If you're not a mental health professional, your exposure to psychosis may come through a variety of channels. You may know someone with a psychotic disorder; you may have a psychotic disorder yourself. You may have taken an introductory class on psychology in high school or college, and you may be aware of psychotic episodes as events in which people lose touch with some element of reality — they may ...

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This must be my eighth cancer scare. (No, I really don’t undergo excessive testing.) Decades ago, I’d noted a possibly normal finding but dropped it after getting no response at subspecialist visits. Recently, following pertinent CME, I asked again and the physician bit. You can guess the rest. One night while dodging traffic I accessed on my phone the ultrasound report from the designated cancer center’s (DCC) patient portal, revealing a ...

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A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Every physician takes the Hippocratic oath and promises to “do no harm.” In the face of the current opioid epidemic, this includes protecting our patients from dependence and addiction, including those who are suffering from debilitating acute and chronic pain. Sometimes this involves ...

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A number of major cities have seen shared e-scooters, or electrical scooters, take over their streets. It's certainly popular with the riders, but it is creating waves with a lot of critics as well. In Portland, Oregon, there are four companies trialing the scooters over a several-month period.  Driving around my city, I find that we are being inundated with scooters being used on the sidewalk, on the streets, in ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 48-year-old man is evaluated for a 4-week history of heartburn that awakens him at night. The symptoms occur about three times per week. He has been taking over-the-counter antacids with incomplete relief. Food triggers include coffee and spicy foods. He has not had unintentional weight loss or difficulty ...

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One of the aspects of depression that’s particularly difficult is the sleep disturbance which accompanies it and often continues after the traditional symptoms of depression have finally gotten better. When studied in the laboratory, the sleep of depressed person is short, shallow (with less deep slow-wave sleep), and frequently interrupted by awakenings. Additionally, there are abnormalities of the timing of rapid eye movement sleep and intensity of eye movements during ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 56-year-old woman is evaluated for a 1-year history of tremor. The tremor is more prominent on the right side. She also reports increasing problems with balance and numerous falls, especially when arising from a chair or turning. The patient does not have any significant cognitive symptoms. She has ...

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I am frequently asked by patients to “run some tests to make sure nothing is wrong.” This makes a lot of sense on the surface but makes no sense as a physician. Why? Because testing without a context or a medical question is nonsensical. Let’s talk about why. How doctors think Studies show that doctors only let their patient speak for 11 seconds on average before we ...

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There’s no disputing that the opioid crisis has become a public health emergency in the United States. And not a day goes by when health care providers don’t encounter some aspect of this epidemic. Far too often, the mention of addiction spurns images of homelessness, back-alley deals and crime. While that can certainly be the case, addiction is an “equal-opportunity employer.” Allow me to share two true stories that illustrate ...

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Trends or challenges have been a part of the fabric of social media for a long time. They have ranged from the benign ice bucket challenge (which raised millions for research on amyotrophic lateral sclerosis) to the highly dangerous Tide pod challenge (which involved eating laundry detergent capsules). All of these internet phenomena involved videotaping an individual who performed a bizarre physical action for the ...

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