An article and accompanying editorial in the June 16, 2015 issue of JAMA looks at the issue and the practical implications of antibiotics versus surgery for acute appendicitis. For years we have treated diverticulitis nonsurgically with few complications. This study was undertaken in Finland but also studies in the US at UCLA are also underway. The… Read More
“Double chin”, “turkey neck”, “neck waddle” or “baggy neck” and otherwise known as submental fullness is one of the most common anesthetic complaints. It doesn’t matter if you a guy or a gal, this solution is effective.pproximately two thirds of people said they are bothered by submental fullness. This can be enforced by multiple factors… Read More
5.8 Million people in the U.S. suffer from CHF and this accounts for over 1 million hospitalizations a year. Rehospitalization rates approach 30% at 90 days. The costs to treat heart failure are over $37 Billion a year. The majority of the costs of heart failure come from hospitalizations and repeat hospitalizations. Hospitalizations account for… Read More
In order to simplify and make more uniform emergency department triage, the ESI acuity scale was developed. ESI has become very popular because it has been validated for interrater and inter-institution reliability and is even endorsed as a best practice by AHRQ ( the Agency for Healthcare Research and Quality). Dr. Wiler and others… Read More
There is an interesting article in the March 3, 2016 issue of NEJM that discusses obesity and that there are two new areas of research including the manipulation of brown adipose tissue and the role played by the gut microbiome in energy balance. With the tremendous epidemic of obesity, type II diabetes and dyslipidemia, it… Read More
Chrohn’s disease, Ulcerative Collitis, inflammatory bowel disease and C. difficile infections plague millions of Americans every year. Chrohn’s disease alone affects approximately 700,000 Americans. Many of these diseases are considered autoimmune disorders and are thought to occur when the immune system attacks healthy tissue. Typical treatments are toxic and have variable efficacy. However, a relatively… Read More
As our population gets older and older patients are living longer with more complicated medical problems it is often a challenge to determine which patients should be admitted and which patient should be discharged home. Additional pressures from CMS(Centers for Medicare and Medicaid Services) and health plans’ pressure to discharge patients adds an additional complexity… Read More
Every couple of years I encounter the story of how a colleague gets accused of something in the media. Sometimes these articles have merit and sometimes these articles are and turn out to be blatantly incorrect. Regardless, they are always shocking and and damaging to the physician’s career. It is interesting that these situations are… Read More
A February 29, 2016 study in JAMA Pediatrics found that parents discovered a surprising number of physician errors in the care of their children. Although it was a small study involving 383 children who were hospitalized during 2013 and 2014, researchers concluded that approximately one in 10 parents caught a mistake their child’s physicians did… Read More
