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.

Don’t wait for the H1N1 vaccine before you get your flu shot

MedPage Today

September 15, 2009

by Cole Petrochko, Staff Writer, MedPage Today

Don’t wait for the pandemic H1N1 vaccine to become available before getting an inoculation for seasonal flu, the National Foundation for Infectious Diseases warned.

Putting off routine flu shots in hopes of one-stop-shopping would defeat the primary line of defense against a proven threat, according to a panel representing some of the nation’s …

What does Tiger Woods have to do with medical futility and end-of-life care?

Michael Kirsch, MD

Conditions and Diseases

September 14, 2009

by Michael Kirsch, MD

Consider this hypothetical vignette. Tiger Woods accepts my challenge to play 18 holes. Obviously, the gallery would be packed with golf enthusiasts who would cancel job interviews, vacations and even worship services in order to witness this historic competition. Spectators would be permitted to place bets at even money. Perhaps, my mother would bet on me, but no other sane person would. They would properly conclude that …

AMA: How to prepare for seasonal and H1N1 influenza

Kevin

Conditions and Diseases

September 10, 2009

The following is part of a series of original guest columns by the American Medical Association.

by Nancy H. Nielsen, MD

This year’s flu season promises to be different than in years past. With the potential of both seasonal and H1N1 influenza circulating this year, it is more critical than ever that health care professionals proactively talk to their patients about influenza.

Many patients will be confused about who needs the H1N1 …

A routine brain MRI can lead to incidental findings

MedPage Today

Conditions and Diseases

September 10, 2009

by Nancy Walsh, Contributing Writer, MedPage Today

Almost 3% of healthy, asymptomatic people who underwent MRI brain scans showed incidental abnormalities in a recent study, leading researchers to express concern about psychological and medical fallout from these increasingly popular screenings.

In meta-analysis of MRI brain scans, the prevalence of neoplastic incidental findings was 0.70% (95% CI 0.47 to 0.98), while the …

The value of a cancer diagnosis second opinion

Wendy S. Harpham, MD

Conditions and Diseases

September 8, 2009

Here are words any patient awaiting cancer surgery would be thrilled to hear: “We are canceling your upcoming operation! It turns out that the suspicious changes we saw on your recent biopsy are completely benign.”

This happy turn of events happened in my life recently, thanks to a second opinion from a type of physician few patients realize plays a critical role in their care: the pathologist.

Pathologists are medical doctors who …

What Mozart can teach us about superbugs and antibiotic resistance

Kevin

Conditions and Diseases

September 6, 2009

by Maya Sequeira

Composer Wolfgang Amadeus Mozart’s death in 1791 has long been a mystery, but a new study published in the Annals of Internal Medicine suggests that it was, of all things, a common strep infection that killed the maestro at the age of 35.

Researchers speculate that Mozart contracted the strep infection—easily treatable today—from a fellow musician who had been hospitalized at a crowded military hospital in Vienna. It’s not …

The drama of using tPA in stroke within the three-hour window

Doctor Grumpy, MD

Conditions and Diseases

September 6, 2009

Before telling this story, I’m going to have to lay some background for my non-medical readers.

The most obscene word in English, in my opinion, has three letters and is an acronym. It’s tPA (it stands for Tissue Plasminogen Activator).

This drug gets a lot of press as a “clotbuster.” It has the potential to break down clots and reverse a stroke. That potential, however, has a dark side. By breaking down …

eRoentgen for the iPhone puts a radiologist by your side

Kevin

Conditions and Diseases

September 5, 2009

The following is a sponsored guest post by Constantine Brocoum, a radiologist in Concord, NH. I have personally used eRoentgen, and recommend the product without reservation.

by Constantine Brocoum, MD

Like most inventions, eRoentgen was developed to respond to a need. As a practicing radiologist, I take frequent calls from primary care providers who need assistance in choosing the smartest way to diagnose their patients’ illnesses. They often need …

Why following a delayed vaccine schedule may be dangerous

Kevin

Conditions and Diseases

August 29, 2009

by Steve Perry, MD

I recently read a post by Dr. Bob Sears which listed several “Vaccine Friendly Doctors” in Colorado and across the nation.

As a pediatrician and vaccine advocate, I thought I’d be on this list. I am “vaccine-friendly doctor” who works with moms and dads to find the best health care plan for their babies. I read the information on both sides of the issue and weighed the science …

Increasing radiation exposure to patients from CT scans and other imaging tests

Kristina Fiore

Conditions and Diseases

August 28, 2009

by Kristina Fiore, Staff Writer, MedPage Today

Imaging procedures can expose patients to high cumulative doses of radiation, researchers say.

In a large study, 193.8 people per 1,000 were exposed to moderate doses of radiation each year, while 18.6 per 1,000 were exposed to high doses, and 1.9 per 1,000 received very high doses, according to Reza Fazel, MD, of …

New troponin tests to better diagnose a heart attack

Crystal Phend

Conditions and Diseases

August 27, 2009

by Crystal Phend, Senior Staff Writer, MedPage Today

A generation of new, more sensitive troponin assays has improved hospitals’ ability to diagnose a heart attack to a point as early as the time of emergency department presentation, two separate studies affirmed.

In one multicenter study, a sensitive troponin I assay had an early diagnostic accuracy of 96%, compared with conventional …

Is Caster Semenya a woman, and the issues surrounding androgen insensitivity syndrome

Kevin

Conditions and Diseases

August 26, 2009

Caster Semenya is the South African track and field star who recently was engulfed in controversy at the recently concluded World Track and Field Championships.

Turns out, there are some who are questioning her gender, and subsequently, tests are being conducted to see if she is really a woman.

It’s not as cut and dry as it appears.

Consider the possibility of Read more…

Is Caster Semenya a woman, and the issues surrounding androgen insensitivity syndrome

Michael Jackson dead from propofol, is Dr. Conrad Murray solely to blame?

Kevin

Conditions and Diseases

August 24, 2009

Recent reports have said that Michael Jackson died from a propofol overdose. Is that really the case?

Here’s what happened, according to the published timeline.

— At about 1:30 a.m., [Dr. Conrad] Murray gave Jackson 10 mg of Valium.
— At about 2 a.m., he injected Jackson with 2 mg of the anti-anxiety drug Ativan.
— At about 3 a.m., Murray then administered 2 mg of the sedative Versed.
— At about 5 …

Read more…

Michael Jackson dead from propofol, is Dr. Conrad Murray solely to blame?

Do patients really need their complete lab and radiology reports?

Kevin

Conditions and Diseases

August 21, 2009

Most prefer the bottom line, sparing them the raw data.

Primary care physician Rob Lamberts asks that exact question, and reprints sample reports of lab tests and an echocardiogram, demonstrating the wealth of information they contain.

So, borrowing this image from Dr. Rob, I’m not sure how useful something like this would be to patients (sorry for the small type, but you get the idea):

How soon should patients receive their test results?

Kevin

Conditions and Diseases

July 9, 2009

And should you assume that no news is good news?

The answer is no. According to a study in the Archives of Internal Medicine, 7 percent of abnormal test results from primary care offices were never reported to the patient. And in a large, unnamed, academic medical center, that number ballooned to 23 percent.

That’s almost a quarter of abnormal test results from that center that patients were never …

Did Demerol cause Michael Jackson’s cardiac arrest and death?

Kevin

Conditions and Diseases

June 26, 2009

Michael Jackson’s death continues to consume the news cycle.

There is currently no clear explanation. Some have speculated that it may be related to the narcotic pain drug, Demerol. According to this report from the UK’s The Sun, “An Emergency Room source at UCLA hospital said Jackson aides told medics he had collapsed after an injection of potent Demerol …

How did Michael Jackson die, and the medicine behind sudden cardiac death

Kevin

Conditions and Diseases

June 25, 2009

Michael Jackson is dead at age 50.

I’ve received several e-mails to comment on this story, but there’s really too few details to go on. I’m sure more will emerge in the near future.

According to news reports, emergency medical services were called to his home in Los Angeles, where he was found in presumed cardiac arrest. CPR …

Steve Jobs received a new liver, and the ethics surrounding his transplant

Kevin

Conditions and Diseases

June 22, 2009

Orac, a general surgeon who blogs at Respectful Insolence, writes the most comprehensive entry I’ve seen thus far on Apple’s Steve Jobs’ liver transplant.

For those interested in the medicine behind the transplant, go and read his post in its entirety. I’d like to highlight some of the potentially questionable ethics surrounding the case.

For one, there is the question why Mr. …

Op-ed: Not all screening tests lead to early, better treatment

Kevin

Conditions and Diseases

April 23, 2009

The following op-ed was published on April 23rd, 2009 in the USA Today.

As a primary care doctor, it’s heartening to hear President Obama call for “the largest investment ever in preventive care.” That means more people, for one, will be undergoing tests to screen for various forms of cancer. But this might be one of those cases where what sounds like common sense is actually more …

Why do I need a rectal exam, and what can doctors find with the gloved finger?

Kevin

Conditions and Diseases

March 6, 2009

Have you ever wondered why doctors have to perform a digital rectal exam?

Well, look no further, as primary care doctor Rob Lamberts gives us the answers discerning readers demand.

Simply by looking at the rectum, which by the way, indeed “takes some getting used to,” can lead to significant diagnostic findings. Furthermore, does tight sphincter tone matter? And should you be worried about the large hands …

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