Encouraging our patients to start thinking about and planning for their end-of-life care is always a challenge. During any given office visit, numerous competing issues vie for time. And when clinicians do surface the topic of Advance Directives, our patients often wonder Continue reading
For whom the bell tolls – steroids or antivirals for Bell palsy?
Sir Charles Bell first described the anatomy and function of the facial nerve in the 1800s. No wonder the eponymous Bell palsy bears his name (apparently we are no longer to refer to it as Bell’s palsy). The term Bell palsy is not synonymous with Continue reading
Pneus on pneumococcal vaccination from the ACIP
The CDC Advisory Committee on Immunization Practices (ACIP) has just changed its recommendations for the use of pneumococcal vaccines for adults 19 years or older with immunocompromising conditions, such as functional or anatomic asplenia, Continue reading
Women who smoke lose a decade of life. Or more.
A study on the effect of smoking on longevity in women was just published in The Lancet of October 27, 2012. As would be expected, the impact is significant. What might be surprising is just how significant. Continue reading
Pre-Halloween scare about strokes in young people
Be alarmed. Be very alarmed. A recent study in the journal Neurology reveals an increasing rate of strokes in young people. Though the overall stroke rate remains low compared to older folks, stroke rates are still climbing in a concerning fashion. Continue reading
Knee MRI – are we getting TMI (Too Much Information)?
A recent BMJ study is an eye-opener about problems interpreting knee MRI’s in older adults. The bottom-line? A picture may not be worth a thousand words.
Let’s look briefly at Continue reading
“In thy foul throat thou liest.” – Richard III, William Shakespeare
The Infectious Disease Society of America recently released its guidelines for the diagnosis and treatment of Group A Streptococcal (GAS) Pharyngitis. It’s difficult when a patient has a sore throat, but it’s a stick-to-your-guns issue for the good of your patients. Continue reading
Why should we be concerned about “amenable mortality”?
I don’t know what you would have done, but when I recently saw the adjective amenable used to describe mortality, I did a double take. The phrase appeared in a recent article in Health Affairs. Like any confused inhabitant of the 21st Century, I immediately went Continue reading
Do doctors die differently?
Now that is a good question, and no one knows the answer for sure. But there is substantial anecdotal evidence that doctors are more likely than others to have their Advance Directive filled out and are more likely to die as they would wish. According to Continue reading
What is the skinny on NAFLD?
Nonalcoholic fatty liver disease – NAFLD – is fairly common among our adult patients, and is increasing in prevalence in our pediatric patients as well. You know the scenario. A person’s transaminases are a bit high on routine screening. Ultrasound shows Continue reading