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When I told a 15 year-old girl and her family that she shouldn't play in a Rugby playoff game the next week because she had had a concussion, they pressed me to change my mind. But I wouldn't change my mind, because two concussions in quick succession can be life-threatening, and mutiple concussions in one's life can lead to dementia and depression.

Their reponse mirrrored that of the N.F.L., which appears only recently to be taking the risk of repeated minor traumatic brain injury in football players seriously.

About a year ago, I saw a man in the emergency department after he had fallen off of his bicycle.

"My doctor said I have osteoporosis," he said, sheepishly, "and my wife doesn't want me to ride any more. She thinks I'm going to break something." I nodded, thinking. This mans was not old, he was healthy, strong, and perhaps on the thin side. Not only that, he exercised vigorously and regularly. Why would he have osteoporosis?

After an evening marshmallow roast, my three-year-old son sits on the sofa with thirty (count them) mosquito bites.

What kind of diseases is he at risk for?

Yesterday, my 3 1/2 year-old son fell asleep at 4 pm and could not be roused. At about 8 pm, I gave up, put a pull-up on him while he was still sleeping, and let him sleep until the morning. When my other kids asked why their little brother had slept for so long, I said "he's trying to grow."

Research has shown that getting sufficient sleep preserves newly-minted brain cells. Sleep is an investment in your brain.

New York Times reporter Gina Kolata recently had a piece in the Times’ Science section headlined “Does Exercise Really Keep Us Healthy?” The upshot was that while there are many health benefits to exercise, those benefits are slim and oversold. But medical research, freely available in electronic form, shows that the benefits of exercise are significant, not slim. The proven health benefits of exercise are reproduced in study after study, and borne out over decades. High quality research, including randomized controlled trials, shows that exercise improves weight loss, increases muscle, prevents diabetes, reduces heart disease, and prevents osteoporosis. Exercise improves functioning and quality of life for cancer survivors, reduces blood pressure, and improves cholesterol. Exercise is one of the few health factors, and possibly the most important, under our own control. The benefits of exercise are not overblown; they are underappreciated.

A Belgian doctor was suspended from medical practice after a court found him to be negligent in failing to appropriately treat a man who complained of a 10-hour erection.

Not for nothing, but this sounds like a serious case of miscommunication. Because the treatment for a persistent erection is, well, basically a urologist or a doctor otherwise empowered to stick harpoons in your penis will, um, stick harpoons in your penis.

The family of former french road worker Francisco Serrano Andrade has accused his employer, Eurovia, with inexcusible fault in his death from skin cancer.

Recent research has unconvered the likely role of bitumen, which is a component of asphalt, in the excess death rate of asphalt and bitumen workers.

The organophosphate toxin Tricresyl Phosphate (TCP) has been found in aircraft cabin air. The problem is that TCP can be neurotoxic. Are we looking at yet another risk of plane travel?

In a surprising study on the effect of significant weight loss by the Centers for Disease Control and Prevention, researchers found that overweight men and women of all weights who lost more than 15 percent of their maximum body weight had a higher risk of death.

But maybe weight loss is a marker for serious disease and not a cause.

This is the difference between intentional weight loss and unintentional weight loss.

What is the big deal about frequent flying? Sure, there is always the concern that a malcontent will try to explode his underpants, but there must be something more. Should I be worried about all the cosmic and ionizing radiation exposure at high altitude?

20 year old Georgian Luger David Kumaritashvili died after hitting a steel pole going 90mph during an Olympic practice run in Vancouver. While the Olympics are a time to enjoy exhilirating athletic performances one has to bear in mind that most of these sports cannot be performed by newcomers to the sport without significant risk of injury.

The General Medical Council, a body that governs physicians in Great Britain, has found Dr. Wakefield's study linking the development of autism to the MMR vaccine to be invalid because of a "dishonest and irresonsible" selection bias in patient enrollment.

Selection bias is an important way that a study can produce results that do not represent the truth.

The plastic surgeon was intermittently sighing, as she watched the endless images of bodies lining roads, extremities dusty, swollen, non-functioning, as they flashed on the television monitor. Haiti, at the mercy of the heavens and western civilization, had been crushed.

"They don't have enough surgeons, and no one knows about compartment syndrome. That 11 year-old girl who was on the news, pulled out from under the buildings, everybody smiling, she died. She looked so good. No one knew to do a fasciotomy. They just need someone to teach them, teach the medical responders," she said.

While most experts speak of the critical 72-hour window for the rescue and treatment of survivors following disasters, it appears that in Haiti, the vast majority of injured survivors will get delayed care, if anything. There is a parallel 72 hour window; that is the window of time for preventative treatment of tetanus following an injury contaminated with soil.

It is hard to imagine a disaster as likely to produce as significant of a tetanus epidemic as an earthquake in an undeveloped nation in which tens of thousands, if not hundreds of thousands, of persons suffer deep wounds contaminated with soil, in the setting of limited or no clean water or medical care.

The 2010 Haiti Earthquake, measured at a magnitude of 7.0 on the Richter Scale, has wreaked social havoc, devastated property and shelter, destroyed lines of communication and transport, disrupted food supply, and has caused an inestimable loss of life. And most, if not all, severely sick or injured patients who cannot breathe on their own will be left for dead. In triage parlance, these patients are termed "expectant".

MedPie.com will donate $.05 for every unique pageview of this article in the next month to Doctors without Borders.

There are many hair regrowth techniques and products in the pipeline, but one currently available medical option that has proven to be a success is the use of finasteride, an inhibitor of the 5-alpha-reductase enzyme.

But finasteride has unpleasant sexual side effects. Beware!

Evidence from human and animal studies has been accumulating for several years to suggest that the painkiller morphine and related opioids, ubiquitous in the treatment of pain related to cancer surgery and also to end-stage cancer, may actually worsen the spread of cancer itself.

While the evidence for this finding is incomplete, it is still strong enough to warrant a frank conversation with your surgeon and anesthesiologist before undergoing cancer surgery.

As a nasal surgery and rhinoplasty specialist, I am often asked by patients about whether a CT scan is needed to better understand their problem. While CT scanning is a wonderful tool for diagnosis and can provide exact information about anatomy, it really isn’t for everything. It does not give information about the soft tissue and cartilage of the nose above and beyond what a simpler test gives, and it exposes the patient to unnecessary and potentially dangerous radiation. And while insurance companies sometimes require the test for objective evidence that a planned nasal surgery is necessary, they do not always pay for the test itself.

Researchers reported in the New England Journal of Medicine today that 9 of 10 patients with sickle cell disease who were treated with a nonmyeloablative stem cell transplant had total reversal of the disease. One important side effect: opiate withdrawal.

According to Russian news agency RIANOVSTI, the death toll from flu in the Ukraine has reached 354 since the beginning of October. At least 78,000 people have been hospitalized and 300 are still in intensive care. Calculated on a death-rate-per-month basis, this makes the epidemic in the Ukraine more than twice as deadly as the epidemic in the United States.

It would seem to make sense, wouldn't it, that detecting cancer early saves lives, but there is little evidence to support the notion. Does prostate screening work? Does lung cancer screening work? Do mammograms in young women make any difference? Medpie crunches the numbers.

Dr. Julian Lieb, a retired Yale medical school psychiatry professor, sheds light on the psychiatric term 'amok', which is a murderous frenzy following depression. By his analysis, the events at Fort Hood represented an amok rather than a planned terrorist event.

He writes "That amok is a manifestation of manic-depressive disorder is suggested by the preliminary symptoms: before the attack, the killer is typically preoccupied, withdrawn, brooding and apathetic - in other words, depressed. Following an amok, the perpetrator is often confused and amnesic, and if not apprehended or killed, may commit suicide."

Army psychiatrist Major Nidal Malik Hasan opened fire in a Fort Hood deployment center today, killing 11 people and wounding 31 before being shot himself. Sometimes this is called suicide by cop.

Almost all people who die by law enforcement assisted suicide are men, and about half brandish or fire a bona fide firearm before being killed by police officers, while some carry plastic firearms or use other pretenses

Electroshock weapon use by police in Massachusetts has been increasing in the last three years, according to data provided by the Massachusetts Executive Office of Public Safety and Security and reported in the Boston Globe. These stun guns are billed as working through neuromuscular incapacitation by makers such as Taser. Risk of serious injury due to electroshock weapons is small, and usually only associated with head injury due to falls.

I just came back from a trip to the dentist with a couple of my kids. I think they did a thorough job. Maybe too thorough. This visit involved jamming those uncomfortable plastic white things that look like small credit cards in my mouth for the purpose of a diagnostic X-ray evaluation. My mother always told me "don't let them take X-rays!" I forgot to tell them. Researchers have determined that a full mouth series of dental X-rays performed over 20 years ago puts one at an increased risk of a menigioma (brain cancer). Hopefully, I won't have a meningioma in 20 years.

It seems like I live in a ghost town because no one walks anywhere. I see the mailman, a few early rising exercisers, and an occasional thirteen-year-old child on a bike. The milkman, door to door sales person, religious recruiters and the exuberant young children playing kick-the-can have all vanished in a puff of car exhaust.

A fourteen year old girl died on Monday shortly after being given the HPV vaccine through a school program in the UK. As of June 1, 2009, there have been 43 deaths in young women and girls associated with the HPV vaccine in the US, although no causal association was found. HPV causes cervical cancer in only a small percentage of women who are exposed. In fact, more than nine out of ten adolscent girls who get infected with the HPV virus will clear the infection on their own within 9 to 12 months. Those who do go on to develop pre-cancerous lesions are more likely to be smokers and to have had first sexual intercourse at a young age than those who do not.

I have become better at dodging plumes of smoke from those smokers who choose to smoke and walk in front of me. I time each exhalation and jolt in front of them to avoid any potential carcinogens with my next breath in. At least I have some control of the situation. Fetuses have no control of their pregnant smoking mothers.

Want to avoid dying young? Want to avoid osteoporosis? Take Vitamin D and calcium supplements. Want to avoid breast cancer, colorectal cancer and diabetes? Us too, but taking Vitamin D and calcium supplements won't help with these ills. The evidence is mixed but one thing is clear: Mom was right. Drink your milk or eat your greens.

The type of skin cancer called malignant melanoma is the fastest growing cancer in the UK. The increase in diagnosis of malignant melanoma started in the 1970s and continues four decades later, but the rate of death from malignant melanoma leveled off in the 1990s. This may represent a change in what type of lesions are classified as malignant melanoma, and not a true increase at all.

According to the French publication Liberation, government strategies to combat the H1N1 influenza pandemic in France threaten to seriously curb individual liberties, without clear benefit. Health care workers in France and in New York State will be required to become vaccinated against swine flu. The protection that universal vaccination will provide is not at all ensured, and this suspension of civil liberties is not justified.

I wasn't that surprised, really, to read that women who had swelling of the arm after having had breast cancer or surgery on the same side benefit from weight lifting. Generally, when you use your body the way it was designed to be used, you get health benefits. This finding is important because we know that women who exercise are less likely to die from breast cancer than those who do not.

While vaginas, unlike many other parts of the body, don’t get drier in hot weather it’s likely that if they did, it’s not a subject many advertisers would hop on. Erectile dysfunction is one thing, but vaginal dyrness? Not yet.

A new study by Huang et al, showed that “younger women” also report problems with vaginal dryness. It’s yet another silly difference between the genders. The truth is postmenopausal women can experience vaginal atrophy or symptoms of vaginal dryness, discomfort itchiness and painful sexual intercourse. In a study of over 1000 post-menopausal women, Huang et al surveyed women aged 55 to 75 years and found nearly half had experienced problematic vaginal dryness and painful intercourse.

After a recent trip to the beach, I was not quite as red as a lobster, but close. Not a good idea.

Even worse idea: using tanning salons. Using a tanning bed before the age of 30 is associated with a 75% increased risk of skin cancer. Do the teenage girls that use them understand their increased risk of skin cancer?

A 6 week old girl's toes were chewed off by rats; the father and another couple have been arrested in connection with the case.

Rats most commonly bite people who cannot affect their own environment, like infants, and people who have reduced feeling in their feet, such as diabetics with peripheral neuropathy.

Women who avoid obesity, get plenty of Vitamin D and bear more than one child have a greater likelihood of avoiding endometrial cancer. Luck plays a part as well: women who experience late menopause have a greater chance of skipping this cancer as well. Endometrial cancer, or cancer of the lining of the uterus, affects 35,000 women in the United States per year.

What do dark oily fish and breast cancer have in common? If you eat more fatty fish you are less likely to develop breast cancer. According to a June 2009 case-control study by Kim et al, eating high quantities of fatty fish reduces the risk of breast cancer in pre- and postmenopausal women. Cold water fatty fish like salmon, mackerel, anchovies, sardines and trout are high in a type of polyunsaturated fatty acid known as Omega-3 fatty acids. Omega-3 fatty acids such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are essential nutrients that can only be obtained through the consumption of food or supplements because our bodies can’t produce them.

9-year-old Jeremy Fraser died yesterday after a long battle with non-Hodgkin's lymphoma, nine months after prosecutors charged his mother with failing to home chemotherapy to the child, according to the Boston Globe and the Salem News. After the failure was recognized, the boy's father, Eric J. Fraser, was granted custody, according to the Salem News. He died at 4:45 a.m. on Monday in hospice. Jeremy Fraser had autism. Non-Hodgkin's Lymphoma is frequently treatable to cure.

High quality medical research shows that exercise improves weight loss, prevents diabetes, and helps in prevention and recovery from diseases ranging from osteoporosis to breast cancer. A lukewarm assessment of the benefits of exercise by the New York Times is faulty: not only does exercise plus diet help improve weight loss compared to diet alone, it also prevents weight regain.

An estimated 9400 children suffer lawn mower injuries each year.  Some of these kids are driving or are passengers on riding mowers, but others are just bystanders.

  Many children get fingers or toes amputated.  Children under age 16 should not operate lawn mowers, and younger children should stay out of the yard when the grass is being cut. 

For heavier kids, summer months often translate to unwelcome pounds. Overweight kids tend to put weight back on that they may have lost from September to June.

Researchers have found that children who are already heavy tend to get heavier in proportion to their height over the summer than normal weight kids. July and August tack on the most weight.

Kids love to jump, bounce and fly through the air with their friends on trampolines, but trampolines are definitely a proven safety risk. Trampoline injuries peak in August, so beware. 

More than half of these injuries occur on trampolines with safety nets.  Nets also do not protect your children from serious spinal injuries.  If the neighbors have a trampoline, instruct your kids to stick to soccer, leap frog, and jump rope. 

When I was eight, I used to take a nifty short cut to summer camp that went right through a mean dog's territory. I was lucky enough not to suffer any injuries, but I did lose a shoe to him. My mother was not pleased.

An average of 914 dog bites are treated in U.S. emergency departments each day, with more bites occurring in the summer months. Most of the victims are young children.

If summer is a time for climbing, swinging and exploring for children, it is also a time for falling out of windows, out of tree houses, and off of rope swings. Head injury and broken bones are the reward.

What's an outdoor lover to do? Bug bites are risky, especially mosquito bites in areas with endemic malaria, dengue or viral encephalitis. Tick bites can transmit Lyme disease. But insect repellant is bad for you too, right?

Massachusetts-based doctor Scott Reuben is accused of fabricating data for at least 21 published research papers. The anesthesiologist, who practiced at Baystate Medical Center, in Springfield, Massachusetts, United States, touted medications that were produced by pharmaceutical companies from which he had received financial grants for research. The fraud, considered to be one of the gravest cases of academic misconduct known because it permeates an entire body of work, as opposed to just one article, has left the subspecialist's understanding of multi-modal analgesia in shambles. Data falsification is not uncommon. Even Andrew Wakefield, the lead author of the 1996 Lancet study that linked the MMR vaccine and autism, has been accused of conflicts of interest and misrepresenting data.

Well, sort of. People who are treated with botulinum toxin A, the ingredient in Botox and Dysport, create a better first impression in observers, according to research to be published next month. This positive first impression leads to a friendly response, which creates a happier person.

Are all the kids, who should playing outside, stuck in front of video games? Video game use is associated with obesity, altered sleep patterns, and impaired memory.

In the early 1900s, Sigmund Freud hypothesized that clitoral orgasms were the norm for younger women, while mature women were more likely to have vaginal orgasms. In the late 1900s, feminists cried foul and decreed that an orgasm is an orgasm. Recent research has revived discussion about orgasms: the ability to fanatasize during sex, and a long, fluid, gait predict orgasm in women, while foreplay seems to have nothing to do with it. No data on why it matters, though.

Twentieth Century Fox on Monday postponed Thursday's opening of "X-Men Origins: Wolverine" because most of the movie theaters were closed, according to Variety. Besides the fear of uncertainty and the remembrances of the 1918 pandemic, there is, however, no indication at this time that this particular virus will result in a major public health crisis. I am treating my patients without wearing a mask myself.

The lifetime of medication that Connie Culp must take to prevent transplant rejection will also put her at risk for diabetes, infection, and cancer. Those are pretty big risks. But not as risky as not having a face.

Fears of a global pandemic of Swine Flu, likely originating in Mexico, increased yesterday after the confirmation of twenty cases in the United States, prompting US officials to declare a public health emergency. Confirmed cases in the US now stand at 40. Mexico, considered to be at the epicenter of the pandemic, has reported more than 1600 suspected cases, with 149 deaths, although only a fraction of those cases had been confirmed.  The cases in Mexico are particularly troubling because most of the fatalities are reported to have been in young adults.  Europeans have been advised to avoid non-essential travel to the US and Mexico.  Death from Swine Flu appears to be due to a 'cytokine storm', causing acute respiratory distress syndrome (ARDS).  It is possible that optimal nutrition with healthy fats and antioxidants may reduce the severity of the disease in patients who get Swine Flu.

Reports surfaced this week of the death of the baby of homebirth advocate Janet Fraser after several days of labor in her Australia home, according to the Sydney Morning Herald. While a study in the British Medical Journal found no increased risk for mother or child for home deliveries, other studies have demonstrated substantial risk.

Anecdotal evidence points to an increase in the incidence of kidney stones in children, according to published reports. While kidney stones in children are quite rare, they appear to be associated with an abnormally developed urinary tract, having had previous urinary tract infections, and a history of kidney stones in the parents. While experts have recommended that children eat less sodium, or salt, in their diet to reduce the risk of kidney stones, there is no definitive evidence that salt reduction works.

This New York Times Magazine article explores the experiences of patient Summer Stiers as she navigates the NIH’s Undiagnosed Diseases Program. Summer suffers from multiple medical problems that may be linked by a single abnormality, possibly a genetic problem with the basement membrane. Ms. Henig's journalistic treatment of the patient objectifies her on a grand scale.

Some of us complain of cold weather during the morning commute, how about 3 days buried under snow? While Donna Molnar’s survival after exposure to extreme cold for three days in Ontario, Canada is amazing, she is reported to suffer from severe frostbite.

Error in medicine is common, but not all error results in patient harm. The newborn twins of actor Dennis Quaid and his wife Kimberly had their hospitalization extended after being given a dose of heparin almost 1,000 times greater than the correct dose for their age and weight in November, 2007.