Physicians writing on KevinMD about the diseases they treat and the people who have them: cancer and its screening arguments, pain and the drugs that treat it, diabetes and the obesity argument, mental illness and who gets treated for it, and the decisions at the end of a life. Five maintained records draw on this archive: Cancer: what physicians say, in their own words, Opioids: what physicians and pain patients say, in their own words, End of life: what physicians say, in their own words, Diabetes and obesity: what physicians say, in their own words, and Mental health: what psychiatrists and physicians say, in their own words.
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 30-year-old woman is evaluated during a follow-up visit for systemic lupus erythematosus. She was diagnosed 3 months ago after presenting with pericarditis and arthritis. She was initially treated with prednisone, 40 mg/d, with improvement of her presenting symptoms. The prednisone has been tapered over 3 months to her current dose of 10 mg/d with …
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MKSAP: 30-year-old woman with systemic lupus erythematosus
Surviving suicide loss is difficult. And in some sense, the resulting grief is open-ended. I am a mother and doctor whose two sons died by suicide associated with psychotic bipolar disorder. My ever-present sensitivity to the fierce loss of death by suicide is again touched when I hear of death by suicide. The suicides of Anthony Bourdain and Kate Spade triggered in me a renewed feeling of grief. Like so …
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After Kate Spade and Anthony Bourdain, it’s time to shift on suicide
A new study confirms something we here at HealthNewsReview.org have been emphasizing for many years: Health news stories often overstate the evidence from a new study, inaccurately claiming that one thing causes another — as in drinking alcohol might help you live longer, facial exercises may keep your cheeks perky, and that diet soda might be a direct line to dementia.
The researchers looked at the 50 “most-shared academic articles and media articles covering them” in …
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Health misinformation in the news: Where does it start?
I still feel a little anxiety whenever I ask someone about suicide.
I have no fear when asking The Question — “Have you been thinking about killing yourself?” — but sometimes I find that I’m not breathing while I await the answer.
What if this person says “yes”?
This anxiety persists even though it’s literally part of my job to ask this question. Despite having asked this question thousands of times, I still …
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When asking about suicide, are you ready for the answer?
Editor’s note: Graphic image below.
Envision a large, loafy muffin top. Not just a central bulge or even love handles. I’m speaking of an apron of skin and fat that hangs down over many an American’s lower torso and groin. Surely you’ve seen it — you may even have one. Its medical name is the pannus.
I had never heard of a pannus in medical school and I still never hear it …
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Obesity from the pathologist’s perspective
It is not clear whether Anthony Bourdain and Kate Spade were getting drug treatment for depression. What is clear is that suicide in the U.S. has never been higher even as the use of SSRI antidepressants has also never been higher. One in every eight American adults recently took an antidepressant says the CDC and the number is only rising. Are the drugs working?
The use of …
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Antidepressant use and the climbing rate of the suicide
I’ve thought a great deal about what to say, if anything, about the two suicides recently of two people who were not merely celebrities in the TMZ sense, but people who represented creativity — perhaps in a way that seemed tangible to the rest of us — and seem to have become celebrities almost by happenstance.
Suicide is not an unfamiliar or difficult topic for me. After all, I am someone …
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It’s time to create the safety net by normalizing psychiatric care
As is often the case when flying I was rewarded for offering a greeting to my row mate on the plane with a bit of insight and knowledge I’d have missed had I not simply reached out a hand and said, “Hi, I’m Darrell.” My momentary companion (we each moved to more spacious seats) had been a schoolmate of the recently deceased Kate Spade. He confirmed her years-long struggle with …
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Call suicide by what it is: the cause of death
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 58-year-old man is evaluated in follow-up for idiopathic pulmonary fibrosis (IPF), which was diagnosed 2 years ago. He has cough and shortness of breath and now requires supplemental oxygen at rest. Previous evaluations have not identified any cause for his symptoms other than progressive IPF. He has participated in pulmonary rehabilitation and continues in …
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MKSAP: 58-year-old man with idiopathic pulmonary fibrosis (IPF)
Where I practice, the process of referring a patient suffering a mental illness is quite infuriating. The wait to get in to see a psychiatrist or psychologist can be months all the while patients are suffering. Worse yet, with certain insurances, there are just no mental health providers available for any of their covered patients. The failure of treating mental health disease in the U.S. is glaring.
In the U.S., approximately …
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The U.S. is failing at mental health care
Vaccines have been hailed by virtually all medical experts, as well as medical historians, as the among the greatest triumphs of public health to occur in the past two centuries. Yet since Jenner first proposed vaccination for smallpox using the vaccinia, or cowpox, virus there have been both skeptics of its effectiveness and people who thought it was dangerous. That is, they had the risk/benefit ratio of vaccination exactly backwards, …
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Has the anti-vaccine movement affected vaccination rates?
The American Cancer Society (ACS) recently released new guidelines regarding colorectal cancer screening for the average-risk individual. The big news is that they now recommend that screening for colorectal cancer begin at age 45 rather than age 50. This reduction in the starting age was in reaction to recent data showing that colon cancer is increasing in younger Americans for unclear reasons. By screening people at a younger age, the hope is …
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Colon cancer screening at age 45: Here’s what a gastroenterologist thinks
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 78-year-old man is evaluated for symptoms of dysphagia that began 2 weeks ago. When he eats, he starts coughing after the first bite of food and occasionally has nasal regurgitation.
On physical examination, blood pressure is 135/90 mm Hg, pulse rate is 78/min, and respiration rate is 12/min. Left-sided weakness is noted in both extremities, …
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MKSAP: 78-year-old man with symptoms of dysphagia
While infertility may be a problem affecting nearly 7.3 million women in the United States between the ages of 15-44, it is a topic that women often don’t discuss. Rather, they suffer from the emotional pain that accompanies hormone injections, multiple procedures, and sometimes miscarriage. How is it best to treat this vulnerable population that rarely gets the attention it deserves? The answer lies in a team approach to medicine.
According …
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The mental health implications of infertility
What is borderline personality disorder (BPD)? According to the National Institute of Mental Health, unstable moods; impulsive and reckless behavior, and unstable or volatile relationships may be indicative of BPD. People with BPD often have high rates of co-occurring disorders, such as depression, anxiety disorders, substance abuse, and eating disorders, along with self-harm, suicidal behaviors, and completed suicides. They often make poor life choices and take unwise risks. Thus, adults with …
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Borderline personality disorder in medical practice
Having worked at both community hospitals and major medical centers, the issue of ultrasound in pregnancy has revealed itself to be more complex over the years. As a resident, I worked with an obstetrics office that only scanned their own patients who had private insurance and would send uninsured or Medicaid patients (often with a high risk of inadequate prenatal care) to the hospital late in the day to be …
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The questionable ethics of ultrasound in pregnancy
Cyberbullying is a major and growing public health problem associated with increased risk of greater psychiatric morbidity and mortality among children and adolescents. Its prevalence, varieties, associations with other forms of maltreatment, risk factors and deleterious effects in different populations are poorly understood.
Furthermore, effective, evidence-based approaches to screening and prevention in different populations are lacking. Developing such approaches is challenged by the rapidity and unpredictability with which electronic social media …
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Cyberbullying and mental illness in kids
Leaving the nursing profession is bittersweet. My heart left nursing a while ago when I came to the realization that nursing left me first. It never was a two-way relationship. The profession left me without acknowledgment of work-related stress, specifically post-traumatic stress (PTS).
First responders and emergency workers often hear the phrase, “It’s just part of the job.” So we all just deal with it — or not. I’ve heard this …
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Here’s why I left nursing
I’ve been practicing as an interventional pain management physician for over six years. It was a long road to get here — four years of medical school, four years of residency in anesthesiology and one year of fellowship (in addition to the four years of undergraduate education). So people say, “You must really love what you do.” Sure, during residency there was light at the end of the grueling tunnel …
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The painfully fine line of pain management
