Epistaxis, commonly called a nosebleed, is a frequently encountered condition that is responsible for about one in 200 emergency department visits here in the U.S. It has an estimated lifetime prevalence of 60%, and about 6% of those who have nosebleeds seek treatment. Management is usually straightforward but can be complicated by several factors, primarily the use of anticoagulant medication.

In most cases, bleeding starts spontaneously without any obvious precipitant. The underlying causes of and risk factors for epistaxis may be classified into local (e.g., lack of humidification, trauma, intranasal medication application, infection, inflammation, and tumors), systemic (e.g., blood diseases, leukemia, hypertension, and congestive

Alopecia (hair loss) of the scalp is a common complaint in primary care medicine. Once the areas of hair loss are found to be non-scarring (scarring refers to scaling, crusting, and obliteration of the hair follicles), the next step is to determine whether the distribution of hair loss is patterned, diffuse, or focal as the distribution guides the possible causes and approaches to treatment. If scarring is present, a scalp biopsy is usually necessary so referral to a specialist is

Glaucoma is a chronic, progressive optic neuropathy characterized by damage to the optic nerve head and retinal nerve fiber layer, both located at the back of the eye. But glaucoma is a disease of the front of the eye, or anterior chamber. The lens separates the eye into the anterior and posterior chambers. In glaucoma, aqueous humor, fluid that is found in the anterior chamber, is unable to drain from the anterior chamber, causing an elevation in intraocular pressure (IOP).


We all remember watching Gov. Cuomo and Mayor de Blasio in the early days of the COVID epidemic when they proposed temporary lockdowns to “flatten the curve.” They claimed to be “following the science.” Well, here we are, more than a year later, and we still have partial lockdowns. So, did they really follow scientific recommendations and did the lockdowns prevent COVID deaths? Growing research tells us that the answer is no. The lockdowns destroyed a booming economy, forced many small

Literary classics, for example works by authors like Mark Twain and Robert Louis Stevenson, often give us a glimpse of medical care as it was many years ago. Take Robert Frost’s 1916 poem “Out, Out- .” It describes the traumatic death of a young boy in a farming accident. It is based on a real-life tragedy; an article from the Littleton New Hampshire Courier published in March 1910 provides the background: Raymond Tracy Fitzgerald…died…as a result of an accident by which one of his hands was

Benign, or noncancerous, tumors come in all shapes and sizes. For example, adenomas are benign tumors that grow in glands, often in glands that control the human endocrine system. When adenomas form in endocrine glands, they often cause a hormonal imbalance which can have negative effects on the body’s hormonal functions. In addition, when adenomas grow in the brain, they displace brain tissue proving the old adage that there is no such thing as a benign brain tumor because the brain is within

Last month, the publisher (Kevin Boyle) received an email from a reader asking me to do a column about home electrocardiograph (EKG or ECG) machines. The reader specifically mentioned the KardiMobile EKG device. Before I get into that device, allow me to mention some basics about the science and technology of EKGs.

An EKG machine measures the tiny electrical currents generated in the heart before, during, and after a heartbeat. To begin a heartbeat, an electrical impulse is generated in the

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