend our years if not decades in training, we strive to become all of these components. But when you miss something — the small details, the nuances of a history and these are the clues that could lead to healing it can be disheartening. When it comes to your own family member, such …
My brother, a physician, died. Could I have done more?
Over the last 20 years, physical fitness as a means to improve overall health has increased among the over-40 set. This is great, right? Yes, absolutely. Athletes who remain active as they age do a better job than non-athletes in retaining lean muscle mass. They also show improved bone density, bone structure and bone strength. However, what physicians are seeing are injuries related to the increased level of activity.
One area …
ACL injuries in middle-age athletes
A contract is an agreement stipulating the rights and obligations of the signatories. In most cases, a contract is consulted when a dispute arises. When all is proceeding swimmingly, the contract remains dormant in a file drawer or in a digital file. In general, decent people resolve differences in the old-fashioned way utilizing the twin arcane legal techniques of reasonableness and compromise. Remember them? Yes, it is possible to settle …
Do opioid contracts harm the doctor-patient relationship?
I was browsing the internet one day and came across a photo of a group of women who appeared educated and influential. They were wearing blue T-shirts with claims that vaccines cause autoimmune diseases, seizures, ADHD or attention deficit hyperactivity disorder, learning disabilities, death, autism, sudden infant death syndrome and infertility.
I couldn’t help but laugh at them! I shared this photo on my Facebook page. To my surprise, one of …
The decision to not vaccinate is driven by fear and misinformation
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 56-year-old man is being evaluated after his 18-year-old son had a syncopal episode during a high school basketball game and was diagnosed with hypertrophic cardiomyopathy (HCM). The patient has had no symptoms, including with physical activity such as golfing or playing tennis. Medical history is unremarkable, and a review of family history …
MKSAP: 56-year-old man with a family history of hypertrophic cardiomyopathy (HCM)
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