Informing DSM 5

  

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Behind On Your Journal Reading? Get Current in just a few minutes a day. MDLinx summarizes ranks and sorts all the best medical journal articles in 32 specialties and 800 sub-specialties from over 2000 journals daily. Check out this month’s top read Psychiatry article. Informing DSM 5: Biological boundaries between Bipolar I, Schizoaffective, and Schizophrenia **Available in Full Text** ► Read It Here MDLinx® Earn Honoraria Earn Honoraria for completing medical information surveys in your spare time. Get Paid for your Professional Opinion ► See Job Openings Search available job listings on MDLinx to have opportunities sent directly to your email inbox. Have your dream job find YOU! ► Do Self-Assessment Answer thousands of multiple choice questions to keep you sharp for exams. Scorecard tracks your progress. Start your Self-Assessment ►

Prep For Your Exams with the Smartest Doc Review Question Banks

  

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Exams Looming? Prepare to Pass with Smartest Doc  Review question banks Whether you're concerned with Boards, maintaining your certification, or  simply want the title of Smartest Doc in America MDLinx offers a challenging bank of multiple choice clinical questions to keep you sharp. Don't waste any time, prepare TODAY with this free MDLinx Member Perk! ► Prepare for your Exams! MDLinx® Earn Honoraria Earn Honoraria for completing medical information surveys in your spare time. Get Paid for your Professional Opinion ► Explore Job Possibilities Search available job listings on MDLinx to have opportunities sent directly to your email inbox. Have your dream job find YOU! ► Take the Tour Explore a self-guided tour through our award-winning offerings and see what our free service can offer you. Start the Self-guided Tour ►

Anaphylaxis: An alarming medical anomaly on the rise

  

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Earn Category 2 CME Credit:  Click Here to Read the Full Summary on MDLinx.com TODAY!

What should your patients know about anaphylaxis?

Anaphylaxis is the rapid onset of a severe and potentially lethal allergic reaction. Unpredictable in nature, the key identifiers for this condition are variable. While most people who experience an anaphylactic reaction have a pre-existing and known allergy to a trigger substance, a smaller fraction of those afflicted are not even aware that they have an allergy. Although the lifetime prevalence is estimated at 0.05-2%, the rate of occurrence is on the rise and even the first episode of anaphylaxis can result in fatality.

Key Components:

• Symptom onset commonly occurs within 2 minutes to 1 hour of exposure to a specific trigger.

• It is uncommon, but it is possible that symptoms do not develop for several hours.

• 80- 90% of anaphylactic reactions include hives (urticarial) and swelling of the skin (angioedema).

• Approximately 70% of reactions cause respiratory symptoms, which are more common in individuals with chronic respiratory diseases.

• Severe anaphylaxis causes sudden collapse without other symptoms; this form occurs most commonly after a person is given a medication intravenously or is stung by an insect.

Common Symptoms:

• EYES: Tearing, redness, itching and swelling

• SKIN: Flushing, hives (urticaria), or swelling (angioedema)

• HEART: Weakness, dizziness, fainting, rapid or irregular heartbeat, and low blood pressure

• NERVOUS SYSTEM: Confusion and anxiety

• DIGESTIVE SYSTEM: Vomiting, abdominal cramps, nausea and diarrhea

• NOSE & MOUTH: Runny nose, sneezing, nasal congestion, swelling of the tongue and metallic taste

• LUNG & THROAT:  Difficulty breathing, excessive coughing, chest tightness, wheezing or other sounds of labored breathing, increased mucus production, throat swelling or itching, hoarseness, change in voice and choking sensation

Who is at risk?

Some people are more likely than others to experience anaphylaxis, for example, those who have one or more of the following:

1. Previously experienced a sudden severe allergic reaction involving the whole body

•  Those who have had allergic reactions to a particular substance in the past are at increased risk. However, the severity of past allergic reactions does not reliably predict the severity of future reactions.

2. Those diagnosed with asthma

• Individuals with asthma are more likely to have severe respiratory problems during anaphylaxis. Data indicate the combination of food allergy (especially to nuts) and asthma seems to put people at increased risk for life-threatening episodes of anaphylaxis when exposed to a trigger.

3. Those with other types of diagnoses

• People with chronic lung disease, especially older adults with chronic obstructive pulmonary disease (COPD) or emphysema, are at increased risk of complications during an anaphylactic reaction. People with coronary artery disease and other heart diseases are also at greater risk of developing complications.

How to prevent/treat?

If patient has had an anaphylactic reaction or has suspected triggers:

• See an allergist for evaluation and for specific training and diagnosis.

• Seek out testing to determine the trigger; an allergist should perform skin testing at least 3-4 weeks after an anaphylactic reaction b  because if done too soon after the event, such tests may give false negative results.

• Avoid triggers! When a trigger has been identified, the individual should be urged to stay away from the substance.

• Always wear medical identification and carry epinephrine!

During an anaphylactic episode:

• Call for emergency help immediately. Episodes are often times life-threatening-- it should be treated as a medical emergency.

• Treat the person with epinephrine, those with a history of anaphylaxis should always carry an injector.

• Place the person on their back or in a semi–reclining position with the lower extremities raised

• During the episode, if needed, give high flow supplemental oxygen, establish intravenous access to provide high volume fluids, and perform cardiopulmonary resuscitation.

• Go to the hospital,  after injecting epinephrine; it is important to be evaluated in a hospital emergency department. There is no reliableway to predict whether or not a late-phase reaction will occur, but up to 20% of people with anaphylaxis have a late-phase reaction and might require additional treatment.

All HCPs are encouraged to talk with their patients who have a history of these types of reactions to develop an Anaphylaxis Action Plan. Many people find having a treatment plan to respond to future reactions reassuring. 

http://www.mdlinx.com/internal-medicine/news-article.cfm/4468027/anaphylaxis-drugs-allergen-

Alcohol + Energy Drinks

  

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Maybe worse than you think

Consuming cocktails that mix alcohol with energy drinks is a growing social trend amongst socialites.  Indulging in the idea of “getting high” without getting tired is not only intriguing, but an ideal way to maximize a night of entertainment and excitement.  Although socially acceptable, this mixture can be detrimental both to your physical and mental health. Many researchers make claims that this activity is most common amongst adolescents; however, according to the American Journal of Drug & Alcohol Abuse there are Correlates of Concurrent Energy Drink and Alcohol Use among Socially Active Adults.

Energy drinks are not regulated by the FDA so producers are not required to disclose the caffeine content on the label.  According to Risks of Energy Drinks Mixed With Alcohol, an article recently summarized on MDLinx.com, energy drink manufacturers are not “held accountable for claims regarding the health and psychosocial benefits of their products.”  High levels of caffeine boost the heart rate and, in combination with alcohol, can increase the risk of heart rhythm complications. The stimulation also masks signs of inebriation, such as the feeling of fatigue, which typically signals the body’s had enough to drink. 

Consequently, drinkers of these trendy cocktails are more likely to make irrational or irresponsible decisions, such as driving while intoxicated or inflicting harm on others. They are also about twice as likely to report being taken advantage of sexually, to report taking advantage of someone else sexually, and to report riding with a driver who was under the influence of alcohol.¹

Not only can the mixture of alcohol with energy drinks be unhealthy, harmful to your body and impair your judgment, it also causes dehydration which worsens a hangover – and there’s nothing worse than waking up after an eventful evening with a dreadful hangover.

1. O’Brien MC, McCoy TP, Rhode SD, Wagoner A, Wolfson M. Caffeinated cocktails; energy drink consumption, high-risk drinking, and alcohol-related consequences among college students. Acad Emerg Med 2008;15(5):453-460.

Are you killing yourself? Think Before You Indulge...

  

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Are you killing yourself? Think Before You Indulge...

We’ve all heard it before- just one cigarette can shave 3 minutes off your life. Well, what if this formula could be applied to all of your guilty pleasures? A study published by the British Medical Journal has linked life expectancy to activities such as having a couple of drinks and even watching TV; activities that to most Americans come as second nature. Did the beers you consumed during Sunday’s Super Bowl shorten your lifespan? 

University of Cambridge statistician Professor David Spiegelhalter sought to find a way to communicate the impact of human behavior on our lifespan in a simple and effective formula. In this analysis, Spiegelhalter further expands on the concept of aging slower/ faster, first introduced through the study of cigarettes on life expectancy more than a decade ago. He explicitly expresses the effect of our daily lifestyle habits as half hours of life expectancy or “microlives.” Through the use of population studies he was able to deduce that on average over a lifetime habit of behavior, that smoking two cigarettes or being 10 pounds overweight, or even watching two hours of TV, equates to the loss of a “microlife.” The idea that watching the Ravens win the Super Bowl could have cost you thirty minutes of your life is alarming to most, considering the inherent concern most humans have with their own mortality.

However, Spiegelhalter’s “microlife”  formula isn’t just a penalty system for life’s indulgences. In contrast, Spiegelhalter says, each day of positive behavior such as exercising or sticking to just one alcoholic beverage will help you gain “microlives” at an even faster rate. He cites that this positive behavior can add up to two hours to your life.

But before you start tracking your behavior and counting “microlives” as if they were calories, read Spiegelhalter’s entire explanation of the concept. He explains that this formula for life expectancy is not definitive but based on a number of assumptions, and should be treated as an approximation. The crux of his article supports the old adage, “Everything in moderation.” 

In Spiegelhalter’s words: "Of course, evaluation studies would be needed to quantify any effect on behavior, but one does not need a study to conclude that people do not generally like the idea of getting older faster."

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Sexual Dysfunction and Diabetes

  

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Is there a correlation?

Diabetic nerve damage and blood vessel damage resulting from high blood sugar can lead to sexual dysfunction in both men and women.  Many medical professional most often associate sexual dysfunction and diabetes with erectile dysfunction/ impotence, but the problem quite often persist in women as well.  Although there are many other factors that play a role in sexual dysfunction, studies have shown a direct correlation between diabetic men and women and sexual dysfunction.  The blood vessels damaged by diabetes control erection in men and the nerves damaged by diabetes prevent women from achieving an orgasm. 

According to an article found on mdlinx.com, published in The Journal ofSexual Medicine, female sexual dysfunction is more frequent in diabetic women.  Women may experience symptoms such as: lack of interest in sexual relations, no sensation in the genital area, or pain and discomfort during sex due to dryness in the vaginal area. 

On average more than 50% of diabetic men over age 50 and 90% of men over age 70 will experience a degree of erectile dysfunction or impotence. 

Although this is a serious issue that many diabetics are forced to cope with, there are many ways to help reduce the risk of sexual dysfunction.  Always check with your doctor for the safest options. 

Tips to lower you risk of sexual dysfunction

• Control blood glucose, blood pressure and cholesterol levels
• Exercise or engage in some type of physical activity that helps maintain healthy weight
• If you are a smoker, QUIT
• Vacuum constriction devices (VCDs)
• Ask your doctor about other treatment options, such as Cialis

Prostatic Specific Antigen Testing for Prostate Cancer

  

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Is it an effective method for screening for Prostate Cancer?

Prostate Cancer is the most frequently diagnosed cancer in men and one of the leading causes of cancer related deaths.   According to The American Cancer Society about 238,590 new cases of prostate cancer will be diagnosed and about 29,720 men will die of prostate cancer in 2013.  It’s primarily detected in men over the age of 40 and it is the second leading cause of cancer-related death in African American men.  Although prostate cancer is an extremely life-threatening disease, the survival rate is over 90%.  The most commonly used screenings for Prostate Cancer are: Digital rectal exam (DRE) and Prostatic Specific Antigen (PSA) testing.  A PSA test measures the blood level of PSA, which is a protein produces by the prostate gland.  Since the 1980’s doctors have been using this test to screen men between the ages of 40-75 for prostate cancer.

Recently many professional organizations are beginning to question the effectiveness of PSA testing.  They feel the benefits of the screening do not outweigh the risks.  When higher PSA levels are detected, it alerts doctors that cancer may be present.  “False positives” are common with PSA test and many times the tumors detected by PSA screening may not develop into life threatening tumors.  There are also situations when PSA test produce “false negatives” due to rapidly growing prostate cancers not producing sufficient PSA.  

Men who choose to be treated (better safe than sorry) and undergo one of many Prostate Cancer treatments are exposed to side-effects such as: Urinary dysfunction, Bowel dysfunction, erectile dysfunction, hormonal changes and infertility that can last up to 10 years after treatment. The severity of the side-effects depends significantly on the individual and his state of health. 

Although controversial for “over diagnosis” and “overtreatment”, “diagnosis and treatment of prostate cancer were radically improved after the discovery of the prostatic-specific antigen”, as noted in the MDLinx article on screening for Prostate Cancer.    Currently most insurance companies as well as Medicare will cover annual PSA screenings.  If a PSA screening detects elevates PSA levels, it’s important to get a biopsy done before starting treatment to accurately determine whether or not Prostate Cancer is evident. Researchers are currently trying to improve the PSA Test.  To learn more about the developments in PSA testing visit http://www.mdlinx.com/oncology/.

The Smartest Doc- a FINALIST for the Best Healthcare Professional Media Brand in the 2012 MM&M Awards!

  

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The Smartest Doc confirmed as a FINALIST for the Best Healthcare Professional Media Brand in the 2012 MM&M Awards! 

We are proud to announce that The Smartest Doc has been confirmed as a FINALIST for the Best Healthcare Professional Media Brand in the 2012 MM&M Awards! 

Our product is one of five in this category chosen by a panel of over 100 industry experts. While it’s an honor just to be nominated, we’re hoping to bring home a prestigious Gold or Silver award. We’ll find out the results during the ceremony being held in NYC on October 9.

Wish us luck!

The Smartest Doc has challenges in Internal Medicine, Family Practice, Oncology, Diabetes, Neurology, Pediatrics, Dermatology and Cardiology. Test your clinical acumen and speed, and generates national recognition.

Smartest Doc Challenge Winners For April 2012

  

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Smartest Doc Challenge Winners

We are happy to announce the Smartest Doc winners in April:

Top 10 Smartest Docs in March:

Compete in May

Take the Smartest Doc in America quiz today and pit your knowledge against other health care professionals in the US! Go to http://thesmartestdoc.com, login with your MDLinx login/password information, and start playing today for your chance to win !