The danger of diabetes is not only the immediate risk of very high blood sugar. Diabetes also has many dreaded long-term complications. (In this post I am referring to both type 1 and type 2 diabetes mellitus.) Diabetes greatly increases the risk of stroke, heart attack, and amputation. In the US it is the leading cause of kidney failure and of blindness in adults. A study performed by researchers at the ...

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“The plastic surgeons tell me that women who like to swim do much better with reconstruction than with prostheses,” says a young breast surgeon at our weekly breast cancer tumor board, the working conference where we discuss every new breast cancer patient before starting treatment. There’s a slight note of surprise in her voice; to her, it’s simply another consideration when advising women before mastectomy. For decades, the only option after a ...

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With the Mediterranean diet all the rage, not only because consumers like its tasty composition but because of research touting its health benefits, experts have had to become more specific about recommendations for fats. There’s a steady drumbeat these days -- from everyone from chefs to food writers to health gurus -- criticizing nutritionists and the “diet police,” who, they claim, ...

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Oncolore: Challenging conventional wisdomIncreasingly, cancer care is becoming more evidence-based and personalized. But there are still a lot of areas where we need to question the conventional wisdom. How much of what we learned during training is based upon evidence versus anecdote and assumption? When I finished medical school, internship was challenging but very rewarding. It helped me recognize much better when people are really ...

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A few years ago I wrote that uncertainty is inevitable in psychiatry.  We literally don’t know the pathogenesis of any psychiatric disorder.  Historically, when the etiology of abnormal behavior became known, the disease was no longer considered psychiatric.  Thus, neurosyphilis and myxedema went to internal medicine; seizures, multiple sclerosis, Parkinson’s, and many other formerly psychiatric conditions went to neurology; brain tumors and hemorrhages went to neurosurgery; and so forth. This leaves psychiatry ...

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Rachel squeezed my hand and looked me in the eye. "Not good, is it?" I shook my head. "How bad?" she asked. I shook my head again, and squeezed her hand back. She sighed, blinked away tears, and forced a smile. "Just give me some time," she said. Time was unfortunately not something Rachel had on her side. At the peak of her career as a world-class ballet dancer, she had been ...

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The American Cancer Society recently released important new data showing that the rate at which people are diagnosed with colon cancer in the U.S. has dropped 30% in the last ten years for those aged 50 and older.  Much of this decline was attributed to the widespread uptake of colonoscopy screening.  Colonoscopy is the only screening test that examines the entire colon and allows removal of precancerous polyps in the ...

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The myth that bras cause breast cancer is apparently coming ‘round the barn again. The latest scare-you-out-of-your-brassiere “article” claims there are “five research studies” that show a strong correlation between bra wearing and breast cancer. Well, that certainly sounds all scientific. Why the bra hullaballoo? A couple of anthropologists wrote a whole book about their incorrect theory back in 1995, Dressed to kill: The link between breast cancer and bras. Every now ...

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recent study, one that received relatively scant media attention (compared with a concurrent New York Times piece about a new psychiatric diagnosis termed "sluggish cognitive tempo" that may be the "new ADHD") showed that antipsychotics are being prescribed to nearly one third of kids (age 2-17) in foster care who are diagnosed with attention deficit hyperactivity disorder (ADHD). This disturbing statistic brought to mind a common complaint I hear from ...

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Stephanie wrote in about a very common problem:

My daughter is 4 years old. She isn’t the tallest cat in town (she is about the 15th-25th percentile for height), and her BMI always ends up being in the high range (like over 85%). I worry about it. I am very health conscious for myself and my family. We live by all of the "rules." And yet. The family doctor doesn’t worry -- ...

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