An avoidable catastrophe?
This is an observational study only, and it doesn't completely answer the question, but this analysis in JAMA Oncology certainly poses one. Understanding this is a bit complicated, and remember, I'm not a real doctor, I'm a doctor of philosophy, but let me tell you what it means to me.Narod et al used a registry called the Surveillance, Epidemiology and End Results (SEER) database to see what happened over 10 and 20 years to women who were diagnosed with so-called Ductal Carcinoma in Situ (DCIS). These are clusters of abnormal cells inside the milk duct. Until the widespread use of screening mammography, they were essentia...
Source: Stayin' Alive - August 21, 2015 Category: American Health Source Type: blogs
Poor Quality Sleep: A Silent Source of Disability in Breast Cancer
The post below ran on Huffington Post Healthy Living on May 13. It is authored by Hrayr Attarian, MD, FACCP, FAASM, Member of the Society for Women’s Health Rearch Network on Sleep and Associate Professor of Neurology, Northwestern University, Circadian Rhythms and Sleep Research Lab for the Society for Women’s Health Interdisciplinary Network on Sleep.
Poor quality sleep is a major contributor to reduced quality of life and can have a negative impact on mood and energy, cognition, metabolic and immunological function, as well as lead to weight gain [3].
Sleep-related complaints are quite common in women with b...
Source: Disruptive Women in Health Care - July 14, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Cancer Source Type: blogs
OIG Releases Mid-Year 2015 Work Plan, Includes New Provisions Related to Open Payments Oversight and Scrutiny into Clinical Laboratory Payments
Yesterday evening the Department of Health and Human Services (HHS) Office of Inspector General (OIG) released their Work Plan Mid-Year Update for fiscal year (FY) 2015, which summarizes new and ongoing reviews and activities that OIG plans to pursue. A number of new terms find its way into the mid-year plan, including a provision related to OIG’s anticipated oversight of the Open Payments program, as well as a provision stating that OIG will analyze CMS payments to the top 25 clinical diagnostic laboratories.
View the Work Plan here.
The OIG’s job is to detect fraud, waste, and abuse; identify opportunities to improve...
Source: Policy and Medicine - May 29, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
How do you know if cancer treatment worked?
The patient was a young looking 74-year-old woman, accompanied by her husband. She was not exactly sure why she was seeing me and nodded as I explained that I see all women with anal or rectal cancer who are being treated with radiation therapy. I explained that we recommend that these patients use vaginal dilators to improve elasticity after radiation in the pelvic region, and my meeting with her was an opportunity for me to show her the dilators, educate her about the reasons for their use, and answer any questions she may have.
“Oh, no thanks, my dear,” she began, “I’ve no need for those. We’re not sexually ac...
Source: Kevin, M.D. - Medical Weblog - May 14, 2015 Category: Journals (General) Authors: Anne Katz, RN, PhD Tags: Conditions Cancer Source Type: blogs
Reflecting on the physician’s social contract
“55-year-old man with history of laryngeal carcinoma, status-post radiation therapy, laryngectomy, bilateral neck dissection, with metastases to the lung, status post thoracotomy, currently undergoing chemotherapy who is being admitted for a for first-time seizure. Patient is a transfer from Riker’s Island.”
Prisoners are a common occurrence in Bellevue Hospital. This, however, was my first prisoner-patient. The hyphenation both as I write this now and as it formed as a concept in my mindset off a series of internal dialogues and periods of self-reflection regarding the rights of patients, physicians, and if these ri...
Source: Kevin, M.D. - Medical Weblog - April 17, 2015 Category: Journals (General) Authors: Hadi J. Minhas Tags: Physician Primary care Source Type: blogs
What Can Patients Do In The Face Of Physician Conflict Of Interest?
Trust has always been essential to medical care. Of what use are the best communication skills, physician empathy, or clinical knowledge if patients don’t trust the advice and information that their doctors give them?
Even the most psychologically disturbed or misanthropic TV doctor—from Doc Martin to Gregory House—can always be trusted to put his patients first; this is precisely because this trustworthiness is so central to our understanding of being a physician. While this sort of idealization is commonplace and reassuring, it has become more and more problematic. For, in today’s medical world, the lines...
Source: Health Affairs Blog - April 10, 2015 Category: Health Management Authors: James Rickert Tags: All Categories Business of Health Care Consumers Health Care Costs Health Care Delivery Payment Personal Experience Physicians Policy Quality Source Type: blogs
Health Affairs’ April Issue: The Cost And Quality Of Cancer Care
This study is part of Health Affairs’ DataWatch series.
Under the new pay-for-performance models, how do low performers fare?
Jessica Greene of George Washington University’s School of Nursing and coauthors studied the impact of a primary care provider compensation model—that of Fairview Health Service, a Pioneer accountable care organization in Minnesota—in which 40 percent of providers’ compensation was based on their clinic-level quality outcomes. The researchers examined providers’ performance data before the model and two years after implementation,
The best predictor of improvement was the primary care pr...
Source: Health Affairs Blog - April 6, 2015 Category: Health Management Authors: Chris Fleming Tags: Access All Categories Chronic Care Comparative Effectiveness Consumers Europe Health Care Costs Health Care Delivery Pharma Policy Quality Research Source Type: blogs
MKSAP: 54-year-old woman asking advice about bone health
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 54-year-old woman comes to the office for advice regarding maintaining bone health. She has no history of fracture. The patient recently had a lumpectomy and radiation therapy to treat breast cancer, is currently taking tamoxifen, and will begin taking an aromatase inhibitor in 2 months. She underwent menopause at age 52 years and has persistent hot flushes. Her risk factors for osteoporosis include a slim body habitus and a mother who had a hip fracture at age 67 years.
Physical examination findings, includin...
Source: Kevin, M.D. - Medical Weblog - March 21, 2015 Category: Journals (General) Authors: mksap Tags: Conditions Endocrinology Source Type: blogs
Which is More Uncomfortable: The Colonoscopy or Treatment for Colon Cancer?
Michelle was a healthy, active 47 year old. She tried to eat right and she exercised. It looked like the hard work was paying off: no health issues and lots of energy. Her work in the healthcare field motivated her to see her doctors regularly for checkups, to get mammograms and to have her blood work done annually. She knew she was getting close to the magical age of 50 and that soon she would need to get a colonoscopy to screen for colorectal cancer. Since she had no family history of the disease she wasn’t worried. She felt certain that, just as all her previous testing had come back normal, this one would too.
...
Source: Disruptive Women in Health Care - March 18, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Cancer Source Type: blogs
Senolytic Drugs to Kill Off Senescent Cells and Thereby Slow the Progression of Degenerative Aging
As we age, an increasing number of cells fall into a senescent state in which they cease dividing and begin to secrete all sorts of compounds that both harm surrounding tissue structure and raise the odds of nearby cells also becoming senescent. This seems to be a tool of embryonic development that now also acts to suppress cancer risk by removing the ability to divide from those cells most likely to become cancerous. Unfortunately it harms tissue function in doing so, and worse, only actually suppresses cancer risk when there are comparatively few senescent cells. Given a lot of these cells their activities cause chronic ...
Source: Fight Aging! - March 9, 2015 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
Targeting Anti-Inflammatory Drugs Directly to Atherosclerotic Lesions in Blood Vessel Walls
In this study, we've shown, for the first time, that a drug that promotes resolution of inflammation and repair is a viable option, when the drug is delivered directly to plaques via nanoparticles." To be ready for testing in humans, the team plans to fine-tune the nanoparticles to optimize drug delivery and to package them with more potent resolution-inducing drugs. "We think that we can obtain even better delivery to plaques and improve healing more than with the current peptides."
Targeted nanoparticles containing the proresolving peptide Ac2-26 protect against advanced atherosclerosis in hypercholesterolemic mice
Chr...
Source: Fight Aging! - February 18, 2015 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
Ever More Cancers Until Cancer and Its Causes are Defeated
Cancer research is perhaps the field of medical science with the greatest level of funding and public support. The next generation of therapies presently under development are a great leap ahead in comparison to the present staples of chemotherapy and radiation therapy, making use of new tools in cellular biotechnology and promising accurate targeting of cancer cells for destruction with few side-effects. This is just as well, as life spans are lengthening now, and will continue to lengthen at an increasingly rapid pace in the future. That additional time brings with it the standard risk of suffering cancer at some point, ...
Source: Fight Aging! - February 4, 2015 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
A Look at the Current State of Cancer Immunotherapy
The next generation of cancer treatments are all about targeting, finding ways to distinguish and destroy only cancer cells, to as to produce therapies that are much more effective, even against late stage metastatic cancer, and have few side effects. The present staples of chemotherapy and radiation therapy are arduous and only partially effective precisely because they are not very selective. It is easy to destroy cells, but hard to destroy only particular cells. One of the more promising lines of research and development for targeted cell destruction is immunotherapy: making use of the existing capabilities of immune ce...
Source: Fight Aging! - December 12, 2014 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
Markers for Senescence Cells
Cells are complex machines that have many carefully regulated states. One of those states is senescence, in which the cell permanently exits the cell cycle, stops dividing, and begins to secrete a variety of molecules that, among other things, degrade surrounding extracellular matrix structures and encourage nearby cells to also become senescent or change their behavior in other ways. This senescent state seems to be a tool that originally evolved to help manage embryonic growth: senescent cells are found in embryos in places that suggest they are managing shape or tissue transitions during development.
Evolution promiscu...
Source: Fight Aging! - December 10, 2014 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
A View of Stochastic DNA Damage in Aging
Cancer is thought to be a disease of aging because we accumulate randomly distributed damage to nuclear DNA as we age. The older you are the more of this damage you have. Sooner or later the right combination of mutations occur in a cell that slips past the monitoring of the immune system and other defensive systems, which themselves decline with age due to other forms of damage, and it runs amok to grow a cancer. It remains an open question as to whether this nuclear DNA damage in aging is significant in any other way besides cancer over the present length of a human life span, though it is the default assumption in the r...
Source: Fight Aging! - December 10, 2014 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
