Juliette is an 8-year-old girl who is in your office for a well-child exam.  Her mother is concerned about the dangers of the internet and the media and asks what websites you recommend and what media tips you use with your own children. Today’s children are growing up as “digital natives,” and as parents we

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Mr. B was tired of waiting at the ER to be seen for his chest pain and dyspnea. He told the triage nurse he was going home as he felt better anyway and was probably making “too much out of nothing”. The charge nurse promptly asked meto sign his AMA form. However, AMA’s are always

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This was a 50-year-old male smoker with a history of hyperlipemia, previous stent, on Plavix and ASA who presented for chest pain to the ER. This was his second visit for chest pain. He was chest pain free with one NTG SL, and his first troponin was negative. There was some discussion about sending him

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A recent study in JAMA Oncology1suggests that the presence of circulating tumor cells in the blood of estrogen receptor-positive, HER-2 negative and node negative breast cancer patients may be predictive of late recurrence. Estrogen-receptor positive, HER-2 negative is the most common breast cancer subtype. A blood test that measures circulating tumor cells may offer additional

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I’ve spent several hours in the last week with my 14-year-old granddaughter.  She’s learning to drive.  Oh boy, what an experience!   I’m not sure how I got this job, but you won’t hear me complain.  It’s easy to forget when you start driving, there’s a huge change from sitting in the passenger seat to sitting

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You are precepting a PA student and she is presenting to you the next patient. Juliette is an 18 month old with a prior 2 day history of nasal congestion and cough and a 1 day history of increasing cough and subcostal retractions.  She presents with a respiratory rate in the low 40’s with slight

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A 7-year-old patient with atopic dermatitis (AD) presents for follow-up with her mother. Despite daily warm water bathing and liberal application of moisturizer, she continues to have dry, itchy skin and recurrent flares of erythematous papules and plaques with excoriation in the antecubital fossa and behind her knees. Review of her medical record over the

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In 2006, my wife and I purchased a Toyota Sienna minivan.  Looking at vehicles, this certainly wasn’t one of my favorite choices.  After some debate, we ended up with the van.  It turned out to be a great decision.  We made hundreds of trips to family and sporting events, mostly chasing our teenaged children to

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Ms. Z is a 40 year old female who was attempting her first half marathon. She reported at mile 11 didn’t feel well. It was hot that day and she thought she was dehydrated. She stopped to call her husband who met her mile ten where she said she had to lay down and, after

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