American College of Physicians: Internal Medicine — Doctors for Adults ®

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Internists play important role in diagnosing, treating MS

From the September ACP Internist, copyright © 2009 by the American College of Physicians

Internists are often patients’ first line of defense in dealing with multiple sclerosis (MS), but the clinical challenges involved can be especially tricky. MS is notoriously difficult to diagnose, so some say it’s best to leave that part to the specialists. On the flip side, though, internists still need to be alert for possible MS symptoms and look beyond the “typical” patient to those who may not match the usual profile. Internists also play an important role in getting new MS patients treated quickly and can help manage other medical problems that can trigger an attack in patients with existing disease. In our cover story, Stacey Butterfield distills experts’ advice on how internists can help tackle MS effectively.

Also, Paula S. Katz provides highlights from Digestive Disease Week, held last May and June in Chicago. Included are tips on diagnosing and treating functional dyspepsia and information on a possible connection between hip fracture risk and therapy with proton-pump inhibitors or histamine-2 receptor antagonists. New research presented at the meeting also suggests how much weight loss is linked to improvement in nonalcoholic steatohepatitis as well as why bariatric surgery in obese patients may not be the best bet to achieve it.

Looking beneath the surface of a patient encounter can sometimes yield surprising information. In this issue’s Mindful Medicine, Jerome Groopman, FACP, and Pamela Hartzband, FACP, provide commentary on a reader-submitted case about a 44-year-old woman with chronic depression who was thinking of committing suicide. Her internist was able to uncover her hidden agenda and avert a tragedy by using availability bias and patient activation and engagement. Drs. Groopman and Hartzband explain these terms and why they worked in this situation.

This issue is my first as editor of ACP Internist, and I’m excited to help continue the good work we’ve done so far. Our news staff takes pride in bringing you the content you want when and how you want it, via our print issue and e-newsletter, ACP InternistWeekly; our Web site; and our blog. Let us know how we’re doing.

Sincerely,
Jennifer Kearney-Strouse

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