About half of all children in the United States with an autistic spectrum disorder are diagnosed at age five or older, according to a May 2012 NCHS (National Center for Health Statistics) data brief. However, many parents are suspicious much sooner. As part of autism awareness month, we bring you clues into toddler development that can alert you to a potential issue.
Pediatricians often use a questionnaire called the M-CHAT (Modified …
A 27-year-old woman is evaluated during the fourth week of an uneventful pregnancy. She has a 3-year history of primary hypothyroidism due to Hashimoto thyroiditis that is treated with levothyroxine, 125 µg/d. She also takes prenatal vitamins and iron sulfate.
On physical examination, temperature is 37.1 °C (98.8 °F), blood pressure is 128/80 mm Hg, …
I was a junior doctor when I experienced my first episode. The strange thing is, that despite my medical training (I may have bunked off a few of the relevant lectures in medical school), I didn’t recognize the symptoms.
I had lost my appetite and had lost weight. I wasn’t sleeping and was irritable, angry and tired most of the time. Most disturbing to me was a feeling (despite being surrounded by work …
As chairman of the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) Work Group on Attention Deficit Hyperactivity Disorder (ADHD) and Disruptive Behavior Disorders, I read the article on ADHD that appeared on the front page of The New York Times on April 1, 2013, with interest and also dismay, which was shared by my colleagues in the work group. We recognize the effort involved …
Lung cancer causes more deaths in the United States, 160,000 estimated in 2012, than the next three most common cancers, colon, breast, and prostate, combined.
More than 1.6 million people worldwide were newly diagnosed with lung cancer, comprising 13% of all new cancer diagnoses, and 1.4 million died of lung cancer, which was 18% of all …
In recent times, it seems as though every newspaper or magazine with a dedicated health section has a focus on the perils of gluten and the benefits that come along with adhering to a gluten-free diet. Or better yet, each week brings a new celebrity touting the dangers of gluten, and how it is an unhealthy ingredient that should be avoided religiously. Is this truly sound advice?
Wemberly worried about everything. Big things. Little things. And things in between.
–Wemberly Worried, Kevin Kenkes
The bottom line: you can add arsenic in rice to your long list of health risks you don’t need to worry about. And you can add Consumer Reports to your long list of media outlets that you can’t depend on for reliable health advice. Inaccuracy and breathlessscaremongering …
One of the things about which I’m asked most commonly is calcium. Some of the confusion comes from the fact that our knowledge about calcium and health is evolving. A recent study showing that men who take calcium supplements have an increased risk of heart attacks is just the latest in an avalanche of sometimes conflicting information.
A 52-year-old man is evaluated for a 5-year history of gradually progressive left knee pain. He has 20 minutes of morning stiffness, which returns after prolonged inactivity. He has minimal to no pain at rest. He reports no clicking or locking of the knee. Over the past several months, the pain has limited his …
When should drivers retire from driving? This question is always difficult to answer. In our suburban car culture driving allows seniors to maintain their independence and prevents social isolation. However, at what point does it become unsafe for the elderly to drive and what are the risks?
One month ago my fit and about 80-year-old in-laws were involved in a serious car accident. A young …
Perhaps you already know the behind-closed-doors guiding principles of the news media, but if so, I suppose I’m a bit naïve in comparison. I thought they would be all about reliably reporting the news. Instead, I learned this guiding principle during my days working as an on-air contributor for ABC News’ Good Morning America: “Comfort the afflicted, and afflict the comfortable.” This is by no means an ABC mantra; …
A common belief, even among doctors, is that almost no one succeeds in losing weight in the long term. And for almost two decades, I’ve counted myself among the skeptics, being able to tally on the fingers of one hand the number of my patients who’ve managed to do it—literally less than five out of multiple hundreds, if not a few thousand.
I have been struggling with a certain degree of cognitive dissonance following the announcement this winter of a study in the New England Journal of Medicine on the efficacy of fecal transplants as a therapy for clostridium difficile (C. diff) infections. While the study is the first to demonstrate the effectiveness of fecal transplants in treating recurrent C. diff infections (15 of the 16 patients in the group were cured …
While the patient populations of individual physician practices vary greatly, nearly all physicians – regardless of practice location or specialty – see patients who have diabetes or cardiovascular disease or are at risk for developing them. Because cardiovascular disease accounts for one third of all deaths in the U.S., and 100 million …
Think of the last few times you watched a popular movie that involved any kind of sex scene? Not as in pornographic sex, but as in two characters ended up in bed together and had, ahem, conjugal relations.
In how many of those scenes did either participant make mention of a condom before the act?
We face a public health crisis of sexually transmitted …
One of the toughest parts of treating patients is managing their expectations. We wish that everyone could enjoy a perfect recovery with complete healing, but the medical profession is imperfect and life is unfair. Some folks cruise by decade after decade without a scratch, while others sag under the weight of chronic illnesses.
Accepting reasonable expectations can change the game for patients and their families. If the patient’s expectations exceed what …
I visited with 5 charming teenagers last week. Four of them had something in common: These teenagers are texting in the middle of the night, nearly every night.
Texting in the middle of the night is not a new phenomenon. Over 2 years ago, reports on teenagers texting at night began to surface. One study concluded the average teenager sends 34 texts after lights out. Simply based on the conversations I …
A 35-year-old woman is evaluated in an urgent care center for an acute exacerbation of asthma. She has a history of frequent asthma exacerbations requiring unscheduled visits; however, between these exacerbations, her examination and pulmonary function studies have been unremarkable. Her current medications are inhaled budesonide and inhaled albuterol.
On physical examination, she is in moderate distress with audible inspiratory and expiratory wheezing. Temperature is 37.0 °C (98.6 °F), pulse rate …
Research shows numerous benefits to meditation: it reduces stress, increases positive emotion, and even treats acute pain. Commonly, meditation involves focusing on one’s breathing as a way to anchor one’s attention in the present moment. Practitioners are also frequently taught to separate their experiences (breathing, pain, thoughts) from their judgments about them. Thus, with respect, for …
I am just back from my colonoscopy more or less. All went well, but I am still shrugging off the lingering tendrils of my sedation. So let’s chalk up any grammatical snafus to that, shall we?
I had, of late, had some GI symptoms. But those were mostly coincidental and likely due to extensive travel and the havoc changing time zones wreaks on circadian rhythms.
A guest column by the 
