The bedrock requirement to obtain informed consent before patients may be enrolled in research has been eroding. I’ve documented the different ways and different reasons for this several times over the years (“Informed Consent for Babies: When Experts Disagree,” “Informed Consent in Infant Research: Ethical Problems Remain,” “Informed Consent in Comparative Effectiveness Research,” and “The […]
Category: Conditions
MKSAP: 30-year-old woman with HIV infection
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 30-year-old woman is evaluated in follow-up after being recently diagnosed with HIV infection. She is asymptomatic. Medical history is unremarkable, and she takes no medications; she has not yet started antiretroviral therapy. She received all scheduled childhood immunizations. On physical […]
MKSAP: 77-year-old woman with frequently fluctuating INRs
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 77-year-old woman is evaluated for frequently fluctuating INRs (<1.8 to >3.5) while taking warfarin therapy. She has undergone INR testing every 1 to 2 weeks and frequent warfarin dose adjustments. She reports a consistent dietary intake. Medical history is notable […]
How clinicians can impede clinical trial recruitment
In the second week of April, I headed to San Francisco where I took part in the SWOG Semi-Annual Meeting. To those who might be unfamiliar with us, SWOG is a member organization of the National Clinical Trials Network (NCTN) and is tasked in running clinical trials across disease sites and scenarios, from prevention to […]
My story isn’t Serena Williams’ story, but some things sound the same
I’m not much of a tennis fan, but I am a fan of Serena Williams. Who wouldn’t be after hearing her story? Her rise to the upper echelon of athletics was remarkable, and her longevity is incomparable. All the while, she has challenged the sporting world’s notions about who and what an elite tennis player […]
The many ways to describe chest pain
There are at least 50 words in the Eskimo languages for snow, 25 in mainstream Swedish, and supposedly 180 or so in the Sami language of the nomadic inhabitants of the northernmost parts of Norway, Sweden, and Finland. But there are even more words than that for “chest pain” among my patients, many of whom […]
Think you have an iodine allergy? You may want to reconsider.
Let’s begin with a quiz question: Patients may be allergic to: A. oxygen B. carbon C. iodine D. none of the above If you answered anything but “D,” better keep reading. Consider this scenario: If a patient is allergic to penicillin, you would document “penicillin” in the medical records. It would never occur to you […]
MKSAP: 57-year-old man with type 2 diabetes mellitus
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 57-year-old man with a 15-year history of type 2 diabetes mellitus is evaluated for bilateral burning sensation in his feet for the last 6 to 12 months. The sensation worsens at night. His HbA1c levels have remained less than 7.0% […]