When children are diagnosed with attention deficit hyperactivity disorder, stimulant medications like Ritalin or Adderall are usually the first line of treatment. The American Academy of Pediatrics issued new guidelines Monday upholding that central role of medications accompanied by behavioral therapy in ADHD treatment. Some experts say, however, they are disappointed the new guidelines don’t recommend behavioral treatment first for more children, as that might lead to better outcomes, recent research suggests. When ...

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On October 1, 2019, Nevada began allowing individuals to avoid living in late-stage dementia. The new statute recognizes the legitimacy of an advance directive that instructs health care providers to stop hand feeding food and fluid by mouth. Individuals have already been completing such directives in New York and Washington. The Nevada law is the first that explicitly authorizes such instructions. Growing ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 54-year-old woman is evaluated for flushing of the face of 1 year's duration. These episodes occur two or three times per week and last about 30 minutes. She went through menopause at age 50 and is on estrogen and progesterone hormone therapy. She also experiences episodes of anxiety, ...

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At first, Dr. Robert Zorowitz thought his 83-year-old mother was confused. She couldn’t remember passwords to accounts on her computer. She would call and say programs had stopped working. But over time, Zorowitz realized his mother — a highly intelligent woman who was comfortable with technology ― was showing early signs of dementia. Increasingly, families will encounter similar concerns as older adults become reliant on computers, cellphones, and tablets: With cognitive impairment, ...

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I can still recall my first day of medical school orientation. A humbling silence fell across a sea of 162 enthusiastic and largely arrogant aspiring trainees as the dean proclaimed, “As doctors, you will all kill someone at some point in your career.” I did not give this declaration much thought at the time. I already had a career as a diagnostic radiologist in my sites and believed that radiologists were ...

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To delay or prevent the onset of memory loss, talk to your doctor. It can really be that simple. Among the diseases that Americans fear most, Alzheimer’s and dementia consistently rank at the top of the list. What people don’t always realize is that many causes of memory loss are treatable and preventable, and the first line of defense is your primary care physician. I recently had the opportunity to present findings ...

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Fat shaming has come back into the collective consciousness in a big way, following James Corden’s rebuke of Bill Maher’s comments that “some amount of shame is good.” Corden, as many have pointed out, is spot-on in his assessment: No amount of fat-shaming is going to help solve the current obesity epidemic. It will, in fact, make it much worse. But perhaps the biggest problem ...

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I walked into the room and said: "Hi, Jason." "Do you think it's deep enough to need stitches? I am really scared of needles," was his reply to me. I said, "Why don't you let me take a look, and we can both come up with a plan of how to make it look better?" "So do you think it needs stitches or not? I'm really scared." After taking a good look at his ...

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On Kimberly Repp’s office wall is a sign in Latin: Hic locus est ubi mors gaudet succurrere vitae. This is a place where the dead delight in helping the living. For medical examiners, it’s a mission. Their job is to investigate deaths and learn from them, for the benefit of us all. Repp, however, isn’t a medical examiner; she’s a Ph.D. microbiologist. And as the Washington County epidemiologist, she was most accustomed ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 40-year-old man is evaluated for a firm, flesh-colored lesion that has been growing on the back for several months. Foul-smelling material can be expressed from the lesion. The patient is bothered by the periodic drainage. He is otherwise healthy and takes no medications. On physical examination, vital signs are ...

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