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.

An informed screening choice for breast cancer

Margaret Polaneczky, MD

September 2, 2011

Most women in their 40′s believe they should have annual mammograms, regardless of what screening regimen their doctor might recommend.

So say researchers in Massachusetts who surveyed women (primarily white, highly educated) ages 39-49 presenting for annual checkups. They gave the women a fact sheet about the new USPSTF guidelines on mammogram screening in their age group, and asked them to read one of two articles either supporting or Read more…

An informed screening choice for breast cancer

Heart valve repair without open surgery

Stephen C. Schimpff, MD

Conditions and Diseases

September 2, 2011

A major innovation are the recent reports of success in replacing or repairing diseased or damaged aortic or mitral valves via catheter-based techniques instead of open surgery.

Mitral regurgitation is when the valve becomes unable to close tightly. Once the regurgitation becomes sufficiently severe to cause heart failure, the death rate reaches about 5% per year. Most such individuals are referred for cardiac surgery to either try to repair the valve, …

Read more…

Heart valve repair without open surgery

Control and be responsible for your diabetes

Trey Stephens

Conditions and Diseases

September 2, 2011

Diabetes tries to steal moments from me every second of every day. I choose to steal these moments back. Thus, the chosen name for my attitude toward diabetes, Outlaw Diabetic.

Unlike the majority of the 360 million diabetics worldwide, I did not become a diabetic in my adult life. I became a type I diabetic at 14 months old. As a result, I have never had to change my way …

Treating fungal laryngitis in patients with asthma

Christopher Chang, MD

Conditions and Diseases

August 31, 2011

It is a big bummer to be an asthmatic. Not only is breathing a problem, but even the treatment for asthma can cause problems.

Take for example steroid inhalers like Advair, Symbicort, fluticasone, etc.

All asthma patients know to rinse their mouth out after inhaler use due to risk of oral thrush, but what about from the back of the mouth down to the vocal cords? This nether region can’t be …

Obesity needs to be treated in primary care

Arya M. Sharma, MD

Conditions and Diseases

August 30, 2011

Given the staggering prevalence of overweight and obesity in most developed countries, there is no other hope than to have general practitioners (and their allied health colleagues) take on the considerable burden of managing obesity in their practices.

In fact, a recent example of a successful weight management program run in primary care just found considerable media attention in local newspapers.

But research shows that most general practitioners (GPs) neither feel confident …

MKSAP: 58-year-old man is evaluated for increasing fatigue

mksap

Conditions and Diseases

August 27, 2011

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

A 58-year-old man is evaluated for increasing fatigue of 2 months’ duration. The patient has hypertension and hyperlipidemia treated with lisinopril and atorvastatin. A sister has hypothyroidism.

On physical examination, temperature is normal, blood pressure is 135/80 mm Hg, pulse rate is 72/min, and respiration rate …

Intuition saved this patient from a potentially fatal diagnosis

Sharon Bahrych, PA-C, MPH

Conditions and Diseases

August 27, 2011

I was working in a rural health clinic when I went into to see a new patient. Amy was 18 years old, with her 6 day old newborn son by her side.

I introduced myself and then asked, “what brings you into the clinic?”

Amy responded, “Shortly after giving birth, I started having problems with shortness of breath, ankle swelling, and high blood pressure. I told the OB residents and they brushed …

Does acupuncture work for headaches?

Dana Winegarner, DO

Conditions and Diseases

August 26, 2011

One interesting therapy for headaches, which generates a lot of questions from patients, is acupuncture. Acupuncture is a traditional Chinese therapy which has been around for centuries but only came around to wide spread use in the West (United States and Europe) in the 20th Century.

There are many misconceptions about acupuncture. One question I get regularly is “Do you think acupuncture works?” This is a difficult question to answer because …

Read more…

Does acupuncture work for headaches?

Navigating the path of contradictory medical opinions

Ralph Gordon, MD

Conditions and Diseases

August 24, 2011

With the advancement in healthcare and technology we are able to greatly extend the life expectancy of the population. For the healthcare provider that means that more elderly patients and patients with multiple chronic medical conditions are being admitted to the hospital. Some “complex” patients require a multidisciplinary approach with the involvement of multiple consultants.

As a primary attending physician for the patient you often have to deal with contradictory …

Checking blood sugar is a habit that must be formed

Trey Stephens

Conditions and Diseases

August 24, 2011

If you don’t know there is a problem how can you fix it? Checking blood sugar for a diabetic is mandatory. This applies to both Type I and II diabetics. I check my blood sugar at least 8 times per day. I do this to allow me to closely monitor my blood sugar level. As a disciplined diabetic, I run the risk of low blood sugar episodes more frequently …

How environmental exposures can contribute to autism and ADHD

Philip J. Landrigan, MD

Conditions and Diseases

August 23, 2011

Each year, biologically based disorders of brain development – autism, attention deficit/hyperactivity disorder (ADHD), mental retardation, dyslexia, and subclinical neurodevelopmental disabilities – affect between 400,000 and 600,000 of the four million babies born in the United States. This means that between 10% and 15% of American children have some kind of learning disability.

Reported rates of autism spectrum disorder (ASD) are sharply increasing. The CDC reports that the rates of ASD increased …

Beware whenever you hear a story about a simple blood test

Gary Schwitzer

Conditions and Diseases

August 22, 2011

After seeing the NBC Nightly News last night, a physician urged me to write about what he saw: a story about a “simple blood test that could save women’s lives.”

Readers – and maybe especially TV viewers – beware whenever you hear a story about “a simple blood test.”

And this is a good case in point.

Brian Williams led into the story stating: “Two of three women who die suddenly of cardiac heart …

The entire approach to food based on nutrients is wrong

Shantanu Nundy, MD

Conditions and Diseases

August 20, 2011

The science of nutrition is changing and not in the way you might expect. After years of “reductionist” thinking — where food has been viewed as the sum of its parts – a call to treat food as food has been sounded. No more poring over nutrition labels to calculate grams of fat or chasing down the latest go-to chemical – be it vitamin E, fish oil or omega-3. …

MKSAP: 89-year-old woman is evaluated for dizziness

mksap

Conditions and Diseases

August 20, 2011

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

An 89-year-old woman is evaluated for dizziness that she has had for the past year, mainly while standing and ambulating. The dizziness is described as a sense of unsteadiness. The symptoms can last for minutes to hours, and she has at least 4 to 5 episodes …

What do tonsils do and why would we take them out?

Christopher Johnson, MD

Conditions and Diseases

August 19, 2011

There are some important new recommendations about tonsillectomy — taking out the tonsils — as a treatment for recurrent strep throats.

Some of us can recall a time when getting your tonsils out was one of the rites of passage of childhood. Usually a related procedure is added — an adenoidectomy, removing the adenoids as well. It’s called a T&A in the medical world, and it’s one of the …

Accommodate people with hearing loss in the hospital

Margaret Mortz, PhD

Conditions and Diseases

August 17, 2011

Hospital care for people with hearing loss can be ineffective when people cannot communicate. Most hard-of-hearing people do not know sign language because they lost hearing later in life and remain in the oral culture. Without effective communication, quality of care is impaired and patient compliance is often reduced. The patient’s bed needs to have proper signage and chart records to alert staff of special communication needs.

Ironically, many hard-of-hearing people …

The majority with diabetes do not lead a disciplined diabetic life

Trey Stephens

Conditions and Diseases

August 16, 2011

“More than half of all Americans may develop diabetes or pre-diabetes by 2020, unless prevention strategies aimed at weight loss and increased physical activity are widely implemented, according to a new analysis. Diabetes is an epidemic, ” according to Denise Mann in WebMD Health News.

At 14 months old, the doctor told my parents that the disease would ultimately take my life. The doctor motioned my father into the hallway of …

Tips to care for your child with extra medical or behavioral needs

dr_som, MD

Conditions and Diseases

August 15, 2011

Lately when I ask my son to make a choice or do anything he considers difficult, he says, “Bus number twenty three. Number twenty three. Bus number seventy nine. Number seventy nine.”

He memorized not only the words but the exact cadence of how buses are announced at his school and recites this script instead of screaming. If you know David, this avoidance tactic is creative, a little annoying, and downright …

Alzheimer’s inevitably leads to loss of financial capacity

Alex Smith, MD

Conditions and Diseases

August 14, 2011

“Mom’s been writing goofy checks…”
“Dad stopped paying his bills….”
“Grandma wired her savings to Nigeria…”

Have you heard these phrases from the family caregivers of your elderly patients? Have you ever been concerned that your patient may lack capacity for financial decision making? How do you decide if they lack capacity? What is the clinician’s role in making these decisions? What is their responsibility?

These important questions are addressed in a terrific new article in …

HIV is devastating poor and minority communities

PalMD

Conditions and Diseases

August 13, 2011

The HIV pandemic in the US has developed a stable appearance over the last few years, and that appearance is notably non-white and non-wealthy. When the pandemic was discovered nearly thirty years ago, it was—in the US—primarily a disease of gay men. In Africa, the disease is everyone’s. Women make up significantly more than half of HIV cases in Africa, and tens of thousands of children are infected during …

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