October 16th, 2011 by Elaine Schattner, M.D. in Research
Tags: Breast Cancer, Cancer Diagnosis, Cancer Treatment, Clinical Trials, DCIS, Ductal Carcinoma in Situ, Malignant, More Magazine, Oncology, Pathology, Research, Study, Surveillance, Treatment, Watchful Waiting
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Ductal Carcinoma in Situ (DCIS) in the breast, histopathology w/ hematoxylin & eosin stain, Wiki-Commons image
More, a magazine “for women of style & substance,” has an unusually thorough, now-available article by Nancy F. Smith in its September issue on A Breast Cancer You May Not Need to Treat.
The article’s subject is DCIS (Ductal Carcinoma in Situ). This non-invasive, “Stage 0” malignancy of the breast has shot up in reported incidence over the past two decades. It’s one of the so-called slow-growing tumors detected by mammography; a woman can have DCIS without a mass or invasive breast cancer.
While some people with this diagnosis choose to have surgery, radiation or hormonal treatments, others opt for a watchful waiting strategy. The article quotes several physicians, including oncologists, who consider Read more »
*This blog post was originally published at Medical Lessons*
October 15th, 2011 by CynthiaBaileyMD in Health Tips, Research
Tags: American Academy of Dermatology, Anti-itch creams, Brachioradial Pruritus, Cold, Compressed Nerve, Dermatology, Dermatome, Dry, Exfoliate, Heat, itch, Itchy Arms, neurogenic itch syndrome, scratch, Skin, Spine, Sunlight
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Medical science is getting closer to understanding one of the most common causes of chronically itchy arms called brachioradial pruritus.
This means we’re also getting closer to helping people who suffer from this extremely frustrating condition!
A new study exploring the cause of brachioradial pruritus was just reported in the October issue of the Journal of the American Academy of Dermatology. The authors used MRI imaging to look at the cervical spine of 41 patients suffering from chronic itching of what was otherwise normal appearing skin on the outer surface of their forearms arms (called brachioradial pruritus). MRI imaging showed a very strong correlation between the itch and nerve compression in the patient’s neck. In fact, the exact site of the itch on the skin correlated precisely with the spinal location in the neck where the nerve resides that supplies that part of the arm skin (we call this a dermatome*).
What’s so interesting is that Read more »
*This blog post was originally published at Dr. Bailey's Skin Care Blog*
October 15th, 2011 by American Journal of Neuroradiology in Research
Tags: Agraphia, Apraxia, Brain, Brain Imaging, Cerebral Vasculitis, Corpus Callosum, CT, Demyelination, Diagnosis, Giant Cell Arteritis, Hemispheres, Hemorrhage, Infarction, Infection, Interhemispheric Disconnect Syndrome, Ischemia, Lesion, Mass, Neurology, Neuropsychiatric, Splenium, Tactile Anomia
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Cerebral vasculitis is a known cause of ischemic and hemorrhagic strokes and has been described as one of the rare but important causes of corpus callosum infarction. Biopsy-proved giant cell arteritis causing callosal infarction is an exceedingly rare finding because a tissue specimen is usually not obtained and conclusions are drawn on the basis of clinical and radiologic findings alone. We present a case of callosal infarction, which evolved and eventually affected large portions of both cerebral hemispheres.
A 63-year-old woman presented to our hospital with left-sided numbness and neglect, cognitive changes, and apraxia. One month earlier, she was found to have a C-reactive protein level of 8.0 mg/dL (normal <0.5 mg/dL) and 75% stenosis in both femoral arteries. These results prompted Read more »
*This blog post was originally published at AJNR Blog*
October 14th, 2011 by John Mandrola, M.D. in Opinion, Research
Tags: AF Ablation, American College of Cardiology, Atrial Fibrillation, Brain Lesions, Cardiology, Death, Electrodes, Medtronic, MRI, Press Release, Pulmonary Veins, PV Stenosis, PVAC Catheter, Risk, Stroke, Technology
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The news wires for atrial fibrillation were abuzz this last week. The vigor and speed with which health news travels is striking.
Since 2.6 million Americans live with AF, my guess is that many are looking at the release of the Medtronic-sponsored TTOP-AF trial with anticipation. Here is a link to the press release. The trial purported to show benefits of Medtronic’s novel phased RF ablation system in treating persistent AF.
The study was small and released at a relatively small symposium in Venice, Italy. The TTOP-AF trial randomized 210 patients with persistent AF (including flutter) to either ablation with Medtronic’s ablation system or conventional therapy with drugs and cardioversions.
They found, not surprisingly, that AF ablation reduced AF burden. AF ablation significantly reduced AF burden in 55.8% percent of patients versus only 26% of those treated with conventional medical treatment. Editorial comment: That kind of data is pretty typical.
The problem with the study Read more »
*This blog post was originally published at Dr John M*
October 13th, 2011 by RyanDuBosar in Research
Tags: Best, CMS, Death, Efficiency, Elderly, Health Affairs, High Cost, Hospitals, Medicare, Minority, Myocardial Infarction, Non-Profit, Pneumonia, Poor, Poverty, Public Institution, Quality, Quality Measures, Research, Worst
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Hospitals that provide the lowest quality care at the highest cost care for more than twice the proportion of elderly minority and poor patients as the nation’s best performers, researchers found. And patients at the “worst” institutions are more likely than patients elsewhere to die of certain conditions, such as heart attacks and pneumonia.
These hospitals and their patients may be the ones most at risk under new Medicare payment arrangements that could cut payments to hospitals that fail to meet quality metrics, reported researchers from the Harvard School of Public Health.
The researchers examined how quality, costs and patients served correlated among 3,200 hospitals nationwide. They then identified 122 “best” hospitals, those that were in the highest quartile of quality and lowest quartile of risk-adjusted costs, and 178 “worst” hospitals, those in the lowest quartile of quality and the highest quartile of costs.
Hospital quality and performance data were Read more »
*This blog post was originally published at ACP Hospitalist*
