Everyone wishes they had baby skin. It feels so soft and smooth; it’s perfectly adapted to induce us adults to want to clean their diaper, no matter how many times they dirty them. Like their big eyes and cute noses, baby skin it part of the whole package of being adorable. But like their eyes, their skin, however beautiful, is immature. Baby skin is thinner, has less natural moisturizers and …
How to protect baby skin during summer
I was thinking about food labels recently as I scanned yet another new food product at the grocery store. It’s become something of a hobby. “Oh, second ingredient evaporated cane juice (AKA sugar) and then at the end ‘natural’ (my quotation marks) flavors.” The verdict: processed food. I don’t need to know any more than that. Don’t care about calories or fat grams or the other things we have been …
Sugar matters when reading food labels
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 68-year-old man is evaluated for a 6-month history of a sensation of dryness in his eyes. He notes that it feels as though there is sand in his eyes.
On physical examination, the eyes are red, and trichiasis (ingrown eyelashes) and symblepharon (adhesions of the eyelid …
MKSAP: 68-year-old man with a sensation of dryness in his eyes
One of the saddest, but more treatable, causes of hair loss in patients is trichotillomania, the impulse control disorder in which a person repeatedly pulls out hair from their body for non-cosmetic reasons. While some people have never even heard of trichotillomania, according to the Trichotillomania Learning Center, as many as ten million Americans (or 4% of the U.S. population) suffer from the disorder.
According to the Diagnositic and Statistical Manual …
Makes you want to pull your hair out: Treating trichotillomania
Under current guidelines from the American Stroke Association, tissue plasminogen activator (tPA, commonly known as a “clot buster” drug) should be administered within 3-4.5 hours of “last seen normal” – and 1 hour of patient arrival – to potentially ameliorate a new onset stroke. (“Last seen normal” means exactly what it says. A patient who went to bet at 10 PM and awoke with slurred speech at 6 AM was …
tPA is the standard of care for stroke but with significant risks
On the theme of knowing when and when not to follow the diktats of emergency medicine, one of the greatest challenges for a practicing ER doc is chest pain. Missed MI is still the biggest driver of malpractice costs, and last I hear, ER docs still send home something like 2% of patients who are having MI or unstable angina. Not good. So over the last decade we’ve gotten all …
Chest pain is where protocol driven medicine breaks down
“U.S. Panel Says No to Prostate Screening for Healthy Men” was the title of an article on the front page of the New York Times on October 6, 2011. The article goes on to suggest that healthy men should no longer receive a PSA blood test to screen for prostate cancer because the test does not save lives over all and often leads to more tests and treatments that needlessly cause pain, impotence and incontinence …
A urologist responds to the new prostate cancer screening guidelines
In the past decade, the incidence of diabetes in the U.S. has nearly doubled – this is due in large part to the obesity epidemic. Currently, it is estimated that the lifetime risk of developing diabetes is around 1 in 3 for males an 2 in 5 for females born after 2000. When you consider that type II diabetes has a strong genetic component – the risk for a …
Steps you can take to prevent developing diabetes
There is a long tradition in folklore, one shared by shamans and occultists, that knowing the true name of something gives you power over it.
Many years ago I had a very sick patient in the PICU who one morning, totally out of the blue, broke out in a bright, red rash all over his body. The boy had many critical problems already and, although the rash didn’t seem to be causing …
Knowing the true name of a medical condition
With the obesity crisis in America, one of the major reasons for increasing health costs, the issue of the causes inevitably arises.
There seem to be two sets of causes postulated by a growing crowd of experts. Unfortunately, each set is aligned in our current polarized political climate with the right or the left. Each set of causes has some basis in reality, but neither fully explains the problem.
On one …
Whose responsibility is childhood obesity?
The last post in this series discussed new advances in cardiology – the two themes of genetically informed therapy and technical advances. I will continue with three additional themes – regenerative medicine, minimally invasive approaches and prevention.
The third of the five themes is regenerative medicine. One major area of investigation is whether stem cells can heal the damaged heart. Perhaps the field is “more glamour than fact” just now …
Stem cells, surgery free heart valve repair and nutraceuticals advance heart care
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 72-year-old woman is evaluated for fatigue and decreased exercise capacity. The patient has severe chronic obstructive pulmonary disease, which was first diagnosed 10 years ago, and was hospitalized for her second exacerbation 1 month ago. She is a former smoker, having stopped smoking 5 years …
MKSAP: 72-year-old woman with fatigue and decreased exercise capacity
Breast cancer may be the most common cancer among women. But, that doesn’t mean you can’t do something to help prevent it.
Researchers have found certain risk factors that increase a woman’s chances of getting breast cancer. We can’t change some of these factors, like age or race. But we can try to control others, like weight gain and alcohol use.
And, taking responsibility for the things you can control may …
5 ways to cut breast cancer risk
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Sadly, recent news reports described two food allergy-related deaths in a single week. Although the details are scant, the victims were a 15 year old and a 20 year old, who apparently ingested unsafe foods and were not treated promptly. These preventable tragedies behoove us to learn how to better manage our food-allergic patients and advocate for them as well.
The Centers for Disease Control and Prevention (CDC) estimated that approximately …
Preventing deaths from food allergy
Whether you are a physician, nurse, physician assistant, pharmacist, or someone else who cares for sick or disabled people, your job as a healthcare professional is an important one. Healthcare professionals are expected to provide services to individuals in need and to do so with quality and care.
One way we can help ensure that we are doing our job the best way possible is to get our annual flu …
Healthcare professionals need to get an annual flu shot
The Cholera outbreak in Haiti reminded us that this is not simply a disease of the distant and unsanitary past. The outbreak was both unique and typical. Caused by a disease that has a long and devastating history, this Haiti outbreak has much in common with the outbreaks of the nineteenth century and twentieth century. History helps us keep in mind five key factors.
1. The role of media coverage …
The Haiti cholera outbreak is a repeat of history
According to a recent study, depression causes an 23% drop in productivity at work. The drop is almost 45% for treatment resistant depression, defined in that study as depression that has not responded to 2 adequate trials (i.e. adequate dosage for adequate duration) of antidepressants.
My gut, based on clinical experience, tells me that even when depressed, people devote lot more of their emotional resources to trying to not let …
Depression causes a drop in productivity at work
Susan Freinkel is the author of the new book, Plastic: A Toxic Love Story.
She was kind enough to answer some health related questions about plastic based on her research for her book.
Is all plastic toxic?
There are lots of different kinds of plastic and some may pose more of a health hazard than others. The two experts are most worried about are:
Polycarbonate, a hard, clear plastic …
Health related questions about plastic
Recently, a friend sent me a text message with a rather conservative back-of-
Here’s the conservative estimate, not including quizzes, workshops, and miscellaneous other goodies: with roughly 100 questions per exam, an average of an exam every 3 weeks, and accounting for a few weeks …
Disease treatment progress will continue to be slow and painful
Tracy has a good question: “My 4 year old is not in day care – he stays with Granny. I heard that once you get a cold, you never get that cold again, and I am worried he isn’t exposed to enough germs now to keep him healthy later. Should we be trying to infect him with more colds now that he has the luxury of staying in PJs all …
The cumulative effect of viruses in day care
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