Category: Conditions

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 […]

Is there parity in mental health or are we still dealing with a paucity?

With the recent 10-year anniversary of the Mental Health Parity Act being signed into law, comes the reminder that we still have so much work to be done. Unfortunately, blatant discrimination in health insurance coverage for mental health and substance abuse has continued despite this legislation. The Parity Act required that dollar limits on mental […]

Evening eating: Are you a “light” eater?

An excerpt from Let Go of Emotional Overeating and Love Your Food: A Five-Point Plan for Success. Copyright © 2018 by Arlene B. Englander. Published by Rowman & Littlefield. All rights reserved.  Anyone who has ever tried to lose weight or keep weight off realizes that evening can be the make or break time of […]

My brother, a physician, died. Could I have done more?

Healers, scientists, leaders — these are all terms that we equate with being a physician. As we spend our years if not decades in training, we strive to become all of these components. But when you miss something — the small details, the nuances of a history and these are the clues that could lead […]

ACL injuries in middle-age athletes

Over the last 20 years, physical fitness as a means to improve overall health has increased among the over-40 set. This is great, right? Yes, absolutely. Athletes who remain active as they age do a better job than non-athletes in retaining lean muscle mass. They also show improved bone density, bone structure and bone strength. […]

Do opioid contracts harm the doctor-patient relationship?

A contract is an agreement stipulating the rights and obligations of the signatories. In most cases, a contract is consulted when a dispute arises. When all is proceeding swimmingly, the contract remains dormant in a file drawer or in a digital file. In general, decent people resolve differences in the old-fashioned way utilizing the twin […]

The decision to not vaccinate is driven by fear and misinformation

I was browsing the internet one day and came across a photo of a group of women who appeared educated and influential. They were wearing blue T-shirts with claims that vaccines cause autoimmune diseases, seizures, ADHD or attention deficit hyperactivity disorder, learning disabilities, death, autism, sudden infant death syndrome and infertility. I couldn’t help but […]

MKSAP: 56-year-old man with a family history of hypertrophic cardiomyopathy (HCM)

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 56-year-old man is being evaluated after his 18-year-old son had a syncopal episode during a high school basketball game and was diagnosed with hypertrophic cardiomyopathy (HCM). The patient has had no symptoms, including with physical activity such as golfing or […]

A reminder that science is never settled

Science is in a constant state of flux. Theories are put forth to explain natural phenomena, based on the best knowledge of the day. These theories are tested. If they correctly predict future observations, the theories become more credible. If, however, these theories fail to predict accurately, they require modification or outright dismissal. What is considered […]

With rising obesity, microbiomes tip the scale

Human beings have grappled with obesity for thousands of years. Greek philosopher and physician Galen described “bad humors” as the cause of obesity and prescribed low-calorie foods, massages, baths, greens and garlic to his patients to help them slim down. In the 18th century, William Banting successfully lost weight following a low-carb diet and spread […]