MKSAP: 24-year-old woman with severe cramps associated with her menstrual periods
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 24-year-old woman is evaluated for severe cramps associated with her menstrual periods. The cramps have worsened over the past year, and the discomfort is severe enough that she has periodically missed work. She reports no abnormal vaginal discharge. Menses are unchanged from her baseline pattern. She has tried ibuprofen and naproxen for pain relief, but these medications cause stomach upset. The patient is sexually active with several male partners. She has no history of sexually transmitted infection and is ...
Source: Kevin, M.D. - Medical Weblog - July 28, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions OB/GYN Source Type: blogs
PrEP: Protection against HIV in a pill?
HIV (the human immunodeficiency virus) weakens the human immune system and destroys the important cells that fight disease and infection. A person can get HIV when bodily fluids — including blood, semen, pre-seminal fluid, rectal fluids, or vaginal fluids of a person with the virus — come in contact with a mucous membrane or damaged tissue. HIV can be transmitted through breast milk, or when a contaminated needle or syringe comes into direct contact with the bloodstream.
There is no cure for HIV, but with proper medical care the virus and its effects can be controlled. HIV transmission can be reduced by consistent use ...
Source: Harvard Health Blog - May 18, 2018 Category: Consumer Health News Authors: Meera Sunder, MBBS, MRCOG Tags: Health HIV Infectious diseases Source Type: blogs
Are you taking too much anti-inflammatory medication?
Follow me on Twitter @RobShmerling
You might call them pain relievers. You might take them for back pain, headache, or arthritis. Your doctor calls them “NSAIDs,” which stands for nonsteroidal anti-inflammatory drugs. Whatever you call them and for whatever reason you take them, NSAIDs are among the most popular medications worldwide. In fact, estimates suggest that about 15% of the US population takes an NSAID regularly (including those that are over the counter and prescription strength). Along with sporadic users, more than 30 billion doses are taken each year.
Some of the most common NSAIDs include ibuprofen (as in...
Source: Harvard Health Blog - April 2, 2018 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Arthritis Back Pain Drugs and Supplements Headache Health Injuries Pain Management Source Type: blogs
Opioids in the household: “Sharing” pain pills is too common
This study alone identified almost six million people, and even this underestimates the problems because the study excluded patients with a cancer diagnosis or who were in hospice. Off the top of my head, I can think of multiple cases where I suspected or was told outright that others were using a hospice patient’s pain pills. I asked the study author, Marissa J. Seamans, PhD, about why they excluded these patients. “Because opioids are indicated for patients diagnosed with malignancy or in hospice care, we excluded them to more easily identify comparable NSAID patients,” she explained. While this made the comparison...
Source: Harvard Health Blog - March 22, 2018 Category: Consumer Health News Authors: Monique Tello, MD, MPH Tags: Addiction Drugs and Supplements Health Pain Management Source Type: blogs
5 things that can help you take a pass on kidney stones
If you’ve ever passed a kidney stone, you probably would not wish it on your worst enemy, and you’ll do anything to avoid it again. “Kidney stones are more common in men than in women, and in about half of people who have had one, kidney stones strike again within 10 to 15 years without preventive measures,” says Dr. Brian Eisner, co-director of the Kidney Stone Program at Harvard-affiliated Massachusetts General Hospital.
Where do kidney stones come from?
Kidney stones form develop when certain substances, such as calcium, oxalate, and uric acid, become concentrated enough to form crystals in your kidneys. The cry...
Source: Harvard Health Blog - March 8, 2018 Category: Consumer Health News Authors: Matthew Solan Tags: Health Kidney and urinary tract Source Type: blogs
Medical marijuana
There are few subjects that can stir up stronger emotions among doctors, scientists, researchers, policy makers, and the public than medical marijuana. Is it safe? Should it be legal? Decriminalized? Has its effectiveness been proven? What conditions is it useful for? Is it addictive? How do we keep it out of the hands of teenagers? Is it really the “wonder drug” that people claim it is? Is medical marijuana just a ploy to legalize marijuana in general?
These are just a few of the excellent questions around this subject, questions that I am going to studiously avoid so we can focus on two specific areas: why do patient...
Source: Harvard Health Blog - January 15, 2018 Category: Consumer Health News Authors: Peter Grinspoon, MD Tags: Complementary and alternative medicine Drugs and Supplements Health Pain Management Source Type: blogs
Rhabdo: A rare but serious complication of … exercise
It’s a new year, the gyms are unusually busy, and many of us started a new physical activity. Several health clubs are offering fun, interactive, and dynamic exercises such as whole-body workouts, functional training, CrossFit, high-intensity interval training, spinning, etc.
Some of these classes are incorporating intense workouts, which was a hot topic in exercise physiology in 2017. There is significant enthusiasm around these programs among my friends, family, and patients. Some of these classes have loud music, lights, and trainers whose job is to push you to a new level. Increasing the intensity of a workout may br...
Source: Harvard Health Blog - January 11, 2018 Category: Consumer Health News Authors: Marcelo Campos, MD Tags: Exercise and Fitness Health Source Type: blogs
Acupressure App – Does it really alleviate menstrual cramps?
The media is abuzz over a study reporting that use of a cell phone app to train women in self-acupressure is effective as pain medication for treating menstrual cramps.
The Android app is called AKUD and is written in German, so unless du sprichst Deutch, it won’t do you much good. But let’s ignore that for now. Here’s the study intervention:
The study intervention
Participants received a menstrual tracking App that included instructions on acupressure for cramp relief. They also got one-on-one instruction on the location of specific acupressure points and use of acupressure using drawings and video. Th...
Source: The Blog That Ate Manhattan - December 12, 2017 Category: Primary Care Authors: Margaret Polaneczky, MD Tags: Alternative Medicine Women's Health app cell phone menstrual cramps Source Type: blogs
What to do for stubborn low back pain
A while back, I covered the updated evidence-based treatment guidelines for acute (less than four weeks) and subacute (less than twelve weeks) low back pain. I promised a post on chronic (more than twelve weeks) back pain.
Well, as I write this, I am suffering from a recurrence of my own low back pain, which radiates down my right leg at times. This has been literally and figuratively a pain in my rear end, for years.
Being a doctor who practices what I preach, I am putting all the advice I dispense to good use.
First, look for possible triggers
This fall, I had gotten away from my regular core-strengthening routine (night...
Source: Harvard Health Blog - December 7, 2017 Category: Consumer Health News Authors: Monique Tello, MD, MPH Tags: Back Pain Health Pain Management Source Type: blogs
She sees difficult patients, but is a difficult patient herself
The patient is a 27-year-old Caucasian woman: slender, well-groomed. She is sitting in the office of her urologist, and she is unconsciously twisting her hands as she interrupts the doctor, having finally worked up the nerve.
“I know you told me to expect some pain for a while after the lithotripsy. But I’ve been having pain in my bladder, even when I don’t think there are any stones. It started two years ago, before the stones. It feels like pressure, and it really stings when I urinate. It especially hurts when I’ve taken naproxen or loratadine, or if I have caffeine, or if I get dehydrated at all...
Source: Kevin, M.D. - Medical Weblog - November 8, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/kristin-puhl" rel="tag" > Kristin Puhl < /a > Tags: Education Primary Care Urology Source Type: blogs
Giving Migraine Treatments the Best Chance - The New York Times
If you've never had a migraine, I have two things to say to you:1) You're damn lucky.2) You can't begin to imagine how awful they are.I had migraines – three times a month, each lasting three days — starting from age 11 and finally ending at menopause.Although my migraines were not nearly as bad as those that afflict many other people, they took a toll on my work, family life and recreation. Atypically, they were not accompanied by nausea or neck pain, nor did I always have to retreat to a dark, soundless room and lie motionless until they abated. But they were not just"bad headaches" — the pain...
Source: Psychology of Pain - September 25, 2017 Category: Anesthesiology Source Type: blogs
Is it safe to take ibuprofen for the aches and pains of exercise?
Follow me on Twitter @RobShmerling
Not long ago, I took ibuprofen after a dental procedure and was amazed at how well it worked. Millions of people have had similar experiences with ibuprofen and related medications (called non-steroidal anti-inflammatory drugs, or NSAIDs) when used for a number of conditions, including arthritis, back pain, and headache. That’s why NSAIDs are among the most commonly prescribed drugs worldwide.
More than a dozen different NSAIDs are available, including naproxen (as in Naprosyn or Aleve), celecoxib (Celebrex), diclofenac (Voltaren) and indomethacin (Indocin). Aspirin is also an NSAID, th...
Source: Harvard Health Blog - August 9, 2017 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Drugs and Supplements Exercise and Fitness Health Kidney and urinary tract Source Type: blogs
Taming the pain of sciatica: For most people, time heals and less is more
Despite being a less common cause of low back pain, sciatica is still something I regularly see as a general internist. Primary care doctors can and should manage sciatica, because for most individuals the body can fix the problem. My job is to help manage the pain while the body does its job. When a person’s symptoms don’t improve, I discuss the role of surgery or an injection to speed things up.
What is sciatica?
Sciatica refers to pain caused by the sciatic nerve that carries messages from the brain down the spinal cord to the legs. The pain of sciatica typically radiates down one side from the lower back into the l...
Source: Harvard Health Blog - July 12, 2017 Category: Consumer Health News Authors: Steven J. Atlas, MD, MPH Tags: Back Pain Health Pain Management Source Type: blogs
Bring On the Exercise, Hold the Painkillers - The New York Times
Taking ibuprofen and related over-the-counter painkillers could have unintended and worrisome consequences for people who vigorously exercise. These popular medicines, known as nonsteroidal anti-inflammatory drugs, or NSAIDs, work by suppressing inflammation. But according to two new studies, in the process they potentially may also overtax the kidneys during prolonged exercise and reduce muscles' ability to recover afterward.Anyone who spends time around people who exercise knows that painkiller use is common among them. Some athletes joke about taking"vitamin I," or ibuprofen, to blunt the pain of strenuous...
Source: Psychology of Pain - July 6, 2017 Category: Anesthesiology Source Type: blogs
Are there any good doctors?
Are doctors who follow “consensus guidelines,” rank high on quality standards set by hospitals, and adhere to rules set by the drug and medical device industries really providing “health”? Would you call a regimen of Lipitor, hydrochlorothiazide, aspirin, metoprolol, Prilosec, and Naprosyn “healthy” because it was prescribed by a “good” doctor?
Health is not provided by doctors; revenue-generating healthcare is provided by doctors–there’s a difference, a big difference.
Health is something you achieve on your own with results that are SUPERIOR to the results doc...
Source: Wheat Belly Blog - June 1, 2017 Category: Cardiology Authors: Dr. Davis Tags: Undoctored Wheat Belly Lifestyle diy healthcare prescriptions sick care Source Type: blogs
