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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

I was offered my choice of bisphosphonates after breaking my shoulder and ended up with a diagnosis of osteoporosis. I initially opted for Reclast, a drug that only requires one dose a year albeit by IV infusion. I made an appointment to get the drug several weeks later. I wanted to have time to research my options. After reading as much as I could during that time, I made an ...

Read more...

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 26-year-old woman is evaluated during a routine examination. Her last Pap smear was performed 1 year ago and was normal. She has received a complete human papillomavirus (HPV) quadrivalent vaccine series. Medical history is unremarkable. Family history is noncontributory. She takes no medications. On physical examination, temperature is normal, blood pressure ...

Read more...

Our culture has taken a strange turn where the truth is relative, and where conspiracy theories rule the day. News sources and social networks are rife with political agendas, fake articles, and disguised advertisements. This chaos harms our social welfare, but can also impact physical health. Misleading news reports of new clinical studies make it difficult to discern medical fact from fiction. I spend hours in clinic justifying recommendations to patients ...

Read more...

When I find a lump in my left breast, I am stunned. I probably shouldn't be surprised, but I'm immobilized. It takes me several days before I tell my partner, who has to push me into action. I get the referral from my doctor and schedule a mammogram. The radiology practice fits me into their schedule that same week, but I still have several days to sit with the unknown. Finally, ...

Read more...

Most Popular