While it is unusual for gastroenterologists to see colorectal tumors in patients under the age of 50, and even more uncommon before the age of 40, it does happen, so patients need to be aware of their risks. Colorectal tumors in young people are often detected either through symptom evaluation or because of a colonoscopy performed for an underlying risk factor, most commonly a family history of colorectal cancer (CRC). During ...

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The page comes from the psychiatry intern on call. “There’s a situation with patient RB on the unit. Please advise.” We gather in the hall outside the patient’s room. There are already three -- no, four -- security guards standing several feet away with their arms folded. Backup. Ready. Ready for what? We whisper in hushed tones as the intern explains what happened. He was “acting out.” He was running through the ...

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I recently fulfilled my civic responsibility by completing a stint on jury duty. Somehow I had never previously been summoned. Being the Law & Order junkie that I am, I was kind of awestruck by my first up-close exposure to the court system. I sat erect and at attention in the courtroom, listening to the judge charge us prospective jurors. I even became slightly teary when he spoke of the important role we ...

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Among the more contentious issues regarding health and weight control -- perhaps surprisingly, contentious among professionals and the general public alike -- is the role of personal responsibility. Unfortunately, this readily devolves into discord, because the cultural tendency of our time is denigrate those with whom we disagree, and hunker down in our distal, opposing corner. Just take a look at Congress to see how well this is ...

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Schuur and colleagues in JAMA Internal Medicine listed five low value services in the emergency department (ED). Although compilation was not solicited by the American College of Emergency Physicians as part of the Choosing Wisely program, it has its ethos. The list was developed by a technical expert panel after multiple iterations. The list is not only wise but derived from sound methodology. Most importantly, the recommendations are ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 35-year-old man is evaluated for a 2-week history of nonproductive cough and fever. He has a 20-year history of asthma. Three weeks ago, he visited friends in Indiana. He has no dyspnea, hemoptysis, or worsening of his baseline asthma symptoms. His only medication is an albuterol inhaler as needed. On physical examination, ...

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In the first recent piece of good news about the child obesity epidemic, the latest statistics on preschoolers -- those 2- to 5-year-old bundles of joy whom we worry about so much -- suggest that they’re less obese than they used to be. Between 2003/2004 and 2011/2012, according to the Centers for Disease Control (CDC), there was a huge drop in the ...

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News reports covering a prostate cancer study recently in the New England Journal of Medicine have all pretty much come out with the same message: men diagnosed with prostate cancer who had radical surgery did much better than men who were assigned to "watchful waiting" after they were diagnosed. But guess what? There's a critical fact that seemed to be missing in much of the coverage I saw. And that fact ...

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Having now lost more than 30 pounds, I am very close to declaring victory (maybe a few more pounds over the next few months).  A colleague has asked me to write my tips as a handout for patients.  This is a daunting task, but that has never stopped me! The weight loss formula is simple and well known.  Achieving lasting weight loss remains challenging.  The mathematical formula is simple.  Weight loss ...

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Adults are the ones who are supposed to be stressed, not kids. Childhood is supposed to be the stress-free part of life, right? Well, maybe not. At least not for teens. According to a recently released survey from the American Psychological Association, teens are actually more stressed than their parents. Researchers surveyed 1950 adults and 1,018 teens last summer and asked them a whole bunch of questions about the stress in their lives, and how ...

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