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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This story has become all too familiar. The patient enters the ER with crushing chest pain and their EKG shows an acute MI, (known today in the colloquial as STEMI, for ST-elevation myocardial infarction). The interventional cardiologist is summoned quickly and in less than 90 minutes from the patient's arrival across the ER door threshold, he or she is on a cardiac cath lab table, where a coronary stent is ...

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The New York Times recently published two articles in a series about inflammatory bowel disease, or IBD, in hopes to destigmatize the disease, and to broadcast medical and surgical advancements that have worked to change how we conceptualize IBD. I applauded the Times for highlighting what can be a debilitating disease for the 1.4 million Americans who are afflicted with it, and thought: Finally! IBD is getting the attention it deserves. Albeit ...

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Mass murders are becoming a depressingly familiar routine in the United States -- we can now expect to experience a media grabbing shooting about once a month. And the frequency can only increase as future cohorts of copycat killers are spawned by the seductive opportunity to temporarily gain the spotlight. Amidst the anguish and heartbreak felt by the victims' families, there are always two haunting questions. What motivates someone to kill ...

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Cancer screening in those with metastatic disease“Your cancer has come back.” These are words no one treated for cancer wants to hear, yet they are words I have said far too often in my own career. In this case, I had said this to a patient I had cared for ever since her initial diagnosis. At that time, she had stage III breast cancer. After her surgery, ...

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In 2010, I lost my mother to cancer.  She was a fighter and had survived well past her prognosis, but her hospital costs outlived her. Let me go back to late 2004. That was the year the doctors suspected she had cancer. My mother, who was not a smoker, was officially diagnosed with non-small cell lung cancer early on in 2005. When the biopsy confirmed that the small lesion in the ...

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I have been blogging and tweeting about ADHD a lot lately because I believe that change is in the air. This is the worst of times for ADHD diagnosis because statistics show it is wildly overdiagnosed and overtreated. This is possibly the best of times for ADHD diagnosis because I think we have reached the tipping point and feel hopeful that the ADHD fad will soon begin to fade. We humans are ...

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