2 Docs Talk: The podcast about healthcare, the science of medicine and everything in between.

With the recent release of the Netflix series, 13 Reasons Why, depression and suicide have been getting a lot of press time. In this episode, we talk about depression, what it is, how it is treated and what's on the horizon for this far too common disorder. 

We also talk a bit about the Netflix series and the problem of suicide. Take a listen and see what you think.

If you think you may be depressed please seek help from a trusted healthcare provider. And if you are contemplating suicide, there is help for you - please contact the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK). Someone will answer your call and help you find the resources you need to deal with your depression. 

RESOURCES:

Brains of people with depression are different

Brain imaging reveals different types of depression

Summary of effectiveness of SSRIs and other antidepressant medications

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So spring breakers on South Padre Island in Texas are coming down with the mumps. Since the MMR (measles, mumps, rubella) vaccine was introduced in 1967, we've stopped expecting these outbreaks. 

But recent increases in those who choose to have their children forego vaccines has led to a loss of herd immunity and an increase in these outbreaks.

To further complicate the issue, it seems that immunity wanes with time, which is why many college students (hello spring break!) find themselves falling ill eight to ten years after their last booster at age 12 to 15. 

Resources:

Mumps at South Padre

Learn more about the Mumps and the Mumps vaccine from the CDC

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If you've ever felt like you had a handle on the evidence about a certain medical topic only to read a headline telling you science now says the opposite, you aren't alone. 

But science isn't about headlines. It's about evaluating the evidence to decide what's real, and it doesn't always conform to what we want. But that doesn't stop the media, (and maybe some journals), from selectively reporting the research that will generate the most buzz.

Today we talk about this issue and ideas that are being discussed to help be sure all the evidence, including the unremarkable evidence, is adequately reported.

Resources:

Nurse's Health Study

Women's Health Initiative

Calcium and Heart Disease Risk

Results-Blind Study

PLOS on Data

2 Docs Talk about Hormone Replacement Therapy

2 Docs Talk about Supplements

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Each year, under Obamacare rules, the USPSTF is required to issue a report on evidence gaps. These are areas of preventive medicine that they decide we are lacking sufficient evidence to determine if the harms outweight the risk.

This week, we take a look at the primary areas of evidence shortfall. If you are wondering about a screening test, take a listen to see if it made the list.

Resources:

Sixth Annual Report to Congress on High Priority Evidence Gaps

2 Docs Talk about Smoking Cessation

2 Docs Talk about dietary supplements

2 Docs Talk about skin cancer prevention

In healthcare, the holy graille seems to be longevity. We look at whether a treatment increases lifespan and use that as a barometer for it's value. 

But should that be the yardstick we use? Or would we be better off with a more subjective measure of improving quality of life, even if that means sacrificing some of the quantity.

Today, 2 Docs Talk about this question propose some things to consider as you consider your approach to aging and healthcare.

Resources:

Colonoscopy study in the Annals of Internal Medicine 

Research on lifespan in Nature

The Austad/Olshansky Wager

Most people probably know someone who has had thyroid disease of some sort, most commonly hypothyroidism - the term low thyroid hormone.

But there has been a significant rise in diagnosed thyroid disease in the past couple of decades due to screening. These diagnoses include problems with thyroid hormone as well as thyroid cancers. It's easy to get excited about diagnosing more disease - you catch it earlier and help people prevent the consequences of the disease. Or do you?

Today we are going to talk about screening asymptomatic patients for thyroid disease. We're also going to address that slipppery category of "subclinical" thyroid disease. 

Resources

British Medical Journal on Increased Diagnosis of Thyroid Cancer

Thyroid Cancer in Korea

GERD or gastroesophageal reflux disease is the very common disorder where acid backs up from the stomach into the esophagus. It results in that all too common problem we call heartburn, along with a slew of other symptoms.

Today we take a look at GERD, the commonly recommended remedies, and the one thing the evidence shows really works to get rid of the burn.

Resources

Risk of dementia in elderly patients with the use of proton pump inhibitors.

Association of Proton Pump Inhibitors With Risk of Dementia: A Pharmacoepidemiological Claims Data Analysis.

Acupuncture for functional gastrointestinal disorders.

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Kendall and Amy are in agreement that hospice care is an important, compassionate aspect of healthcare that humanizes what can be a very clinical, impersonal process. We've both experience with hospice - personally and professionally. 

Sadly, like most aspects of healthcare, the potential for profit has introduced some ugly practices into what should be focused solely on the needs of dying patients and their families.

Today, Kendall and Amy talk about the good and the bad of hospice as it exists in 2017.

Resources:

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Ever since Sarah Palin famously accused Obamacare of promoting death panels, the idea remains a fixture for some politicians to fall back on to impugn the healhcare law. 

But were death panels ever a part of the original healthcare law? And more importantly, how should patients and their physicians be approaching the topic of death, if at all?

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Hepatitis C infection is on the rise in recent years. The growing opioid epidemic has multiplied the problem, as the primary means of spread is IV drug use. 

Surprisingly only 35 percent of those infected received treatment even though excellent treatment available is for this devastating disease. Not surprisingly, drug costs are a major factor in this issue.

Join us as we discuss the issue of Hep C and what can be done about it.

Resources:

American Journal of Managed Care Special Issue on Hepatitis C Virus

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