Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 55-year-old man is reevaluated during a follow-up examination for a wrist fracture and anemia. The patient is otherwise asymptomatic. He was treated in the emergency department 2 weeks ago after he slipped in his driveway and sustained a right wrist fracture; mild iron deficiency anemia was detected at that time. He ...

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Top stories in health and medicine, August 29, 2014From MedPage Today:

  1. Thyroid Problems May Up BP Risks in Pregnancy. Women with hyperthyroidism and even high-normal free T4 during early pregnancy had an elevated risk for developing hypertensive disorders.
  2. Study Questions Surveillance Colonoscopy. Removal of adenomatous polyps -- without follow-up surveillance colonoscopy -- led to a colorectal-cancer mortality similar to that ...

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I am a regular reader of patient blogs, and I find myself frequently gasping at the mistreatment they experience at the hands of my peers. I recently had the “pleasure” of being a patient myself, and found that my professional ties did not protect me from outrageously poor bedside manners. I suppose I’m writing this partly to vent, but also to remind health care professionals what not to do ...

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Top stories in health and medicine, August 15, 2014From MedPage Today:

  1. NSAIDs May Slow Breast Ca in Obese Women. Obese women with estrogen receptor-positive breast cancer had a 52% lower risk of recurrence when they regularly used aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs).
  2. Mix of Kudos and Caution for Fecal DNA Test. Approval and imminent Medicare coverage of a ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 25-year-old man is evaluated for a 5-year history of slowly progressive solid-food dysphagia that is accompanied by a sensation of food sticking in his lower retrosternal area. He has compensated by modifying his diet and avoiding fibrous meats. He has not lost weight, and he has not had trouble drinking liquids. ...

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At the critical time when our nation has made meaningful and measurable progress against colorectal cancer incidence, threats to reimbursement for colonoscopy screening for Medicare beneficiaries are looming, which may jeopardize the effectiveness of public health strategies to increase screening and prevention of colorectal cancer in the U.S. New data from the American Cancer Society indicate that colorectal cancer has declined by 30% in just the last decade among those aged 50 ...

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Not long ago, Tracy Hume, a freelance writer who lives in Greeley, Colorado, sent me an email posing this question: "Do ER-affiliated urgent care providers ever try to escalate patients to the ER when it is not medically necessary?" It seems that over the July 4th weekend, Tracy’s teenage son was complaining of a headache, nausea and abdominal pain, and was vomiting. He doesn't complain much, she said, so thinking that ...

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I’m a law abiding blogger. Laws are meant to be obeyed. If an individual opposes a law in a free country, then he should operate within the system to modify it. I recognize that even in free societies, certain laws are so unjust and in violation of natural law that that the citizenry may be justified in relying upon other measures to affect necessary reform. I’m not suggesting that an unwelcome ...

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Mr. D was my patient in the partial hospital program for the chronically and persistently mentally ill, and he was barely maintaining the level of functioning necessary to remain outside of the inpatient unit. A middle aged man with long-term psychotic and depressive symptoms, Mr. D’s care was made even more complicated by an extensive history of alcohol dependence and intravenous drug use that had left him with a severely ...

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A 32-year-old woman recently came to see me for an opinion on stomach pain.  Why would I refuse to see her again?  Abdominal pain is an everyday occurrence for a gastroenterologist.  She was accompanied by her mother.  I had never met this woman previously. She had suffered abdominal pains for as long as she could remember.  She recalled frequent visits with the school nurse when she was a young girl. She has abdominal distress ...

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