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.
We all know that the use of baby oils and baking in the sun for hours on end is probably not a good idea. We know that increased sun exposure correlates with increasing skin cancer rates. We know that it can cause accelerated skin damage in the form of pigmentation changes, wrinkles, and increased skin laxity. Don’t believe me? Check out this picture! Truck drivers tend to get increased sun …
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Should I get a spray tan? A doctor discusses whether it’s safe
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 37-year-old woman undergoes preoperative evaluation prior to a hysterectomy for worsening menstrual bleeding of several years’ duration caused by uterine fibroids. She has a recent history of recurrent epistaxis and bleeding after recent dental work but denies thromboembolism and a family history of unusual bleeding. The patient is otherwise healthy. Her only medication …
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MKSAP: 37-year-old woman undergoes preoperative evaluation
If we want to fight childhood obesity, we need to get kids moving.
Sounds incredibly obvious. And that was my reaction when I first read the study just released in the journal Pediatrics—in it, the authors said that high school students were less likely to be overweight or obese if they played at least two sports during the school year, or if they walked or biked to school. Really? Next we …
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When it comes to exercise, stating the obvious is really important
Zumba, the Latin dance-inspired fitness craze, is a great way to burn calories, up to 500 per hour. It also gives you a good cardiovascular workout without making you feel like you’re exercising. This increasingly popular workout attracts a diverse crowd at dance studios and health clubs, including a sizable number of those 50 and up.
But for people who are out of shape, taking the first classes can be like …
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How to avoid Zumba injuries: 10 physician tips
In a recent report released by the UNAIDS, the number of new HIV (human immunodeficiency virus) infections has fallen by 19% since 1999. And of the 33.3 million people living with HIV, only a little over 5 million people are receiving HIV treatment. That is, roughly 15 percent of the world’s population. Ghastly, some might say, but improving, optimists would say.
According to the 2010 UNAIDS Report on the Global Aids …
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The HIV vaccine does not promise the end of AIDS
In my behavioral pediatrics practice, it is not uncommon for parents to go to great lengths to put up a good front. They feel terrible shame about moments of out-of-control behavior, and also fear that I will blame them for their child’s troubles. They focus primarily on “what to do” about their child’s difficult behavior. However with time, and the realization that I am interested in understanding, not shaming or …
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Eliminate the guilt in parenting
In the summer of 2007, then-U.S. Preventive Services Task Force member Russ Harris, MD, MPH approached me about taking on what he suggested would be a fairly quick and straightforward project: summarizing the small amount of medical literature on the benefits and harms of the prostate-specific antigen (PSA) test that is commonly used to screen asymptomatic men for prostate cancer.
Little did I know that this research and its implications would …
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Reaching the end of PSA screening
A silent pattern of discrimination persists today in healthcare institutions in the United States, according to a number of hepatitis B experts and advocates. A number of doctors have been recently dismissed or threatened with dismissal when they were discovered to carry the hepatitis B virus (HBV). Infected medical and dental students have had their acceptances deferred or rescinded altogether. These are nefarious instances of defensive medicine, based on an …
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Discrimination against providers and students with hepatitis B
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
As a critical care anesthesiologist, I care for patients when they are most vulnerable. Critical care patients require intravenous (I.V.) fluids and medications, frequently through central venous access. These are catheters inserted into larger veins with a special procedure. I believe managing I.V. lines requires procedural skills, …
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The role of IVs and central lines in critical care
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 79-year-old man is evaluated in the emergency department for vertigo that began suddenly about 1 hour ago, associated with severe nausea and vomiting. He noticed that he could not seem to sit up straight and could not walk without assistance. The patient denies confusion, motor weakness, hearing loss, dysarthria, diplopia, fever, or paresthesias. …
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MKSAP: 79-year-old man with vertigo
Much of the debate over the future edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has centered on what disorders will be added, modified or dropped. But lost in the discussion is a change that will align disorders along a developmental continuum—one that looks at them across the lifespan. This shift will provide clinicians with a critical perspective that until now has been missing.
Historically, disorders were classified …
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DSM-5 will capture the dynamic nature of mental illness
I’ve been interested in health and nutrition since I started playing high school sports. During my 3 year stint as a personal trainer, I developed a distinct opinion of the Body Mass Index (or BMI – the most widely used anthropomorphic measurement in medicine): it’s not a very good tool.
My issue with BMI began here – it doesn’t actually measure a person’s body fat or lean mass, but rather is …
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Is measuring Body Mass Index (BMI) obsolete?
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 25-year-old woman is evaluated for a 2-year history of almost daily bloating and lower abdominal cramping; the symptoms are associated with constipation, relieved with bowel movements, and seem worse when she is under stress. She has one or two small bowel movements a week and often has a feeling of incomplete evacuation. She …
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MKSAP: 25-year-old woman with bloating and abdominal cramping
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 45-year-old woman is seen for routine follow-up. She has type 2 diabetes mellitus, diagnosed 5 years ago; initial treatment included metformin and glimepiride. A daily injection of insulin glargine was added to her regimen 1 year ago.
At present, her hemoglobin A1c value is 8.1%. Mean blood glucose values derived from the past 4 …
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MKSAP: 45-year-old woman is seen for diabetes follow-up
As a college health physician, I see my fair share of fainting patients, including syncopal episodes within the clinic itself, typically while they are using the toilet, or after venipuncture and vaccinations. Our staff is as proactive as possible to avoid these predictable occurrences, listening for problems in the restrooms, putting students in a recliner chair for their blood draws and observing them for awhile post-injection for lightheadedness. Despite taking …
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How to recognize positional orthostatic tachycardic syndrome (POTS)
I was recently invited to present at an international symposium in Germany on rheumatoid arthritis. My brief was to discuss how BJC Health, our clinic, provides integrated patient care for rheumatic disease. As it turns out, I had to turn down the invite due to conflicting commitments.
But I was flattered. Our Connected Care approach is being noticed.
Over the course of the last 24 hours, I’ve been thinking about what I would …
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Patients with arthritis deserve an integrated approach to their care
Having a major cardiac event can be a stressful, life changing occurrence. Often, the psychological impacts of having a heart attack (myocardial infarction) are underestimated and can be long lasting. In fact, there is evidence to suggest that these that the emotional stressors that occur post-MI are consistent with symptoms of post traumatic stress disorder. PTSD has been shown to be associated with higher rates of recurrent coronary events and …
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PTSD, stress and anxiety after a major cardiac event
