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 ...

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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 ...

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Recently, a friend sent me a text message with a rather conservative back-of-the-envelope calculation putting the number of lecture slides we’ve seen since October 2009 at roughly 41,000. That got me thinking:  how many questions have I answered in that same time period? Here’s the conservative estimate, not including quizzes, workshops, and miscellaneous other goodies: with roughly 100 questions per exam, an average of an exam every 3 weeks, and accounting for a few weeks ...

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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 ...

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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 ...

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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 ...

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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 ...

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"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 ...

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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 ...

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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 coast during ...

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