I was changing my daughter’s diaper the other night when I noticed some spots. There was a cluster of six or so around her belly button and a line of them tracing her bottom rib on the right. They were reddish-brownish-purple pinpoints and when I pressed on them, they did not blanch. She did not seem bothered by them at all. I, on the other hand, began to quietly freak ...

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As I have mentioned before, all surgeons think they are the best. Of course when we ourselves need surgery, there is a bit of a dilemma deciding who is the best qualified to carry out the procedure. So when I realized there was a strange looking skin lesion in my right inner thigh, I decided only the best would do to operate me. In my rooms I informed the sister I ...

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There is an epidemic of gun violence. This is a serious health problem. Watching your diet, exercising, and taking pills is all for naught if a bullet kills you. In Newtown, Conn., one of the worst mass shooting occurred last week when a gunman shot his mother at home, apparently with her own gun, then walked into an elementary school and shot six other adults and 20 children, before shooting himself. ...

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For just a moment, let's take a scientific viewpoint about gun control here and try to leave emotions (and the Constitutional argument) out. The best type of study to determine whether gun control and/or regulation would be a randomized trial: randomizing a state or country to regulation or not. Since that's not going to happen, the next best type of evidence we have to go by is observational, either case-control or cohort ...

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shutterstock_105594971 I knew he was sick when he told me he'd thrown out his cigarettes on account of how badly he felt. Mr. P had gotten used to the breathlessness when he climbed stairs and the hacking, dry cough that followed him everywhere. What else could he expect after smoking three packs a day since he was six years old? But he had shown ...

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It has always been my assumption that my new practice will be as “digital” as possible.  No, I am not going into urology, I am talking about computers. [Waiting for the chuckles to subside] For at least ten years, I’ve used a digital EKG and spirometer that integrated with our medical record system, taking the data and storing it as meaningful numbers, not just pictures of squiggly lines (which is how EKG’s ...

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asco-logoOne of the toughest situations in oncology is the discussion about next steps, particularly when it comes to treatment of recurrent or metastatic disease. I believe very much that it is realistic to offer a patient the hope of cancer as a “chronic disease,” that treatment can result in disease stability, even though I cannot predict how chronic “chronic” is. I was ...

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Disclosure. I am a pathologist, and I work at the interface of molecular oncology and information technology. Approximately 600,000 American cancer patients emerge uncured from standard of care treatment by medicine, surgery, and radiation each year. That is 1,600 every day. What then? Enlightened palliation on the way to hospice care does make sense for many. But now there are additional options based upon emerging science. Molecular testing of the actual ...

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Sam burst into the office, a two-year-old wild bundle of energy. Squealing with delight -- or was it distress; it was hard to tell -- he ran from toy to toy not looking at me or his mother, Jane. He was unable to engage with anything. Jane had brought him to see me in my pediatric practice because, “he hits me, has explosive tantrums, and I can’t take him anywhere.” ...

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shutterstock_111707921 America consumes 80% of the world opioid supply (99% of the world hydrocodone supply), but has about 5% of the world’s population. If you don’t think America has some kind of opioid problem, then move along because this rational, evidence-based, experience-laden way in which I’m going to discuss opioid use and misuse will not interest you. To combat our opioidification the
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