October 14th, 2011 by John Mandrola, M.D. in Opinion, Research
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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 1st, 2011 by RamonaBatesMD in News, Opinion
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When Wanda Skyes, 47, had a bilateral breast reduction in February, the pathology returned with DCIS present in the left breast specimen. Recently the comedian appeared on “The Ellen DeGeneres Show” and during the interview revealed her breast cancer diagnosis and her decision to have a double mastectomy.
Sykes continued, “It wasn’t until after the reduction that in the lab work, the pathology, that they found that I had DCIS [ductal carcinoma in situ] in my left breast. I was very, very lucky because DCIS is basically stage-zero cancer. So I was very lucky.”
But, she added, “Cancer is still cancer. I had the choice of, ‘You can go back every three months and get it checked. Have a mammogram, MRI every three months just to see what it’s doing.’ But, I’m not good at keeping on top of stuff. I’m sure I’m overdue for an oil change and a teeth cleaning already.”
Because she has a history of breast cancer on her mother’s side of the family, Sykes explained she opted to have a bilateral mastectomy.
“I had both breasts removed, because now I have zero chance of having breast cancer,” she said. “It sounds scary up front, but what do you want? Do you want to wait and not be as fortunate when it comes back and it’s too late?”
The American Cancer Society Read more »
*This blog post was originally published at Suture for a Living*
September 30th, 2011 by ChristopherChangMD in Research
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Researchers at Johns Hopkins published a study that reports that MRI scans CAN cause feelings of dizziness induced by magnetic fields causing motion of the electrically charged fluid of the inner ear.
In both ears, there is a “gyroscope” called the labyrinth. Whenever the head turns or a force like gravity is exerted on this system, fluid moves within, which tells the brain that motion has occurred. It’s much like looking into a glass of water and based on the way the water tilts in the glass, you can guess which way motion is occurring.
In any case, the study Read more »
*This blog post was originally published at Fauquier ENT Blog*
September 7th, 2011 by RamonaBatesMD in News, Opinion
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It’s amazing what you will find sorting through more than 20 years of stuff. This picture of 3 implants includes: top — an old McGhan double lumen (silicone gel implant surrounded by a saline implant); bottom left – Dow Corning textured silicone implant; and bottom right – Dow Corning smooth silicone implant. Dow Corning has not made breast implants since approximately 1992.
Last week the FDA met to discuss and make recommendations on postmarketing issues related to silicone gel-filled breast implants. As a condition of placing silicone implants back on the market in 2006, both Mentor and Allergan (McGhan) were supposed to enroll patients in 10-year-long follow up studies on side effects related to implants. The aim was for 80,000 women.
I agree these studies are needed, but it is difficult to get women to return year after year. This is evident in the data presented at the meeting: Read more »
*This blog post was originally published at Suture for a Living*
August 12th, 2011 by Shadowfax in Opinion, True Stories
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Yesterday, I presented the case of a woman with double vision and ptosis and challenged you all to a game of “spot the lesion.” To be honest, I found this stuff impenetrable as a medical student and it was only by sheer force of will that I was able to commit it to memory for exactly long enough to pass a test on it before immediately purging it from my memory. I did this several times for various board exams and such, but it never really “stuck.” Hated neuro beyond words, I did.
As mind-numbing as I found it all in the abstract, I get excited about these cases in application. I may not remember where exactly the internal capsule is or what it does, but when I see someone with an interesting neuro deficit due to a lesion there, all of a sudden it makes so much more sense, and is, dare I say it, cool. I know, kinda sad.
This case is as classic (and cool) as you will ever see. It’s a complete palsy of the Oculomotor Nerve (CN 3 for those keeping score at home).
So how do you approach figuring that out? Read more »
*This blog post was originally published at Movin' Meat*
