A total knee replacement is a very common operation and more than 700,000 of them are performed each year in the United States. With a mean cost of about $16,000 each, in 2011 we spent over eleven billion dollars paying for knee replacements. Projections are that, by 2030, we’ll be doing 3.5 million per year. The operation has great results and patients generally do well during and after their surgery. Anesthetic care has improved dramatically ...

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Toilet training can sometimes be a stressful process. This is particularly the case for children who achieve daytime dryness but continue to wet themselves, and the bed, overnight. It may leave you wondering what’s normal and what you can do to help your child. Nighttime wetting is one of the most common urologic conditions in childhood. The vast majority of cases are not related to a physical cause. Most commonly, nighttime ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 38-year-old man is evaluated for a 1-year history of cough with mucoid sputum and a 6-month history of mildly progressive dyspnea. He has a 12-pack-year history of smoking. He has no history of asthma, allergies, skin disease, or liver disease. On physical examination, vital signs are normal. Pulmonary examination discloses decreased breath ...

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The Ellen DeGeneres Show has repeatedly put out a call for viewers to send in their funny sunburn pictures and stories. The following was posted on the website:

Summer is here and everyone is hitting the beach or pool. Just don't forget the sunscreen! If you did, and you have the bad sunburn to prove it, we want to see the funny photos. Be sure to tell us the story behind ...

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On a cold, blustery Cleveland day when I was a resident, a forty-year-old man walked into our infectious disease clinic at the Cleveland Clinic. The patient was undergoing routine visits in preparation for a kidney transplant. This poor man had been hospitalized six months earlier at another hospital where he caught a terrible infection and was readmitted in septic shock and multi-organ failure. Luckily he survived, but in the process ...

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As a resident of San Francisco (and with Los Angeles just a drive away), I cannot escape the food hate.  Whether it be a campaign against cooked provisions, farmed products or anything of solid consistency, I cannot help but wonder if any possible benefit of these diets outweigh the risk of missing out on amazing grub. But what about gluten-free diets? Gluten sensitivity Gluten, a protein found in foodstuffs such as wheat, barley ...

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Recently, someone asked me on Twitter, “Has the change in classification of obesity as a disease affected how you treat patients presenting w/ the disease?” The classification change in question is regarding the American Medical Association’s declaration that obesity is a disease rather than a comorbidity factor. This change in classification affected 78 million American adults and 12 million children. The new status for obesity means that this is now considered a ...

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A 35-year-old woman is evaluated for new-onset thrombocytopenia. She is gravida 1 at 36 weeks' gestation. Her pregnancy has been otherwise uncomplicated. She takes only a prenatal vitamin. On physical examination, temperature is normal, blood pressure is 110/65 mm Hg, pulse rate is 110/min, and respiration rate is 22/min. There are no ecchymoses or petechiae. Abdominal examination discloses no right upper quadrant pain. She has a gravid uterus. Neurologic examination is ...

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As a parent, my words to and about my child will probably be one of the single most influential aspects of their development. Children learn to see themselves through their parents’ eyes, and what we tell them they are, they are likely to become. The labels we place on them often tend to be a self-fulfilling prophecy. I’ve seen this play out in my own life and in the lives of ...

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Youre doing it wrong: The Paleo diet Go ahead, eat more meat, butter and cheese. Let me know how it turns out for you. I certainly won't be joining you, despite the current popularity of the proposition. For one thing, there is no case -- none -- that eating more meat, butter and cheese would be good for us. Rather, the case is advanced these days -- 
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