Category: Conditions

Personal intimacy as an overlooked antidepressant

Depression is commonly linked to career disappointments, financial setbacks, and disruption of normal routines — especially sleep pattern — as well as social pressures and conflict in personal relationships. It is this last factor that has captured my attention in relation to depression. Personal relationships, in particular, the most personal, love partnerships, have a profound […]

Teleneurology works. Here’s why.

Teleneurology is the new and vastly expanding practice of neurology involving the use of technology and/or video chat to improve access to services. With an ever-increasing aging population there is and will continue to be a shortage of neurologists in the United States. Teleneurology has increased patient access to neurologists especially in rural areas but […]

Flu vaccination in pregnant women reduces risk of hospitalization

Influenza is the leading cause of vaccine-preventable deaths in the United States. Influenza also tops the list of the burden of disease and disability-adjusted life years (DALYs) according to a Eurosurveillance article. The flu is more likely to cause severe illness and harm pregnant women as compared to women who are not pregnant. Changes in the immune […]

First trauma in the ER

I spent the summer between the first and second years of medical school in the emergency department at Cincinnati’s major trauma hospital. More specifically, I spent summer nights there, studying the effects of interpersonal violence. Cincinnati is both a friendly city and a violent city. People say “Hello” when you pass in a corridor. At […]

MKSAP: 34-year-old man with slow-growing lesions

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 34-year-old man is evaluated for several slow-growing lesions on his penis. He first noticed the wart-like growths 3 years ago, and they have progressively enlarged. He was treated with topical cryotherapy six times and topical imiquimod over the past year […]

Not so fast with joint MRIs

You wake up one morning, and your shoulder hurts. You’re not sure why, and blame it on your sleeping position. Perhaps you bend down to pick something up, and when you stand up your knee hurts. These are very common stories heard from patients in an orthopedic surgeon’s office. The onset of joint pain without […]

We have to deal with the trauma in veterans early on

My medical center recently cemented an agreement with the Veterans Administration to offer care to veterans who could not be accommodated at the VA. We need paying patients, they need doctors of our caliber — establishing mutual benefit. Military veterans have always been among our patients. During my professional lifetime that has included men of […]

Antibiotics vs. surgery for appendicitis: what one surgeon thinks

Here are a few thoughts about the latest chapter in the never-ending debate about antibiotics vs. surgery for the treatment of uncomplicated appendicitis. You will recall the randomized controlled trial from Finland published in 2015 that found a 27% rate of failure of antibiotics within the first year. Now that the patients have now been followed for […]

Best practices in head CT imaging: How are we doing?

Computed tomography, or CT scanning, is one of the most powerful diagnostic tools to emerge during my medical career. Just look at the detail in the brain images above, taken at 90-degree angles through the brain. And I was there at the beginning. I remember well when I was a medical student taking neurology, and […]

MKSAP: 36-year-old woman with refractory constipation

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 36-year-old woman is evaluated for a 12-year history of refractory constipation. Her symptoms began after a difficult childbirth. She has constipation marked by straining, bloating, and a constant sensation of incomplete emptying. She sometimes has 4 or more days between […]