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Latest Posts

Researchers Explore New Methods Of Testing Blood Sugar

My fingers hate diabetes. Several times a day they get poked with a sharp, needle-like lancet. The drops of blood they give up tell me how my blood sugar roller coaster is doing. That’s really important information I need to determine whether to eat, exercise, or give myself some insulin.

It would be such a treat to check my blood sugar (glucose) without pricking a finger, squeezing out a drop of blood, and placing it on a small test strip attached to a meter. Help may be on the way—though I’m not expecting any big breakthroughs for another few years—as researchers across the country explore prick-free ways to measure blood sugar.

Here are three interesting approaches. Read more »

*This blog post was originally published at Harvard Health Blog*

Dealing With Cyclic Vomiting Syndrome Given How Little Is Known About The Condition

I have been working as an ER doctor for over a decade, and in that time I have come to recognize that there are certain complaints, and certain patients who bear these complaints, that are very challenging to take care of. I’m trying to be diplomatic here. What I really mean is that there are certain presentations that just make you cringe, drain the life force out of you, and make you wish you’d listened to mother and gone into investment banking instead. Among these, perhaps most prominently, is that of the patient with cyclic vomiting syndrome.

The diagnosis of cyclic vomiting syndrome, or CVS, is something which is only in recent years applied to adult patients.  Previously, it was only described in the pediatric population. It has generally been defined as a disease in which patients will have intermittent severe and prolonged episodes of intractable vomiting separated by asymptomatic intervals, over a period of years, for which no other adequate medical explanation can be found, and for which other causes have been ruled out.

That is not much in the way of good literature about this disease entity, which is surprising, because it is something that I see in the emergency department fairly regularly, and something with which nearly all emergency providers are quite familiar. These patients are familiar to us in part because we see them again and again, in part because they are memorable because they are so challenging to take care of.

Some things about the cyclic vomiting patient that pose particular challenges: Read more »

*This blog post was originally published at Movin' Meat*

Eye Health As A Predictor Of Future Disability

The idea that the eyes are a window to the soul traces back through history in many forms, but the idea that the eyes might reveal medical secrets didn’t fall far behind the metaphor.

The clues lie on the retina, which reflects the same microvascular changes that might be seen elsewhere in the body from cardiovascular changes and other diseases. The question now is how to associate retinal changes to specific diseases.

To assess potential associations between retinal microvascular changes with disability in performing activities of daily living, researchers conducted a prospective cohort study of 1,487 community-dwelling, disability-free participants in the Cardiovascular Health Study.

The main outcome measure was Read more »

*This blog post was originally published at ACP Internist*

Research Points Out The Down Side Of Chasing Success

Bill Gates once said:

Success is a lousy teacher. It seduces smart people into thinking they can’t lose.

It’s clever, and it seems right.  Now there is science to prove it.

In a study published last week, scientists studied special imaging scans of doctors’ brains as they made simulated medical decisions.  Those doctors who paid attention to their mistakes made better decisions than those who were more interested in their successes: Read more »

*This blog post was originally published at BestDoctors.com: See First Blog*

Progress In The Field Of Personalized Medicine And What We Can Expect Next

The third edition of The Case for Personalized Medicine (PDF) was released a week ago and I had a chance to do an interview with Edward Abrahams, Ph.D. of the Personalized Medicine Coalition.  The new edition is a primer that highlights the progress in the field of personalized medicine for policymakers, researchers, and business leaders.

  • How many prominent examples of personalized medicine might we have next year?

It’s impossible for us to know how many prominent examples of personalized medicine products will be available a year from now, but we project that the rapid acceleration in the number of new products coming onto the market will continue. When we published the first edition of The Case for Personalized Medicine in 2006 – there were only 13 available products; when we published the second edition in 2009, there were 37 products available, and now, in 2011, there are 72.

  • Sometimes lecturers use two numbers: 7 billion and 3 billion referring to the mass sequencing of everyone’s DNA in the world. When could it happen, what is your estimation? Read more »

*This blog post was originally published at ScienceRoll*

Latest Interviews

Caring For Winter Olympians In Sochi: An Interview With Team USA’s Chief Medical Officer Dr. Gloria Beim

I am a huge fan of the winter Olympics partly because I grew up in Canada where most kids can ski and skate before they can run and partly because I used to participate in Downhill ski racing. Now that I m a rehab physician with a reconstructed knee I…

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How Do Hospital Executives Feel About Locum Tenens Agencies And Traveling Physicians?

I recently wrote about my experiences as a traveling physician and how to navigate locum tenens work. Today I want to talk about the client in this case hospital side of the equation. I ve had the chance to speak with several executives some were physicians themselves about the overall…

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Latest Book Reviews

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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Unaccountable: A Book About The Underbelly Of Hospital Care

I met Dr. Marty Makary over lunch at Founding Farmers restaurant in DC about three years ago. We had an animated conversation about hospital safety the potential contribution of checklists to reducing medical errors and his upcoming book about the need for more transparency in the healthcare system. Marty was…

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