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Latest Posts

Jock Itch: How To Get Rid Of It

I’ve been seeing a lot of jocks lately. The anatomical area, not the athletes. Summertime means heat and humidity, sports, and itchy groins. Jock itch is a general term for an itchy rash in the groin. Heat, sweat, and skin rubbing on skin can leave the area looking like you slid into second base, groin first.

There are three main causes of an itchy groin. Classic jock itch is caused by a fungus, the same fungus that causes athlete’s foot. This fungus often causes a red scaly rash on the inner thighs. It tends to be dry and can have bumps or pimples. The fungus is often spread from your feet or from contaminated sports equipment, towels, etc. It can be treated with topical terbinafine cream 1% twice a day for 2-4 weeks. Severe cases can require oral anti-fungal medications, especially if the fungus has spread to other areas on your body. Read more »

*This blog post was originally published at The Dermatology Blog*

Bike Helmet Makes A Stink

k2gnego1.jpgResearch scientists at the Fraunhofer Institute for Mechanics of Materials IWM in Freiburg, Germany, have developed a helmet that will make you think twice about continuing to cycle with a damaged helmet.

For maximum protection, safety helmets need to be damage-free, but it’s often impossible to know if a helmet is actually flawed after it’s been dropped or hit by something. The researchers have used polymers that start to smell if there are any small cracks, and will really stink in the case of any large cracks. Read more »

*This blog post was originally published at Medgadget*

Remembrance And Rules For Cyclists And Motorists

This third installment of “Cycling Wednesdays” comes as a guest post from Rachel Fagerburg. Rachel is a dear friend, mother of two young children, fellow cyclist, and wife of a teammate. She is famous in this area for her talent as a race announcer. I am grateful for her words:

On May 19, my husband and I joined thousands across the globe to honor cyclists who have been injured or killed while cycling on public roadways. With 1,000 participants at the first ride in 2003, the Ride of Silence has grown to a worldwide event raising awareness of the tragedies that can occur between motorists and cyclists. My husband and I rode in honor of two people we were privileged to call “friend.” Read more »

*This blog post was originally published at Dr John M*

Physical Exam: Dr. Rob Examines Your Shoulder

SOFT When you were last enraptured by my physical exam series, I was explaining the different directions doctors use to confuse themselves and everyone else.  I am happy to leave that land of relativity and now re-embark on the actual human body.  I am sure this relativistic view of direction was invented by some liberal anatomist intent on socializing the human body.  It is a stop on the road to death panels, in my opinion.

It’s good to get that posterior to me.

My distraction (I get distracted, you know) happened as I was trying to explain how the shoulder works.  Since the shoulder moves in so many directions and with such huge angles, I felt it was necessary to totally confuse you and so hide any chance you would pick up my ignorance.  It’s always good to keep your readers snowed.  So, after spending a whole post making poems about the shoulder (that will no doubt go down in the anals annals of poetry about joints) and another post about the confusing directions we doctors use to confuse other doctors, I will now talk about the actual exam of the shoulder.

As you probably have been taught, the shoulder is the joint that attaches your arms to your body.  Some people refer to the top of their torso as their shoulders (as in “shoulder straps”), but this is not what I am talking about.  The shoulder is supposed to be the joint between three bones:

  1. The humerus  – which is the long bone in the upper arm, and got its name because of its habit of playing practical jokes on the ulna.  The other bones are always inviting the humerus to parties.
  2. The clavicle – also known as the collarbone.  This bone actually looks nothing like a collar, and it resents the implication.
  3. The scapula – called the shoulder blade.  The collarbone is jealous because the scapula has a much cooler nickname.  This causes the scapula to snicker often at the clavicle’s wimpy nickname.

shoulderanatomy

Credit

Examining the shoulder Read more »

*This blog post was originally published at Musings of a Distractible Mind*

Fluroquinolone Antibiotics and Tendon Rupture

Outdoor enthusiasts are often stricken with infections for which they might be prescribed antibiotics in the class known as fluoroquinolones, one common member of which is ciprofloxacin (Cipro). They should be aware that a fairly well accepted complication of taking a fluoroquinolone for more than a few days is development of tendinitis leading to tendon rupture, notably of the Achilles tendon. The risk is such that the Food and Drug Administration (FDA) requires the makers of such drugs as ciprofloxacin and levofloxacin (Levaquin) to publish a black box warning on the packages alerting users to potentially serious side effects. The full list of drugs affected by the warning include ciprofloxacin (marketed as Cipro and generic ciprofloxacin); ciprofloxacin extended release (marketed as Cipro XR and Proquin XR); gemifloxacin (marketed as Factive); levofloxacin (marketed as Levaquin); moxifloxacin (marketed as Avelox); norfloxacin (marketed as Noroxin); and ofloxacin (marketed as Floxin and generic ofloxacin). As new fluoroquinolones appear on the market, they will undoubtedly be included in the warning program. The warning does not apply to eye and ear drops – only to medications taken orally or by injection.

Many patients and health care professionals are not aware of this risk, which is very real, having been officially reported in literally hundreds of patients. Although the drugs are phenomenal in terms of their ability to fight certain bacterial infections, users should be aware of this possible side effect, so that they can discontinue taking the culprit medication and switch to an alternative antibiotic(s) if need be. If tendon pain develops (typically about a week after initiation of therapy) when a person is taking a fluoroquinolone antibiotic, that is the time to make the switch. Simultaneously, anyone affected should diminish or avoid exercise and cease stressing the affected area until such time as the situation is resolved, as would be determined by decreased pain and other signs of inflammation. Most patients can be expected to recover within 10 weeks after discontinuing the antibiotic, but it may take longer.

Fluoroquinolones are widely used to treat infections in adults. They are not commonly prescribed for children because of a risk for eroding cartilage; however, if the medical necessity is important, they can be used in young individuals. The tendon rupture problem is therefore largely a problem of adults, and typically affects the Achilles tendon, with onset of symptoms within the first few weeks after the initiation of antibiotic therapy. Other tendons, including those of the upper extremity, may be involved. It is perhaps the large forces placed upon the Achilles tendon that makes it so prominent in this particular medical situation. Furthermore, the risk of fluoroquinolone-associated tendinitis and tendon rupture appears to be greater in persons older than 60 years of age, in those taking corticosteroid drugs (“steroids”), and in kidney, heart, and lung transplant recipients.

This post, Fluroquinolone Antibiotics and Tendon Rupture, was originally published on Healthine.com by Paul Auerbach, M.D..

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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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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