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Prescription Opiate Abuse On The Rise

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Prescription opiates rose to one-third of all treatment admissions in 2009, from 8% in 1999, reflecting the rising trends in prescription opiate abuse. There were nearly 2 million substance abuse treatment admissions in 2009 among people ages 12 and older were reported to the Treatment Episode Data Set, a reporting system involving treatment facilities from across the country.

Five substance groups accounted for 96% of admissions: alcohol (42%), opiates (21%), marijuana (18%), cocaine (9%), and methamphetamine/amphetamines (6%), reported the Substance Abuse and Mental Health Services Administration. The data came from 49 states and Puerto Rico. Georgia and the District of Columbia did not report admissions for 2009. One person can be reported as multiple admissions in a year.

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*This blog post was originally published at ACP Internist*

Loss Of Consciousness From Vigorous Laughter: A Case Series

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Laughter is the best medicine, and now, here’s the best medicine to treat laughter. Fainting from laughter happens, albeit rarely, and is probably a vasovagal response, reports a case series in the medical literature.

Dubbed “Sitcom Syncope,” the series of three patients and a literature review of other cases evaluated patients who reported loss of consciousness during vigorous laughter. The series was reported by Prashan H. Thiagarajah, MD, an ACP Associate Member at the Allegheny General Hospital in Pittsburgh, Pa., and colleagues in Postgraduate Medicine.

The three patients reported seven fainting spells induced by vigorous laughter that were witnessed friends or family.

All patients were hospitalized and underwent a complete history and physical, 12-lead echocardiogram, chest radiograph, routine blood analysis, transthoracic echocardiography, Holter monitoring, carotid duplex study, stress testing, polysomnography, and head-up tilt table testing. In each cases, structural heart disease and cerebrovascular disease were ruled out. Read more »

*This blog post was originally published at ACP Internist*

Beware Of Potatoes: They May Cause You To Pack On Pounds

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Chips

Without meaning to, you’ve gained a few pounds over the last few years. How did that happen? Certain foods, especially the humble potato, may be partly to blame.

In a fascinating study of 120,000 healthy, non-obese women and men taking part in long-term studies of diet and health, the participants gained an average of 3.3 pounds every four years over a 13-year period. When the researchers tallied up the foods that contributed most to this weight gain, potatoes topped the list—twice:

  • potato chips
  • potatoes
  • sugar-sweetened beverages
  • red meat
  • processed meats

Other contributors to weight gain included sleeping less than six hours a night or more than eight hours, drinking alcohol, and watching television. The results were just published in The New England Journal of Medicine.

The study offered some good news and tips for losing weight, too. Foods and lifestyle choices associated with losing weight included Read more »

*This blog post was originally published at Harvard Health Blog*

Does Accutane Cause Inflammatory Bowel Disease? The Evidence Is Weak

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At home the kids’ current TV show of choice is How I Met Your Mother, supplanting Scrubs as the veg out show in the evening. Both shows are always on a cable channel somewhere and are often broadcast late at night. Late night commercials can be curious, and as I work on projects, I watch the shows and commercials out of the corner of my eye.

Law firms trolling for business seem common. If you or a family member has had a serious stroke, heart attack or death from Avandia, call now. The non-serious deaths? I suppose do not bother. One ad in particular caught my eye: anyone who developed ulcerative colitis or Crohn’s disease (collectively referred to inflammatory bowel disease, or IBD) after using Accutane, call now. Millions have been awarded.

My eye may have been caught because of my new progressive lenses, but I will admit to an interest in inflammatory bowel disease, having had ulcerative colitis for years until I took the steel cure. It also piqued my interest as these were three conditions among which I could not seen any connections. Accutane, ulcerative colitis, and Crohn’s. One of these is not like the other. Read more »

*This blog post was originally published at Science-Based Medicine*

A Rare MRI Finding In Multiple Sclerosis

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Gray matter (GM) damage, in terms of focal lesions,1 “diffuse” tissue injury, and atrophy is a well-known feature of multiple sclerosis (MS). Recently, T1-hyperintensity on unenhanced T1-weighted sequences has been found in the dentate nuclei of patients with MS with severe disability and high T2 lesion load.2 Such an abnormality has been interpreted as an additional sign of the neurodegenerative processes known to occur in the course of MS. This report describes a patient who, despite being mildly disabled and having a low T2 lesion load and no evident brain atrophy, showed a bilateral dentate nucleus T1 hyperintensity.

The patient was a 44-year-old man who had a diagnosis of relapsing-remitting MS (RRMS) in September 1997, after 3 relapses that occurred in June 1995, March 1997, and September 1997. Brain and cord MR imaging and CSF examination were suggestive of MS. After the diagnosis, he started treatment with interferonβ-1α, with clinical stability until January 2009, when he complained of vertigo, which gradually resolved after 5 days of steroidtreatment (methylprednisolone, 1 g daily intravenously). In September 2010, he entered a research protocol and underwent neurologic and neuropsychologic (Rao Brief Repeatable Neuropsychological Battery) evaluations and brain MR imaging on a 3T scanner. The neurologic examination showed Read more »

*This blog post was originally published at AJNR Blog*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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