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.

Linking the USPSTF mammogram guidelines to their virtual colonoscopy recommendations

Kevin

January 7, 2010

by Mark E. Klein, MD

“I think anytime you use science to kind of fundamentally change what people are used to, I think it’s a difficult thing to grapple with.” So spoke Ned Calonge, chair of the United States Preventive Services Task Force (USPSTF) in explaining the reaction to that group’s recommendation to radically alter their previous guidelines for breast cancer screening. Regrettably the incorrect application of science, as in …

How effective is CA 125 and other biomarkers to screen for ovarian cancer?

Kevin

Conditions and Diseases

January 7, 2010

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

Rising blood levels of several biomarkers show the presence of ovarian cancer — just not early enough.

That’s the conclusion of a retrospective longitudinal case-control study of levels of half a dozen proteins linked to the disease, according to Garnet Anderson, PhD, of the Fred Hutchinson Cancer Research Center in …

Despite no cure, progress in the treatment of HIV/AIDS

Kevin

Conditions and Diseases

January 6, 2010

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

It’s 1984. A 20-year-old homosexual man walks into the clinic complaining of swollen glands.

It could well be a death sentence.

It is only three years since the first handful of cases of what would come to be known as acquired immune deficiency syndrome (AIDS) were described. Little is known about …

How patients are dying from H1N1 infection

Kevin

Conditions and Diseases

January 5, 2010

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

Brazilian researchers have found three distinct patterns of lung damage in patients who died of the H1N1 pandemic flu.

They also found evidence of a so-called “cytokine storm,” a runaway immune response associated with the lung damage, according to Thais Mauad, MD, PhD, of Sao Paulo University Medical School, …

How can medical guidelines be immune from politics?

Marya Zilberberg, MD, MPH

Conditions and Diseases

January 4, 2010

The recent uproar over the new screening mammography recommendations got me thinking about a lot of stuff. One of the lessons cited by some journalists and pundits is on how potentially volatile information should be presented to the public. The USPSTF was excoriated by critics not only for what it said, but how it said it. While the objections over the former can be dismissed as ravings of loud and …

What’s the most popular way to diagnose a pulmonary embolism?

Kevin

Conditions and Diseases

January 4, 2010

Originally published in MedPage Today

by Chris Emery, MedPage Today Contributing Writer

Emergency physicians and radiologists overwhelmingly choose computed tomography (CT) imaging to diagnose pulmonary embolism, a potentially deadly blockage of lung arteries, a new study found.

Ninety percent of radiologists and 96% of emergency physicians use CT as their first-line choice for the diagnosis of pulmonary embolism, according to a report …

Why are women refusing an MRI to screen for breast cancer?

Kevin

Conditions and Diseases

December 30, 2009

Originally published in MedPage Today

by Crystal Phend, MedPage Today Senior Staff Writer

Many women at elevated breast cancer risk may refuse MRI as part of their screening program, largely because of fear and inconvenience, researchers found.

Among eligible women with dense breasts who were at intermediate to high risk for breast cancer, 42.1% refused additional MRI screening as part of a …

How to find the best cancer specialist for you

Kevin

Conditions and Diseases

December 29, 2009

by Dana Griffen

Receiving a cancer diagnosis is an upsetting experience for the patient, as well as his or her family and friends. Cancer patients are thrust into a new world with new language and new rules. Knowing where to turn and who you can trust is a huge concern.

One of the first things a cancer patient will discover is that he or she will not be treated by only one …

Smoking related diseases are the number one cause of death in African-Americans

Erin Marcus, MD

Conditions and Diseases

December 28, 2009

Lawrence Jones started smoking Kool Menthols when he was playing Rhythm and Blues in the ‘70s, as a way of fitting in with his bandmates and the in crowd at the clubs where he played.

The band broke up after a few years, but the cigarettes remained. Instead of being a way to look sophisticated, smoking became a means for Jones to relax and, he says, to feel he was “in …

A review of the latest stroke studies

Kevin

Conditions and Diseases

December 23, 2009

Originally published in HCPLive.com

by Victor G. Dostrow, MD

There are some recent developments in the world of stroke, which are interesting:

The first manuscript is an evaluation of stroke risk and the “stroke belt” (North Carolina, South Carolina, Georgia, Tennessee, Arkansas, Mississippi, or Alabama).

The authors evaluated stroke risk measured over three decade census intervals for persons aged 30 to 80, based on …

Read more…

A review of the latest stroke studies

How constant H1N1 breaking news updates may be going too far

Jeffrey Hall Dobken, MD, MPH

Conditions and Diseases

December 23, 2009

Originally posted in MedPage Today

She is 11, a fifth grader, as prepubescent as nature allows, and utterly terrified.

She hasn’t eaten normally for nearly a month, her mother reports. She sleeps poorly, reports nightmares, and cleans her hands so obsessively that she is literally bleeding raw.

Her fifth grade peer group typically does not guard its language nor govern its remarks, …

Is the end of pandemic H1N1 flu near?

Kevin

Conditions and Diseases

December 20, 2009

Originally posted in MedPage Today

by Crystal Phend, MedPage Today Senior Staff Writer

The end of the so-called second wave of pandemic H1N1 influenza may be in sight as testing rates — and the number of positive tests for the virus — show evidence of decline across the country, a report affirmed.

From their peak in late October, diagnostic H1N1 testing rates …

Read more…

Is the end of pandemic H1N1 flu near?

How can quitting smoking improve lung function in patients with asthma?

Kevin

Conditions and Diseases

December 18, 2009

Originally published in MedPage Today

by Chris Emery, MedPage Today Contributing Writer

Asthmatic smokers who quit the habit can reverse lung damage that exacerbates their breathing difficulties, regardless of how long and how often they smoked in the past, a Dutch study found.

The lungs of asthmatics who stopped smoking were in similar condition to those of asthmatics who never smoked, based …

What women should know about the new mammogram guidelines

Erin Marcus, MD

Conditions and Diseases

December 17, 2009

Whenever I order a mammogram for a woman in her 40’s, I also give her a warning: “Don’t get scared if it’s abnormal.” I tell her this because research shows that a woman who undergoes 10 routine screening mammograms has a 50-50 chance of having something unusual that requires her to go for more tests. The vast majority of these mammographic abnormalities aren’t cancer, but she still needs to get …

Explaining basic radiation therapy terms to cancer patients

Kevin

Conditions and Diseases

December 17, 2009

Originally posted in HCPLive.com

by Colleen O’Leary, RN, MSN, AOCNS

I have always been very intrigued by the various forms of radiation therapy and used to relish the day that I would take my basic oncology class to the radiation oncology department for a tour. I learned something every time. But now, with the advent of new technology and the trend for facilities to advertise that they have the biggest and best …

Why juvenile delinquency may lead to poor adult health

Kevin

Conditions and Diseases

December 12, 2009

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

Bad boys grow up to be sick men, researchers say.

In a long-running British study of juvenile delinquency in boys, death and disability at age 48 were strongly linked to antisocial behavior in youth, according to Jonathan Shepherd, PhD, of Cardiff University in Wales, and colleagues.

The imbalances in mortality and disability …

Some patients won’t accept a conservative approach to medical treatment

Michael Kirsch, MD

Conditions and Diseases

December 12, 2009

by Michael Kirsch, MD

Who says one person can’t make a difference? This past week, I personally set back health care reform. No, I wasn’t attending a ‘tea party’ or decrying Obamacare in a venomous letter to the editor. I single-handedly bent the health care cost curve in the wrong direction. I performed an unnecessary medical test on a hospitalized patient, which exposed her to risk and cost the system money. …

Is constipation a sign of early Parkinson’s disease?

Kevin

Conditions and Diseases

December 11, 2009

Originally published in MedPage Today

by Charles Bankhead, MedPage Today Staff Writer

Constipation may represent one of the earliest signs of Parkinson’s disease, preceding the onset of motor symptoms by two decades or more, data from a case-control study suggest.

Patients with Parkinson’s disease were more than twice as likely to report a history of constipation compared with a control population. The …

Should body mass index (BMI) be used as a college graduation requirement?

Amy Tuteur, MD

Conditions and Diseases

December 10, 2009

It’s official. America hates fat people.

Human beings are constantly searching for socially sanctioned reasons to feel superior to others and in 2009, those who are thin feel mighty superior to those who are not. How else could a college dare to make body mass index (BMI) a graduation requirement?

According to James DeBoy, the chair of Lincoln’s Department of Health, Physical Education, and Recreation, the point of the new policy is …

How well can doctors diagnose child abuse from bone fractures?

Kevin

Conditions and Diseases

December 10, 2009

Originally published in MedPage Today

by Chris Emery, MedPage Today Contributing Writer

Physicians often misdiagnose bone fractures caused by child abuse as accidental breaks, particularly if the child is male and the doctor is not a pediatrician, a new study found.

Of children who suffered fractures from abuse, about 20% had at least one previous medical visit during which a doctor missed …