Simon Douglas Murray, MD

In March, the television news show 60 Minutes devoted a segment to a clinical trial using polio virus to treat glioblastoma multiforme. The segment called "Killing Cancer" did a good job of illustrating the potential power of this new treatment as well as the problems associated with glioblastoma multiforme which typically kills patients in a matter of months.

A 50-year-old forest ranger noted this rash, which he thinks has been present for several weeks. He noticed a similar rash on his dog. It is itchy, with a raised red border and a clear center. It may have increased in size slightly over several weeks. He is otherwise asymptomatic. What is the next step in treating him?

A frequent challenge when prescribing antibiotics is what to prescribe for the patient who states they are allergic to penicillin. This is particularly true when prescribing cephalosporins. The frequently quoted rate of cross-sensitivity between penicillin and cephalosporins is between 5 and 10 percent.

This discussion is with David Lazarus, MD, the chairman of medicine at Princeton University Medical, Plainsboro, NJ. We are deliberating the maintenance of certification (MOC) requirements for internal medicine.

Statistical analysis is essential to practicing modern medicine. Properly designed clinical trials are at the heart of Evidence-based medicine (EBM). The concept of EBM has evolved over the last 30 years from the work of Archie Cochran, an epidemiologist, who wrote a series of lectures in 1972 on the efficacy of medical services.

Twenty-five years ago I was told by my partner who had considerably more experience than I that the best way to build a medical practice was to follow the 3 "A's of medicine". In order of relevance they are availability, affability, and ability. Ability comes third because unless a doctor is available to patients so they come enough to like him, they would never know if he has any ability.

Ronald Nahass, MD, MHCM, FACP, FIDSA, is a certified infectious disease expert in central New Jersey with the University Medical Center of Princeton at Plainsboro. He speaks with Internal Medicine World Report Editor-in-Chief, Simon Douglas Murray, MD, about several misconceptions surrounding the Ebola outbreak and provides insight to educate the readers.

Harry Agis, MD, is a vascular surgeon and a partner in the New Jersey Vein Institute, Morristown, NJ. He speaks with Internal Medicine World Report Editor-in-Chief, Simon Douglas Murray, MD about the utility of the ankle-brachial index (ABI) in screening for peripheral artery disease and atherosclerosis and then will touch briefly on a few other subjects that might be relevant to internists with regards to vascular surgery.

The Ebola epidemic in Central Africa has riveted the American public. Press accounts of the homegrown case of a Liberian man who developed symptoms after arriving in Texas has driven anxiety higher. There is growing fear among many that the virus will spread rapidly in the US causing widespread death. This week a patient advised me to stock up on food and water and get a gun to prepare for the impending epidemic.

There is a wide variety of evidence to support benefits of low-fat diets versus low carbohydrate diets and vice versa. As of today, no one can tell us with certainty whether the well-worn dictum "calories in calories out" is really true. The National Weight Control Registry data give us some confidence in recommending that to lose weight most people need to alter their diet to reduce calories, and need to exercise on a near-daily basis.

"The art of medicine consists in amusing the patient while nature cures the disease." While this statement attributed to Voltaire is less true today than it was in the philosopher's time, there is still a familiar ring to it.

Internists must resist taking as much as they can carry from the current healthcare system just because they can get away with it.

Patients find it very attractive to self-select a variety of vitamins and supplements that promise to improve their immune system and combat obesity without any dangers or dependence on healthcare professionals, but these claims are just not true.

As internists, the best product we can offer to patients is our opinion derived from clinical experience and education.

If there is one absolute truth in medicine, it is that the truth will change over time.