Several years ago, I was meeting a young woman in my clinic for the first time. She was healthy but had been obese most of her adult life, even though she had tried many methods of losing weight. We spoke for a few minutes about diet and exercise, and she agreed to see the nutritionist. A few months later, she came back to check her progress. She had lost weight, about ...

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Perhaps, doctors struggle more than most with memories that mark sad moments in their careers. For me, one of the most indelible was of a wonderful young man with chronic myeloid leukemia (CML). When I started my oncology career in the early 1970s, CML was almost always fatal. It would start with a chronic phase, which was treated with pretty simple medications. But those medications didn’t cure the disease. The “almost always” ...

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Liver transplantation for alcoholic liver disease has been controversial since the advent of the procedure. The perception that alcohol-related liver disease is self-inflicted combined with concerns of a high risk of recidivism to alcohol use, recurrent alcoholic liver disease, and non-compliance post-transplant has led a lack of support for transplantation for alcoholic patients in the public and among physicians. After initially avoiding transplants in this group of patients, the majority ...

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A recent study of men with early-stage prostate cancer found no difference in 10-year death rates, regardless of whether their doctors actively monitored the cancers for signs of growth or eradicated the men’s cancers with surgery or radiation. What does this study mean for patients? Based on research we have conducted on prostate cancer decision-making, the implications are clear: Patients need to find physicians who will interact with ...

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Domestic violence is ubiquitous in our society. Few are untouched by the physical and emotional consequences of abuse -- whether they were directly abused or know others who were. However, little has been done to prevent it. We’ve recognized prevention as critical to national health. This awareness has led to everything from decreased vehicular deaths by 90 percent since 1925 to millions of lives saved from vaccines. But even with all ...

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A 54-year-old man is evaluated during follow-up consultation regarding laboratory studies completed for a life insurance policy. He reports no symptoms. On physical examination, temperature is 37.2 °C (99.0 °F), blood pressure is 131/76 mm Hg, pulse rate is 88/min, and respiration rate is 15/min. No splenomegaly is noted. Laboratory studies: Hemoglobin 8.9 g/dL (89 g/L) Leukocyte count 3000/µL (3.0 × 109/L) with 30% neutrophils, 10% monocytes, and 60% lymphocytes Mean corpuscular volume 105 fL Platelet count 75,000/µL ...

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Asthma is a complex, chronic lung problem that now affects nearly 10 percent of all children. Both the incidence of new cases and the prevalence of ongoing cases in the pediatric population have been rising steadily for years, although there are hints these increases may have leveled off. A wealth of research suggests a huge part of asthma causation comes from the environment the child lives in, things like air quality and exposure to various ...

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Ben Stiller—one of the few comedians on this side of the pond who can make me laugh—said prostate-specific antigen (PSA) testing saved his life. I suspect he wasn’t being funny. Stiller had Gleason Grade 7 localized prostate cancer. Is he right? The honest answer is that we don’t know for certain. Before I get granular, we must visit proof, level of proof and burden of proof. The statement, “there’s no ...

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As a forensic psychiatrist, I have testified in courtrooms, at depositions, legal hearings, and inquests. I’ve been cross-examined by attorneys whose agenda was to discredit my testimony or demean psychiatry as a medical specialty. Two criticisms frequently leveled at psychiatry are: 1) Psychiatry has not changed significantly for the last sixty years and, 2) Psychiatry is the least scientific of all medical specialties. These beliefs are not true. Over the last few ...

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It is common practice in health care today for physicians to read articles published in leading journals within their fields and extract what they think is important for their patients. Though in most cases it is to the patient’s benefit that their physician stays up to date with the latest scientific advances, it is nonetheless important that doctors pay particular attention to research methodology and how generalizable these studies are ...

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