January 27th, 2011 by Linda Burke-Galloway, M.D. in Health Tips, Opinion
Tags: Background Check, Choosing a Doctor, Dr. Linda Burke-Galloway, Empowered Patient, Fetal Health, Healthy Baby, Healthy Pregnancy, Labor And Delivery, Maternal-Fetal Specialist, Medical Credentials, OB/GYN, Obstetrics And Gynecology, Patient Empowerment, Smart Mother, Unborn Child, Women's Health
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The journey to a healthy pregnancy and delivery begins with the selection of a healthcare provider, and the challenge is to find the right one. This is the person who will be in charge of your pregnancy up until the time of the delivery, so it certainly is not a casual date. For the next 280 days your life and the life of your unborn child will be in this person’s hands. A background check is therefore in order.
One of the best ways to find the right healthcare provider is by word-of-mouth referral from neighbors, friends, or family members however please don’t stop there. Labor and delivery nurses are also a great source of referral because they have seen physicians and midwives under their most vulnerable and challenging moments.
Don’t feel intimidated about checking a provider’s credentials — this is public information. You can find out whether the provider’s medical license is current or expired. You’ll also be able to obtain information on whether the provider has ever been disciplined by the board for medical malpractice or unprofessional behavior or misconduct. Healthcare providers are not exempt from problems with alcoholism, drug addiction, professional incompetence, and unprofessional or unethical behaviors. Although less than five percent of healthcare providers have egregious problems, you want to make certain that your provider is not one of them. Read more »
*This blog post was originally published at Dr. Linda Burke-Galloway*
January 27th, 2011 by John Di Saia, M.D. in News, Opinion
Tags: ALCL, Anaplastic Large Cell Lymphoma, Breast Cancer, Breast Implants, Cosmetic Surgery, Dr. John Di Saia, FDA, Food and Drug Administration, Gel-Filled, National Cancer Institute, NCI, Plastic Surgery, Saline, Silicone, Women's Health
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From the Food and Drug Administration (FDA) safety alert yesterday:
ISSUE: The FDA announced a possible association between saline and silicone gel-filled breast implants and anaplastic large cell lymphoma (ALCL), a very rare type of cancer. Data reviewed by the FDA suggest that patients with breast implants may have a very small but significant risk of ALCL in the scar capsule adjacent to the implant.
BACKGROUND: In total, the agency is aware of about 60 cases of ALCL in women with breast implants worldwide. This number is difficult to verify because not all cases were published in the scientific literature and some may be duplicate reports. An estimated 5 million to 10 million women worldwide have breast implants. According to the National Cancer Institute, ALCL appears in different parts of the body including the lymph nodes and skin. Each year ALCL is diagnosed in about 1 out of 500,000 women in the United States. ALCL located in breast tissue is found in only about 3 out of every 100 million women nationwide without breast implants.
While the FDA’s new report is interesting, as it stands it’s of little consequence. A mere 60 cases of a unusual breast cancer worldwide is a tiny number compared to the huge number who develop the much more common ductal breast cancers (about one in seven women in the U.S.) Breast implants have not been found to affect this more common cancer incidence. I do expect this statistic to be misquoted by the anti-breast implant factions online.
As an aside, I do remember a case in a fellow plastic surgeon’s mother of a lymphoma near a breast implant capsule when I was a resident. This is the only breast cancer of this type I have ever seen, however, in 14 years of practice. While I don’t doubt the association, I do focus on the significance of this report to the average breast implant patient, which is very little at this point.
– John Di Saia, M.D.
*This blog post was originally published at Truth in Cosmetic Surgery*
January 26th, 2011 by Mark Crislip, M.D. in Opinion, Research
Tags: Bladder Infection, Cochrane Database of Systematic Reviews, Cranberry Juice, Cystitis, Dr. Mark Crislip, E. Coli, Family Medicine, Internal Medicine, Kidney Infection, Lack of Scientific Medical Evidence, Medical Myths, Non-Evidence-Based, Primary Care, Pseudoscience, Pyelonephritis, SBM, Science Based Medicine, Unproven Medical Studies, Urinary Tract Infection, UTI
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It always somewhat surprises me how some interventions never seem to die. One therapy that refuses to be put to rest, or even to be clarified, is the use of cranberry juice for urinary tract infections (UTIs). PubMed references go back to 1962, and there are over 100 references. Firm conclusions are still lacking.
There is a reasonable, but incomplete, basic science behind the use of the cranberry juice for UTIs. E. coli , the most common cause of UTIs, causes infection in the bladder by binding to the uroepithelial cells. To do this, they make fimbriae, proteinaceous fibers on the bacterial cell wall. Fimbriae are adhesins that attach to specific sugar based receptors on uroepithelial cells. Think Velcro. Being able to stick to cells is an important virulence factor for bacteria, but not a critical one — it is not the sine qua non of bladder infections.
Are all E. coli causing UTIs fimbriated? No. It is the minority of E. coli that cause UTI that have fimbria, and the presence of fimbriae may be more important for the development of pyelonephritis (kidney infection) than cystitis (bladder infection). Read more »
*This blog post was originally published at Science-Based Medicine*
January 26th, 2011 by GarySchwitzer in Health Tips, Opinion
Tags: Cardiology, Gary Schwitzer, Harold Demonaco, HealthNewsReview.org, Heart Attack Risk, Heart Health, Inaccurate Health Reporting, Massachusetts General Hospital, Media Inaccuracy, Media Misinterpretation, Medical Reporting, Non-Evidence-Based, Overtesting, Prevention Magazine, Preventive Health, Preventive Medicine, Screening Tests, Unnecessary Medical Tests, Women's Health
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The February issue of Prevention magazine has an article entitled “Surprising Faces of Heart Attack” profiling “three women (who) didn’t think they were at high risk. Their stories are proof that you could be in danger without even knowing it.” No, their stories are not proof of that.
The story is about three women in their 40s. The story varyingly states that the three should have had the following screening tests:
— Advanced cholesterol test, carotid intimal medial thickness test ( CIMT)
— Advanced cholesterol test and stress echocardiography
— Cardiac calcium scoring and CIMT
There’s an accompanying piece: “7 Tests You’re Not Having That Could Save Your Life.”
I asked one of our HealthNewsReview.org medical editors, Harold Demonaco, director of the Innovation Support Center at the Massachusetts General Hospital, to review the two pieces. As his day-job title suggests, he deals with review of the evidence for new and emerging healthcare technologies. He wrote:
The section “7 Tests you are not having that could save your life” states: “If you have not had these cutting edge screenings, put this magazine down and call your doctor. Now.”
Wow. While much of the information is correct, it is the context that is disturbing. Suggesting that these tests are essential in everyone is a bit over the top. Some of the information provided for each test is basically correct. However in some cases the recommendations go well beyond national guidelines.
The major issue here is the tacit assumption that tests are infallible, without any downsides and are always a good thing. That is simply not the case. So who should get these tests? Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
January 26th, 2011 by Elaine Schattner, M.D. in Health Tips, Opinion
Tags: Cancer Treatment, Choosing a Doctor, Delayed Treatment, Doctor Patient Relationship, Dr. Elaine Schattner, Empowered Patient, Finding the Right Doctor, Medical Lessons, Medical Opinions, Oncology, Patient Empowerment, Physicians' Opinion, Second Opinion, Too Many Medical Opinions
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A few years ago I started writing a book on what it was like to be a cancer patient and an oncologist. This morning I came upon this section on second opinions:
Is It OK To Get A Second Opinion?
Definitely. And there’s no need to be secretive about it, or to worry about hurting the doctor’s feelings. Second opinions are routine in fields like oncology, and are often covered by insurance. Be up-front: Any decent oncologist can understand a cancer patient’s need to find a doctor who’s right for them, with whom they’re comfortable making important decisions. And in difficult cases, some specialists appreciate the chance to discuss the situation with another expert. So a second opinion can be beneficial to patients and physicians alike.
When things can get out of hand, though, is when patients start “doctor shopping.” For example, I’ve cared for some patients with leukemia who’ve been to see over 10 oncologists. If you’re acutely sick, this sort of approach to illness can be counterproductive — it can delay needed therapy. From the physician’s perspective, it’s alienating: Who wants to invest her time, intellectual effort, and feelings for a patient who’s unlikely to follow up? Besides, oncology is the sort of field where each consulting doctor may have a distinct opinion. (If you see 10 oncologists, you may get 10 opinions.) Beyond a certain point, it may not help to get more input, but instead will cloud the issue. Read more »
*This blog post was originally published at Medical Lessons*
