The bacteria that live in our healthy guts are a garden of cooperating and competing species that help to determine our intestinal health. When we take antibiotics, we kill countless bystander bacteria in our guts and sometimes develop changes in our digestion which can be severe. Clostridium difficile infection is one of these conditions, a superinfection with a bacterium which is pretty resistant to antibiotics and causes infection of the …
Medicines and other treatments need to be tested. We want reliable proof that something works and is safe before we recommend it. We don’t like the false dichotomy of “alternative medicine”. If there is good evidence that it works, it’s medicine. If it doesn’t work, it’s quackery.
It doesn’t matter who’s doing the quacking. A quack is a quack, even if …
Junior Seau had CTE, chronic traumatic encephalopathy, the degenerative brain disease known to afflict individuals who have sustained repeated head injuries over time.
Junior Seau played football his whole life and was never officially diagnosed with a concussion. Last May he sat down one day and shot himself in the heart. Dave Duerson, the former Bears safety, did this too, as a way to …
A 38-year-old man is evaluated during a routine examination. He was diagnosed with ulcerative colitis 10 years ago and is currently asymptomatic. His last colonoscopy, performed at the time of diagnosis, showed mildly active extensive colitis extending to the hepatic flexure. There is no family history of colon cancer or colon polyps. His only …
An editorial by two oncologists in the New Year’s issue of Annals of Internal Medicine discusses overdiagnosis, a controversial health problem that some have called “a modern epidemic” but others, including the editorialists, feel is a minor concern. Although many chronic conditions are overdiagnosed, cancer is the most thoroughly studied, as well as the most emotionally charged.
I am a generally healthy man with no family history …
This little cartoon, courtesy of xkcd, highlights a problem we have had for some time, but which is getting worse–highly antibiotic-resistant bacteria. Soon after the first antibiotics appeared, especially penicillin, doctors noticed the phenomenon of developing bacterial resistance to them. The cause is evolution in action. The replication time for bacteria is extremely fast, as short as …
A 27-year-old woman is evaluated for a 4-week history of wheals, characterized by a burning sensation without pruritus. Each individual lesion persists for 48 hours and slowly resolves, leaving a bruise. Current medications are diphenhydramine, hydroxyzine, cetirizine, and oral contraceptives. The patient’s mother has systemic lupus erythematosus.
On physical examination, vital signs are normal. She …
Add to the growing list of reasons antibiotics might not be good for you and your children: a recent study showing a statistical link between early ear infections and inflammatory bowel disease (IBD).
Researchers in the UK analyzed data from about a million children, looking specifically at the 750 who developed IBD (Crohn’s disease and ulcerative colitis, mostly.) They then compared the kids with IBD to children without that …
I live in Louisville, KY, which is the epicenter for heart disease in the United States. My state ranks 49th out of 50 states for heart attack mortality. This is a complex issue with many contributing factors, including access to care, patient education, health insurance, cooperation between EMS and hospitals, among others. The thing is: heart disease is our number one …
For around four years in a row, starting around 1996, my husband and I rented one of those inflatable bouncy houses for my son’s birthday party every August. We invited a whole bunch of his friends and cousins to bounce in it for a few hours (and let them play in the sprinkler and fed them cake). Nobody got hurt.
Recently, an article was published in the New England Journal of Medicine questioning the utility of mammogram screening for prevention of death from breast cancer.
The authors were research professor Archie Bleyer MD at Oregon Health and Sciences University in Portland, an oncologist who was chief of pediatrics at MD Anderson Cancer Center and H. Gilbert Welch MD, MPH, a professor at …
Losing weight can decrease the incidence of several chronic and debilitating diseases, as well as their associated complications and risks during the surgical period. Additionally, it can facilitate recovery after surgery. Obesity increases the risk for:
Diabetes
Obstructive sleep apnea
Hypertension
Cardiovascular disease
Depression
Joint degeneration
Cancer
Additionally, obese patients may present special challenges for anesthesiologists:
Blood pressure monitoring (finding an appropriate fitting blood pressure cuff)
Many older patients fall in the hospital and these falls often lead to injury. Hospitals are under a lot of pressure to reduce falls. Generally, these falls happen when patients transfer such as when an older person tries to get out of bed or get up from a chair. While hospitalized, many patients are weak, dizzy, or confused, and they can be at risk of falling when ambulating …
We pay a lot of attention to hearing. Newborns get their hearing tested in most states, and periodic hearing screening is part of regular checkups. We know which children cannot hear. So why is it that so many kids don’t listen?
When we’re raising little kids, we know that we’re supposed to talk all the time. We yammer on in the grocery …
In September the United States Preventive Services Task Force, a panel of medical experts, concluded that tests to screen for ovarian cancer do more harm than good. As a result, insurers will not be required by federal law to pay for such tests.
And the announcement was met with near silence.
Why was this recommendation greeted with such malaise when the same panel’s earlier and similar conclusions about Read more…
When it comes to getting parents to cut back on their kids’ screen time, we doctors aren’t doing such a great job.
Like most of my colleagues, I talk about screen time at almost all checkups. I talk about how too much screen time makes a kid more likely to be overweight and have behavioral problems. With the parents of babies and …
Are you or your patients sleeping well? Mine are not, and I wasn’t either. Do you ask them how they sleep? I never used to ask, and no one asked me. When I was in medical school, we had rigorous instruction in taking detailed medical histories. Sleep quantity and quality were not included.
I only met her once; she was young—in her mid-thirties—and she had been diagnosed with ovarian cancer during her pregnancy. Following chemotherapy and the delivery of a healthy baby, she underwent a hysterectomy and staging. She was ultimately diagnosed with a rare ovarian cancer: small cell carcinoma. She underwent postoperative chemotherapy and had gone into remission.
A 50-year-old man is seen for a new-patient evaluation. He reports a recent diagnosis of Parkinson disease made after a 2-year history of stiffness in his right arm, a tendency to posture when walking, an awkward and stiffly inverted step when using the right leg, but no tremor. During this period, his voice became …
