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
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“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
Dementia rates are down, recovery rates are up. Many are thriving mentally and physically deep into their later years. Excerpt – A long-running study of older people in the greater New Haven, Conn., area found that most who had lost the ability to feed or bathe themselves recovered within six months, and often sooner. The Einstein Aging Study, which has followed people 70 or older from the Bronx since 1993, discovered a declining rate of dementia in successive age cohorts born after 1929. According to research at the Stanford Center on Longevity, older Americans report higher levels of emotional well-being … 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
“In her book Chemically Imbalanced, Joanna Moncrieff, Professor of Critical and Social Psychiatry at University College London, synthesizes three key questions around the use of SSRIs [selective serotonin reuptake inhibitors]. First, on effectiveness, Moncrieff references a 2002 meta-analysis, which concluded that compared with placebo their effects were clinically negligible. However, other studies have shown effectiveness, including a 2018 meta-analysis in The Lancet, which concluded that all antidepressants are more efficacious than placebo in adults with a diagnosis of major depressive disorder, with odds ratios ranging between 2·23 and 1·37. Second, Moncrieff reviews the so-called serotonin hypothesis of depression. In 1975, … Read More
“Symptoms of hypothyroidism are nonspecific and poorly predict clinically significant thyroid dysfunction, especially in patients with underlying medical conditions and advanced age. Thus, it is essential to identify thyroid dysfunction before initiating therapy. Yet, it is estimated that about 30% of persons newly started on l-thyroxine treatment in the United States have normal thyroid function. When symptoms result in ordering thyroid function tests, an elevated thyroid-stimulating hormone (TSH) level should not trigger therapy without confirmatory TSH and free thyroxine (FT4) levels. Symptoms associated with overt hypothyroidism (elevated TSH, low FT4) usually resolve with l-thyroxine replacement, but therapy for subclinical hypothyroidism … Read More
“In the case of substance abuse, decades of research established a taxonomy that is more nuanced than simply alcohol abuse vs use. The National Institute of Alcohol Abuse and Alcoholism has established different usage patterns that have been studied both for their independent effects on functioning and how each might ultimately lead to the clinical entity of alcohol use disorder (Table). We propose an analogous taxonomy for digital media use that identifies patterns of use, irrespective of content, that could be problematic but, at a minimum, should be flagged as warranting further evaluation and potential remediation. Although in this Viewpoint … Read More
“There were 26.4 deaths per 100,000 people from diabetes, according to early death certificate data for the third quarter of 2024 published this month by the CDC’s National Center for Health Statistics. Death rates from diabetes peaked in 2021, according to CDC figures, at 31.1 deaths per 100,000 people for that year. Diabetes was the eighth leading cause of death in 2021. The CDC says the link between COVID-19 and diabetes may be to blame for that increase. “Data show an increase in mortality rates for all people during the COVID-19 pandemic, and research shows that people with underlying conditions, … Read More
“[Introduction] Despite spending more than any country in the world on health care, life expectancy in the US is comparably worse than that of most other high-income countries and declining both in absolute value and relative rank. However, life expectancy across US states varies just as markedly as it does across high-income countries, from 81.8 years in Hawaiʻi to 74.7 years in Mississippi in 2019—a divergence that has been increasing over time. US states vary considerably on policy decisions related to the spending, regulation, and provision of health care; reproductive health; tax policy; social welfare programs; and in relation to … Read More