The largest challenge facing the infectious disease community in the 21st century is the increasing number of resistant organisms found in various disease processes.  The reason is much more complex than the over prescribing of oral antibiotics for sore throats.  This is not to say that good antibiotic stewardship is an important concept because it is but it must be recognized that the medical challenges of the human population today is ...

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The tragic case of Thomas Eric Duncan represents a failure of communication with consequences that extend well beyond the current Ebola crisis. When Mr. Duncan first presented at Texas Health Presbyterian Hospital in Dallas, his recent travel history from Liberia was reportedly ascertained and entered into the hospital’s electronic health record (EHR) system. Somehow, this critical piece of information never registered with the physician who diagnosed Mr. Duncan, and in ...

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Recently, NPR published the results of a study confirming that removal of both breasts (a double mastectomy) fails to improve the chance of survival compared to breast conserving treatments for breast cancer. The headline of the story was “Double Mastectomies Don't Yield Expected Results, Study Finds.” This finding is not actually news to informed physicians. Since the 1980s, there has been widespread recognition that both mastectomies and lumpectomies offer an ...

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One of the most frequent questions gastroenterologists are asked about is diet, health and disease; and some of the questions gastroenterologists are least comfortable answering are about diet, health and disease. This disconnect occurs for several reasons. Although the subject of nutrition is taught in medical school, it usually covers malabsorption of nutrients, vitamins and minerals that have limited relevance to the concerns of most patients. The modern physician does not see ...

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After a prostate cancer diagnosis: The urgency to treat Hearing the words “you have cancer” changes everything. In my role as clinical nurse specialist in a busy prostate clinic, I see the effects of these three words on men and their families every day. The shock and disbelief, the fear and confusion as most men feel perfectly well with no symptoms at all. Many men want to do something ...

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Ebola is a scary topic; there’s no doubt about that. With the onslaught of media coverage that has no end in sight, it’s likely that older children have already heard of the Ebola outbreak or will hear about it in the near future. The question is, what can we do to help our kids work through the confusing and frightening messages they see on television? Here are some suggestions to help ...

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When an unconscious person is first brought to the emergency room, there may be little indication if the individual has diabetes or a thyroid condition. Since millions of people have common hormone health conditions like these, emergency room clinicians and other acute care providers need to watch for cases where an endocrine disorder is causing or contributing to a medical emergency. More than 29 million people in the United States have diabetes, ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 72-year-old woman is evaluated during a routine examination. She has very severe COPD with multiple exacerbations. She has dyspnea at all times with decreased exercise capacity. She does not have cough or any change in baseline sputum production. She is adherent to her medication regimen, and she completed pulmonary rehabilitation 1 ...

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In June, a man became very ill during a flight into Lagos, Nigeria. On the plane, he developed vomiting and diarrhea, and he collapsed in the very busy airport. Contacts on the plane and on the ground had no idea that he had Ebola -- initially, he was treated for malaria -- and many health care workers and bystanders on the plane and in the airport were exposed to his ...

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A few weeks ago an emergency room doctor called our infectious disease physician group concerning a patient who had returned from Liberia and was having nausea and vomiting. Several of the patient’s family members had died of Ebola. As panic struck us, our decisive question was: When did he return from Liberia? The Centers for Disease Control and Prevention guidelines for screening and isolating patients for possible Ebola infection are clear: ...

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