“Although physicians excel at mapping disease spatially (eg, locating tumors, charting lesions, pursuing biomarkers), patients organize their lives around temporal uncertainty. This pattern extends across episodic conditions. Patients often find that uncertainty between episodes causes more distress than the acute symptoms. They organize their lives around the possibility of recurrence, not the reality of crisis. Chronic episodic disorders do not fit easily into static disease models. Yet clinical coding captures diagnoses, not trajectories. Quality metrics reward event suppression, not functional recovery. A routine office visit might document recent symptoms but overlook emerging vulnerability. In many such conditions, success has been … Read More
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“Public health is an organized effort to protect and improve the health of populations through education, policy, and preventive programs (Table). Within public health, the concept of primordial prevention is well-defined as population-level efforts to prevent risk factors for incident or worsening disease, such as water sanitation systems. Primordial care is the individual-level equivalent: a person’s efforts to prevent the onset or worsening of sickness for himself or herself. This cognitive framing is a crucial distinction; individuals engaging in primordial care do not necessarily see themselves as sick or requiring treatment that would compel entry into the medical system. Individuals … Read More
“The committee [The National Academies of Sciences, Engineering, and Medicine (NASEM) convened a multidisciplinary committee of individuals with expertise in alcohol exposure measurement, the relevant clinical outcomes, epidemiology, evidence synthesis, previous experience with the 2025 Dietary Guidelines for Americans, and public health] evaluated the associations between moderate alcohol consumption (defined in previous DGA versions as 1 drink or 14 g of alcohol per day for women and 2 drinks or 28 g of alcohol per day for men) and all-cause mortality, weight changes, certain types of cancer, cardiovascular disease, and neurocognition. [..] The standard drink size of 14 g of … Read More
“early-onset cancer has emerged as a federal health priority. The Cancer Grand Challenges program, funded by the National Cancer Institute and Cancer Research UK, has allocated $25 million to uncover biological causes for rising rates. Early-onset cancer has also been highlighted as an area of scientific focus in the US National Cancer Plan. Research interest has concurrently surged, with the proportion of PubMed citations related to early-onset cancer more than tripling during the past 3 decades. Rising rates have also prompted recent shifts in policy, such as the US Preventive Services Task Force lowering the recommended initial age for colorectal cancer and breast … Read More
A research group reviewed each country’s residents’ probability of dying from a non-communicable disease (including, but not limited to cancers; cardiovascular diseases; diabetes; endocrine, blood, and immune disorders; non-infectious respiratory, digestive, and genitourinary diseases; neurological conditions; mental and substance use disorders; congenital anomalies; and sense organ, skin, musculoskeletal, and oral or dental conditions) at 2001, 2010, and 2019. When looking at the probability of dying from a non-communicable disease between birth and age 80 in 2019, here are the top five performers by gender, along with America, Canada and England: For females For males “the poor performance of the USA … Read More
“Long-term routine laboratory toxicity monitoring (lt-RLTM) is used for management of patients with rheumatoid arthritis (RA) who are being treated with disease-modifying antirheumatic drugs (DMARDs). Intensive monitoring is recommended during the first 6 months due to higher risks for adverse reactions, followed by less frequent monitoring for the duration of DMARD use, which can last for decades. Laboratory parameters used for lt-RLTM typically include liver, renal, and hematologic toxicity markers. Despite high consistency in the types of tests ordered, the frequency of testing and responses to abnormal results vary widely across practices. [..] Typically, lt-RLTM is performed every 3 months … Read More
Too often, doctors pursue ‘normal’ numbers instead of looking closely at the patient “Once we base our definition of disease on numerical abnormalities, we can change the numbers in a way that expands those who have the disease. This has been occurring in dramatic fashion the past 20 years, especially since Medicare (by congressional decree) relinquished the task of defining normal numbers to specialty medical societies. Hence the American College of Cardiology can change the definition of an abnormal cholesterol reading or abnormal blood pressure reading such that more people will be labeled with a diagnosed disease related to these … Read More
“clinicians in the US have increasingly prescribed amphetamine-type stimulants, most commonly to treat attention-deficit/hyperactivity disorder (ADHD). But a cross-sectional study published in JAMA Psychiatry found that among those taking prescription stimulants, about 25% reported using them outside of their intended purpose and 9% had prescription stimulant use disorder (PSUD), which causes clinically significant impairment or distress. Looking at data from adults aged 18 to 64 years, researchers found that misuse was about 3 times higher for prescription amphetamines than for methylphenidate, which is generally considered less potent. [..] Those taking amphetamines were also more likely to develop PSUD. Although women … Read More
The drugs treat disorders such as anxiety, panic attacks and insomnia, but stopping them abruptly can compound users’ symptoms and even endanger their lives. “Prescriptions for benzodiazepines like Xanax, Ativan and Valium have been trending down since 2016, in part because of doctors’ concerns. Even so, these medications are considered quick and efficacious, and they remain among the most commonly prescribed drugs in the country to treat conditions including anxiety and sleep disorders. In 2019, an estimated 92 million benzodiazepine prescriptions were dispensed in the United States, according to the Food and Drug Administration. Current guidelines recommend prescribing the lowest effective dose … Read More
“In the survey by Kleck and Gertz, more than 4% of gun-owning respondents reported a history of DGU within the previous 5 years. In this survey by Anestis et al, 8% of gun owners reported a lifetime history of DGU. Anestis et al. suggest approximately 489 000 DGU events of firing at or in the vicinity of a perceived threat occur each year. But combining with the number of people who either tell a threat about their firearm or show said firearm could raise that number to nearly 1.17 million annual DGU events. As these estimates fall within the previously reported range of … Read More