Removing the Fallopian Tubes to Prevent Ovarian Cancer – Something to Consider
New information strongly suggests that most ovarian cancers originate, not in the ovary, but in the fallopian tube. If this is so, then removal of the fallopian tubes may actually prevent ovarian cancer.
The evidence is powerful enough that the American Congress of Obstetricians & Gynecologists is now recommending that fallopian tube removal be considered in women planning to undergo surgical sterilization or hysterectomy.
The Fallopian Tube Origin of Ovarian Cancer
We used to think that ovarian cancer originated in the peritoneal lining that covers the ovaries and abdominal organs. But the fallopian tube origin of ova...
Source: The Blog That Ate Manhattan - January 23, 2015 Category: Primary Care Authors: Margaret Polaneczky, MD Tags: Best of TBTAM Family Planning Ovarian Cancer Essure Fallopian tube oophorectomy prophylactic salpingectomy Sterilization Tie my tuibes tubal ligation Tubes Source Type: blogs
Hysterectomy for chronic pelvic pain: 7 questions to ask
Chronic pelvic pain (CPP, pain in the pelvis that is present for more than 2 weeks a month and has been there for more than 6 months) affects 15 percent of women and accounts for upwards of $2 billion a year in direct medical costs. To say it is a significant health burden is a gross underestimate at best. My entire practice is devoted to the treatment of pelvic pain and there are few words to describe the suffering, much of it compounded by societal misunderstanding of the condition (i.e., the misperception that it is “all in your head”). Many doctors also don’t understand CPP leading many women down what I can only...
Source: Kevin, M.D. - Medical Weblog - December 26, 2014 Category: Journals (General) Authors: Jennifer Gunter, MD Tags: Conditions OB/GYN Source Type: blogs
Top stories in health and medicine, November 25, 2014
From MedPage Today:
FDA Advisers Tackle Epidural Steroid Shots. An FDA advisory committee is meeting Monday and Tuesday to discuss adverse neurologic effects following the use of epidural steroid injections for pain management.
FDA Stiffens Warning on Power Morcellators. The FDA has warned against using power morcellators during hysterectomy or treatment of uterine fibroids and ordered new contraindications and a boxed warning for the devices’ labeling.
Former HHS Official Calls For ‘Smarter’ Networks. Many consumers who signed up for health coverage through online insurance exchanges discovered their d...
Source: Kevin, M.D. - Medical Weblog - November 25, 2014 Category: Journals (General) Authors: MedPage Today Tags: News Hospital OB/GYN Pain management Source Type: blogs
Why hysterectomy for many endometrial hyperplasias is often overkill
A recent case that I saw in consultation at the patient’s request highlights the pervasive problem of overdiagnosis and overtreatment of endometrial hyperplasia. This 46-year-old woman was diagnosed with simple hyperplasia without atypia within an excised endometrial polyp, for which both her gynecologist and pathologist recommended hysterectomy. The basis for this recommendation was a perceived increased risk of endometrial cancer, either currently lurking within her uterus or to be developed in the future, even though the cancer risk for this lesion has never been shown to be above the 2 to 3 percent overall lifetime r...
Source: Kevin, M.D. - Medical Weblog - October 21, 2014 Category: Journals (General) Authors: Roger Reichert, MD, PhD Tags: Conditions OB/GYN Source Type: blogs
Who is NOT a DIEP flap candidate?
With more women becoming aware of DIEP flap breast reconstruction as an option, the question of who is and who isn't a good DIEP flap candidate is coming up more often.As a general rule, women that have had extensive abdominal surgery like a previous TRAM flap, tummy tuck or a complex hernia repair cannot have a DIEP or SIEA flap breast reconstruction. This is because the lower tummy tissue that is needed has usually been removed or moved around, and the necessary blood supply has been disrupted.Having said that, most of the time previous abdominal surgery isn't an issue in experienced hands.Many women these days have...
Source: Breast Cancer Reconstruction Blog - October 21, 2014 Category: Cancer & Oncology Tags: breast reconstruction bulging c-section complications CT angiogram diep flap candidate hernia hysterectomy siea flap TRAM flap tummy tuck ultrasound Source Type: blogs
Who is NOT a DIEP flap candidate?
With more women becoming aware of DIEP flap breast reconstruction as an option, the question of who is and who isn't a good DIEP flap candidate is coming up more often.As a general rule, women that have had extensive abdominal surgery like a previous TRAM flap, tummy tuck or a complex hernia repair cannot have a DIEP or SIEA flap breast reconstruction. This is because the lower tummy tissue that is needed has usually been removed or moved around, and the necessary blood supply has been disrupted.Having said that, most of the time previous abdominal surgery isn't an issue in experienced hands.Many women these days have...
Source: Breast Cancer Reconstruction Blog - October 21, 2014 Category: Cancer & Oncology Tags: breast reconstruction bulging c-section complications CT angiogram diep flap candidate hernia hysterectomy siea flap TRAM flap tummy tuck ultrasound Source Type: blogs
The Hospital Discharge Race: is Sooner Always Better?
They say that if you can remember the 1960s, you weren’t there. I do remember this about 1966, however: I spent my birthday that year in a hospital bed, where I’d been a patient for a full month recuperating from a ruptured appendix and a nasty case of peritonitis. Back then during the dawn of civilization, it was common for patients to spend far longer in hospital than we ever would now. For example:
For North American maternity patients during the same era, the average length of stay in hospital for uncomplicated vaginal deliveries was about seven days. Today, that stay is more likely to be just 1-2 days(1).
F...
Source: Disruptive Women in Health Care - September 10, 2014 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Uncategorized Source Type: blogs
The RUC. "an Independent Group of Physicians?" - But It Includes Executives and Board Members of For-Profit Health Care Corporations and Large Hospital Systems
Introduction We just discussed how a major story in Politico has once again drawn attention to the opaque RUC (Resource Based Relative Value System Update Committee) and its important role in determining what physicians are paid for different kinds of services, and hence the incentives that have helped make the US health care system so procedurally oriented. (See the end of our last post for a summary of the complex issues that swirl around the RUC.)The Politico article covered most of the bases, but notably omitted how the RUC may be tied to various large health care organizations, especially for-profit, and how the...
Source: Health Care Renewal - August 28, 2014 Category: Health Management Tags: AMA boards of directors conflicts of interest health care prices healthcare executive hospital systems perverse incentives regulatory capture RUC Source Type: blogs
My University of Michigan Experience
By: Ethel Osei-Tutu, medical student, University of Cape Coast, School of Medical Sciences, Ghana
Editor’s Note: For more information on the Ghana–Michigan medical student exchange program, see “Perceptions of Ghanaian Medical Students Completing a Clinical Elective at the University of Michigan Medical School” by Abedini, Danso-Bamfo, and colleagues, published in the July issue.
The University of Cape Coast, School of Medical Sciences (UCCSMS) began a yearly exchange program with the University of Michigan (UMich) in 2012. Four final-year students from UCCSMS are selected each year based on merit ...
Source: Academic Medicine Blog - August 28, 2014 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Trainee Perspective international exchange program international medical education patient centered care University of Cape Coast School of Medical Sciences University of Michigan Medical School Source Type: blogs
Patient-centered care about more than just financial gains
by Thomas Dahlborg
This week my intention was to follow up my recent post highlighting kindness, compassion and patient-centered care with additional positive signs of a healthcare transformation where patients and families are engaged, care teams are healthy and whole and positioned to honor their patients, and patient preferences, patient safety and healthcare outcomes are all being optimized.
And then two things happened.
The first was a discussion within the Robert Wood Johnson Foundation (RWFJ) Leadership Network LinkedIn forum. I asked a question relative to patient engagement, tools, lessons learned and best prac...
Source: hospital impact - August 3, 2014 Category: Health Managers Authors: Wendy Johnson Source Type: blogs
Healthcare Update — 07-24-2014
This study might suggest that mega-hospital care is better, but is immediate care in small volume emergency departments better than delays in care during travel to a mega-hospital … or no care at all because patients can’t get there?
This may explain why doctors are so good at practicing defensive medicine. During their careers, doctors spend more time in the courtroom than in the classroom.
The headline is misleading since during a lawsuit, doctors aren’t in the courtroom 40 hours per week as they are during medical school. The point is that for 11% of their careers, an average physician has a lawsuit ha...
Source: WhiteCoat's Call Room - July 24, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Healthcare Update Source Type: blogs
Robots invade the rest of the world
There's a lot of good news in this story by Jaimy Lee at Modern Healthcare, but there is also a warning. The good:Intuitive Surgical saw its revenue and income fall again in the second quarter as sales of its da Vinci robotic surgery systems continued to drop.The use of robotic surgery systems in gynecologic procedures such as hysterectomies continued to decline, and that trend is not expected to reverse, company officials noted during a call with investors.The warning:Worldwide procedure volume for the company's products went up 9%, led by . . . a higher number of urologic procedures outside of the U.S. This re...
Source: Running a hospital - July 23, 2014 Category: Health Managers Source Type: blogs
Collateral damage after cancer surgery
Dr. Robert’s office felt right to me, with a musical birdsong soundtrack, soft lighting and fresh green tea, and I had my best friend in tow: piece of cake. In this serene atmosphere, I was sure that I’d find out what to do next to finish treating my endometrial cancer.
“It’s probably gone now, since my hysterectomy two weeks back,” I thought. “But let’s play it safe; he’s the gynecological-cancer guru.”
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Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - June 11, 2014 Category: Journals (General) Authors: Brenda Tags: Patient Cancer Source Type: blogs
Power morcellation: Answers to your safety questions
The Food and Drug Administration (FDA) recently released a statement about power morcellation during hysterectomy and myomectomy (surgery to remove uterine fibroids), raising concerns about these devices spreading unanticipated cancers. There have been several reports in the literature and the press alike of this happening and when it does it significantly worsens the prognosis. The American Congress of Obstetrician and Gynecologists (ACOG) is now re-exploring this issue. Pending a full review the FDA is discouraging the use of power morcellators for hysterectomy and myomectomy.
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Your patients are...
Source: Kevin, M.D. - Medical Weblog - May 28, 2014 Category: Journals (General) Authors: Jennifer Gunter, MD Tags: Conditions OB/GYN Source Type: blogs
A Patient’s Story–How Much Can or Should– Your Doctor Tell You About Potential Risks?
Below a non-fiction story from Pulse: Voices from the Heart of Medicine, “an online magazine of personal experience in health.” Pulse is both a magazine and an online community that provides a chance for patients, doctors, nurses, social workers to come together, and share their experiences.
The magazine’s founders write: “Despite the large numbers of health magazines and medical journals, few openly describe the emotional and practical realties of health care. We at Pulse believe that our stories and poems have the power to bring us together and promote compassionate health care. “ Pulse was launched by th...
Source: Health Beat - May 18, 2014 Category: American Health Authors: Maggie Mahar Tags: endometrial cancer malpractice suit Pulse: voices from the heart of medicine shared decision making follow-up surgery lymlymphectomy/omentectomy lymph-vessel blockage lymphedema Source Type: blogs
