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.
Dead babies aren’t something anybody likes to talk about. But while it may be an uncomfortable topic, it’s also an important one — because there are things we can do to make it happen less frequently. The loss of an infant is something parents never really get over, and something that no parent should have to experience. Here’s a look at the most common causes of infant mortality and some things you …
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Prevent your baby from dying: 9 tips every parent should know
Some maladies that attract psychiatric attention are unequivocally brain diseases. Huntington’s disease. Brain tumors. Lead poisoning. However, these are not psychiatric diseases. Huntington’s is a genetic abnormality diagnosed and treated by neurologists. Brain tumors are managed by neurosurgeons and oncologists. Lead toxicity is treated by internal medicine. Indeed, a long list of medical and surgical diseases include psychiatric features: stroke, anoxic brain injury, meningitis, lupus, diabetic ketoacidosis, and febrile delirium to name a few. One important …
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Are psychiatric disorders actually brain diseases?
A JAMA Surgery Viewpoint recently suggested that because of the findings of a Finnish randomized trial, surgeons now should give patients with appendicitis a choice between an appendectomy or treatment with antibiotics.
The paper acknowledged my criticisms of the Finnish study that found that simple appendicitis could be treated successfully with antibiotics in almost 75 percent of patients.
I respect the authors of the JAMA Surgery article and am happy they Read more…
The problem with shared decision-making in appendicitis
Recently, during a typical day as a developmental pediatrician, I walked down the hall to schedule an ophthalmology appointment for a toddler. As I spoke with the secretary, I saw a thin “new patient” chart on her desk for another patient. I recognized the name at once and was immediately transported back 25 years ago, to when I was a fellow in training at the center and learned a very …
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Pediatricians should listen to parents. Here’s why.
Recently, another study was published showing that SSRI antidepressant use during pregnancy is associated with increased rates of autism in the children. By my count, this is now the tenth study on this topic — all of which found links between SSRI antidepressant use in pregnancy and autism in the offspring. Most of these studies were recently reviewed, and also concluded that SSRI antidepressant use during pregnancy is associated …
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The truth about antidepressants and autism
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 48-year-old man with newly diagnosed hypertension is referred for an echocardiogram to assess findings of left ventricular hypertrophy noted on the electrocardiogram. He is asymptomatic, and his medical history is unremarkable other than hypertension. His only medication is chlorthalidone.
On physical examination, blood pressure is 128/70 mm Hg, pulse rate is 60/min and regular, and …
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MKSAP: 48-year-old man with newly diagnosed hypertension
Marijuana use today is not limited to the poor, the marginalized among us; nor is it kept in the inner city, as it pretty much was when I was a kid. Now it is widespread, even legal in some states. One might even make the argument it has become a substantial part of the life of the elite, the affluent of America. And when we think of elite and powerful …
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Is your doctor a marijuana user? Maybe you should ask.
To many, the extent to which Charlie Sheen tried to keep his HIV status from becoming public knowledge came as a surprise — and suggests that HIV-related stigma and discrimination remains pervasive despite strides that have been made in fighting the disease.
Diagnosed nearly four years ago, Sheen reported paying more than $10 million in bribes to keep his HIV status secret. Sheen decided to go public, he told Matt Lauer …
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Charlie Sheen and the enduring stigma attached to HIV
I donated blood today. I’m one of those people who doesn’t shudder at the thought of needles piercing my skin, or get queasy as I watch the blood drain from my vein into the collection bag. It’s no big deal. I eat the cookies and drink the juice afterward, and I kind of enjoy talking with the elderly volunteers.
I think I’m lucky. I know so many people who are sickened …
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What a nurse learned from a patient who wasn’t afraid to die
I walk into the exam room on a Friday afternoon to find a 16-year-old female who is coming in to see me for a sport physical. On paper, everything looks great: Her vital signs are on point, she’s a straight A student, vaccines are up to date, she eats healthy and exercises regularly, Mom and Dad are still happily married and she’s not dating an abusive senior who is pressuring her into …
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A straightforward office visit with a teenager turns into something much more
Today, I talked at length with that lady whose husband has Creutzfeldt–Jakob disease (CJD). That patient — the one with arbitrary myoclonic jerks, always naked and uncovered by blankets due to uncontrolled flailing, his penis and Foley catheter exposed. That one with overgrown mycotic toenails and eyes that are always only half-open, his gaze drifting everywhere. He was until now just a patient for me — the CJD patient.
Yet today …
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A patient with Creutzfeldt–Jakob disease. An unconditional love.
Because of their beauty, their amazing biology, and their use in developing medicines, venomous animals are found in captive collections far beyond their native ranges. Fortunately, accidents involving them are rare. But people who take care of such animals need to be prepared for an emergency, and if they wait until the last minute things can go very wrong. Speaking as one who receives emergency calls, I offer the following …
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9 tips to find a doctor if you work with venomous animals
In my first quarter of medical school, I learned about prenatal screening for cystic fibrosis (CF), a progressive multisystem disease caused by an autosomal recessive mutation in the CF transmembrane regulator gene. We also learned about bronchiectasis, a common pathology of CF that consists of the irreversible enlargement of airways, promoting continuous low-grade bacterial infection and causing deadly respiratory failure.
But despite my hours of studying and memorization, these clinical facts …
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A day with a cystic fibrosis patient
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 54-year-old man is seen for follow-up evaluation of a tremor in his upper extremities that has been present since age 20 years. The tremor was mild for many years and did not interfere with his work but has become more prominent in recent years. He has difficulty writing and using utensils during meals. He …
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MKSAP: 54-year-old man with a tremor
Spend spend spend — that’s the push by marketers and websites this time of year. Except from me. Here are three holiday gift things nobody needs. Save your money, or buy something else if you must, but stay away from today’s featured items:
1. Crib bumpers. The American Academy of Pediatrics has called for banning these things since 2007, but they’re still sold. And they’re still killing babies. A Read more…
Don’t buy these 3 gifts for babies this holiday season
