A surgeon I’m thinking about seeing said on his website that breast implants were able to be done under local + intravenous anesthetic (like twilight). Can this really be done? I always thought it was too invasive for just twilight, especially if it is under the muscle. Is there an advantage to using twilight? After looking it up, there are lots of differing opinions out there, but I think that this may just be a way for the surgeon to cut costs. What is the cosmetic surgery truth here, Dr. D?
I am not a fan of local anesthesia or twilight sleep for breast implant surgery except in rare cases (simple redos and such). The reasons are patient comfort and practicality. I place most of my breast implants under the pectoral muscles, and these muscles need to be relaxed for this to work out. That relaxation is suboptimal under less than a general anesthetic. Read more »
Have you heard the new urban legend about plastic products? A growing number of celebrities and websites have been fueling a plastic paranoia, striking fear in the hearts of parents, fitness buffs, and microwave container users. Concerns reached such a fever pitch that I wondered if there may be something to this buzz: Can certain plastics harm our bodies or even cause cancer?
But like the buzz surrounding vaccines and autism (there is NO link between the two), plastiphobia (as I like to call it) is not backed by any clear evidence of human harm. Chemist, Dr. Joe Schwarcz of McGill University (who has no financial ties to plastics manufacturers, by the way) has reviewed the scientific literature and has found plastics to be an extremely unlikely candidate for human injury. (Well, unless you hit someone over the head with a water bottle.) Dr. Schwarcz reviewed plastics safety in a live health chat on December 8th. You can review the entertaining conversation here.
Plastiphobia has fueled an entire industry of plastic-free baby bottles and “microwave safe” containers. Read more »
The National Institute of Allergy and Infectious Diseases (NIAID) issued comprehensive food allergy guidelines to help primary care physicians and subspecialists diagnose and manage patients.
The guidelines establish consistent terminology and definitions, diagnostic criteria and patient management practices. Additional topics covered by the guidelines include the prevalence of food allergy and management of acute allergic reactions to food, including anaphylaxis. The report also identifies gaps about what is known about food allergy.
NIAID Director Anthony S. Fauci, MACP, said, “Because these guidelines provide standardized, concise recommendations on how to diagnose and manage food allergy and treat acute food allergy reactions across specialties, we expect both clinicians and food allergy patients to greatly benefit from these clear state-of-the-science clinical standards.” Read more »
*This blog post was originally published at ACP Internist*
Not as often as you think, even though Medicare may be willing to pay for it every two years. Via Science Daily:
Now a new study led by Margaret L. Gourlay, MD, MPH of the University of North Carolina at Chapel Hill School of Medicine finds that women aged 67 years and older with normal bone mineral density scores may not need screening again for 10 years.
“If a woman’s bone density at age 67 is very good, then she doesn’t need to be re-screened in two years or three years, because we’re not likely to see much change,” Gourlay said. “Our study found it would take about 16 years for 10 percent of women in the highest bone density ranges to develop osteoporosis. That was longer than we expected, and it’s great news for this group of women,” Gourlay said.
The researchers suggest that for T scores > -1.5, repeat testing needn’t be done for 10 years. Women with T scores between -1.5 and -2.0 can be re-screened in 5 years, and those with T scores below -2.0 can have every other year testing as is done now.
To be honest, I’ve been spacing out bone density testing in woman with good baseline scores for some time, but not knowing how long I can go. This is great information for me and for my patients.
*This blog post was originally published at tbtam*
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