Archive for November, 2009

Women should still get regular mammograms

The U.S. Preventive Services Task Force has put forth new guidelines for screening mammogram in women ages 40-49, annually mammograms in women 50 and older and self-exams. The recommendations from the federal government-funded committee has created confusion and raised questions.

The task force has always suggested an annual mammogram starting at age 40 and encouraged self-examination. The task force recommends against routine mammograms for women until they are 50 or older. The report called for routine screening every two years for women ages 50 to 74.

Perhaps most surprisingly the committee says no more monthly self-exams to perform to detect lumps, bumps or other changes in breast tissue that could be a sign of breast cancer.

The analysis by the task force seems sound on paper. According to the panel, a staggering 10 percent of mammograms result in false-positive readings that lead to unjustified worry and needless procedures, for example biopsies.

The reality is, every year, 43,000 women die from breast cancer, but many of those deaths could be avoided if more women had regular mammograms. Mortality from breast cancer has decreased by 2 percent per year over the last 10 years due in large part to improved mammography and dedicated screening programs. These new, government-endorsed guidelines will be a significant setback to the gains that have been made.

Although the task force said it did not consider costs, there is also an undisputable financial effect of the shift as well. Around 37 million mammograms are administered annually. Each one costs about $100. So reducing the number of mammograms could result in billions of dollars in savings. The U.S. does a better job of treating cancer than any country in the world in part because of the screenings, which may not be covered in many other countries.

New research says people can hear with their skin

According to new research, people can also hear with their skin. Dr. Bryan Gick and his team at the University of British Columbia in Vancouver, Canada, sought to determine if tactile sensations could affect hearing.

In there study involving 22 people, they found that inaudible puffs of air delivered alongside certain sounds influenced what participants thought they were listening to. There research may lead to better aids for the hard of hearing, experts said.

The study participants were more likely to recognize aspirated syllables correctly when they heard those syllables when receiving slight, inaudible air puffs to the skin, the team report in the Nov. 26 Nature. Air puffs enhanced detection of aspirated ta and pa sounds and increased the likelihood of mishearing non-aspirated da and ba sounds as their aspirated counterparts, the researchers say.

Dr Bryan Gick said his team would now work to create a hearing aid using the findings from their study.

“All we need is a pneumatic device that can produce air puffs aimed at the neck at the right times based on acoustic input into the hearing aid, and then a set of experiments to test the efficacy.” Dr Bryan Gick said.

“What’s so persuasive about this particular effect,” he added, “is that people are picking up on this information that they don’t know they are using.” That supports the idea that integrating different sensory cues is innate.

New breast cancer screening guidelines: Science or money?

The United States Preventive Services Task Force’s new recommendations for women receiving mammograms have turned years of medical advice on its head. Now some organizations and doctors are refuting the recommendations.

The USPSTF now suggests routine screening mammography in women ages 40-49 and in women over 75. The task force also recommends that screening between the ages of 50 and 74 be performed every two years rather than each year. The USPSTF says that a mammography is less effective at distinguishing cancers from normal breast tissue in premenopausal women, mammograms miss cancers in some younger women and raise a false alarm in others.

The new guidelines for screening mammography, clinical breast examination and breast self-examination are in conflict with the facts. One in every 14 women faces the risk of developing breast cancer. Globally, incidences of breast cancer are 25 to 30 per thousand population. The alarmed response to this report demonstrates just how invested Americans have become in the idea of early cancer detection.

A national survey of 1,136 women furthermore showed that approximately 76 percent of respondents thought the new guidelines were not driven by scientific data, but by the push among government healthcare officials to cut costs. The White House clearly backed off initial support of the new guidelines set by the task force on mammograms and the one on Pap smears for cervical cancer after they produced bitter debate that was viewed as detrimental to chances for adoption of the overall medical-reform package.

Community-associated MRSA on the rise in U.S. hopitals

According to a new study, community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is on the rise in U.S. hospitals. From 1999 to 2006, there has been an astonishing seven-fold growth in the new community-associated strain CA-MRSA in hospital outpatient units over the last decade, according to new research.

The researchers discovered two new strains of methicillin-resistant Staphylococcus aureus were circulating in patients and they are unlike to the strains commonly seen in hospitals. This increase jeopardizes the safety of patients because health care professionals and patients travel often between a hospital’s inpatient and outpatient units, the authors warned.

The rapid rate of infection spread endangers inpatient settings as well, according to the December issue of the Centers for Disease Control and Prevention’s Emerging Infectious Diseases, which summarizes findings from 300 microbiology labs serving U.S. hospitals.

“We found during 1999-2006 that the percentage of S. aureus infections resistant to methicillin increased more than 90 percent, or 10 percent a year, in outpatients admitted to U.S. hospitals,” the authors wrote in the report published in the December journal Emerging Infectious Diseases. “This increase was caused almost entirely by community-acquired MRSA strains, which increased more than 33 percent annually.”

MRSA is the most common cause of hospital-acquired infections. Other places where it can be picked up from are schools, fitness centers and similar areas. Symptoms can range from abscesses to bloodborne infections that can kill quickly.

Not getting angry at work is bad for your heart

According to new research, by not expressing feelings over unfair treatment at work, it may have major consequences on your heart. People who convey their feelings openly, for instance by getting angry, have no increased risk of heart problems

Lead researchers, Lipids and Fibrinogen Stockholm, studied 2,755 male employees who had not had a heart attack when the study began in 1992-1995. The workers were asked how they handled work-related confrontations: whether they expressed their anger or suppressed it, whether they got a headache or stomachache or vented it out at home.

Previous research has shown covert coping with job conflict has a link to heart disease risk factors, but not heart disease itself, Leineweber and her team note in the Journal of Epidemiology and Community Health.

Leineweber added. “I think men can’t help how they behave in conflict situations - it’s not something they think about, it’s just how they react instinctively.

“If you are smoking and don’t exercise you would be much more conscious of the risk.”

“It is not good just to walk away after having such a conflict or to swallow one’s feelings,” said Leineweber.

The research to begin with included women however their statistics were withdrawn as the number of heart attacks among them was too low for any conclusions to be drawn.

Tobacco and lead strongly increase risk of developing ADHD

According to new research, prenatal exposure to tobacco smoke and childhood exposure to lead are linked to an increased risk of developing attention deficit hyperactivity disorder (ADHD) in children. Some official statistics show that, if these two factors were eliminated, the number of children suffering from ADHD could be reduced by as much as 800,000.

“Tobacco and lead exposure each have their own important adverse effect … But if children are exposed to both lead and prenatal tobacco, the combined effect is synergistic,” lead author, Tanya Froehlich, a physician in the Division of Developmental and Behavioral Pediatrics at Cincinnati Children’s Hospital said.

The research team studied the cases of 3,907 children aged 8 to 15, gathered between 2001 and 2004 from the National Health and Nutrition Examination Survey (NHANES) from the National Center for Health Statistics at the Centers for Disease Control and Prevention. Prenatal tobacco exposure was measured by report of maternal cigarette use during pregnancy, and lead exposure was assessed by current blood lead levels. Based on the data, children exposed to tobacco smoke prenatally were found 2.4 times more likely to suffer ADHD.

Robert Kahn, a doctor and researcher at Cincinnati Children’s Hospital Medical Center and the study’s senior author said, “Although we tend to focus on ADHD treatment rather than prevention, our study suggests that reducing exposures to environmental toxicants might be an important way to lower rates of ADHD.”

Man spends 23 years in a coma but was awake the entire time

Rom Houben, a 46-year-old Belgian who doctors believed was in a coma, caused by a car crash in 1983, had in fact been conscious for 23 years. Houben had heard the doctors, nurses and family speaking in his room for decades but could do nothing to tell them.

Doctors in Zolder, Belgium thought that a car accident left Rom Houben in a vegetative state, unable to understand what was going on around him. The doctors used the internationally accepted Glasgow Coma Scale to assess his eye, verbal and motor responses. However after doctors at the University of Liege reassessed his case, they found he was entirely conscious.

“I screamed, but there was nothing to hear” says Rom. All those years able to hear everyone around him, but unable to reach out; “frustration is too small a word to describe what I felt,” he said.

“Frustration is too small a word to describe what I felt,” Houben said. “I shall never forget the day when they discovered what was truly wrong with me - it was my second birth.”

Houben’s case spotlights the challenges doctors face when attempting to diagnose the level of consciousness of a patient in a coma-like state.

After a 16-month study of coma patients in the light of the Houben case, Laureys and his team discovered that 41 percent of people diagnosed as being in a persistent vegetative state showed signs of consciousness.

Women confused with new breast cancer screening guidelines

On Monday, a government appointed group known as the U.S. Preventive Services Task Force released their new guidelines for mammograms. The task force now suggests women younger than the age of 50 do not need mammograms. It is important to note the revised recommendation pertain to women at average risk of getting breast cancer and not to women who are at high risk.

For several years, a number of doctors have questioned the efficacy of regular screening for breast and prostate cancers. The recent JAMA report showed that improvements in screening mammography produced a 40 percent increase in diagnosis and a corresponding decline in late-stage breast cancer was expected. However, only a 10 percent decline in late-stage breast cancer.

Without question many women in their 40s are feeling confused by the U.S. Preventive Services Task Force’s newest recommendation against getting regular screening mammograms. Almost 195,000 American women will develop breast cancer this year, and approximately 40,000 will die. Yet the business of offering mammograms has been in steady decline in recent years as a large number of clinics have opted out of the screening business because of low insurance reimbursements. Medicare generally pays around $94 for a mammogram, and private insurers might pay an additional 20 percent or more.

When looking purely at  statistics there is no doubt the task force’s new recommendations are wrong. Current statistics say one in eight women will have breast cancer, and one in 35 will die from it. Although some doctors say they will disregard the new guidelines, the real danger here is that insurance companies will use these recommendations as an excuse to stop paying for mammograms.

Plastic surgeons say no Botax on Botox

Plastic surgeons across the U.S. are seeing red over a piece of proposed legislation that could make a trip to the plastic surgeon or a medical spa more expensive.

There were approximately 4.7 million Botox visits in the U.S. last year, with the average cost per visit around $400. Cosmetic surgery has been spreading not only among individuals in their 20s, but also among teens and people in their 60s.

Senator Harry Reid, D-Nev., revealed the new plan on Wednesday which includes a 5 percent tax on cosmetic procedures and surgeries. If passed into law, the tax will go into effect on January 1, 2010, in hopes of generating $5.8 billion over the next 10 years to help fund the $849 billion health care plan.

The new tax will apply to all procedures that are “not necessary to ameliorate a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma, or disfiguring disease.”

The ASPS says the tax will mainly affect the middle class working women of the US who are the aesthetic industry’s largest group. Dr. Michael McGuire, President of ASPS said, “Elective surgery taxes discriminate against women, given that 86 percent of cosmetic surgery patients are female.” McGuire also argued that plastic surgeries are no longer considered luxury procedures only for the wealthy. Others are concerned that after cosmetic surgery the tax will be applied to an increasing number of other procedures, for example, laser eye surgery, knee-replacement surgery, etc.

New breast cancer screening guidelines being questioned

The United States Preventive Services Task Force, a government-operated board of outside experts, has advised the Department of Health and Human Services on new guidelines for breast cancer screenings. The “task force” says women do not need mammograms in their 40s and should get one every two years starting at 50. Instead of each year. In addition, they said that breast self-exams “do no good” and that we should not be taught to do them.

The task force says that early and frequent screenings often lead to false alarms and unnecessary procedures, without substantially improving the odds of survival.

The purpose of this panel is to routinely review the newest medical research and issue guidelines to reduce health risks. This task force is considered the gold standard in prevention recommendations because board members have no financial conflicts of interest.

The American College of Obstetricians and Gynecologists announced this week that it is maintaining its advice that women in their 40s get mammography screening every one-two years and women older than 50 get one each year. However, the group did say it would evaluate the data and the panel’s interpretations in greater detail.

If carried out, the task-force recommendations could possibly put a large number of women at risk of unnecessary death from a disease that has made significant headway. Is this government panel making these new guidelines now so that our proposed national health care plan does not have to allow them in the future? Another concern is whether insurance companies will begin denying coverage of breast cancer screens in women under 50 who want them?