Newswise — Who would enjoy being a patient so much that they would fake being sick? John S. Fordtran, M.D., gastroenterologist and past chairman of medicine at Baylor University Medical Center at Dallas, presents five fascinating case studies of feigned illness, also called factitious disease, and one case in which the symptoms were considered "psychogenic" but actually had a physical cause. The cases include laxative-induced diarrhea, sepsis caused by self-inoculation with bacterial cultures, and feigned cancer. Dr. Fordtran profiles these patients and reviews theories about the psychological basis of the disorder. He also describes strategies for confrontation and ethical issues in caring for patients with factitious disease. (http://wwwp.baylorhealth.edu/proceedings/19_3/19_3_Fordtran.pdf)
After a major cardiac event such as a heart attack, patients receive conflicting advice. Some are told not to drive more than 30 minutes, not to "get exhausted" for a month, or not to lift more than 25 pounds for a period of time—or ever. These guidelines are not only confusing but can also promote fear and inactivity. When physicians do prescribe exercise, it is usually walking or another form of aerobic activity. In contrast, patients usually focus on the ability to perform tasks such as mowing the lawn or lifting grandchildren. Jenny Adams, Ph.D., an exercise physiologist at the Baylor Jack and Jane Hamilton Heart and Vascular Hospital, and her colleagues argue that weight training should be promoted as well as aerobic activity for these patients. They present four main points: 1) Activities of daily living require more strength than most people realize; 2) Resistance training improves patients' quality of life; 3) Resistance training has been shown to be effective in reducing risk factors for cardiovascular disease; and 4) Under the supervision of experienced personnel, resistance training is safe. (http://wwwp.baylorhealth.edu/proceedings/19_3/19_3_Adams.pdf)
Also in this issue:
—Jennifer Clay Cather, M.D., a dermatologist on the medical staff at Baylor University Medical Center at Dallas, reports on ways to treat warts—even reviewing one "duct tape" method. (http://wwwp.baylorhealth.edu/proceedings/19_3/19_3_Cather.pdf)
—Jonathan Whitfield, M.D., chairman emeritus of pediatrics at Baylor University Medical Center at Dallas, explores how aggressive nutritional approaches in the premature infant should be considered along with initial efforts focusing on warmth, respiratory support, and cardiovascular support. (http://wwwp.baylorhealth.edu/proceedings/19_3/19_3_Whitfield.pdf)
Baylor University Medical Center Proceedings, now in its 19th year, is an institutional peer-reviewed medical journal that was accepted into PubMed Central in 2005. It has a circulation of 6,000. To read Proceedings online, visit http://wwwp.baylorhealth.edu/proceedings/currentissue.htm. Baylor University Medical Center at Dallas is the flagship hospital of Baylor Health Care System.
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