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By Elaine Schattner, MD, on January 31st, 2012
Yesterday the AMA news informed me that cyberchondria is on the rise. So it’s a good moment to consider the term’s meaning and history.
Cyberchondria is an unfounded health concern that develops upon searching the Internet for information about symptoms or a disease. A cyberchondriac is someone who surfs the Web about a medical problem and worries about it unduly.
Through Wikipedia, I located what might be the first reference to cyberchondria in a medical journal: a 2003 article in the Journal of Neurology, Neurosurgery, and Psychiatry. A section on the new diagnosis starts like this: “Although not yet in the Oxford English Dictionary, the word ‘cyberchondria’ has been coined to describe the excessive use of internet health sites to fuel health anxiety.” That academic report links back to a 2001 story in the Independent, “Are you a Cyberchondriac?”
Two Microsoft researchers, Ryen White and Eric Horvitz, authored a “classic” paper: Cyberchondria: Studies of the Escalation of Medical Concerns
See more Cyberchondria Rising — What is the Term’s Meaning and History?
By Elaine Schattner, MD, on January 30th, 2012
 image, “the Iron Lady”
Over the weekend I saw the Iron Lady, a movie about Margaret Thatcher, the former Prime Minister of England. I expected a top-notch, accented and nuanced performance by Meryl Streep, and got that.
The film surprised me in several respects. It’s really about aging, and how a fiercely independent woman withers. The camera takes you within her elderly, blurry, husband-conjuring mind. She’s forgetful and rambling, but maintains an interest in current events, and ideas. She looks back on events in her life with pride and, seemingly, some regrets.
Well done, worth seeing!
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See more The Iron Lady, a Film About an Aging Woman
By Elaine Schattner, MD, on January 27th, 2012
 The current debate about the individual mandate reminded me to post this -
About a year ago, I had the opportunity to hear Wendell Potter, author of Deadly Spin - an insider’s sharp critique of the insurance industry, speak at a meeting of the New York Metropolitan Chapter of Physicians for a National Health Program. Despite the cold, dark winter night and midtown dreariness of the meeting location, the large lecture room was packed. I arrived well before Potter’s presentation but couldn’t get a copy of his book; they’d sold out.
The meeting was instructive: I got a sense of Potter’s personal story (he’s from Tennessee, and lived for a while in Appalachia), his previous career (he worked as a journalist, turned to marketing, eventually led PR for Cigna) and his perspective on how people in the health care industry use language to frame the debate on health care reform. Since 2009, when he left his position at Cigna, he writes and
See more Notes on Wendell Potter, and Why Companies Support the Individual Mandate
By Elaine Schattner, MD, on January 26th, 2012
Last week’s NEJM delivered an intriguing, imperfect article on a new approach to treating hepatitis C (HCV). The paper’s careful title, Preliminary Study of Two Antiviral Agents for Hepatitis C Genotype 1, seems right. The analysis, with 17 authors listed, traces the response of 21 people with hepatitis C (HCV) who got two new anti-viral agents, with or without older drugs, in a clinical trial sponsored by Bristol-Meyers Squibb.
The 21 study participants all had chronic infection by HCV genotype 1, a strain that’s common in North America and relatively resistant to standard treatment. All subjects were between 18 and 70 years old, with a measurable level of HCV RNA in the blood, no evidence of cirrhosis, and no response to prior HCV treatment (according to criteria detailed in the paper). In the trial, 11 patients received a combination regimen of daclatasvir (60 mg once daily, by mouth) and asunaprevir (600 mg, twice daily by mouth) alone; the other 10 patients took the experimental drugs
See more NEJM Reports on 2 New Drugs for Hepatitis C
By Elaine Schattner, MD, on January 25th, 2012
Yesterday Dr. Val Jones, @DrVal, took med-blog Grand Rounds to a new level. She poured through over 100 entries, and published 55 synopses at USA Today’s Healthy Perspective column.
There are 4 parts:
Health Tips
True Stories
Myth-busters and Controversies
Health Care Costs
Congratulations, and thanks, to Val for pulling together so much thoughtful work!
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Related Posts:Med-Blog Grand Rounds Takes a Virtual TourAnnouncement for Next Week’s Med-Blog Grand RoundsHot Topics: This Week’s Med-Blog Rounds at Bedside MannerWhy Should Physicians Blog or Use Twitter?Shoutout to Shrink Rap
By Elaine Schattner, MD, on January 24th, 2012
Last week I came upon a new term in the cancer literature: the Disease Control Rate. The DCR refers to the total proportion of patients who demonstrate a response to treatment.
In oncology terms: The DCR is the sum of complete responses (CR) + partial responses (PR) + stable disease (SD).
Another way of explaining it: Some people with cancer have measurable, growing tumors. For example, a man might have a sarcoma with multiple metastases in the lung that are evidently progressing. If the patient starts a new treatment and the lung mets don’t shrink but stop getting bigger, that might be considered a stabilizing effect from the therapy, and his response would be included in the DCR. —
Related Posts:Lowering Cancer Care Costs by Reducing Tests After TreatmentDefining a Cluster of Differentiation, or CDReview: Dr. Eric Topol’s Creative Destruction of MedicineNew Studies on Colon Cancer Screening by Colonoscopy and Fecal Blood Testing50–50, A Serious Film About a Young Man With a Rare Cancer
By Elaine Schattner, MD, on January 23rd, 2012
Today’s Wall Street Journal includes a special Big Issues health care section. A post on their blog caught my attention: Should Patient Have Electronic Identification Numbers?
The idea is that people who use health care would each be assigned a universal patient identifier, or UPI. This unique number would link to a person’s health records. In principle it would facilitate transfer of a patient’s medical history between doctors, hospitals and, likely, insurance companies. There are arguments pro – mainly having to do with efficiency and patient safety; and against – mainly having to do with privacy.
My issue is that it reminds me of Auschwitz. But apart from that particular association, labeling people with numbers seems dehumanizing — what’s already a big negative in modern health care. I/we need to realize that already we have numbers. Most people have social security numbers. I have several hospital ID numbers and insurance company numbers.
As for privacy, that’s
See more The ‘Journal’ Asks, Should Patients Have Identification Numbers?
By Elaine Schattner, MD, on January 22nd, 2012
 Paula Deen’s new message
I never heard of Paula Deen until this week, when the plump Food Channel celebrity and cookbook author announced she has Type 2 diabetes. The Georgia-born, sweet tea-loving cook has teamed up with Novo Nordisc to spread the word about dietary modification and life with diabetes. Her new platform, Diabetes in a New Light, highlights a drug she’s taking called Victoza.
Type 2 diabetes tends to develop in overweight people who become resistant to insulin. Thi disease is epidemic in North America; it affects over 8 percent of the population. Almost 95 percent of adult-onset diabetes cases are Type 2; many could be avoided by diet and lifestyle modification. Diabetes causes blood vessel abnormalities throughout the body; it leads to secondary illnesses like heart disease, stroke, poor vision and blindness, kidney problems, neuropathy and other serious health problems. It’s a costly disease, apart from the medical effects; The NIH estimates
See more A Good Outcome from Celebrity Chef Paula Deen’s Message about Diabetes?
By Elaine Schattner, MD, on January 18th, 2012
Tomorrow the American Society of Clinical Oncology* will host its 9th annual GI Cancers Symposium. Bloomberg and the LA Times have already reported findings of a paper, still in abstract form, to be presented on Saturday.
The drug of interest is regorafenib, a pill that loosely inhibits quite a few kinases – enzymes critical in cell signals that control growth of normal cells, tumors and blood vessels. The experimental med, manufactured by Bayer, is also known as BAY 73–4506. The new data emerge from an international, randomized Phase III trial that goes by a loaded acronym: CORRECT.
The study included 760 patients with advanced colon or rectal cancer whose tumor progressed after receiving standard treatments. Participants received either the study drug or BSC (best supportive care) and a placebo. According to the paper, BSC includes antibiotics, pain meds, radiation for bone mets, steroids and some other treatments. The median survival in patients who received the
See more Regorafenib, an Experimental Pill Tested in Colon and Rectal Cancer Patients, on Conference Agenda
By Elaine Schattner, MD, on January 17th, 2012
This week I finished reading the Emperor of All Maladies, the 2010 “biography” of cancer by Dr. Siddhartha Mukherjee. The author, a medical oncologist and researcher now at Columbia University, provides a detailed account of malignancies – and how physicians and scientists have understood and approached a myriad of tumors – through history.
The encyclopedic, Pulitzer Prize-winning book is rich with details. In the first half, Mukherjee focuses on clinical aspects of malignancy. He works both ancient and modern stories into the narrative; the reader learns of Atossa, the Persian queen of the 6th Century BCE who covered her breast disease, and Thomas Hodgkin, who in the 19th Century dissected cadavers and noted a “peculiar” pattern of glandular swelling in some young men, and Einar Gustafson, aka Jimmy, who was among the first children cured of leukemia in the 1950s.
The second half is a tour-de force on cancer biology; the author winds distinct threads
See more The Emperor of All Maladies: A Detailed Narrative of Cancer History and Ideas
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