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  • 2/22/2018 Last week I had a young patient ask me what the difference is between an MRI and a CT scan. Not long after that, I noticed an error in a newspaper article that mixed up the two technologies.
    Radiologic imaging of the human body has revolutionized the diagnostic accuracy of physicians. However, it has also had the negative effect of reducing our reliance on a good medical history and physical examination.
    There is also a real concern about patients receiving too much radiation over their lifetimes as a result of having too many CT scans (more below). This is particularly concerning in children who may receive numerous scans over their lifetimes that may increase their risk of cancer.
    We are the only country in the world where a CT and/or MRI scanner is in the neighborhood of virtually every citizen. While this is convenient, it leads to over-utilization of these very expensive and sometimes unnecessary technologies.
  • 2/14/2018 Sometimes I get asked questions in unusual places. A few months ago at church I was pulled aside and asked if I could write my column on that malady of menopausal women – hot flashes.
    Hot flashes are usually described as a feeling of intense heat, usually with sweating and a rapid heartbeat. They can last a few minutes up to a half hour or so. The feeling usually starts on the face or upper chest but can also be on the neck and even spread over the entire body. Many women experience flushing of the skin over the involved area, hence the alternate name hot flushes.
  • 2/6/2018 We do seem to be living in a post-truth world. It’s not just in the political sphere that we have to be careful of facts and “alternate facts.” It also extends to the scientific world as well. The public is being constantly bombarded with scientific information through the popular media and especially the Internet. How is a non-scientist supposed to filter all this information and figure out what to believe? I want to give you some tips to use when evaluating what you see or hear.
  • Shoulder Pain Part 2
    1/27/2018 Welcome back to part two of my series on shoulder pain. First, I want to do a quick review of shoulder anatomy (see diagram of the right shoulder from the front view). The upper arm bone (humerus) joins to the scapula at the glenoid and is held in place by two structures: (1) a rim of cartilage (glenoid labrum) that forms a shallow cup for the head of the humerus to sit in, and (2) the rotator cuff which is made up of four tendons that wrap around the head of the humerus.
    As I stated last week, in order for the shoulder to move in so many directions, it has to be inherently unstable. Since it is so unstable, two of the most common injuries are dislocations and subluxations. Dislocations result when the ball on the head of the humerus slips out of the glenoid “cup” and stays there. This typically happens when a person’s upper arm is hit from behind when the arm is raised to the side and the shoulder is cocked and ready to throw.
  • My shoulder hurts
    1/22/2018 The next two weeks, I’d like to address a commonly injured body part – the shoulder. Most people experience shoulder pain at some point in their life. Doctors typically see it in athletes, people who overuse their shoulders and others who may have fallen on their shoulder or outstretched arm.
    To understand shoulder pain, it’s important to know the basic anatomy of the shoulder joint itself (see diagram of the front view of the right shoulder). The joint is one of the most complex in the body. Most joints permit only a fairly limited range of motion. The anatomy of the shoulder joint, in contrast, allows for a vast range of movements. To be so versatile, It has to be relatively unstable compared to our other joints. 
  • 1/10/2018 There is no doubt that antibiotics have saved millions of lives. But, is it all good news? I hope our readers have been noting the increasing number of news stories related to problems with the overuse of antibiotics and the development of resistant bacteria. We have known this was coming since Alexander Fleming (the discoverer of penicillin) warned of it in his Nobel Prize speech in 1945, but it has now reached a tipping point. Sally Davies, the Chief Medical Officer of the United Kingdom, has equated the critical health threat of antibiotic resistance to the risk of terrorism.
  • 12/18/2017 

    My patient Jim asked me to re-run my column about warts. It’s estimated that up to 12 percent of people worldwide have had warts and that 10 to 20 percent of school-aged children have them at any given time.

    Warts are caused by a group of viruses called human papilloma viruses or HPV. When people hear HPV they often think of genital warts that are caused by certain strains of HPV virus, some of which can cause cervical or even mouth and throat cancers. There are over 100 known types of HPV, all of which share the characteristic of being able to infect skin cells.

  • 12/12/2017 

    An adult patient has asked me to write about night terrors. While night terrors can be seen in adults, they are much more common in children. It’s hypothesized that this is due to brain development in these children.

    Night terrors are a subclass of sleep disorders called “parasomnias.” Rather than focus specifically on adults, I’d also like to talk a bit about kids. People who exhibit parasomnias often have family members who suffer from them as well. Virtually all of these conditions go away with time.

  • 12/5/2017 

    The cold weather is finally arriving and it’s time to prepare for the flu. Most people us the term “flu” in a very generic sense, meaning anything from cold symptoms to having a case of vomiting and diarrhea.  The “flu” in this column refers to respiratory influenza that kills 36,000 Americans each year and puts another 200,000 in the hospital.

    Influenza is caused by a virus and Type A and Type B cause the majority of infections.  Type B typically does not cause severe disease whereas Type A can be lethal, particularly in the young, elderly, and those who have compromised immune systems.

  • 11/27/2017 

    A patient whose mother is having hearing difficulties asked me to write about the best way to choose someone to fit hearing aids. I’d like to begin with some background on hearing.

    It goes without saying that hearing is one of our most important senses. It is critical for our quality of life as well as for safety and social interaction. There are an estimated 30 million Americans who have some degree of hearing loss, 65 percent of whom are younger than 65 years of age. It’s very concerning that one in 14 younger adults and one in 20 adolescents have measurable hearing loss.  Since 1971, the number of Americans with hearing disorders over three years old has doubled.

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Friday, February 23, 2018

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