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 best way to control a pertussis outbreak is to vaccinate

Conditions and Diseases
May 12, 2011

The Douglas County Health Department in Omaha, Neb., responded to a 26-person outbreak of pertussis from Sept. 26 to Nov. 21, 2008. Afterward, the department and the CDC assessed the total cost in time and personnel of the response.

“The elevated incidence of pertussis and the burden of response placed on health departments warrants exploring the impact of alternative response and …

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The best way to control a pertussis outbreak is to vaccinate

The problem with naming a diet low carb

Conditions and Diseases
May 12, 2011

What does low-carb mean?  Well, the first thing it means is that something else has more carb.  So what are you comparing it to?   Breakfast cereal?  Angel food cake?  The standard American diet (sAd)?  Anything would be low-carb compared to those.

A whole bunch of folks at the Nutrition & Metabolism Society have been working hard to help people understand that carbohydrate, and not dietary fat, is the main dietary component causing …

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The problem with naming a diet low carb

Sunscreen advice from a dermatologist to prevent skin cancer

Conditions and Diseases
May 12, 2011

by Susan Y. Chon, MD

You know you need sunscreen. But with so many lotions, sprays and gels to choose from, how do you know which sunblock will actually prevent sunburns — and skin cancer?

When it comes to shielding your skin from the sun, the type of sunscreen you choose is as important as how you use it.

I hear many people blame their sunscreen when …

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Sunscreen advice from a dermatologist to prevent skin cancer

Treating stress with cognitive behavioral therapy can impact cardiovascular disease

Conditions and Diseases
May 11, 2011

“This job is killing me” is not a statement of jest. It is a desperate plea of outright sincerity.

Stress, anxiety, depression – all have been associated with an increased risk of cardiovascular disease and mortality. But can interventions to help people cope with stress positively affect longevity and decrease risk of dying? The results of a study in the Archives of Internal Medicine would imply the answer …

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Treating stress with cognitive behavioral therapy can impact cardiovascular disease

Using genomics in cancer, and for early diagnosis in infectious disease

Conditions and Diseases
May 11, 2011

In the previous post I discussed the field of pharmacogenomics.

Today I will focus on:

  • Nutragenomics
  • Disease classification
  • Disease prognostication
  • Early and rapid diagnosis
  • Prediction of diseases to develop later in life

Nutragenomics or the science of how our genes affect what we eat is a developing field.

Here is one example. Cholesterol is an important part of our physiology although too much in the wrong places is harmful. Cholesterol is carried in the body by …

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Using genomics in cancer, and for early diagnosis in infectious disease

Health related anxiety in patients with complex problems

Conditions and Diseases
May 10, 2011

As an academic gastroenterologist at a tertiary care university medical center, I often see patients who have failed traditional therapies that many of my colleagues in the community have tried.

Over the past several years my practice has evolved, from dealing with predominantly the medical aspects of my patients’ diseases to embracing the biopsychosocial model of illness.  One of my colleagues has been the world leader in patient care and research in the …

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Health related anxiety in patients with complex problems

MKSAP: 67-year-old man with an abdominal aortic aneurysm

Conditions and Diseases
May 7, 2011

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

A 67-year-old businessman is evaluated during a routine health examination. He has a 30 pack-year history of smoking, but quit 5 years ago. He consumes two or more alcoholic beverages on most days. He is asymptomatic, but performs no regular physical exercise. He takes no medications.

On …

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MKSAP: 67-year-old man with an abdominal aortic aneurysm

Explaining why belief in pseudoscience is often evidence resistant

Conditions and Diseases
May 4, 2011

What links belief in tarot cards, UFOs and vaccine rejectionism? Yes, they are all forms of superstitious or magical thinking, but are there characteristics that predict who will believe in such nonsense? That’s one of the questions that psychologists Marjaana Lindeman and Kia Aarnio seek to answer in their paper, Superstitious, magical, and paranormal beliefs: An integrative model.

Lindeman and Aarnio postulate that believers in superstition, paranormal phenomena and pseudoscience make …

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Explaining why belief in pseudoscience is often evidence resistant

MKSAP: 24-year-old woman is evaluated for irregular menses and infertility

Conditions and Diseases
April 30, 2011

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

A 24-year-old woman is evaluated for irregular menses and infertility. She reports having had normal puberty but having irregular menses until she started taking an oral contraceptive pill.

She has been unable to become pregnant since marrying 1 year ago despite regular intercourse and discontinuing the …

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MKSAP: 24-year-old woman is evaluated for irregular menses and infertility

The war on pubic hair must end

Conditions and Diseases
April 29, 2011

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I must have missed the declaration of war on pubic hair.

It must have happened sometime in the last decade because the amount of time, energy, money and emotion both genders spend on abolishing every hair from their genitals is astronomical.  The genital hair removal industry, including medical professionals who advertise their specialty services to those seeking the “clean and bare” look, …

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The war on pubic hair must end

Tips to prevent heart disease in women

Conditions and Diseases
April 29, 2011

American Heart Month may be officially over, but don’t let the lack of media attention fool you into thinking heart disease isn’t a critical issue.

We still need to be mindful of the fact that heart disease is the number one killer of women.

There are simple lifestyle choices you can make to help prevent you from heart disease.

I hope after reading this post you don’t just move on, but I hope …

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Tips to prevent heart disease in women

Why depression continues to go undiagnosed and untreated in primary care

Conditions and Diseases
April 28, 2011

What medical condition is the most costly to employers?  I’ll give you a hint.  It is also a medical condition that is likely to go unrecognized and undiagnosed by primary care physicians.

If you guessed depression you are correct.  If you mentioned obesity you get a gold star since that comes in right behind depression for both …

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Why depression continues to go undiagnosed and untreated in primary care

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Osteoporosis in patients with HIV

Conditions and Diseases
April 22, 2011

At the age of 56, Jules Levin felt pretty invincible, despite being HIV positive. He went to the gym regularly and controlled his disease well by taking his antiretroviral medicines every day.

Then he slipped one day while on vacation and broke his wrist.

He underwent an operation to insert pins in his bones and needed to wear a cast for a month, keep his arm …

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Osteoporosis in patients with HIV

Myths about the HPV vaccine for boys

Conditions and Diseases
April 20, 2011

A vaccination policy statement released by the American Academy of Pediatrics has already drawn fire from a number of anti-vaccine groups, specifically for its endorsement of vaccination against HPV infection in boys.

First, let’s examine exactly what the AAP added to its guidelines regarding the HPV4 and HPV2 vaccines: “HPV4 may be administered in a 3-dose series …

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Myths about the HPV vaccine for boys

MKSAP: 63-year-old woman with a 4 week history of fatigue

Conditions and Diseases
April 16, 2011

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

A 63-year-old woman is evaluated during a follow-up visit for a 4-week history of fatigue; pain in the proximal interphalangeal joints, knees, and hips; and low-grade fever.

She has not had joint swelling, chest pain, or shortness of breath. Over the past 4 years, she has …

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MKSAP: 63-year-old woman with a 4 week history of fatigue

Google affects how clinicians and the public collect diagnostic information

Conditions and Diseases
April 12, 2011

My Google Reader accidentally picked up an intriguing abstract that examined a research study of resources that medical students use in solving diagnostic cases.

The abstract was picked up because it contained the word “exercise” that is one of my PubMed filter queries.  Although we often think that most diagnostic decision-making occurs from learned information stored in physician’s brains, information resources can …

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Google affects how clinicians and the public collect diagnostic information

Are memory loss and mood disorders actually diabetes of the brain?

Conditions and Diseases
April 9, 2011

An excerpt from Feed Your Brain Lose Your Belly.

by Larry McCleary, MD

As diseases, memory loss and mood disorders appear to have very little in common. But could memory loss (even severe memory loss such as that which occurs in Alzheimer’s disease) and mood illnesses such as depression and bipolar disorder, actually be treated much the same …

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Are memory loss and mood disorders actually diabetes of the brain?

7 procedures that can affect the way you breathe and sleep

Conditions and Diseases
April 9, 2011

Millions of surgical operations are performed every year to improve your health, beauty, and even your smile, but there’s a hidden danger in some of the most common procedures that can aggravate if not actually cause obstructive sleep apnea.

Sleep apnea happens when your jaws are too narrow, which constricts the internal soft tissue layer that lines your upper breathing passageways, from …

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7 procedures that can affect the way you breathe and sleep

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