Conditions and Diseases

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.

The problem with physically disciplining children

Justin Morgan, MD

September 28, 2014

The recent arrest of Minnesota Vikings star running back Adrian Peterson on child abuse charges has sparked a national conversation on the manner in which parents should discipline their children. Allegedly, Adrian Peterson injured his 4-year-old son by spanking him with a thin tree branch (“a switch”) and leaving cuts and bruises all over his body.

After learning of Adrian Peterson’s indictment, Peterson’s mother, Bonita Jackson, was interviewed by the …

When your child doesn’t poop: Solving the constipation death spiral

Roy Benaroch, MD

Conditions and Diseases

September 27, 2014

Michelle wrote in: “We trained my 3-year-old son approximately 3 months ago, and it’s been great. He’s been having virtually no accidents. The problem is that he’s terrified of making ‘dirty’ on the toilet. He does it in his pamper at night when he’s sleeping. He’s very verbal about it, and tells me that he’s scared to let the dirty come out. It’s really difficult to deal with because there …

An insider guide to reading your radiology report

Rourke Stay, MD

Conditions and Diseases

September 26, 2014

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The simple truth is that radiology reports can be hard to read, especially for those without a medical background. The combination of advanced medical technology and the wonderful subtle intricacies of the human body often result in a final document that more closely resembles a William Faulkner novel (translation: difficult to understand!) than Dr. Seuss. The goal is to try to …

Exploring the Angelina Jolie effect in breast cancer screening

Alan Cassels

Conditions and Diseases

September 26, 2014

Up to this point, it had only been a hypothesis: That celebrity firepower can definitively drive consumer health behavior in a certain direction. The case here concerns whether women wish to embark on a genetic hunting expedition to see if they are at high risk of developing a particular disease such as breast cancer, and the motivator in this case is Angelina Jolie.

The actress underwent genetic testing for mutations related …

Don’t spank your children. Do these 5 things instead.

Wendy Sue Swanson, MD

Conditions and Diseases

September 24, 2014

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In my mind it’s no wonder the American Academy of Pediatrics has a statement against spanking. Spanking, in the simplest form, is the act of hitting a child, using physical force to try to get a different outcome. Thing is, spanking is an ineffective discipline tool in the long run and research shows it’s damaging to a child’s mental health. …

MKSAP: 69-year-old woman with a lump under her arm

mksap

Conditions and Diseases

September 21, 2014

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 69-year-old woman is evaluated for a lump under her arm found on self-examination. She is otherwise healthy and has no other symptoms. Medical and family histories are unremarkable, and she takes no medications.

On physical examination, temperature is 37.4 °C (99.3 °F), blood pressure is 110/70 mm Hg, pulse rate is 72/min, …

Ebola: Don’t forget the patients who are left behind

Edwin Leap, MD

Conditions and Diseases

September 20, 2014

Ebola virus is rampant in West Africa. So far, the death toll is around 2,296, which makes it one of the largest outbreaks ever. Ebola is what’s known as a hemorrhagic fever virus, and belongs to a large family of nasty viruses that are widespread around the world. There’s even one in the American Southwest known as hantavirus, that lives in a species of mice. Yellow fever, which killed so …

MKSAP: 72-year-old unconscious woman in the ER

mksap

Conditions and Diseases

September 20, 2014

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 72-year-old woman is evaluated in the emergency department for loss of consciousness. Her son, who brought her in, says she seemed confused and agitated when he spoke to her on the telephone less than 2 hours ago. The patient has an 8-year history of type 2 diabetes mellitus. She had strict …

Ebola needs an ice bucket challenge

Tina Shah, MD, MPH

Conditions and Diseases

September 19, 2014

This is the story. Ebola emerged in 1976 and the last major outbreak occurred in 2007 in Uganda and D.R. Congo. Now we are experiencing the largest outbreak of Ebola ever seen with a death toll of 1,848 and number of infected of 3,707, but these are only the “confirmed” cases.

Ebola is affecting 4 countries in West Africa: Guinea, Liberia, Nigeria and Serra Lione, and while we have only seen …

Read more…

Ebola needs an ice bucket challenge

A pediatrician answers your HPV vaccine questions

Jean Moorjani, MD

Conditions and Diseases

September 18, 2014

What is HPV?

HPV stands for human papillomavirus, and these viruses are the most common sexually transmitted viruses in the United States. Most of the people who are diagnosed with HPV are young and sexually active. The rates of HPV infection are high because most people who have HPV do not know they are infected because sometimes the virus shows no symptoms. Most HPV infections show no symptoms, and resolve within …

Deactivating a pacemaker: Is it euthanasia?

Eric Widera, MD

Conditions and Diseases

September 18, 2014

“He’d feel okay about not replacing the pacemaker’s battery when it ran down, he said. But turning it off, he said, would be ‘too active.’ Later he would tell me that it would have been “like putting a pillow over your father’s head.”

These are the words of Katy Butler in her book Knocking on Heaven’s Door – The Path to a Better Way of Death in which she writes about her …

Who should be receiving therapeutic hypothermia?

Peter Ubel, MD

Conditions and Diseases

September 17, 2014

Thanks to the popularity of medical television shows, most people have witnessed hundreds of fictional cardiac arrests in their lifetime. In most of these scenes, the patient loses consciousness, and the medical team rushes to the bedside:

“He’s in v-fib.”

“Get me the paddles.”

The team performs urgent chest compressions for a few seconds. Then they place the metal paddles on the victim’s chest:

“Clear!” Kathump.

The patient’s heart is back to normal again, tragedy …

Abortion or ectopic pregnancy? When politicians confuse medical terms.

Jennifer Gunter, MD

Conditions and Diseases

September 17, 2014

Wendy Davis, gubernatorial candidate for Texas, has a new memoir Forgetting to Be Afraid. In it she describes terminating two pregnancies. One termination appears to have been in the second trimester for fetal indications and the other she describes as an ectopic pregnancy. She writes, “The only medical option was to have surgery to terminate the pregnancy and remove the affected fallopian tube — which …

The enterovirus outbreak: What you need to know

Wendy Sue Swanson, MD

Conditions and Diseases

September 16, 2014

Widespread news coverage has heightened concerns by many parents about a severe-symptom viral infection causing respiratory illness in children, predominately in the Midwest. Over the last month there has been a dramatic up-spike in children hospitalized with severe cold symptoms and wheezing. The virus isn’t new, but its effect on children seems to be. The Centers for Disease Control (CDC) has confirmed tests on children both in Kansas …

Health anxiety: What hypochondriasis really should be called

Lucy Hornstein, MD

Conditions and Diseases

September 16, 2014

“Am I a hypochondriac?”

It’s a question I hear with quite some regularity, almost never from people who suffer from bona fide anxiety disorders related to their health.

No, the fact that all you have is a simple upper respiratory infection — the common cold — instead of a potentially lethal strain of H1N1 avian flu does not qualify. Not when your response to my reassurance is relief. That’s completely appropriate, and …

An early school-year phone call: Could my child be autistic?

Lisa Shulman, MD

Conditions and Diseases

September 16, 2014

Back-to-school shopping, new sneakers and first-day outfits, sharpened pencils and fresh notebooks in oversized backpacks by the door: As a parent, these are the images I’ve come to associate with the start of every school year.

But with my 20-plus-year history as a developmental pediatrician specializing in autism at Albert Einstein’s Children’s Evaluation and Rehabilitation Center, I have an added association with the start of the school year: a particular type of …

Low-fat or low-carb diets: Interpreting results of the new study

Albert Fuchs, MD

Conditions and Diseases

September 16, 2014

The joys of September! Parents gleefully shove their reluctant children onto school buses, the palm trees in Los Angeles don’t change color, and everyone realizes that they gained 20 pounds during their summer vacation. It’s time to get serious again about losing weight.

But how should you eat to best help you shed the extra pounds? Many people are passionate about their favorite diet, but there is very little data comparing …

MKSAP: 32-year-old man with cough and nasal congestion

mksap

Conditions and Diseases

September 14, 2014

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 32-year-old man is evaluated for a 3-day history of productive cough, sore throat, coryza, rhinorrhea, nasal congestion, generalized myalgia, and fatigue. His sputum is slightly yellow. His two children (ages 3 years and 1 year) had similar symptoms 1 week ago. He is a nonsmoker and has no history of asthma.

On …

Sex or death: The difficult decisions of prostate cancer treatment

Anne Katz, RN, PhD

Conditions and Diseases

September 12, 2014

As part of my role as a clinical nurse specialist in a busy prostate clinic, I see men (with their partner) as part of their decision-making process for active treatment for prostate cancer. The purpose of the appointment is for me to explain the results of their prostate biopsy, dispel any …

Pain as a vital sign has contributed to the opioid epidemic

Skeptical Scalpel, MD

Conditions and Diseases

September 10, 2014

Contrary to what you may have heard, pain is not the fifth vital sign. It’s not a sign at all.

Vital signs are the following: heart rate, blood pressure, respiratory rate, temperature.

What do those four signs have in common?

They can be measured.

A sign is defined as something that can be measured. On the other hand, pain is subjective. It can be felt by a patient. Despite efforts to quantify it with numbers …

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