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.

MKSAP: 52-year-old man with perineal and suprapubic pain

mksap

December 3, 2011

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

A 52-year-old man is evaluated for a 3-month history of perineal and suprapubic pain. He has experienced urinary frequency and dysuria for 4 to 6 weeks. The patient reports fatigue, insomnia, and low mood for the past 6 months. He has hypertension. Current medications are hydrochlorothiazide …

Pancreas cancer: Exposing the silent killer

Daniel Labow, MD

Conditions and Diseases

November 23, 2011

November is Pancreas Cancer Awareness Month and with the recent passing of Patrick Swayze and Steve Jobs, now is as good a time as ever to educate ourselves about this deadly disease. Almost 40,000 people per year will die of this disease in the U.S., making it the 4th most common cancer killer. It is through education and research that we can continue to improve survival and outcome …

Back to school fatigue can be caused by environmental allergies

Sakina Shikari Bajowala, MD

Conditions and Diseases

November 21, 2011

Back to school. Kids get back into a routine, and mom gets her life back, right? Wrong. For most moms, back to school is anything but relaxing. However, for some of us, it’s even more tiring.

Is this the time of year when you struggle to drag yourself out of bed, despite hitting the sack as soon as you put the kids down for the night?

Is your focus during the day …

Major advances in radiation therapy for cancer treatment

Stephen C. Schimpff, MD

Conditions and Diseases

November 19, 2011

Radiation therapy has advanced dramatically in the past few decades and the rate of change is increasing rapidly. Innovations as a result of engineering and computer advances along with conceptual advances are making a dramatic difference.

Some of the new technologies include improved computer assisted treatment planning (smarter and faster and has more capability like auto-contouring, smart segmentation and improved algorithms) , continuous imaging guidance (fluoroscopic, stereoscopic, and cone beam CT), …

Running a marathon when pregnant

Linda Burke, MD

Conditions and Diseases

November 18, 2011

The fact that Amber Miller did not fall or faint or develop complications while running in the Chicago Marathon is nothing short of a miracle. An ounce of prevention is worth a pound of cure. What on earth was her physician thinking when she was given the green light to half-run half-walk a 26.2 mile marathon? Miller was not your usual runner; she was approximately 39 weeks pregnant.

Although pregnant women …

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Running a marathon when pregnant

The risks of exercise injury can increase health care utilization

Juliet K. Mavromatis, MD

Conditions and Diseases

November 15, 2011

The health benefits of exercise are well-established. A recent study published in the Journal of the American College of Cardiology showed that one’s fitness level, as measured a person’s one mile run speed, compared to other cardiovascular risk factors, was the best single predictor of heart attack risk and life span. Studies have shown that regular exercise reduces one’s risk of obesity, diabetes, and hypertension. Exercise has been shown to …

The stigma of HIV continues today

Jessica Gold

Conditions and Diseases

November 15, 2011

Firefighters are heroes because they run into a burning building. They run towards a fire, risking their lives to save others. No one would doubt that they are heroic, but most will wonder how this is even possible. How is it that some people can ignore our innate drives to survive to instead, help others do just that?

Doctors are not typically equated with this type of heroic measure, we give …

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The stigma of HIV continues today

The problem with healthy fats

Roxanne B. Sukol, MD

Conditions and Diseases

November 14, 2011

Frankly, it rankles me when people use the term “healthy fats.” We don’t make a distinction like that when we’re talking about carbohydrates, although there are certainly carbs that are nutritious and carbs that are not.

Consider the Atkins diet. I like to believe that Dr. Atkins was on the right track, but that he had some of the details wrong. Clearly, he realized that there was something about carbohydrate in …

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The problem with healthy fats

Simple tips to improve your blood pressure checks

Dr. Charles

Conditions and Diseases

November 13, 2011

A recent study confirmed that the doctor’s office may be one of the worst places to determine if your blood pressure is under control. The automatic rise in tension many people experience when they are being scrutinized contributes to artificially high blood pressure readings. Although many times the only way improve one’s blood pressure is through treatment (such as medication, a low salt diet, and weight loss), other times …

New approaches to cancer screening and diagnosis

Stephen C. Schimpff, MD

Conditions and Diseases

November 10, 2011

I see five major themes in cancer care advances: new approaches to screening and diagnosis, better understanding of the role of viruses as causative agents, targeted therapies, new technologies and improved approaches to ensuring better quality of life.

Screening for the most common major cancers has been straight forward for years – women should get an annual mammogram and Pap smear, men should get a PSA test annually, both should get …

Why more cancer screening may not be productive

Richard Just, MD

Conditions and Diseases

November 9, 2011

The longer I continue in practice, the more complex it becomes. I thought advances in our understanding of the molecular basis of cancer would clarify decision making; instead answers have led to more questions. In the spirit of the immortal Henny Youngman: Take the issue of cancer screening, please.

The story of screening for colorectal cancer (CRC) and prostate cancer has many similarities. The primary screening and diagnostic tool during my …

The fallacies of screening tests extend beyond false positives

Manoj Jain, MD, MPH

Conditions and Diseases

November 7, 2011

Several years ago, during an annual mammogram, my wife, who is in her 40s, was told a mass had been found in one of her breasts. Anxious and uncertain, she had a biopsy, and we braced for the worst.

My father-in-law, when in his 50s, went through a similarly harrowing experience when a prostate specific antigen (PSA) test given during a routine physical exam came out positive, and he underwent a …

Treating Adele’s vocal cord hemorrhage

Christopher Chang, MD

Conditions and Diseases

November 6, 2011

Before going any further, the title to a Los Angeles Times story was “Adele to have surgery to treat vocal cord hemorrhage. What is it?”

I sincerely hope that whomever her surgeon is knows not to perform surgery when the vocal cord is in the middle of a hemorrhage. You do the surgery when the hemorrhage is gone and the culprit blood vessel is left behind which likely is the reason …

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Treating Adele’s vocal cord hemorrhage

Neuropsychologists in the evaluation of ADHD

Dominic A. Carone, PhD

Conditions and Diseases

November 6, 2011

Recently, the media has reported that the American Academy of Pediatrics (AAP) has broadened its 2000-2001 guidelines for the diagnosis of and treatment of ADHD. While the prior guidelines focused on children from ages 6 to 12, the new guidelines cover ages 4 to 18. The story is being covered by the media with lead-ins such as saying that AAP is “expanding the age range for diagnosis and treatment.”

This is …

MKSAP: 32-year-old man with abdominal pain

mksap

Conditions and Diseases

November 5, 2011

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

A 32-year-old man is evaluated in the emergency department for a 5-day history of worsening crampy abdominal pain and eight to ten loose bowel movements a day. The patient has a 5-year history of ulcerative colitis treated with azathioprine and topical mesalamine; before this episode, he had one or two bowel movements of well-formed stool …

A medical student becomes a diabetic and finds public disapproval

Atalanta

Conditions and Diseases

October 31, 2011

Recently, our whole class was asked to “become” a diabetic to try and really understand what it is we’re diagnosing people with. Fantastic idea. Fantastic opportunity.

Not so fantastic to carry out. I opted for the insulin-dependent, type I option, which meant I had to keep a diary of what I ate (including counting carbohydrates), regularly check my glucose level, and inject myself before meals. (We didn’t actually inject insulin or saline, …

How alternative medicine may have killed Steve Jobs

Michele R. Berman, MD

Conditions and Diseases

October 30, 2011

When they first discovered the tumor in his pancreas in October 2003, his doctors told him an immediate operation was necessary, and could lead to a cure.

As first reported by Peter Elkind in 2008, Jobs decided to think different, declined surgery, and explored alternative medicine treatments for his disease.

Nine months later, in July 2004, the tumor had grown. Only then would he allow his doctors to operate.

Would Steve Jobs be alive today had he consented to surgery when they first discovered …

MKSAP: 25-year-old man is evaluated for infertility

mksap

Conditions and Diseases

October 29, 2011

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

A 25-year-old man is evaluated for a 2-year history of infertility. He and his wife have been unable to conceive since marrying 2 years ago. Analysis of a semen sample provided 3 weeks ago during an infertility evaluation showed azoospermia. The patient has a strong libido …

Does your doctor really know what you should be eating?

Gregory A. Buford, MD

Conditions and Diseases

October 28, 2011

For years, it has been widely known throughout the medical profession that basic education in nutrition for training physicians has simply been ineffective. And whether this failure was due to a lack of time or simply a failure of emphasis, the point remains that the medical profession in general is woefully inadequate when it comes to a sound knowledge base related to nutrition and its effects on optimal health. …

PSA testing: Information is better than ignorance

David B. Samadi, MD

Conditions and Diseases

October 26, 2011

With just a few minutes of research on prostate cancer, you will find that it is the most common cancer in men; approximately 1 in 6 men will develop prostate cancer in their lifetime. In these few minutes you will also identify the only two methods available for prostate cancer screening: PSA tests and digital rectal exams (DRE). Alone, these exams are not very sensitive in detecting prostate cancer, …

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