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.
by Lone Hummelshoj
Earlier this year, we finished a month dedicated to women and mothers. In the U.S., we celebrated “National Women’s Health Week” and before it Mother’s Day. One study suggested Americans would spend a total of $14.6 billion in May alone to honor our mothers. And we should honor our mothers!
However, for millions of women with endometriosis, motherhood is elusive. In fact, an estimated …
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For women with endometriosis, motherhood is elusive
Cancer prevention is built around screening. In screening, the hope is to catch cancer at an earlier stage than it would be found otherwise and increase options for treatment and chances of cure. In some cases, screening prevents cancer — for example, when a precancerous polyp is removed from the colon during colonoscopy — but generally it is aimed at early detection.
What if instead we could prevent cancer from developing …
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Tamoxifen for breast cancer prevention is not routinely used
The New England Journal of Medicine recently published a troubling article on acupuncture, which was ably deconstructed by Dr. Mark Crislip. This incident has reignited a discussion of what, exactly, “placebo” is.
A common argument is that placebo is like any other intervention, something that can be intentionally harnessed for the benefit of patients. This is both true and overly simplistic.
First, we must review what “placebo” …
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Is placebo a therapy, like surgery or medication?
Continuous fetal heart rate monitoring is at its core an almost laughable idea.
We are checking a single vital sign and using that vital sign to extrapolate a host of ideas and meanings. OBs that have read strips for years can make some sense of them, but would we give so much meaning to any other single vital sign? Would we do it with an adult? Of course not, but there …
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Fetal heart rate monitoring is given too much importance
Insanity: Doing the same thing over and over and expecting different results.
– Albert Einstein
As medical students rotating through the wards, we spent a significant portion of each day ordering laboratory tests and then chasing down the results. We wanted to investigate our patients’ illnesses and, just as importantly, we wanted to be prepared for any question with which our professors might surprise us during Attending Rounds.
One day, as I was …
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Before ordering a test, know what to do with the result
Everyone knows that the heart health of Americans is dismal. Obesity, diabetes, and high blood pressure are all on the rise.
For now, technological advances in cardiac care continue to maintain, or in some cases, lower the death rate from heart disease. Squishing blockages, ablating abnormal heart tissue, and installing cardiac devices have successfully kept the abysmal lifestyle habits of so many at bay. Despite all the fury of modern technology …
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Heart health depends on healthy behaviors
by John Gever
Elderly people who are depressed may be at twice the risk of developing dementia or Alzheimer’s disease over time — but it’s unclear whether depression causes dementia or vice versa, researchers said.
Among more than 900 participants in the original Framingham Heart Study, almost 22% of those who were depressed when screened between 1990 to 1994 were diagnosed with dementia over 17 years of follow-up, compared with 16.6% of …
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Depressed elderly at risk for dementia or Alzheimer’s disease
by Leonard R. Friedman, MD
In diagnosing areas of chronic pain for adult pain management, I have come across a helpful test which I have unable to peer review.
It is the Draw a Person test. Pain management physicians have not used this easily identifiable test to evaluate the subconscious of the patient. This is done by asking the patient to draw a male and a female, with …
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Draw a Person test to help with pain management diagnosis
Summer has already begun, and LeeAnn has already had enough of mosquitoes. She wants to know, “Does taking Vitamin B1 really help keep mosquitoes from biting? How much is safe for children?”
I remember a trip to the Florida Everglades as a child with school—surrounded by mosquitoes, alligators, and miles of swamp, our teachers told us that mosquitoes are a vital part of the food chain, and essential to the ecosystem.
I …
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How to prevent and treat mosquito bites in children
by Todd Neale
Postmenopausal women of any age with a 10-year fracture risk equal to or greater than that of a 65-year-old woman and no other osteoporosis risk factors should be screened for the disease, according to draft guidelines from the U.S. Preventive Services Task Force (USPSTF).
The 2002 USPSTF guidelines recommended routine screening only for women ages 65 and older, as well as women ages 60 to 64 with an increased …
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New osteoporosis screening guidelines from the USPSTF
It’s exceedingly uncommon for a healthy middle-aged man to walk into his doctor’s office and demand a colonoscopy. But even though he lacked a family history, Stanley Thornton, an African-American engineer who was then in his mid-40’s, wouldn’t take no for an answer.
“I was concerned that African-Americans do get colorectal cancer earlier, and I said, ‘hey, let me lead by example,’” he said recently. “We argued about it for a …
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Colonoscopy and other screening options for colon cancer
by John Gever
So-called cyberbullies share many of the psychosocial features as their victims — and in fact many bullies were also victims themselves, researchers from Finland said.
A population-based cross-sectional study surveyed more than 2,000 seventh- and ninth-graders in two Finnish communities and found that cyberbullies had higher than average rates of self-perceived difficulties in life, headache, feeling unsafe at school, and perceiving teachers as uncaring, among other problems, reported Andre …
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What cyberbullies have in common with their victims
One of my medical school professors was an internationally renowned subspecialist, whose ward occupied the entire top floor of the medical tower at Academy Hospital in Uppsala.
He had cadres of residents working for him, and for two glorious months I rotated through his ward as part of my internal medicine training in medical school.
One thing that stands out in my memory, to this day, from those two months is how …
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Male hormone treatment and testosterone replacement concerns
by Michael Smith
It’s not just TV — video games are also associated with an increased risk of attention problems in children, researchers said.
A large study found that children who spent more than three hours in front of a computer or television screen — whether playing video games or watching TV — were significantly more likely to have attention problems, according to Edward Swing, MS, of Iowa State University in Ames, …
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Video games are linked with attention problems in children
by Diana E. Lee
Last year, People published an interview with Cindy McCain, wife of U.S. Senator John McCain of Arizona.
She revealed she has dealt with excruciating migraine attacks for about 15 years, including during her husband’s presidential campaign. Though she has never discussed them publicly before, she has chosen to talk about her situation now to help bring awareness to this disabling condition and all the people going through what …
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Is migraine pain comparable to torture?
I’ve been interested in the role of testosterone in physical performance, depression and aging for many years. While at the University of Iowa, I was involved in research to detect testosterone doping, the psychological effects of testosterone and the potential for testosterone to alleviate depression in older men.
One of the difficult questions facing clinicians is when is testosterone too low in older men.
One problem with answering this question is the …
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Testosterone and when should low levels be treated in older men
Zahia Esber, ACP Associate Member, who practices at McKenzie-Willamette Medical Center in Eugene, Ore., told us about a case of a 71-year-old obese woman whose mental status deteriorated rapidly while in the hospital.
The patient had undergone a sigmoid resection in December 2009 for colon cancer. At that time, her mental status was intact. Three weeks after surgery, she returned to the hospital because of nausea and anorexia. She told the …
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Attribution error in a patient with colon cancer
Unlike climate change, where there’s a large contingent of denialists who spread doubt about the scientific evidence, no one denies that antibiotic resistance is a problem. There is controversy, however, on the question of just how much the widespread use of antibiotics contributes to the problem.
The mechanism is not in dispute: If you expose bacteria to antibiotics, they will mutate to become resistant. But “overuse” of antibiotics is not the …
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Bacterial resistance to chronic antibiotics, and why it’s a problem
I received a very troubling phone call from a close friend recently. He underwent a study, at the age of 40, and the physician came out of the procedure and said, “you have a large tumor, do you want me to call a surgeon for you.”
The purpose of this post is not to comment on the physician’s behavior or delivery techniques, but to define this very precarious and anxiety producing …
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Minimize patient waiting after a potential cancer diagnosis
A 35-year-old man is evaluated for red eye and acute onset of right eye pain. He wears contact lenses daily. Fluorescein staining is positive for corneal abrasion without a dendritic, or branching, pattern. He is instructed to stop wearing the contact …
