February 8th, 2011 by GarySchwitzer in News, Research
Tags: Antidepressants, Emotional Health, Gary Schwitzer, HealthNewsReview.org, Jina Pagura, Journal of Clinical Psychiatry, Major Depression, Mental Health, Mental Illness, Overprescribed Medications, Prescription Drug Misuse, Psychiatry and Psychology, Psychotherapy, Reuters Health, Underdiagnosed, University of Manitoba
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Reuters Health reports that more than a quarter of Americans taking antidepressants have never been diagnosed with any of the conditions the drugs are typically used to treat, according to new research published in the Journal of Clinical Psychiatry. An excerpt:
“We cannot be sure that the risks and side effects of antidepressants are worth the benefit of taking them for people who do not meet criteria for major depression,” said Jina Pagura, a psychologist and currently a medical student at the University of Manitoba in Canada, who worked on the study.
“These individuals are likely approaching their physicians with concerns that may be related to depression, and could include symptoms like trouble sleeping, poor mood, difficulties in relationships, etc.,” she added in an e-mail to Reuters Health. “Although an antidepressant might help with these issues, the problems may also go away on their own with time, or might be more amenable to counseling or psychotherapy.”
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
February 8th, 2011 by RyanDuBosar in Better Health Network, Research
Tags: ACP Internist, American College Of Physicians, Difficult Patients, Difficult Physician-Patient Encounters, Doctor Patient Relationship, Doctor-Patient Communication, Doctor-Patient Interaction, Doctors' Perspective, Journal of General Internal Medicine, Patient Health Outcomes, Patient Satisfaction, Primary Care, Ryan DuBosar, Worsening Of Symptoms
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Physicians see nearly one in five patients as “difficult,” report researchers. Not surprisingly, these patients don’t fare as well as others after visiting their doctor.
Researchers took into account both patient and clinician factors associated with being considered “difficult,” as well as assessing the impact on patient health outcomes. They reported results in the Journal of General Internal Medicine.
Researchers assessed 750 adults prior to their visit to a primary care walk-in clinic for symptoms, expectations, and general health; for how they functioned physically, socially and emotionally; and whether they had mental disorders. Immediately after their visit, participants were asked about their satisfaction with the encounter, any unmet expectations, and their levels of trust in their doctor. Two weeks later, researchers checked symptoms again.
Also, clinicians were asked to rate how difficult the encounter was after each visit. Nearly 18 percent were “difficult.” They had more symptoms, worse functional status, used the clinic more frequently and were more likely to have an underlying psychiatric disorder than non-difficult patients. These patients were less satisfied, trusted their physicians less, and had a greater number of unmet expectations. Two weeks later, they were also more likely to experience worsening of their symptoms.
But the label works both ways, as physicians with a more open communication style and those with more experience reported fewer difficult encounters, researchers said.
On a lighter note, TV’s comedy “Seinfeld” dedicated an entire plotline from one of its many episodes to Elaine, her doctor, and the label of being a difficult patient. It’s worth watching here.
*This blog post was originally published at ACP Internist*
February 8th, 2011 by ChristopherChangMD in Health Tips, Research
Tags: Dr. Christopher Chang, Ear Nose and Throat, Fauquier ENT, New York Times, Otolaryngology, Sore Throat, Supraglottic Hyperfunction, Vocal Cords, Voice Problems, Whispering
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Is whispering bad for your vocal cords? For most people, the answer is yes according to research publicized in a recent New York Times article.
In the mentioned study, out of a group of 100 patients, 69 percent exhibited increased supraglottic hyperfunction with whispered voice (i.e. it was bad for the voice.) Eighteen percent had no change and 13 percent had less severe hyperfunction.
As such, though whispering is not bad for everybody, it is for most people and as such, the safest thing to do if the vocal cords are damaged whether by infection or trauma is to rest your voice. If you have to talk, do not whisper, but rather talk in a soft voice.
The best way to think about injured vocal cords is to talk in an analogy. Laryngitis is like a badly sprained ankle. In this scenario, talking is like walking and screaming is like running. So just like you would rest the sprained ankle and not walk on it in order for it to recover as quickly as possible, you should refrain from talking in order for the laryngitis to recover as quickly as possible. Where does whispering fall in this analogy? Probably equivalent to running on a sprained ankle.
Read more about voice problems here.
REFERENCE: “Laryngeal hyperfunction during whispering: reality or myth?” J Voice. 2006 Mar;20(1):121-7.
*This blog post was originally published at Fauquier ENT Blog*
February 6th, 2011 by RyanDuBosar in Better Health Network, Research
Tags: ACP Internist, American College Of Physicians, Blood Pressure, Cardiac Mortality, Cardiovascular Risk, Clinical Cardiology, Epidemiology, Football Fans, Green Bay Packers, Heart Attack, Heart Rate, Heart Stress, Obesity, Pittsburgh Steelers, Ryan DuBosar, Sports and Heart Health, Sports and Stress, Sports and Your Health, Sports Fans and Cardiovascular Health, Sports-Related Health Conditions, Stress and Anxiety, Super Bowl 2011, Super Bowl and Health, Super Bowl Diet, Super Bowl Food, Super Bowl XLV
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Sports fans may literally live and die on their team’s victories, according to researchers who examined cardiac mortality rates after the home team won and lost the Super Bowl.
Total and cardiac mortality rates in Los Angeles County increased after the football team’s 1980 Super Bowl loss but overall mortality fell after the 1984 the team’s Super Bowl win, researchers concluded from a review of death certificates reported in Clinical Cardiology.
First, authors gave a clinical review. Stress causes a cardiac cascade. The sympathetic nervous system increases and releases catecholamines. This triggers a rise in heart rate and blood pressure, and ventricular contractility increases oxygen demand, causing blood the sheer against and fracture atherosclerotic plaque, the authors explained. Stimulation of alpha receptors in the vasculature further constrict coronary vessels, increasing oxygen demand while limiting oxygen supply to the heart.
Next, they gave a sporting review. Los Angeles has played twice in the Super Bowl, the first time losing to the Pittsburgh Steelers (who play in this Sunday’s Super Bowl, incidentally) in 1980. The Los Angeles Rams, as they were known then, were a long-time hometown team and played the game in nearby Pasadena, Calif. “This game was high intensity,” wrote the authors, “with seven lead changes before Los Angeles lost a fourth-quarter lead and the game.”
Later, a new football franchise arrived in town, the Los Angeles Raiders. In 1984 the Los Angeles Raiders traveled to Tampa, Fla. to beat the Washington Redskins in a more mundane affair.
Now, the review of findings. Researchers combed death certificates based on age, race and sex to compare mortality rates for Super Bowl-related days with non-Super Bowl days and created regression models predicting daily death rates per 100,000. Read more »
*This blog post was originally published at ACP Internist*
February 5th, 2011 by KevinMD in Opinion, Research
Tags: Dr. Kevin Pho, Dr. Pauline Chen, Female Doctors, Financially Penalized, Gender Gap In Medicine, General Medicine, Health Affairs, Healthcare Politics, How Men and Women Practice Medicine, KevinMD, Male Physicians, Medical Practice Style, More Time With Patients, New York Times, Physician Compensation, Physicians' Salaries, Sexism In Healthcare, Women In Medicine
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Female doctors make less than male physicians. That conclusion gained major media traction recently. A recent post on KevinMD.com by medical student Emily Lu had some great conversation discussing reasons why women make less money in medicine.
To recap, the study from Health Affairs concluded that,
newly-trained physicians who are women are being paid significantly lower salaries than their male counterparts according to a new study. The authors identify an unexplained gender gap in starting salaries for physicians that has been growing steadily since 1999, increasing from a difference of $3,600 in 1999 to $16,819 in 2008. This gap exists even after accounting for gender differences in determinants of salary including medical specialty, hours worked, and practice type, say the authors.
Everyone hypothesized all sorts of reasons. Female doctors prefer more family-friendly hours and less call, which may impact their salary. Women are simply worse negotiators than men. Blatant sexism exists when hiring new physicians. Money isn’t as important to women as it is to men. All of which may, or may not, be true. Read more »
*This blog post was originally published at KevinMD.com*
