Acute diarrhea is defined as lasting less than 14 days and can cause significant illness and even death in rare cases, especially among older patients. In the U.S., there are about 179 million cases of acute diarrhea, or gastroenteritis, per year, including about 48 million cases of food-borne illness. Most adults who have not traveled abroad have no known cause identified for their acute diarrhea, although most non-food related cases are usually viral with norovirus accounting for about 26 percent of cases seen in ERs. Norovirus is often the cause of outbreaks of vomiting and diarrhea on cruise ships, and 90 percent of deaths related to norovirus occur in people 65 and older. Bacterial infections potentially susceptible to antibiotics

Many states allow parents to opt-out of vaccinating their children due to philosophical (i.e. fear that the vaccine will cause autism, a theory that has been totally disproven) or religious beliefs. These beliefs are called personal belief exemptions, or PBEs. In 2016, the California Senate passed a bill to eliminate PBEs from the state’s school-entry mandates. Passage of that bill left vaccine-hesitant parents with only one legal option to keep their kids from getting vaccinated. That option

It is estimated that about 14 percent of patients who visit a primary care provider are depressed, but that depression is often not diagnosed. Recently a diagnostic tool was redesigned to help primary care providers diagnose depression. That tool is called Patient Health Questionnaire 9 (PHQ9). There are nine questions listed below and four possible answers to each question. PHQ9 uses a scoring system to assess whether the patient is depressed and how severe that depression is. The scoring

The pharmaceuticals market in the U.S. is very complex. On the distribution side, physical drug products such as a pill or vial leave the manufacturer when it is purchased by a distributor. Distributors then sell and ship the products to retail pharmacies where patients access their prescription medications. On the financing side, since the 1980s, pharmaceutical benefit managers (PBMs) have evolved to provide services to help payers like insurance companies manage their drug benefits. PBMs

Medications can cause a wide variety of signs, symptoms, and medical conditions, some of which are direct adverse effects (AEs) of a medication and others that are the result of a drug-drug interaction. Today I would like to discuss some of these AEs and interactions. The most common cause for ER visits for AEs in the U.S. is bleeding, and the majority of these cases are related to Coumadin, generically called warfarin. Warfarin has serious drug interactions with many other medications and

Inguinal hernias, which occur in the groin area, are much more common in men than women, although they can occur in women. The reason for this is that men have an opening in both sides of the lower abdomen, or groin area, through which the spermatic cords pass on their way to the testicles. The spermatic cord contains a vein, artery, vas deferens (this carries sperm from the testicle), and the ilioinguinal nerve. Obviously, women do not have this opening in the abdominal wall. The contents of

Cellphones, and particularly smartphones, are everywhere these days. It is estimated that 77 percent of the U.S. population has or has access to a smartphone. Smartphones feature recording devices that can record both audio and video, and can do so clandestinely. Physicians and other health care professionals are now realizing that some patients are recording their office visits, often without the consent of the person being recorded. In one survey of the general public done in the United

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