Dr. Cheryl Iglesia

On the heels of Breast Cancer Screening guidelines changing back and forth, the Cervical Cancer screenings, Pap Smears, are also changing.

The new guidelines are now recommending women start screening after the age of 21 and less frequently thereafter. Previously, it was encouraged for girls to start screening three months after the first sexual encounter and have regular annual checkups.

Since the Obama Administration stabilized the uproar of breast cancer screening after the age of 50, the panel of obstetrician’s group that proposed the Pap smear guidelines, reassures that it is simply bad timing, and is not related to the Preventative Services Task Force that released the mammography guidelines just two days ago.

“Dr. Cheryl B. Iglesia, the chairwoman of a panel in the obstetricians’ group said the latest recommendations had been in the works for several years, “long before the Obama health plan came into existence.’”

Dr. Iglesia called the timing crazy, uncanny and “an unfortunate perfect storm,” adding, “There’s no political agenda with regard to these recommendations.”

cervical cancer screenings (cervical-cancer-law.com)

The obstetricians’ group feels strongly about the need to cut back on Pap screenings that are more harmful when done too frequently.  The cervix in young women often shows abnormalities that resolve themselves on their own with time.  However, additional procedures done in the cervix leads to new problems that arise during pregnancies.

Still, the new guidelines should be applied to each woman differently.  The fear is that taking emphasis off the importance of testing may backfire on younger girls who have sexual intercourse at the age of 12 or 13.

“I’m concerned that whenever you send a message out to the public to do less, the most vulnerable people at highest risk might take the message and not get screened at all,” said Dr. Carol Brown a gynecologic oncologist and surgeon at Memorial Sloan-Kettering Cancer Center.

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(rlv.zcache.com)

Are mammograms unnecessary for women until they turn 50? Have the politics on health care reform gotten in the way of doing what’s best for the prevention of breast cancer? Will this effect insurance coverage for the procedure?

Addressing one of the questions, The Obama Administration announced government insurance programs would continue to cover routine mammograms for women starting at age 40, reports today’s New York Times.

This was in response to the Preventative Services Task Force recommendations that women not start routine mammograms until they are aged 50, instead of 40. The research showed that benefits gained starting at aged 40 were small. The downside of earlier screenings was that they lead to excess biopsies, unnecessary anxiety as well as discovery and treatment of tumors that would not cause problems if left alone.

The Physician Data Query Group, a physician group that evaluates new research on cancer research for the National Cancer Institute, recommended that the task force’s evidence be added to all information passed onto doctors and the public.
Members of the group were frustrated that mammogram screenings had become the center of political debate.

One member of the Physician Date Query, Dr. Russell Harris, a former member of the Preventative Services Task Force, explained that when the old guidelines were released by the task force in 2002 there had been less research on the topic.

According to Vitals.com, Dr. Russell received his medical degree at John Hopkins University and completed his specialty training at Duke University.

The Democrats believe the timing of the study’s release was just another opportunity for Republicans to raise doubts about the health care plan now being prepared for a vote in the Senate. Kathleen Sebelius, the Secretary of Health and Human services, assured the country that their policies remain unchanged on this issue. She pointed out that the task force is an outside independent panel of doctors and scientists who make recommendations but don’t set federal policy.

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Dr. Kenneth Baughman

Baughman, 63, of Newton, Massachusetts was the director of advanced heart disease at Brigham and Women’s Hospital. He was also a triathlete passionate about running, biking and swimming.

The Orlando area ranked as the most dangerous for pedestrians out of 52 cities of a million or more residents in a recent report released by Transportation for America.

Baughman served as director of the cardiology division at Johns Hopkins University School of Medicine in Baltimore before joining Brigham and Women’s in 2002. 

“Ken was a physician’s physician, an exemplar of how you can lead and teach as a model to others,’’ said Dr. Myron Weisfeldt of  the cardiology department of Johns Hopkins.

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Dr. Diana Petitti (sci.asu.edu)

There are 192,000 new cases of breast cancer and about 40,000 deaths in the United States every year, reports the Wall Street Journal. Women in their 40’s account for at least a quarter of breast cancer diagnoses, 17% of breast cancer deaths, suffer from more aggressive cases and have a higher risk of death according to the Los Angeles Times.

Yet according to new guidelines released Monday by the United States Preventative Services Task Force, women do not need to start regular breast cancer screening until they reach the age of 50. The task force also recommended that these women only require mammograms every two years and that doctors should stop teaching women to examine their breasts on a regular basis.

Just seven years ago the task force recommended that women should have mammograms every one to two years once they turn 40. This influential group, appointed by the Department of Health and Human Services, provides guidelines for doctors, insurance companies and policy makers.

“No one is saying that women should not be screened in their 40’s,” said Dr. Diana Petitti, vice chair of the task force and a professor of biomedical informatics, whose work is followed closely by doctors and insurance companies.

“That change is really a change between doing it routinely and don’t do it routinely. Women 40 and older, should talk to their doctors and decide with them whether or not to put off screening for a few years.”

Dr. Petitti was more explicit about the issue of ‘breast self- examinations’. “Women should know it doesn’t work. Two large studies published since the last guidelines involving 200,000 women in China and more than 100,000 in Russia showed no benefits from breast cancer self examinations.”

mammograms (sedonaobserver.com)

According to Vitals.com, Dr. Petitti received her medical degree at Harvard University and completed her specialty training at the University Of Colorado School Of Medicine.

The new recommendations would not apply to women with risk factors.  Overall the report stated that the modest benefit of mammograms reduce the breast cancer rate by 15% and must be weighed against the harms, reports The New York Times.

The harms, which loom larger for women in their 40’s than women in their 50’s, are described as false positives that generate anxiety and unnecessary additional tests and biopsies. The harms are nearly cut in half when women begin screenings in their 50’s and have mammograms every other year instead of every year. But the benefits are almost unchanged.

READ MORE ABOUT DR. DIANA PETITTI

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Vitals.com is now publishing average wait times of 100,000 doctors. Look for the clock in the doctors  profile for average wait time on each individual doctor.

Here are the grim facts about wait time:

• The longer an ill patient has to wait to see a doctor, the greater the chance their sickness will worsen.
• Wait times places patients’ health at risk and costs hospitals, insurers and patients more in resources and dollars.
• Patients who give up and walkout, will often get sicker and show up later in worse shape.
• An Institute of Medicine report on the crisis in U.S. emergency did a study on why wait times are increasing:
• Doctors overbook patients. Overbooking is usually deliberate because doctors are paid by volume under many health insurance reimbursement systems.
• Increased demand - the number of patients seeking ER care jumped 26 percent to 114 million in the last few years.
• Doctor shortages especially in rural areas and certain types of specialties.
• Hospitals closing the Emergency Room - the number of U.S. emergency departments fell about 12 percent in the last few years. Patients will need to make a decision to go to a nearby doctor or travel a long distance to find an available emergency room.

What are the solutions?

• If you have to wait, at least the doctor can make it a comfortable wait. Some emergency rooms and busy doctors now give patients pagers that will buzz when it’s their turn. This allows patients to go out for a breather without risk of losing their spot in line.
• Insurance companies can provide reimbursement for less traditional patient visits, such as telephone and e-mail consultations to give patients speedier access to doctors.
• Doctors can reserve a big percentage of their day for patients who call early for same-day appointments.
• Go electronic. Patients can provide medical details about themselves prior to a visit and then get test results electronically the same time as the doctor through a private online account.
• Finally, check your doctor’s wait time on his/her profile on Vitals.com

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Dr. Roger Blumenthal

Researchers studied two medications that control cholesterol and found that adding an old standby drug, niacin, was superior in reducing buildup in the carotid artery, then Zetia, a newer drug.

The controversial research on cholesterol drugs was published in The New England Journal of Medicine and has the potential to strongly affect which cholesterol drugs will be prescribed in the future.

“It will certainly strengthen the idea that, after you give a statin, as a second agent, you should give a niacin. That is the implication of the study,” said Dr. Roger S. Blumenthal, a professor of medicine at the John Hopkins School of Medicine.

According to Vitals, Dr. Blumenthal received his medical degree at Cornell University and did his specialty training at John Hopkins University.

The results of this relatively small study have become a hot topic among the medical community, reports the New York Times. Some cardiologists praise the study as an indication that the drug companies’ profit, with combined sales of 4.6 billion dollars, is excessive considering the lack of concrete evidence of its benefit on heart health.

It has also attracted the attention of a powerful Republican Senator, Charles E. Grassley, who has been scrutinizing the two recently merged drug companies, Merck and Schering-Plough. But keeping a close eye on the activities of drug companies and their pursuit for profit has become increasingly necessary.

(injuryboard.com)

According to another New York Times story, the industry has been raising its prices at the fastest rate in years despite their promise to support the healthcare reform bill by shaving 8 billion a year off the nation’s drug’s costs.

The study randomly assigned 208 patients, with heart disease or at risk of heart, a statin and either Zetia or Niaspan. Over the course of 14 months, the bad cholesterol of the patients on Zetia decreased by 19.2 percent, but the patient’s arterial wall thickness stayed the same. In the niacin group, good cholesterol increased by 18.4 percent and the carotid wall thickness decreased.

Dr. Peter S. Kim, President of Merck Laboratories contests the results, saying the research was limited because it did not compare the groups of patients taking a statin and a second drug to a placebo group.

Dr. James H. Stein, a professor at the University of Wisconsin Medical School, sees the study as being especially significant when combined with the results of 30 years of research on the use of niacin. It adds to the weight of evidence that this drug might be instrumental in helping treat patients with heart disease.

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Dr. Stephen Wolf (i.cdn.turner.com)

Dr. Stephen Wolf, a Nichols Hills physicians has been arrested for the murdering of his 9-year-old son and wounding his wife, Mary Wolf.

Several 911 calls were made around 4 a.m. from a neighbor who overheard an altercation between the Wolfs in their son’s room. Tommy Wolf was pronounced dead when authorities arrived shortly after. They disarmed Stephen Wolf, who was holding a knife. Mary Wolf suffered non-life-threatening wounds to her hands and mouth, trying to protect her son.

Tommy Wolf (tulsaworld.com)

According to Vitals.com, Dr. Stephen Wolf is an Internist in Oklahoma City, OK. He completed his medical degree at University of Oklahoma College of Medicine.

“”We are trying to put all the facts together,” Police Chief Richard Mask said. The boy’s death, he said, had had a “devastating” effect on Nichols Hills, a small town about 15 miles northwest of Oklahoma City. “It’s had a huge impact,” he said.”

“I can’t perceive it happening anywhere anytime but it does and Nichols Hills is not that much different from any other community,” Mask said. “I know that sounds strange, but people are people and everyone has their problems.”

READ MORE ABOUT DR. STEPHEN WOLF

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Dr. Andrew Ordon

Dr. Andrew Ordon, the star on CBS’s hit daytime show, The Doctors. He is referred to as “the governor of plastic surgery” and “plastic surgeon to the stars”. Dr. Ordon is teaming up with renowned plastic surgeons Dr. Kami Parsa and Dr. Jay Calvert to form a new foundation, Surgical Friends Foundation. The trio joined together to combat the most difficult, and often life-threatening, reconstructive cases of individuals in need and without health insurance.

The mission of Surgical Friends Foundation is to unite philanthropists, reconstructive surgeons, and patients in need of surgery but without the financial resources. As plastic surgeons with sub-specialty expertise, they are well-suited to perform these life-altering surgeries. Most of the foundation’s patients have physical deformities that are congenital, post-traumatic or acquired in nature.

Their first mission will be to Cambodia where they will handle a full slate of pediatric cases - all children who have been victims of land mines, as a result of decades of civil war. After 20 years of war, one out of every 290 Cambodians is living with a deformity as a direct result of the numerous land mines plaguing their landscape. This is one of the highest ratios in the world

For more information on the Surgical Friends Foundation and to view a video of a recent case surgery, visit www.surgicalfriends.org.

The Doctors (fox61.com)

Dr. Andrew P. Ordon, M.D is a surgeon in the area of aesthetic plastic and reconstructive surgery with a private practice in Beverly Hills and Rancho Mirage. Dr. Ordon is a Phi Beta Kappa graduate of the University of California where he earned his under-graduate degree with Honors in Biological Sciences. He then received his medical degree from USC School of Medicine with Honors in Medicine.

Dr. Ordon in His Own Words: For decades I have been privileged to help rebuild and enhance the lives of many individuals. I bring a unique combination of training, experience, and quality of care to all of my patients. I have a commitment to enhancing an individual’s natural beauty through using the latest techniques in cosmetic and reconstructive surgery. Our relationship begins with trust and ends with the successful completion of natural rejuvenation or reconstruction

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Dr Atala spoke about this study: “It provides a tailor-made transplant. Once the tissue is there, the body recognizes the tissue as its own. We are seeing babies born with deficient genitalia all the time. That was the inspiration for this work. There are no good options today. Patients with congenital anomalies, penile cancer, traumatic penile injury, and some types of organic erectile dysfunction could benefit from this technology in the future. The process takes six weeks from beginning to end, he said, and there is reason to believe a penis grafted onto a baby would grow with the child.”

Full report is available online in the Nov. 9-13 issue of the Proceedings of the National Academy of Sciences.

Dr. Anthony Atala (usnews.com)

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President Obama among the increasing numbers of people smoking in America (weblogs.cltv.com)

Although anti-smoking campaigns worked well in the past decades lowering rates by 4% since 1998 alone, these last five years showed no progress in stopping Americans from smoking. In fact, the rate has increased from 2007 to 2008, according to U.S. Centers for Disease Control and Prevention.

Experts believe the decline is affected by the “cutbacks in funding for state tobacco-control programs, which had proven successful before.”

“Tobacco is the leading cause of preventable death in the U.S., and we know what to do,” said Dr. Thomas Frieden, the CDC director. “We want to provide support to states and localities to implement proven programs, and if we do that, we can save literally millions of lives in the decades to come.”

According to Vitals.com, Dr. Thomas Frieden is also the Commisioner of Health and Mental Hygiene of NYC.  He completed his medical degree at Columbia University and residency for infectious disease at Yale University School of Medicine.

Dr. Thomas Frieden believes that creating smok-free environment, like restaurants and office buildings has contributed to the overall decrease in the past decade.  It will continue to be enforced in more and more states, which hopefully impact the increasing rates of smokers.

In addition, more places are becoming smoke-free, he said. “Going smoke-free not only protects the health of nonsmokers but also encourages smokers to quit,” Freiden said.

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