Our nation has recently witnessed another tragedy involving a young adult, with young adult victims. Facts often emerge slowly and it is important not to speculate about diagnoses through the news media; however, it seems clear in this case that mental illness is a factor — even though few people living with mental illness are violent.
To avoid tragedies, solutions are needed. One area of real promise is early …
A total knee replacement is a very common operation and more than 700,000 of them are performed each year in the United States. With a mean cost of about $16,000 each, in 2011 we spent over eleven billion dollars paying for knee replacements. Projections are that, by 2030, we’ll be doing 3.5 million per year. The operation has great results and patients generally do well during and after their surgery.
Toilet training can sometimes be a stressful process. This is particularly the case for children who achieve daytime dryness but continue to wet themselves, and the bed, overnight. It may leave you wondering what’s normal and what you can do to help your child.
Nighttime wetting is one of the most common urologic conditions in childhood. The vast majority of cases are not related to a physical cause. Most commonly, nighttime …
A 38-year-old man is evaluated for a 1-year history of cough with mucoid sputum and a 6-month history of mildly progressive dyspnea. He has a 12-pack-year history of smoking. He has no history of asthma, allergies, skin disease, or liver disease.
On physical examination, vital signs are normal. Pulmonary examination discloses decreased breath …
The Ellen DeGeneres Show has repeatedly put out a call for viewers to send in their funny sunburn pictures and stories. The following was posted on the website:
Summer is here and everyone is hitting the beach or pool. Just don’t forget the sunscreen! If you did, and you have the bad sunburn to prove it, we want to see the funny photos. Be sure to tell us the story behind …
On a cold, blustery Cleveland day when I was a resident, a forty-year-old man walked into our infectious disease clinic at the Cleveland Clinic. The patient was undergoing routine visits in preparation for a kidney transplant. This poor man had been hospitalized six months earlier at another hospital where he caught a terrible infection and was readmitted in septic shock and multi-organ failure. Luckily he survived, but in the process …
As a resident of San Francisco (and with Los Angeles just a drive away), I cannot escape the food hate. Whether it be a campaign against cooked provisions, farmed products or anything of solid consistency, I cannot help but wonder if any possible benefit of these diets outweigh the risk of missing out on amazing grub.
But what about gluten-free diets?
Gluten sensitivity
Gluten, a protein found in foodstuffs such as wheat, barley …
Recently, someone asked me on Twitter, “Has the change in classification of obesity as a disease affected how you treat patients presenting w/ the disease?”
The classification change in question is regarding the American Medical Association’s declaration that obesity is a disease rather than a comorbidity factor.
This change in classification affected 78 million American adults and 12 million children. The new status for obesity means that this is now considered a medical condition …
A 35-year-old woman is evaluated for new-onset thrombocytopenia. She is gravida 1 at 36 weeks’ gestation. Her pregnancy has been otherwise uncomplicated. She takes only a prenatal vitamin.
On physical examination, temperature is normal, blood pressure is 110/65 mm Hg, pulse rate is 110/min, and respiration rate is 22/min. There are no ecchymoses or petechiae. Abdominal examination discloses no right upper quadrant pain. She has a gravid uterus. Neurologic examination is …
As a parent, my words to and about my child will probably be one of the single most influential aspects of their development. Children learn to see themselves through their parents’ eyes, and what we tell them they are, they are likely to become. The labels we place on them often tend to be a self-fulfilling prophecy.
I’ve seen this play out in my own life and in the lives of …
Go ahead, eat more meat, butter and cheese. Let me know how it turns out for you. I certainly won’t be joining you, despite the current popularity of the proposition.
For one thing, there is no case — none — that eating more meat, butter and cheese would be good for us. Rather, the case is advanced these days — Read more…
This story has become all too familiar. The patient enters the ER with crushing chest pain and their EKG shows an acute MI, (known today in the colloquial as STEMI, for ST-elevation myocardial infarction). The interventional cardiologist is summoned quickly and in less than 90 minutes from the patient’s arrival across the ER door threshold, he or she is on a cardiac cath lab table, where a coronary stent is …
The New York Times recently published two articles in a series about inflammatory bowel disease, or IBD, in hopes to destigmatize the disease, and to broadcast medical and surgical advancements that have worked to change how we conceptualize IBD. I applauded the Times for highlighting what can be a debilitating disease for the 1.4 million Americans who are afflicted with it, and thought: Finally! IBD is getting the attention it deserves.
Mass murders are becoming a depressingly familiar routine in the United States — we can now expect to experience a media grabbing shooting about once a month. And the frequency can only increase as future cohorts of copycat killers are spawned by the seductive opportunity to temporarily gain the spotlight.
Amidst the anguish and heartbreak felt by the victims’ families, there are always two haunting questions. What motivates someone to kill …
These are words no one treated for cancer wants to hear, yet they are words I have said far too often in my own career. In this case, I had said this to a patient I had cared for ever since her initial diagnosis. At that time, she had stage III breast cancer. After her surgery, …
In 2010, I lost my mother to cancer. She was a fighter and had survived well past her prognosis, but her hospital costs outlived her.
Let me go back to late 2004. That was the year the doctors suspected she had cancer. My mother, who was not a smoker, was officially diagnosed with non-small cell lung cancer early on in 2005. When the biopsy confirmed that the small lesion in the …
I have been blogging and tweeting about ADHD a lot lately because I believe that change is in the air.
This is the worst of times for ADHD diagnosis because statistics show it is wildly overdiagnosed and overtreated. This is possibly the best of times for ADHD diagnosis because I think we have reached the tipping point and feel hopeful that the ADHD fad will soon begin to fade.
He was a 24-year-old African American man with no history of medical or eye problems. On an ordinary Thursday evening at 8 p.m., he arrived into the emergency department complaining of a sudden loss of vision in both eyes.
“He couldn’t see a thing on our chart. Vitals are fine, pupils are equal and reactive, and the rest of the neuro exam is unremarkable,” the emergency room attending briefly explained. “Can …
Cardiovascular disease still remains the number one cause of death in women. Heart attacks account for 24% and strokes 7% of all deaths. Among minority women, these numbers are even higher. The challenge remains that doctors traditionally have not identified women at high risk of stroke. Internists and cardiologists do not routinely think of stroke prevention in women, and neurologists have been busy treating stroke victims and have had no …
A 32-year-old woman is evaluated for a 6-month history of nonproductive cough. She has no history of recurrent upper respiratory tract infections and has never smoked cigarettes. She has no fever, dyspnea on exertion, hemoptysis, heartburn, or wheezing. She has worked in the same office for 7 years and has lived in …
