DermHelpCentral

Early Prostate Cancer

"The treatment of men with early-stage prostate cancer has undergone a sea change. Five years ago, nearly all opted for surgery or radiation; now, nearly half are choosing no treatment at all.

The approach is called active surveillance. It means their cancers are left alone but regularly monitored to be sure they are not growing. Just 10 percent to 15 percent of early-stage prostate cancer patients were being treated by active surveillance several years ago. Now, national data from three independent sources consistently finds that 40 percent to 50 percent of them are making that choice."

See NY Times Article by Gina Kolata.

This is an important article.  Another concept is that PSA tests are done unnecessarily which leads to  to unnecessary biopsies which leads to diagnosis of early prostate cancer and then surgery or radiation.  Patients travel down this slippery slope.

After The Fall

As the population ages and people live longer in bad shape, the number of older Americans who fall and suffer serious, even fatal, injuries is soaring.  This is a two part article on falls in the elderly.  It is comprehensive and very well done.

Part I: Bracing for the Falls of an Aging Nation

Part II: A Tiny Stumble, a Life Upended

 

Overtreatment

An important article appeared in the Health Section of the NY Time on October 4, 2011.

"Has American health care become overly aggressive? Many primary care doctors think so, according to a survey published last week in Archives of Internal Medicine. More than 40 percent of 627 primary care doctors who responded to the survey thought their own patients were overtreated; only 6 percent thought the patients received too little care.

"In another study published in the journal, doctors who reviewed the charts of elderly patients were able to discontinue nearly half of their medications without any detriment to the patients.

"If you take medications on a regular basis, have your doctor review your drug regimen periodically. Ask whether you may be able to wean yourself off a drug like a proton pump inhibitor if you make diet or lifestyle changes."

See: Steer Towards the Path of Least Treatment. 

Soul 2 Cell

From the NY Times: An article in JAMA this week describes a "new technique, called targeted muscle reinnervation which involves taking the nerves that remain after an arm is amputated and connecting them to another muscle in the body, often in the chest. Electrodes are placed over the chest muscles, acting as antennae. When the person wants to move the arm, the brain sends signals that first contract the chest muscles, which send an electrical signal to the prosthetic arm, instructing it to move. The process requires no more conscious effort than it would for a person who has a natural arm."  Full article.

Oh Brave New World...  Here the mind uses the nerves to send messages to myocytes (cells) to move artificial fingers.  These are the first baby steps, early insights into how the soul can direct the soul.

Dry, Itchy Skin

  cartoon by Gene Blasen

This is a good discussion of the dry, itchy skin many people experience during winters: 
It’s Cold and Your Skin Is Suffering. So What Are You Doing to Moisturize? 

It begins:  IT’S been a challenging winter for people with dry skin. The country has been blasted with Arctic air, making this winter the coldest so far in a decade, according to Scott Stephens, a meteorologist with the National Oceanic and Atmospheric Administration National Climatic Data Center. With the cold comes low humidity — sometimes as low as 10 percent — along with moisture-stripping winds that can cause chapped, flaky skin."

This article has some practical (and very inexpensive tips) as well as an interesting multimedia presentation.

Food Allergy Research

There was a good article in the December 9 2008, NY Times on Food Allergies.

(Picture from Times article: A DAILY STRUGGLE Sean Batson, 5, who is allergic to soy, eggs and milk, is participating in a large food allergy study.)

Excerpt: "Indeed, with recent data showing a marked increase in the number of food allergies, which cannot be explained by a lack of detection in years past, the national institutes have begun an initiative to address food allergies as an emerging health challenge.

Although it is possible to be allergic to any food, eight foods account for 90 percent of all reactions — milk, eggs, peanuts, fish, shellfish, soy, wheat, and tree nuts like cashews and almonds."

If you have an interest in this subject, this is a good place to begin.  Researchers Put a Microscope on Food Allergies

Brian Maurer, a pediatric physician's assistant in Enfield Connecticut has these comments about this article and food allergies:

"In today’s New York Times we read about the latest emerging healthcare challenge: 4 percent of the general population suffers from food allergies.  Fifteen years ago, clinicians paid little attention to food allergies; they were thought to be relatively rare.  Nowadays, more and more children are being diagnosed with allergic disease triggered by milk, soy, egg, wheat, peanut, tree nuts, fish and shellfish.  The question is: how many of these are bona fide allergies?
 
Certainly, if a child demonstrates clinical signs of an allergic reaction when challenged with a particular food substance—hives, wheezing, dysphagia, angioedema—there is little doubt of the diagnosis.  The clinical waters become murkier when we attempt to arrive at a diagnosis through screening tests.  Many patients who show significant reactions to skin-prick testing demonstrate no problem when challenged with the actual foodstuff in the diet.  As the article points out: “[i]n China…skin-prick testing found that large percentages of one rural population were sensitive to shellfish (16.7 percent) and peanuts (12.3 percent). Yet actual food allergies in that population, as diagnosed by physicians, were all but unheard of: less than 1 percent.”  How reliable is skin-prick testing?
 
Anecdotally, I have had one pediatric allergist—an internationally recognized researcher and clinician—tell me that blanket screening tests are basically useless.  His recommendation is to measure quantitative IgE levels for those substances to which the patient has demonstrated a past sensitivity in order to assess the degree of allergy over time.
 

Pregnancy and Acne

This article from the NY Times on Acne and Pregnancy is fluff -- but is still interesting.