September 7th, 2011 by RamonaBatesMD in News, Opinion
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It’s amazing what you will find sorting through more than 20 years of stuff. This picture of 3 implants includes: top — an old McGhan double lumen (silicone gel implant surrounded by a saline implant); bottom left – Dow Corning textured silicone implant; and bottom right – Dow Corning smooth silicone implant. Dow Corning has not made breast implants since approximately 1992.
Last week the FDA met to discuss and make recommendations on postmarketing issues related to silicone gel-filled breast implants. As a condition of placing silicone implants back on the market in 2006, both Mentor and Allergan (McGhan) were supposed to enroll patients in 10-year-long follow up studies on side effects related to implants. The aim was for 80,000 women.
I agree these studies are needed, but it is difficult to get women to return year after year. This is evident in the data presented at the meeting: Read more »
*This blog post was originally published at Suture for a Living*
September 2nd, 2011 by RamonaBatesMD in Research
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I have written of keloid treatment (general, not site specific) previously. I have always tried to include pressure treatment as part of the plan when treating keloids of the ear lobe. This pressure treatment came in the form of pressure earrings — clip-on, disc-shaped.
The recent article (full reference below) in the Archives of Facial Plastic Surgery journal introduces a new pressure device which looks like it will work better than what has been available (photo credit)
and as can be seen in this photo, the upper ear can be treated with pressure which has not been possible with the clip earrings: Read more »
*This blog post was originally published at Suture for a Living*
August 25th, 2011 by RamonaBatesMD in Research
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I was alerted to this Archives of Surgery article (full reference below) by MedPage Today: Role Playing Boosts Surgical Residents’ Bedside Manner.
I find it intriguing. Role playing gives you a chance for a “do-over” when you make a social or communication faux pas.
So much of medicine is communication. Those of us who have been at it for years, deliver bad news differently (learned the hard way) now than we did previously. You choose your words more carefully (though I still occasionally screw up). Some words are more emotionally charged than others. Some patients want more information than others.
The University of Connecticut Health Center conducted a prospective study of a pilot project designed to teach surgical residents patient-centered communication skills.
The study offered Read more »
*This blog post was originally published at Suture for a Living*
August 17th, 2011 by RamonaBatesMD in Opinion
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A couple of nice articles recently on latex allergy have crossed my path – one in a journal I subscribe to (Aesthetic Surgery Journal) and the other via twitter and @Allergy (Ves Dimov, M.D., blogs at Allergy Notes). I’ve put both full references below.
Latex allergy became widely recognized in the late 1980s and early 1990s. The increase in latex allergies cases is felt to be associated with the increase use of latex gloves and implementation of universal precautions (now known as standard precautions) in the 1980s.
Management of possible or confirmed latex allergic patients begin with history and suspicion:
All patients who present for surgical procedures or exams which require latex gloves (pelvic exam, dental exams, etc) should be questioned about possible latex allergy.
Patients at highest risk include those who Read more »
*This blog post was originally published at Suture for a Living*
August 9th, 2011 by RamonaBatesMD in Opinion, Research
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Recently I gave in and went to see a rheumatologist after more than 3 months of intense morning stiffness and swelling of my hands (especially around the PIPs and MCPs) and wrists which improved during the day but never went away. It had gotten to the point where I could no longer open small lid jars (decreased strength), do my push-ups or pull ups (pain and limited wrist motion), and OTC products (Tylenol, Advil, etc) weren’t working. I can’t take Aleve due to the severe esophagitis it induces. I didn’t want to write a prescription for my self-diagnosed (without) lab arthritis.
BTW, all the lab work came back negative with the exception of a slightly elevated sed rate and very weakly positive ANA. The rheumatologist was impressed with the swelling, pain, and stiffness and was as surprised as I by the normal lab work. He thinks (and I agree) that I am in the early presentation of rheumatoid arthritis. He wrote a prescription for Celebrex and told me to continue with the Zantac I was already taking (thanks to the Aleve). The Celebrex is helping.
So I was happy to see this article (full reference below) come across by twitter feed. H/T to @marcuspainmd: Useful review of NSAIDs effects & side effects for arthritis pain: Read more »
*This blog post was originally published at Suture for a Living*
