Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 40-year-old woman is evaluated for a rash on her hands that has been present for 6 weeks. This rash comes and goes throughout the year and has been present for many years, but never as severe as it is now. She also experiences itchy skin on her body. She had eczema ...

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Last year, Dean Dupuy, 46, an engineer at Apple, suddenly died of a heart attack while playing hockey. He experienced no warning symptoms and, with a healthy, active lifestyle, did not fit the profile of someone at risk. Too late to save him, Dupuy’s wife Victoria discovered that early coronary disease can be identified by simple CT scans. She recently launched a nonprofit organization, No More Broken Hearts, in San ...

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The fact that childhood cancer is, thankfully, a rare disease belies the fact that it is the leading cause of disease-related death in U.S. children, age 1 to 19.  The fact that it is a rare disease also belies the fact the number of people with a direct stake in expanding research into pediatric cancer is quite large and extends well beyond the small number of children with cancer and ...

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Nobody, it seems, is comfortable with death. In Haiti, where death and life are fluid concepts, where voodoo curses and ghosts are spoken of as fact rather than fiction, death is comfortably present. The dead are buried in mass graves throughout the country, victims of political crime, violence, malnourishment and infectious disease. There, life can be drained from a healthy person in a matter of hours for lack of clean ...

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What Mayor Thomas Menino taught us about cancer Beloved and deeply respected Boston mayor Thomas M. Menino died on hospice in Brigham and Women’s Hospital recently.  Menino developed advanced cancer of unknown primary (CUP) in the spring of this year, and after six months of chemotherapy, he elected to stop active treatment.  Reportedly he was comfortable, and surrounded by friends and family at the time of his death.  The press, the ...

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A new study from surgeons at UCLA found that laparoscopic cholecystectomies done at night for acute cholecystitis have a significantly higher rate of conversion to open than those done during daylight hours. Nighttime cholecystectomies were converted 11 percent of the time vs. only 6 percent for daytime operations, p = 0.008, but there was no difference in the rates of complications or hospital lengths of stay. The study, published online in the ...

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Remember when we were trying not to panic about Ebola? Seems like that was only yesterday. Oh wait -- it was only yesterday. But it already seems as if we are trying to remember that we were trying not to panic. I listened to my favorite news radio station out of New York City while driving to the office recently. They address all of the major news stories in the first eight ...

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Walk in the shoes of a cancer patient We sit, we listen, we attempt to focus and absorb what we are required to know. We learn how to give bad news, even using one another as makeshift “standardized” patients. How does one “standardize” a patient anyway? Who knows, who cares, time to cram for the endocrine exam. But what happens when you stop pretending? When you wake up one morning ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 55-year-old man is evaluated during a routine examination. He has a 2-year history of nonischemic cardiomyopathy. (Echocardiogram 2 years ago demonstrated a left ventricular ejection fraction of 35%.) He is feeling well and reports no shortness of breath; he walks 2 miles daily without symptoms. Medical history is remarkable for hypertension. ...

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Carl didn’t know what was happening to his wife. The German railway clerk from Morfelder Landstasse and his wife Auguste had been happily married for twenty-eight years.They had one daughter, Thekla, and their marriage had always been harmonious -- that is, until one Spring day in 1901 when Auguste suddenly exhibited signs of jealousy. Auguste accused Carl of going for a walk with a female neighbor, and since then, she had ...

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