September 13th, 2011 by RamonaBatesMD in Opinion, Research
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Many women with large breast and weight issues seek breast reduction. I was taught to encourage them to lose weight first. Now there is a very small study that backs this up (full reference below).
The American Society of Plastic Surgeons issued a press release entitled “Breast Reduction and Bariatric Surgery—Which Should Be Done First?” and provided the answer “Final Results May Be Better When Weight Loss Comes First.” I agree, but find it odd that such a small study was published. There should have been more patients included.
Jeffrey A. Gusenoff, MD, and colleagues reviewed two groups of patients who sought consultation for body contouring surgery August of 2008 and February of 2010 after massive weight loss (defined as a weight loss of greater than 50 pounds).
Group I (n=15) included Read more »
*This blog post was originally published at Suture for a Living*
September 13th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
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Patients are first. Patients are the reason for the existence of the healthcare system. Physicians are second. They are trained to understand the pathophysiology of illness and to treat patients for their disease. Everyone else is a secondary stakeholder (provider).
All the stakeholders create waste in the healthcare system. If an accurate analysis were performed, most of the waste and the resulting profits would be attributed to the secondary stakeholders. Patient and physicians drive this waste and profits into the hands of the secondary stakeholders. Neither patients nor physicians are aware of driving the waste and profit into these stakeholders’ coffers.
The patient-physician relationship should be a one on one transaction. Patients and physicians are frustrated and many have accepted the disappearance of this human-to-human interaction.
Healthcare insurance companies and hospital systems think they own the patients and the physicians. This will turnout to be a fatal misperception.
To many observers of the healthcare system Read more »
*This blog post was originally published at Repairing the Healthcare System*
September 12th, 2011 by RyanDuBosar in Research
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Treating 1,000 people with preventive aspirin for five years prevents 2.9 major cardiovascular events (nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death) and causes 2.8 major bleeds, according to a meta-analysis.
Nine primary prevention trials compared results for aspirin alone for the primary prevention of cardiovascular disease, and reported data on myocardial infarction, stroke and cardiovascular deaths. Aspirin doses ranged from 100 mg every other day to 500 mg/d, and seven of them studied doses from 75 mg/d to 162.5 mg/d. No dose-dependent effects were noted, the researchers said. Results appeared in the July issue of the American Heart Journal.
A total of 2,029 major cardiovascular events occurred among 52,145 (3.86%) patients allocated to aspirin compared with 2,099 major cardiovascular events among 50,476 (4.16%) patients assigned to placebo or control. Over a mean follow-up of nearly 7 years, aspirin was Read more »
*This blog post was originally published at ACP Internist*
September 12th, 2011 by David Kroll, Ph.D. in News, Research
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As early as 2006, I used to be able to write monthly about US FDA warnings on erectile dysfunction supplements being found adulterated with prescription drugs such as sildenafil, the phosphodiesterase-5 inhibitor found in Viagra. These adulteration episodes raised the question of how many anecdotal reports of herbal products “working” had to do with them containing approved medicines.
So common was this practice that FDA created a site in 2008 that was dedicated to this problem: Hidden Risks of Erectile Dysfunction “Treatments” Sold Online. Indeed, these products were more commonly encountered from online retailers and not in health food stores. Other similar practices include bodybuilding supplement being spiked with anabolic steroids and weight loss supplements being adulterated with sibutramine (formerly Meridia), an anorectant removed from the market last year after showing increased incidence of heart attacks and stroke in patients with preexisting cardiovascular disease.
The herbal industry, led by the American Herbal Products Association (AHPA), aimed to clean up this problem and launched an initiative called, KeepSupplementsClean.org. Spurred by an FDA letter to the industry on 15 December 2010 of increased scrutiny on the adulteration problem, AHPA actually encouraged FDA to Read more »
*This blog post was originally published at Science-Based Medicine*
September 12th, 2011 by PreparedPatient in Health Policy
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How do you calibrate care so that it is neither too much nor too little? In this collection of recent posts, health care professionals search for that “just right” level of care.
“I bet celebrities and other VIPs (as they’re known in hospitals) get some of the worst healthcare in America. And, when I mean worst, I mean the most,” says Jay Parkinson in a recent post. Parkinson explores what is publically known about Apple’s CEO Steve Jobs’ care and calls specific attention to “incidentalomas.” Parkinson describes these asymptomatic tumors, sometimes discovered by especially aggressive care, and suggests that they may be over-treated, leading to poor health outcomes.
Mark W. Browne asks, Is the health quality bar set high enough? Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
