When I hear debate over the association between SSRIs (selective serotonin re-uptake inhibitors, a class of antidepressant medication) and suicidal behavior in children and adolescents, I am immediately brought back to a night in the early 2000s.  As the covering pediatrician I was called to the emergency room to see a young man, a patient of a pediatrician in a neighboring town, who had attempted suicide by taking a nearly ...

Read more...

If you’ve ever worked in an emergency room, you’ve likely treated a victim of human trafficking. We all have, often without knowing it. With nearly thirty million people in modern-day slavery around the world, there are more slaves today than at any point in history. Human trafficking is defined as “the recruitment, harboring, transportation, provision, or obtaining a person for labor or services, through the use of force, fraud, or coercion” for the ...

Read more...

Most hospitals are strapped with a massive amount of debt.  Not monetary debt, but sleep debt.   Amongst both the staff and patients, sleep is severely lacking.  In our busy society, we associate sleep with leisure and relaxation; a reward at the end of a long day.  But sleep isn’t a luxury.  Rather, it’s a medical necessity. Sleep deprivation has widespread consequences, causing cognitive dysfunction, weakened immune system, impaired healing, increased blood ...

Read more...

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 59-year-old man is evaluated for a 3-month history of intermittent itching on the forearms. He describes the itch as deep, with a burning or tingling sensation. Scratching helps somewhat, but over-the-counter topical corticosteroids have not helped. Cooling the skin soothes the itch. He did not notice a rash until he started ...

Read more...

We live in a digital age. Technology has become an integral part of how we see, learn about, and interact with the world. From computers at the office, to televisions at home, to smartphones on the bus or in the grocery line, many of us spend over half of our waking lives in front of a screen. Naturally, some of us have begun to worry about the effects this may have ...

Read more...

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 21-year-old man is evaluated during a medical examination for health insurance. The patient is a weight lifter. He has no medical problems and takes no medications or illicit drugs. On physical examination, blood pressure is 128/73 mm Hg, pulse rate is 56/min, and respiration rate is 16/min; BMI is 30. Increased skeletal ...

Read more...

From time immemorial until about 75 years ago or so most babies were born at home. Now it’s around 1% in the USA, although it’s much higher than that in many Western European countries. The shift to hospital births paralleled the growth of hospitals, pediatrics, and obstetrics. With that shift there has been a perceived decrease in women’s autonomy over their healthcare decisions. There has also been an unsurprising jump in ...

Read more...

Last week a patient said to me, "You live your whole life thinking you're going to have time to enjoy life later on, and then this happens." Then he started to cry because we had just reviewed his recent CT scans and some of his lab results and he had a new diagnosis of a type and stage of cancer that meant he likely had about eight months to live. ...

Read more...

We are civilized people in the United States. We don't set up leper colonies or concentration camps or psychiatric snake pits to banish people with severe mental illness. Instead we send them to jail or prison -- almost 400,000 of them, more than 10 times the number receiving care in hospitals. And we also blithely ignore the fact that additional hundreds of thousands live homeless on the streets or in ...

Read more...

In my pediatric nutrition practice, I often preach about getting more fruits and vegetables into the diets of the children I see. Eating more vegetables is a proven way to fight obesity and promote better health. Sometimes the question of where and how to find healthy food comes up during my conversations with parents. Many of my clients reside in the Bronx, where sometimes the closest vegetable is the pickle on ...

Read more...

Most Popular