What Our Physicians are Reading
Caduceus is committed in staying current with health care data and advances in medical care. Our physicians participate in ongoing education including staying abreast of changes in health care through published medical journals.
Below are links to a few of these resources.
Disclaimer
Any articles provided are for informational purposes only and Caduceus makes no professional representation or endorsement of fact or efficacy. We advise that you consult your physician directly
Articles
January 2010
NEJM: Getting the Facts Straight on Health Care Reform
New England Journal of Medicine: Health Care Reform
The United States stands on the verge of the most significant change to our health care system since the 1965 introduction of Medicare. The bill that was passed by the House and a parallel bill before the Senate would cover most uninsured Americans, saving thousands of lives each year and putting an end to our status as the only developed country that places so many of its citizens at risk for medical bankruptcy.
NEJM: Medicine’s Ethical Responsibility for Health Care Reform — The Top Five List
New England Journal of Medicine: Ethical Responsibility for Health Care Reform
Health Care reform ideas abound. Dr. Howard Brody channels David Letterman to champion the "The Top Five List." The Top Five list would consist of five diagnostic tests or treatments that are very commonly ordered by members of every specialty, that are among the most expensive services provided, and that have been shown by the currently available evidence not to provide any meaningful benefit. Examples of items that could easily end up on such lists include arthroscopic surgery for knee osteoarthritis and many common uses of computed tomographic scans, which not only add to costs but also expose patients to the risks of radiation.
December 2009
The Lancet: Sustained efficacy and immunogenicity of the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine: analysis of a randomised placebo-controlled trial up to 6.4 years
www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)61567-1/fulltext
The HPV Vaccine turns 6 and a half years old. Over 1,100 women aged 15-25 years old with normal cervical cytology were followed over a 6.5 year course. Vaccine efficacy against incident infection with HPV 16/18 was 95.3% and against 12-month persistent infection was 100%. Vaccine efficacy against CIN2+ was 100% for lesions associated with HPV-16/18 and 71·9% for lesions independent of HPV DNA. Happy anniversary indeed.
JAMA: Rethinking Screening for Breast Cancer and Prostate Cancer
http://jama.ama-assn.org/cgi/content/abstract/302/15/1685?home
Dr. Laura Esserman argures, "Breast cancer and prostate cancer screening may be increasing the burden of low-risk cancers without significantly reducing the burden of more aggressively growing cancers and therefore not resulting in the anticipated reduction in cancer mortality."
AJOG: Prediction of neonatal acidemia by computer analysis of fetal heart rate and ST event signals
www.ajog.org/article/S0002-9378(09)00427-X/abstract
Can baby EKG's produce large scale reduction in neonatal acidemia? Nearly 150 FHR tracings were evaluated by comparing red-alerts from FHR and ST event signals to umbilical artery acidemia (pH ≤7.05). The results? Improved prediction of neonatal compromise that just may allow adult obstetricians to breath easier, and calm their own EKG's.
The Wall Street Journal: Scientist With Endometriosis Seeks Insights Into Her Disease
http://blogs.wsj.com/health/2009/12/04/scientist-with-endometriosis-seeks-insights-into-her-disease/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+wsj%2Fhealth%2Ffeed+%28WSJ.com%3A+Health+Blog%29&mod=smallbusiness
Geniuses pick... endometriosis? An MIT professor has launched a new center to study endometriosis and other diseases of the female reproductive tract in response to her own diagnosis and dilemmas. Dr. Linda Griffith, winner of the 2006 McArthur Genius Grant, asserts, “We need gynepathology to be something my dean can talk about with a straight face the same way he would talk about breast cancer."
BBC: Scientists find foetal blood vessel failure clue
http://news.bbc.co.uk/2/hi/health/8390868.stm
While conducting research on mice a team from Munich found that platelets congregate at the ductus arteriosus during closure, promoting the formation of a clot as the vessel contracts. They further showed that in mice with defective platelet function, the ductus arteriosus failed to close. Some believe this could lead to identifying patients at high risk for patent ductus arteriosus.
The New York Times: Protecting Pregnant Women in Car Accidents
http://well.blogs.nytimes.com/2009/12/04/protecting-unborn-babies-in-car-accidents/
Car safety experts at Virginia Tech University, funded in part by Ford Motor Company, are trying to develop a computerized crash test model to determine how best to protect pregnant women and their unborn children during a collision. Review the Question and Answer session with Stefan Duma, Virginia Tech’s head of biomechanical engineering.
Los Angeles Times: The Risk Business of Cheerleading
http://latimesblogs.latimes.com/booster_shots/2009/12/the-risky-business-of-cheerleading.html
T is for Trauma. The Journal of Athletic Training reports 79 fall-related injuries among 412 cheer teams over the last year. The most common injuries were sprains sustained from a fall of 1 to 11 feet, 85% took place during practice and 89% of the incidents occurred while cheerleaders were attempting a stunt or a pyramid.
ESPN: Notre Dame Women top Eagles, Coach returns after 500th victory
http://sports.espn.go.com/ncw/recap?gameId=293360087
More examples of women's athletics. Notre Dame athletic director Jack Swarbrick presented women's basketball coach Muffet McGraw a basketball and a bouquet after the Fighting Irish (No. 6 ESPN/USA Today, No. 5 AP) beat Eastern Michigan 69-59 Wednesday night in her first home game since getting her 500th win at Notre Dame during the Paradise Jam in the Virgin Islands.
Annals of Internal Medicine: Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement www.annals.org/content/151/10/716.full
- The USPSTF recommends against routine screening mammography in women aged 40 to 49 years. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient's values regarding specific benefits and harms. This is a C recommendation.
- The USPSTF recommends biennial screening mammography for women aged 50 to 74 years. This is a B recommendation.
Obstetrics & Gynecology: Response of The American College of Obstetricians and Gynecologists to New Breast Cancer Screening Recommendations from the U.S. Preventive Services Task Force www.acog.org/from_home/Misc/uspstfResponse.cfm
The College is continuing to evaluate in detail the new USPSTF recommendations and the new evidence considered by the USPSTF, released 11/17/09. See the current recommendations as well as commentary on the proposed changes:
- Screening mammography every 1-2 years for women aged 40-49 years
- Screening mammography every year for women age 50 or older
- BSE; BSE has the potential to detect palpable breast cancer and can be recommended
Obstetrics & Gynecology: 2009–2010 Influenza Season Assessment and Treatment for Pregnant Women with Influenza-Like Illness www.acog.org/departments/resourceCenter/2009H1N1TriageTreatment.pdf
ACOG reminds its members about the latest guidelines from the CDC regarding treating pregnant women with flu-like symptoms.
General Websites
New England Journal of Medicine
American Academy of Family Physicians
American Academy of Pediatrics
American Medical Association