March 9th, 2011 by RamonaBatesMD in Opinion, Research
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An outcomes article in the January 2011 issue of the Journal of Plastic and Reconstructive Surgery asks the question: “Are patients making high-quality decisions about breast reconstruction after mastectomy?”
The objective of the study was to “measure women’s knowledge about reconstruction and to evaluate the degree to which treatments reflected patients’ goals and preferences.” Their conclusion (bold emphasis is mine):
Women treated with mastectomy in this study were not well-informed about breast reconstruction. Treatments were associated with patients’ goals and concerns, however, and patients were highly involved in their decisions. Knowledge deficits suggest that breast cancer patients would benefit from interventions to support their decision making.
Granted the study was small, but it left me wondering if we the medical community fails to educate these women.
The study involved a cross-sectional survey of early-stage breast cancer survivors from four university medical centers. The survey included measures of knowledge about specific reconstruction facts, personal goals and concerns, and involvement in decision making. Only 84 patients participated (59 percent response rate). Participants answered only 37.9 percent of knowledge questions correctly. Read more »
*This blog post was originally published at Suture for a Living*
February 14th, 2011 by RamonaBatesMD in Better Health Network, Book Reviews
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Listening to NPR on Saturday morning I caught part of Scott Simon’s interview with brothers Stephen Amidon and Thomas Amidon, M.D. discussing their book “The Sublime Engine: A Biography of the Human Heart.” The interview touched on the story of the human heart in science and medicine, history, and culture:
It turns out that the classic red heart symbol we see almost everywhere around Valentine’s Day doesn’t look much like a real human heart at all.
“Of all the theories about where that symbol comes from, my favorite is that it is a representation of a sixth century B.C. aphrodisiac from northern Africa,” says Stephen Amidon…”And I kind of like that history because it sort of suggests that early on, people sort of understood the connection between love and the heart.”
Words and how we use them were the focus of Dr. Pauline Chen’s interview by WIHI host Madge Kaplan this past Thursday, February 10th, “A Legible Prescription for Health“:
On this edition of WIHI, Dr. Chen wants to spend some time talking about language, especially the words doctors use with one another when describing patients; the unintended barriers created the more doctors and nurses don protective, infection-protecting garb; the mounting weight of patient satisfaction surveys; and more.
Back to the NPR interview on the human heart as a “sublime engine,” the authors don’t feel that as our advances in surgical techniques become commonplace that the heart will lose any of its cultural and metaphorical significance. Read more »
*This blog post was originally published at Suture for a Living*
January 26th, 2011 by RamonaBatesMD in Better Health Network, Research
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The Science Daily article entitled Body dysmorphic disorder patients who loathe appearance often get better, but it could take years discusses the disorder as highlighted in the Journal of Nervous and Mental Disease (JNMD).
The JNMD article reports the results of the longest-term study so far to track people with body dysmorphic disorder (BDD). The study was conducted by researchers at Brown University and Rhode Island Hospital. The good news? The researchers “found high rates of recovery, although recovery can take more than five years.”
This is a small study with only 15 BDD patients who were followed over an eight-year span. An excerpt:
After statistical adjustments, the recovery rate for sufferers in the study over eight years was 76 percent and the recurrence rate was 14 percent. While a few sufferers recovered within two years, only about half had recovered after five years.
The subjects were a small group diagnosed with the disorder out of hundreds of people participating in the Harvard/Brown Anxiety Research Project (HARP). Study co-author Martin Keller, professor of psychiatry and human behavior and principal investigator of the HARP research program which has been ongoing for more than 20 years, said that because the BDD sufferers were identified through this broader anxiety study, rather than being recruited specifically because they had been diagnosed with BDD, they generally had more subtle cases of the disorder than people in other BDD studies. In comparing the HARP study with the prior longitudinal study of BDD, it is possible that the high recovery rate in the HARP study is due to participants having less severe BDD on average.
About body dysmorphic disorder:
— In its simplest definition, it is an obsessive preoccupation with a slight, imperceptible, or actually nonexistent anatomic irregularity to the degree that it interferes with normal adjustment within society. Read more »
*This blog post was originally published at Suture for a Living*
January 13th, 2011 by RamonaBatesMD in Health Tips, Research
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Not all maternal influence on daughter behavior is good. Take for example the influence of the unhealthy use of indoor tanning beds as presented in a recent Archives of Dermatology article (full reference below) which “investigated whether indoor tanning with one’s mother the first time would influence frequency of tanning later in life and whether it was associated with age of initiation.”
Joel Hillhouse, Ph.D., of East Tennessee State University-Johnson City and colleagues published a study the May 2010 issue of the Archives of Dermatology which looked at which health-based intervention worked best in reducing skin cancer risks. They found that “emphasizing the appearance-damaging effects of UV light, both indoor and outdoor, to young patients who are tanning is important no matter what their pathological tanning behavior status.”
For this study, Hillhouse and colleagues randomly selected a total of 800 female students who were then sent a screening questionnaire on their indoor tanning history. Those who reported ever indoor tanning (n = 252) were invited to participate in the study and offered an incentive ($5). A total of 227 (mean age, 21.33 years; age range, 18-30 years) agreed, signed informed consent documents, and completed assessments.
One of the questions asked who accompanied the participant the first time they indoor tanned (i.e. tanned alone, with friend, with mother, or other). Read more »
*This blog post was originally published at Suture for a Living*
January 4th, 2011 by RamonaBatesMD in Better Health Network, News, Research
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This article (full reference below, free access) came to my attention via MDLinx. It was interesting to read. The conclusion verified my expectations rather than surprised me.
The authors conducted a retrospective review of patient demographics and implant information from three university settings: Kelowna (British Columbia, Canada), Loma Linda (California, USA), and Temple (Texas, USA). Each cohort included 100 consecutive breast augmentation cases. Characteristics analyzed included age, height, weight, BME, parity, and average implant volume.
When considering the 300 as one cohort, the average age was 34 years with a height of 163 cm (5’4”), weight of 58.1 (127.8 lb) and parity of 1.7 . The average implant size was 370 ml. Read more »
*This blog post was originally published at Suture for a Living*
