Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 32-year-old man is brought to the emergency department after becoming disoriented, combative, and agitated earlier that day. He is accompanied by a friend, who states that the patient has a history of alcohol and drug abuse, including inhalants.
On physical examination, the patient is uncooperative and …
I’m reluctant to write a post about ADHD. It just seems like treacherous ground. Judging by comments I’ve read online and in magazines, and my own personal experience, expressing an opinion about this diagnosis—or just about anything in child psychiatry—will be met with criticism from one side or another. But after reading L. Alan Sroufe’s article (“Ritalin Gone Wild”) in the New York Times, I feel compelled to write.
If …
Today, I want to review another article I wrote in last year. That article started with a confession: “I confessed that I ate lunch with a representative of a pharmaceutical company.”
I must now confess that I often eat lunch with representatives of pharmaceutical companies and I’m proud of it. At this stage of my career, I can well afford my own lunch. I could sit quietly and relax over a cup …
When they first discovered the tumor in his pancreas in October 2003, his doctors told him an immediate operation was necessary, and could lead to a cure.
As first reported by Peter Elkind in 2008, Jobs decided to think different, declined surgery, and explored alternative medicine treatments for his disease.
Nine months later, in July 2004, the tumor had grown. Only then would he allow his doctors to operate.
Would Steve Jobs be alive today had he consented to surgery when they first discovered …
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 …
Being a physician certainly biases how I view the world around me. I can’t help but think in terms of problem-solving and healing. But have you noticed how medicalized our society has become? The other night watching television, we watched at least four drug commercials and one health insurance commercial — during a half-hour show! I believe we are in the middle of the medicalization of America, and I don’t …
A young man on my sobriety-based detox program (only after showing positive for opiates) admitted to heroin-usage, but hedged the matter saying it was “5 days ago.” His implicit presumption was that an isolated episode, days ago — compared to continuous, more recent, heroin-usage — would lessen the likelihood of his getting kicked off the program.
Is his story of “no heroin [ingestion] in the last five days,” likely, the whole …
We have to crush pills sometimes. Either the patient (through aversion or physical limitation from stroke) can’t swallow whole pills so we crush them and put them in applesauce, or the patient gets their pills through a tube, so we crush them and dissolve them in water.
When I started nursing, we had a mortar and pestle.
Anyway, this is what we used …
While diligently perusing a stack of unread journals, a piece in the July 25, 2011 issue of Modern Healthcare caught my attention.
Titled “What’s the Agenda?” this special report deftly navigated the murky waters of “physician participation on advisory boards” and managed to present an accurate appraisal of the issues.
Here is a brief recap.
Back in the days before “medical ethics” issues were commonplace, pharmaceutical and medical device manufacturers were accustomed …
Do you, or many of your patients, have a little more belly fat around your and their middle than you and they would like? Me, too.
Turns out that there are two decent published studies from reputable places that report that a person may rub a cream on their skin over the fat spots and make the fat go away.
Wow, what a deal.
The first study addresses fat thighs, with each …
We certainly wish that antidepressants in particular, and all psychiatric medications in particular were free of side-effects. It would be a boon to our patients, and their families. Sadly, there is no such thing as a medication without any risk of side-effects. Even over-the-counter medications such as Tylenol, Benadryl an aspirin can have pretty serious side-effects.
Some side-effects of medications are related to dose — the higher the dose, the …
Walgreens is being sued by customers who are not happy that their prescription information – even though it has been de-identified – is being sold by Walgreens to data-mining companies.
The data privacy and security concerns surrounding the transfer of de-identified data are significant. To “de-identify” what is otherwise protected health information under HIPAA, some outfits will simply strip data of 18 types of identifiers listed in federal …
Embryonic stem cells are present after a fertilized egg divides for two or three days. They have the seemingly miraculous ability to turn into any of the tissue types in the body—whether brain neurons, beating heart cells, bone, or pancreatic islet cells. It is important to understand just where these cells come from.
Those used in science are …
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Having a healthy level of respect for opioids is critical for any physician. For those of us who prescribe or recommend this class of medicines on a daily basis, this statement rings all the more true.Recent events and research reinforce this reality.
“Oxycontin, Other Opioid Painkillers Tied to Higher Health Risks” was the title of a recent BusinessWeek article …
Have you ever opened a prescription bottle to find the wrong pills inside? If so, you may have found it to be an expensive mistake.
Whatever the reason for the error (and there are numerous possible causes), here is how to best handle the situation.
Of course, it is always smart to confirm the medications, quantities and dosages at the pharmacy checkout. A mistake recognized at the time of purchase can be easily …
I decided to dedicate a medical blog on smoking cessation after realizing that too many people in Douglas County (Omaha, Nebraska) smoke. Did you know that despite a smoking ban in restaurants and bars, 18.3% of people in Nebraska are smokers? That’s one in five people. And this number contributes to Omaha’s health ranking of 142 out of 182 cities in …
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Coverage requests get rejected when the requested service does not fit within an insurance company’s initial guidelines for approval.
This happens for a number of reasons, but usually it comes down to poor documentation or inappropriate care, or in some cases care that is appropriate but can’t be supported in the literature. When a denial occurs, the physician or patient has several opportunities to appeal this decision. The first appeal is …
by Marianna Rakovitsky, RPh
Recently, I have talked about the concerns with the use of NSAIDs and their effects on the heart. All medications carry a risk of adverse effects. NSAIDs are usually very effective in controlling pain especially muscle and bone pain, but they also carry a potential risk of side effects such as stomach and kidney problems, increased risk of bleeding and adverse effects …
The other day, I happened to be talking to Mark, a sales representative from one of the pharmaceutical companies. He’s the type of rep that many doctors don’t mind seeing – someone who is careful of your time, is happy to hunt down the answers to questions that come up on the medications his company makes, and brings by useful information about new drugs that seem to be practice-appropriate. He …
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An excerpt from White Coat, Black Hat.
by Carl Elliott
Many of us have a relatively simple, commonsense view of the way that drug development and marketing work.
People get diseases; scientists develop drugs to treat those diseases; and marketers sell the drugs by showing that the drugs work better than their competitors. Sometimes, however, this pattern works in reverse. Drug company scientists develop a drug …
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