Conditions

Poll: Changing clinical study entry criteria to include terminal patients

When it comes to terminal disease, experimental therapies can be a patient’s last hope.

Should physicians try to bend the entry criteria of clinical studies to include these often desperate patients?

A recent study from the University of Massachusetts medical school revealed that 90 percent of physicians would ignore the entry guidelines for a study if they felt that it would benefit the patient.

The New York Times cited examples ranging from “altering …

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How the mammogram and Pap smear debates ignore the uninsured

by Jeoffry B.Gordon, MD, MPH

The recent recommendation of the US Preventive Services Task Force against routine screening mammograms for healthy, low risk women under the age of fifty has demonstrated our broad consensus about the value of breast cancer screening. The discussions about new guidance from the American Academy of Obstetrics and Gynecology on when to start and how often to do PAP smears illuminate the impact, effectiveness and support …

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The health reform politics of mammograms and breast cancer screening

Originally published in MedPage Today

by Emily P. Walker, MedPage Today Washington Correspondent

The emotional debate over a federal panel’s proposal to end routine mammograms for women in their 40s has reignited controversy over a contentious healthcare reform issue: comparative effectiveness research.

Healthcare reform opponents say the new mammogram guidelines by the U.S. Preventive Services Task Force (USPSTF) make their point: If …

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What is the death toll for the H1N1 flu pandemic?

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

In the first six months of the H1N1 flu pandemic, 22 million Americans fell ill from the virus, the CDC now estimates.

Of those, about 98,000 needed inpatient care, and 3,900 died, according to Anne Schuchat, MD, director of the CDC’s National Center for Immunization and Respiratory Diseases.

The estimates …

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Using cell phone text messages to remind people to use sunscreen

Originally published in Insidermedicine

Daily text messages sent to individuals’ cells phones can help remind them to use sunscreen, according to research published in the latest issue of the Archives of Dermatology.

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When women should have their first Pap smear; the new cervical cancer screening guidelines

Originally published in MedPage Today

by Charles Bankhead, MedPage Today Staff Writer

Women can wait longer for their first Pap smear and then repeat the test less frequently, according to recommendations from the American College of Obstetricians and Gynecologists (ACOG).

The organization now says women should begin cervical cancer screening with a Pap test at age 21. Subsequent tests should occur at …

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Why health reformers should be worried about the breast cancer screening backlash

What if a non-partisan, authoritative entity wrote a robust, evidence-based guideline, but nobody followed it?

That is precisely what’s happening with the USPSTF’s recent revision of their breast cancer screening recommendations. The change most find problematic is their recommendation that women younger than 50 not undergo any breast cancer screening, such as with a mammogram.

Here are their reasons explaining why:

The harms resulting from screening for breast cancer include psychological harms, …

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Can family doctors do safe first trimester abortions?

Originally published in MedPage Today

by Chris Emery, MedPage Today Contributing Writer

Complications from first trimester abortions performed by family practitioners are rare, and family doctors could help address abortion provider shortages across the U.S., a new study found.

Among more than 2,500 abortions performed by family physicians, abortion was successful without complications in 96.5% of patients using medications (95% CI 95.5% …

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Will patients accept the new, evidence-based, breast cancer screening guidelines?

Breast cancer screening has been scaled back, according to the recent recommendations of the USPSTF.

That’s the right move. Although women aged 50 to 74 years should receive a mammogram every 2 years, evidence of breast cancer screening in other age groups has been marginally conclusive at best, and non-existent when it comes to clinical self-exams.

Furthermore, the guidelines implicitly acknowledge the downsides of cancer screening, including the possibility of biospies …

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Who’s dying from the H1N1 flu pandemic?

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

Although the pandemic H1N1 flu tends to strike younger people, it can be life-threatening when older people are infected, California researchers said.

In the first four months of the pandemic, 1,088 people in the state needed inpatient care or died of the pandemic flu strain, according to Janice Louie, …

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Does television make toddlers more aggressive?

Originally published in Insidermedicine

Both watching television and having a television on in the household are associated with a higher level of aggression in three-year-olds, according to research published in the latest issue of the Archives of Pediatric and Adolescent Medicine.

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Many women report nerve-related persistent pain after breast surgery

Originally published in Insidermedicine

Nearly half of women who undergo surgery and other treatments for breast cancer report having persistent pain in and around the treatment area a year or more later, probably because of nerve damage, according to research published in the November 10 issue of the Journal of the American Medical Association.

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Will video cameras in the OR decrease the rate of wrong-site surgery?

by Kristina Fiore, MedPage Today Staff Writer

Rhode Island Hospital, located in Providence, will pay $150,000 and install video cameras in all of its operating rooms after performing its fifth wrong-site surgery since 2007, according to the state’s Department of Health.

The hospital will also have to open its ORs to an inspector who will observe surgical procedures and protocols for at …

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How do people with dementia die?

Originally published in HCPLive.com

by Victor G. Dostrow, MD

Dementia is a terminal illness. However, people with advanced dementias often languish in skilled nursing facilities, far from the ministrations of specialists. And, with reasonable luck, they have directives that specify that they are not to be taken to the hospital in the event of a respiratory arrest. Consequently, most of us are not privy to the mechanisms of demise in such situations.

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Do home fetal heart monitors give mothers false reassurance?

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Expectant mothers may enjoy listening to their unborn babies’ heartbeats, but they shouldn’t rely on home fetal heart monitors to provide an accurate picture of fetal health, researchers say.

The devices may provide false reassurance in some situations, according to Abhijoy Chakladar, MD, of Princess Royal Hospital in West Sussex, …

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H1N1 flu is potentially life threatening to people of all ages

Originally published in Insidermedicine

H1N1 flu can cause serious illness, resulting in hospitalization and even death among individuals of all ages, according to surveillance information coming out of California that was published in the November 4 issue of the Journal of the American Medical Association.

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