Whether you are a physician, nurse, physician assistant, pharmacist, or someone else who cares for sick or disabled people, your job as a healthcare professional is an important one. Healthcare professionals are expected to provide services to individuals in need and to do so with quality and care.One way we can help ensure that we are doing our job the best way possible is to get our annual flu ...
Conditions
The Haiti cholera outbreak is a repeat of history
The Cholera outbreak in Haiti reminded us that this is not simply a disease of the distant and unsanitary past. The outbreak was both unique and typical. Caused by a disease that has a long and devastating history, this Haiti outbreak has much in common with the outbreaks of the nineteenth century and twentieth century. History helps us keep in mind five key factors.1. The role of media coverage ...
Depression causes a drop in productivity at work
According to a recent study, depression causes an 23% drop in productivity at work. The drop is almost 45% for treatment resistant depression, defined in that study as depression that has not responded to 2 adequate trials (i.e. adequate dosage for adequate duration) of antidepressants.My gut, based on clinical experience, tells me that even when depressed, people devote lot more of their emotional resources to trying to not let ...
Health related questions about plastic
Susan Freinkel is the author of the new book, Plastic: A Toxic Love Story.She was kind enough to answer some health related questions about plastic based on her research for her book.Is all plastic toxic?There are lots of different kinds of plastic and some may pose more of a health hazard than others. The two experts are most worried about are:Polycarbonate, a hard, clear plastic ...
Disease treatment progress will continue to be slow and painful
Recently, a friend sent me a text message with a rather conservative back-of-
The cumulative effect of viruses in day care
Tracy has a good question: "My 4 year old is not in day care – he stays with Granny. I heard that once you get a cold, you never get that cold again, and I am worried he isn’t exposed to enough germs now to keep him healthy later. Should we be trying to infect him with more colds now that he has the luxury of staying in PJs all ...
Genetically informed therapy and technical innovations in cardiology
I want to give an overview of cardiac care advances – the first two themes are discussed here. I want to thank Dr. Mandeep Mehra, chief of cardiology at the University of Maryland for conceptualizing these themes for me.First is genetically informed therapy. Pharmacogenomics is having an impact in the use of warfarin (Coumadin) and clopidogrel (Plavix). Warfarin dosage can now be titrated in part based on a person’s genomic makeup. In ...
The decision to pursue a rare illness
Patricia Daly, FACP, of Warren Memorial Hospital in Front Royal, Va., told us about the case of a 49-year-old man who presented with marked weight loss. A year prior, the patient had weighed about 220 pounds and intentionally put himself on a diet, but after losing 45 pounds, he developed poor appetite and early satiety.He continued to lose weight to a nadir of 143 pounds. He found it increasingly difficult ...
MKSAP: 75-year-old woman with a sudden loss of vision
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.A 75-year-old woman is evaluated for a sudden loss of vision in the left eye that began 30 minutes ago. She has a 2-week history of fatigue; malaise; and pain in the shoulders, neck, hips, and lower back. She also has a 5-day history of ...
An MRI for back pain may only confuse the diagnosis
"Doc, my back is killing me! I think I need an MRI."I don't know if you've ever uttered those words, but I can tell you I've sure heard them ... more times than I can count. And believe me, I get it. When you're in pain, all you care about is finding out what's causing it as soon as possible so you can get rid of it as soon as possible. It’s quite tempting to ...
Divorce after the diagnosis of Alzheimer’s disease
I was tempted to avoid venturing into this topic, only because I strive to keep my website and blog away from politics and religion. In that light, I am going to stay away from the politics and religion of this topic and just stick with the main theme of the story and respond based on my own experiences, which includes assessing patients who are known to have or are suspected ...
Health effects of the BP Gulf Coast oil spill
People living along the Gulf of Mexico are still feeling the effect of the BP oil spill disaster, the largest oil catastrophe in history. To learn more about the spill's health effects, I spoke with Dr. Gina Solomon, an Associate Clinical Professor of Medicine at the University of California, San Francisco, and Senior Scientist at the Natural Resources Defense Council. Dr. Solomon was on the Louisiana ...
Achieving a 90 minute door-to-balloon time in STEMI patients
At a recent committee meeting, my hospital’s administration announced new quality measures and targets. Striving for top performance, the board of the hospital system set the bar extraordinarily high. The bonuses of senior management are tied to achieving the targets, so the announcement had everyone’s attention.
One target that caught my interest was for achieving a door-to-balloon time of less than 90 minutes in STEMI patients. As an interventional cardiologist who ...
Discussing a colostomy in a patient with rectal cancer
Sturdy and thickly-built, long since widowed, cheery in a sardonic sort of way, tough and opinionated, Flora's European roots ran deep; she'd been an Italian farm girl, and she'd rather be in her garden than anywhere else. The only reason she agreed to come inside and go to the doctor was that her bowel movements had finally gotten too painful, and too bloody to ignore. Which she had been doing, ...
Exercise can help treat fibromyalgia
What is fibromyalgia and what exactly what does exercise have to do with the treatment and long-term outcome of the condition? A recent study published in Medicine & Science in Sports & Exercise is helpful in understanding the relationship between fibromyalgia and exercise and how clinicians (and patients) might find better strategies for treatment.Fibromyalgia is a clinically defined pain syndrome estimated to affect about 5 per cent of the general population with criteria for ...
The progress we have made in the diagnosis and treatment of cancer
An article released by the Centers for Disease Control and Prevention in their weekly publication Morbidity and Mortality Weekly Report provides an assessment of the progress we have made in the diagnosis and treatment of cancer.Clearly, since 1971, we have made substantial advances in the cancer treatment. We have become a larger and older nation. ...
ADHD and the lack of quality sleep
As the new school year begins, it’s only natural that there’s more awareness about learning and behavior issues. One of the most controversial topics that came up frequently is ADHD, or Attention Deficit Hyperactivity Disorder. It’s thought that 2-4% of children have this condition, and a shocking 50% of children with this condition are on some form of prescription medication. Not only is it seen in children, but adults ...
MKSAP: 81-year-old man is evaluated for the gradual onset and progression of memory loss
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.An 81-year-old man is evaluated for the gradual onset and progression of memory loss over the past year. He says he has difficulty recalling the names of familiar people, has misplaced his wallet on numerous occasions, and is slower to find his car in large, ...
Andrea Mitchell breast cancer thoughts
For the past 24 hours I've squirmed about whether to or how to criticize NBC's Andrea Mitchell about her on-air announcement of her breast cancer diagnosis and treatment. How can you criticize someone who is dealing with what she - and so many other women - are dealing with? But it's now clear that some breast cancer survivors and others who know the science are critical of the message ...
Biology and biography: The Two-B Factor of depression
An excerpt from Living with Depression: Why Biology and Biography Matter along the Path to Hope and Healing (Rowman & Littlefield Publishing Group).To be human is to experience an array of different emotions. We can feel upbeat and hopeful, cool and unconcerned or frustrated and fearful in a given day—even in a given moment. The heart of human experience beats with moments of joy and flashes of sorrow, and with ...
