An Open Letter to the Boston Globe About Lyme Disease
Today, the Boston Globe editorial board spoke out against a bill "that would require insurers in Massachusetts to cover Lyme disease treatments for as long as a doctor says they're needed." The Globe writes: Lawmakers may have good intentions, but they don't possess the expertise to decide whether it's beneficial, cost-efficient, or safe, to keep using strong medicines to treat a condition the medical establishment doubts is real. Such questions should be resolved by a consensus of doctors and researchers -- and buttressed by convincing clinical date [sic] -- not determined by legislative mandate. Who among the Boston Globe editorial board possesses the medical expertise to make this call is not disclosed, but this information would be useful given that the Globe's stance presumes absolute authority on the matter of treating Lyme disease -- siding with the Centers for Disease Control and Prevention on the controversial matter of diagnosing and treating persistent Lyme and associated diseases, and ignoring an abundant and growing body of contradictory research. The Globe states that, "According to the CDC, medical specialists believe the persistent ailments are likely caused by 'residual damage to tissues and the immune system that occurred during the infection.'" Some medical specialists believe this, based on evidence. Other recent evidence demonstrates that certain strains of the Lyme-causing Borrelia burgdorferi bacteria create what are known as "p...
The current meta-analysis of interventions for smoking cessation in patients with peripheral arterial disease is welcomed.1 However, the conclusion is discouraging. None of the randomized clinical trials revealed strong evidence that any behavioral or pharmacological aids helped.
ConclusionThe DCE-MRI radiomics model, especially image features extracted from the delayed phases, can help improve the performance in predicting TILs. The radiomics nomogram is effective in predicting TILs in breast cancer.Key Points•Radiomics features extracted from DCE-MRI, especially delayed phase images, help predict TIL levels in breast cancer.•We developed a nomogram based on MRI to predict TILs in breast cancer that achieved the highest AUC of 0.950.
ConclusionWe observed strong reproducibility in the assessment of PI-QUAL between two radiologists with high expertise in prostate mpMRI. At present, PI-QUAL offers clinicians the only available tool for evaluating and reporting the quality of prostate mpMRI in a systematic manner but further refinements of this scoring system are warranted.Key Points•Inter-reader agreement for each single Prostate Imaging Quality (PI-QUAL) score (i.e., PI-QUAL 1 to PI-QUAL 5) was strong, with weighted kappa = 0.85 (95% confidence intervals: 0.51 – 1) and percent agreement = 84%.• Interobserver agreement was strong wh...
This study was designed to compare the detection of subtle lesions (calcification clusters or masses) when using the combination of digital breast tomosynthesis (DBT) and synthetic mammography (SM) with digital mammography (DM) alone or combined with DBT.MethodsA set of 166 cases without cancer was acquired on a DBT mammography system. Realistic subtle calcification clusters and masses in the DM images and DBT planes were digitally inserted into 104 of the acquired cases. Three study arms were created: DM alone, DM with DBT and SM with DBT. Five mammographic readers located the centre of any lesion within the images that s...
Cervical artery dissection is a common cause of stroke in young adults and can lead to significant disability. Clinicians should be able to recognize the clinical presentation and diagnose this condition to prevent cerebral ischemia and its complications. Consider cervical artery dissection in a young adult with new-onset, unilateral head pain with or without neck pain with antecedent neck trauma, with or without neurologic deficits or risk factors for dissection. Early diagnosis can lead to better outcomes but the overall prognosis is good for young adults with cervical artery dissection.
This article analyzes the burden of COVID-19 on patients with opioid addiction and discusses the beneficial policy changes that improve access to substance abuse care.
No abstract available
The number of people living with chronic immunosuppression is increasing in the United States. Patients with HIV, those who have had bone marrow or solid organ transplants, and patients taking biologics for autoimmune diseases are at increased risk for skin cancer. Skin cancer in these patients is more aggressive and more likely to metastasize and cause death. Medications and individual risk factors such as sex, age, and ethnicity are independent risk factors for the development of skin cancer. Routine screening and aggressive treatment of actinic keratoses and nonmelanoma skin cancers can reduce patients' skin cancer burd...
Using tofacitinib to treat rheumatoid arthritis increases the risk of developing cancer by 48% vs a TNF inhibitor, according to a safety analysis published in The New England Journal of Medicine.Reuters Health Information
Prostate Cancer and Prostatic Diseases, Published online: 28 January 2022; doi:10.1038/s41391-021-00334-3Prostate Cancer: a comparison of focal therapy and radical prostatectomy
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