This year, we celebrated our 25th wedding anniversary. So, last week, one evening, I told my wife about a news story I heard on National Public Radio (NPR) about the microbiology of a kiss. My wife smiled.
A group of researchers, I said, looked at the oral bacterial flora of 21 couples to determine how many bacteria were transferred by a kiss. …
The microbiology versus the psychology of kissing
Look here: I am a breastfeeding supporter. I regularly help new moms breastfeed successfully, and I even took a special class to learn how to do a brief procedure to help babies overcome breastfeeding problems caused by tongue-tie. I’ve got a happy breast support sticker, right on my AAP card.
But I think honesty is (or should be) the breast policy. Some …
Stop the hyperbole when it comes to breastfeeding
Since Ebola was first discovered in 1976, there have been an estimated 16 to 22 recorded outbreaks. In August, the World Health Organization designated the most recent outbreak a global emergency.
Ebola is a deadly infection and the scope of the current epidemic in West Africa is unprecedented. More than 17,000 people have contracted Ebola virus disease (EVD) with more than 6,000 estimated deaths.
Many in the health care field have criticized the response of world …
Our fascination with Ebola exposes a double standard
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 32-year-old woman is evaluated as a new patient. She is planning to attempt conception with her partner. She has a history of systemic lupus erythematosus complicated by chronic kidney disease that has been inactive for several years off of treatment. She has had borderline blood pressure elevations since the …
MKSAP: 32-year-old woman with systemic lupus erythematosus
So many foods beckoning us from the grocery store shelves — but which ones are healthy for us to consume? We could study nutritional facts labels, but that feels as challenging as the math portion of the SAT, with so much numerical information to process. The label tells us how many calories are in the food in question — how many grams of protein, how many grams of fat, and …
Red light, green light: How nutritional labels can mislead
Chronic pelvic pain (CPP, pain in the pelvis that is present for more than 2 weeks a month and has been there for more than 6 months) affects 15 percent of women and accounts for upwards of $2 billion a year in direct medical costs. To say it is a significant health burden is a gross underestimate at best. My entire practice is devoted to the treatment of pelvic pain …
Hysterectomy for chronic pelvic pain: 7 questions to ask
Sometimes I tell people I’m learning how to treat cancer, and their first question is ‘why haven’t we cured cancer yet?’
We will. It’s coming.
In medicine, we’re much better at treating infections than cancer, but it wasn’t always that way:
The people who will cure cancer are the patients
Every new parent has heard the dire warning: Never sleep with your baby.
State and local health departments in Massachusetts and around the U.S. have prioritized this message. Millions of dollars have been invested in promoting it, and millions more spent on giving away cribs to poor families. It all comes from the official recommendations of the influential American Academy of Pediatrics published …
Never sleep with your baby: Has that advice backfired?
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 76-year-old woman is evaluated for a 1-day history of headache, left eye pain, nausea and vomiting, seeing halos around lights, and decreased visual acuity of the left eye. She has type 2 diabetes mellitus, hypertension, and atrial fibrillation. Medications are metformin, digoxin, metoprolol, hydrochlorothiazide, and warfarin.
On physical examination, temperature is 36.8 …
MKSAP: 76-year-old woman with a headache
Value.
A simple word with lots of meanings, all of which depend on the context of the moment. Value in health care — especially in cancer care — is certainly no exception. What is undeniable is that we are seeing an increasing clamor about value in cancer treatment. And one person’s value is clearly another person’s concern.
At the crux …
What is value in cancer care? It depends.
Old age is no place for sissies.
-Bette Davis
“I want the surgery today!” She started to cry. “I’m ninety-four years old. I’ll accept any risk. Just take this thing out!”
She looked back and forth between the anesthesiologist and me. Her golf-ball sized tongue cancer had been growing over the past six months. It wasn’t changing from day-to-day, but it had increased over the course of the three weeks since we had …
Tongue cancer in an elderly patient: Thinking of my grandmother
Unfortunately, measles is in the news again.
Measles is a very contagious viral illness that causes a high fever, rash, cough, and a runny nose. Complications include pneumonia, brain inflammation and death. Prior to 1963 there were hundreds of thousands of measles cases in the U.S. annually, causing hundreds of deaths. In 1963 the measles vaccine was introduced, leading to an immediate decrease of measles cases in this country.
In 2000 measles was …
Those who refuse vaccines endanger all of our kids
I had just started the sexual health clinic at Massachusetts General Hospital (MGH) when I was approached to meet with a group of prostate cancer survivors. I was hesitant at first — my interests were in female cancer survivors who had experienced sexual dysfunction. This was partly because I had assumed men had an easier time accessing information on …
After prostate cancer treatment: What about intimacy for men?
ADVERTISEMENT
The holiday season is well underway. This is the time of year for celebrating with family and close friends and reflecting on what is truly important to us. It can also be a time of significant stress, inevitable over-eating and deviation from our usual routines. Essentially, the holidays can be hazardous to your health and this is particularly true when it comes to your gastrointestinal (GI) system. So what can …
Say happy holidays to your GI tract
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 50-year-old man is evaluated in follow-up for a recent diagnosis of cirrhosis secondary to nonalcoholic steatohepatitis. He has a history of asthma, type 2 diabetes mellitus, hyperlipidemia, and obesity. His current medications are inhaled fluticasone, montelukast, insulin glargine, insulin lispro, simvastatin, and lisinopril.
On physical examination, temperature is 37.5 °C (99.5 °F), …
MKSAP: 50-year-old man with cirrhosis
A thought provoking article in the November, 2014 edition of Pediatrics highlights a growing problem with modern medicine: Just because we can make a diagnosis doesn’t mean we should.
The article, titled “Overdiagnosis: How our compulsion for diagnosis may be harming our children,” has been made available for free to everyone. It’s fairly dense and technical, but if you’ve been following this blog …
You’re fine: That’s the hardest diagnosis to make
McKinsey & Company recently issued a report on effective means of fighting hyper-endemic obesity in the modern world. Among other things, they concluded that “implementing an obesity-abatement program on the required scale will not be easy.” I presume that is intended to be somber, but the magnitude of understatement makes it almost funny. And sad.
No, it will not be easy — not in the world as it is. In the world as …
Fixing obesity: It’s a matter of changing our perspective
One of my residents presented some research that she had completed under my supervision. Since I left the staff of the U.S. Preventive Services Task Force four years ago, it has been my sense that the Task Force has substantially lowered its evidence “bar” for recommending a preventive service, an impression confirmed in private discussions with colleagues who closely follow the group’s activities. In a JAMA editorial published last year, Drs. Steven Woolf …
Evidence-based preventive care: Should it be free?
Preventing infection after surgery is very important as not only are these infections often uncomfortable and make you feel very sick, but they also increase the risk of more serious complications. For example, if you are less mobile because of an infection after surgery you are at higher risk for a blood clot or if you need a prolonged hospitalization because of an infection in your surgical wound you are …
Antibiotics during gynecological surgery: When are they necessary?
Every fall I write about bronchiolitis because it is one of the most common respiratory ailments affecting infants and children under about two years of age. It is the most common reason infants end up in the hospital during the winter and early spring months. Every year we get severe cases in the PICU. Pediatricians have struggled for decades to figure out how to treat bronchiolitis but we don’t have …
Analyzing the new treatment recommendations for bronchiolitis
Get free updates delivered free to your inbox.
