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.
Are you one of those people who simply cannot concentrate for long enough? Do you find that no sooner than you start doing something, that your attention is scattered all over the place? Do you find that you log onto your computer and within minutes are surfing every possible tangential site that you find?
Your problem may not be a problem with your attention. In fact, it may be that the …
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Your attention deficit disorder may be an anxiety disorder
Many patients erroneously believe that x-rays and CAT scans have no risk.
In their minds, they are non-invasive studies that can cause no harm. Since there are no incisions or anesthesia, they regard the experience as having the same risk as taking a family photograph. How wrong they are. In my mind the danger from non-invasive radiology studies may surpass the risk of hard core medical treatment. True, radiology tests won’t …
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CT scans and x-rays draw patients into risk and overutilization
Advocates of alternative health attribute all sorts of fantastical properties to the human body. The body supposedly “knows” how to live a long healthy life; the body is supposedly “designed” to work perfectly. The tenets of natural childbirth philosophy also invoke these fantastical properties. The body “knows” how to give birth; a woman’s body is “designed” to give birth.
On their face these claims are obviously false. The body doesn’t “know” …
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Natural lifespan and whether a woman is designed to give birth
I’m becoming more of a believer in giving children probiotics. Not for everything and not for everyone; I really don’t think we should put them in the water.
Probiotics, essentially live “good” bacteria we use to supplement our diet (usually Lactobacillus Acidophilus in the US), are becoming more and more available and recommended by more and more physicians. The role microbes play in our health is a hot …
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Giving children probiotics
by Paul M. Cinciripini, PhD
If you smoke, quitting the habit is the best New Year’s resolution you could make — and keep — in 2011. That’s true even if you’re just a social smoker.
A new report from the Surgeon General shows that even occasional smoking and secondhand smoke cause immediate damage to the body.
The good news is that people who stop smoking before age 50 cut their risk of dying …
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Quit smoking in 2011: 5 steps you need to know
by VeronicaB, MD
A baby died today; a very small infant. One minute I’m excited by the end of my overnight shift quickly approaching, and the next I am hearing the words you never want to hear come over the radio, “En route to home for infant not breathing.” I think the whole ED staff stopped for a minute waiting for the next report.
Then we begin to …
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Infant resuscitation in the ED
About 60% of patients suffering from depression do not find any benefit from their first antidepressant. Up to 20% of patients find depression impossible to overcome even after 1 year. Assertive treatment of depression from the get go is essential to helping recover from depression.
Psychiatrists don’t have a shared definition of treatment resistant depression. However, most would agree that your depression may be treatment resistant if it has not resolved …
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Solving treatment resistant depression
Call it the McVictim syndrome. Too many pundits, public health experts and politicians are working overtime to find scapegoats for America’s obesity epidemic.
In his latest book, former FDA Commissioner David A. Kessler argues that modern food is addictive. In it, he recounts how he was once helpless to stop himself from eating a cookie. In a paper in this month’s Journal …
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Obesity patients are not victims
“Dr. Roy, you’ve got to help me!”
The most heartfelt pleas I ever hear from parents are for three things:
- The three year old who won’t use the potty—so can’t register for school.
- The 15 month old who still isn’t sleeping through the night.
- The school-aged girl(s) with recurrent lice.
Parents hate the idea that their child has lice. They’re icky, they’re crawly, and even talking about them makes everyone in the room start scratching. …
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How to find and treat lice in children
The mole on Ivis Febus-Sampayo’s face looked odd. But it wasn’t until her son needed treatment for acne that she went to a dermatologist.
“As mothers, we’re working, we’re busy,” she said. “I forgot about me and called the dermatologist to make sure my son was getting taken care of.”
The doctor removed a sliver of the mole, and reassured Ivis that it was probably nothing to worry about. Two weeks later, …
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Check for skin cancer and melanoma, even with dark skin
by Diana E. Lee
It sounds like NFL Wide Receiver Percy Harvin (Minnesota Vikings) is one of the luckier chronic migraine patients out there.
He was actually able to identify a specific reason for his drastically increased number of migraine attacks (sleep apnea) and implement a treatment that seems to be helping (CPAP). He is performing solidly and confidently and taking contact without any issues.
I know a …
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Percy Harvin and how sleep apnea affected his migraine headaches
The September issue of Journal Watch General Medicine included an article from the American Academy of Pediatrics about new criteria for diagnosis and management of concussions in children and adolescents.
Shortly after this issue was published, a segment aired on ESPN regarding a confrontation between the head football coach at Texas Christian University and its team physician over holding a player out of the game due to a concussion.
As a sports …
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Playing hurt and when to return to football after a concussion
Reading the newspapers and watching the news lately would lead you to believe that screening for cancer is largely a waste of time.
Yet, in the same week that the NEJM published Norwegian data showing a remarkably small survival benefit of 2% associated with screening mammography, HealthDay reported a decrease in cancer incidence of almost 1% per year from 1999 to 2006 and a decrease in cancer deaths …
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Early detection and improving cancer cure rates
Temperament is generally defined as innate early emotional and behavioral characteristics that precede puberty and adult development. Felt to have significant genetic components, temperament is also potentially influenced by environmental factors.
There are a variety of temperament domains that have received significant attention in childhood, adolescent and adult populations.
Some of the most commonly studied domains include:
- neuroticism
- harm avoidance
- novelty seeking
- reward dependence
- perfectionism (subdomains have included: concern about mistakes, personal standards, doubts about actions, organization
The …
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Temperament of perfectionism in anorexia nervosa
B12.
Sounds simple, huh?
1 letter, 2 numbers. One of the B vitamins. It’s important in a number of body functions, particularly the nervous system and blood cell production. It’s in pretty much all meats and vegetables, and multivitamins you can buy.
To me, it’s also a good example of what’s wrong in health care.
Let’s take Mrs. Olde.
She goes to her internist, and is complaining of feeling weak and tired. So he checks …
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Redundant tests waste health care dollars
It had been a high-speed motor-vehicle accident. One car. A twenty-something male driver without passengers. No seat belt. And now, this same driver had no movement from his waist down and no sensations below his mid-abdomen.
According to bystanders, he had been driving his sedan dangerously fast, some estimates of nearly 100 m.p.h., before losing control. The car veered off the roadway to the right, flipping mid-air before smacking head-on into …
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Priapism is indicative of spinal cord injury in trauma
Have you ever wondered by some people never get colds? Why do other people get colds at the drop of a sneeze?
An opinion piece recently published in the New York Times explains away a common myth—that you have to strengthen your immune system to fight a cold. His argument is that your symptoms of a cold are actually your immune system over-reacting to harmless viruses. This is …
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Sleep-breathing, your immune system, and colds
Recently, medical writer and pediatrician Perri Klass wrote in the New York Times about evolving issues regarding the diagnosis of appendicitis in children, which are also applicable to adults. There is well-documented concern regarding the excessive radiation exposure associated with CT scans.
For example, a recent paper reported that a single abdominal CT scan with contrast delivers a radiation dose equal to undergoing more than 200 regular …
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Appendicitis in children and radiation exposure from CT scans
by Shelley Carson, PhD
Both highly creative individuals and ADHD-diagnosed individuals often report feeling out of place, like a square peg in a round hole.
(In fact, in my creativity research questionnaires I actually ask the question “Do you often feel like a square peg in a round hole?” Participants who score high on the Creative …
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Creativity and ADHD may share some common genetic vulnerabilities
A 70-year-old woman with hypothyroidism fell and fractured her hip. During preoperative evaluation for hip fracture repair, she mentions recent mild fatigue, which has not significantly limited performance of her daily activities, and ongoing right upper-quadrant abdominal pain after eating. She takes levothyroxine, 0.075 …
