Sunday, April 27, 2014

Low-Dose Aspirin, Pre-eclampsia

“For every four women who would have gotten pre-eclampsia, one case is prevented,” said Dr. Ira M. Bernstein, the chair of department of obstetrics, gynecology and reproductive sciences at the University of Vermont. “The ability to prevent a quarter of disease is substantial.” (source infra)

Panel Urges Low-Dose Aspirin to Reduce Pre-eclampsia Risk - NYTimes.com: "Pregnant women should take low-dose aspirin daily to reduce their chance of developing pre-eclampsia if they are at high risk for the life-threatening disorder, an influential government panel said on Monday. The United States Preventive Services Task Force’s draft recommendation follows a growing scientific consensus that low doses may be beneficial to some high-risk women and their offspring. Low-dose aspirin reduced the risk of pre-eclampsia by 24 percent in clinical trials, according to a systematic review underpinning the new recommendation, which was published in Annals of Internal Medicine. Low-dose aspirin also reduced the risk of premature birth by 14 percent and of intrauterine growth restriction — a condition in which the fetus doesn’t grow as fast as expected — by 20 percent...." read more at link above

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Sunday, April 20, 2014

Mammography, Cancer, Overdiagnosis, False Positives, Overtreatment

One especially disturbing criticism is that screening mammography may lead to “overtreatment,” in which some women go through grueling therapies — surgery, radiation, chemotherapy — that they do not need. Indeed, some studies estimate that 19 percent or more of women whose breast cancers are found by mammography wind up being overtreated.(source infra)

Look for Cancer, and Find It - NYTimes.com. . . . Overdiagnosis is not the same as a false positive result, in which a test like a mammogram initially suggests a problem but is proved wrong. False positives are frightening and expensive, but overtreatment is the potential harm of mammography that worries doctors most, according to an article published last week in The Journal of the American Medical Association. . . .(read more at links above)

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Sunday, April 13, 2014

Dogs, Breast Cancer, Research

From Dogs, Answers About Breast Cancer - NYTimes.com: ".... Because dogs typically have 10 mammary glands and often develop tumors in several glands at the same time, they present a unique research opportunity, enabling scientists to study lesions that are at different stages of development — from benign to cancerous, and at transitional stages — all in the same animal. “The dog gives us the potential to answer the question: When did something go wrong at the molecular level?” said Dr. Karin Sorenmo, chief of medical oncology at Penn Vet’s Ryan Hospital, who founded the Penn Vet canine mammary tumor program in 2009. “We can also study the benign tumors and ask: What’s different in that one tumor that doesn’t change and become malignant versus another one that does change?”...."

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Sunday, April 6, 2014

Doctor White Coats, infections

February issue of Infection Control and Hospital Epidemiology, suggests that to minimize infection risk, hospitals might want to adopt a “bare below the elbows” policy that includes short sleeves and no wristwatch, jewelry or neckties during contact with patients.
Goodbye to the Doctor's White Coat? - NYTimes.com: ".... The authors also recommend that if the use of white coats is not entirely abandoned, each doctor should have at least two, worn alternately and laundered frequently. And even if they wear the coat at other times, they should be encouraged to remove it before approaching patients. The authors emphasize that the recommendations are based more on the biological plausibility of transmitting infection through clothing than on strong scientific evidence, which is limited. The lead author, Dr. Gonzalo Bearman, a professor of medicine at Virginia Commonwealth University, said that hand washing, bathing patients with antibacterial soap, and checklists for inserting intravenous lines are all proven to reduce infection. “Apparel should come next in level of concern,” he said. “The more patients are aware that apparel may impact hospital infections, the more doctors will consider how clean they are.”"

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