Screening mammography leads to overdiagnosis of small breast tumors The routine use of screening mammography has resulted in the increased diagnosis of small breast tumors and a decreasing incidence in large tumors, according to observational study results published in The New England Journal of Medicine. However, this diagnostic shift more likely represents overdiagnosis of small tumors than early detection of malignant tumors, and likely has not contributed to reduced breast cancer mortality, according to the researchers. Screening mammography is intended to diagnose asymptomatic small malignant tumors. Effective routine screening should result in the greater detection of small tumors, thereby reducing the rate of large tumors. “Although the biologic characteristics of a tumor are now recognized to be more relevant to breast cancer prognosis than the size of the tumor, tumor size is more relevant to the assessment of the proximate effect of screening,” H. Size-specific fatality rates declined during both study periods.
Climate change threats to family farmers' sense of place and mental wellbeing: A case study from the Western Australian Wheatbelt Highlights Sense of place is a significant driver of farmers' mental health and wellbeing. Weather influences farmers' emotional and psychological states. Climate change-related mental health risks cumulate over time. A place-based approach may limit climate change mental health risks to farmers. Abstract Myths in Emergency Medicine: Still Prescribing Oseltamivir? : Emergency Medicine News Let's start this one at the end: Oseltamivir, better known as Tamiflu to everyone else on the planet, is a dud of a drug. There is plenty more to discuss on the subject, but these are the highlights, courtesy of a truly remarkable and headline-making Cochrane review by Tom Jefferson, MD, and colleagues: * It does not decrease hospitalizations in patients with influenza. * It does not decrease complications of influenza. * It makes patients vomit. (NNTH=22 in adults, 19 in kids.)
Shared decision making in patients with low risk chest pain: prospective randomized pragmatic trial Erik P Hess, associate professor1 2 3, Judd E Hollander, professor4, Jason T Schaffer, assistant professor5, Jeffrey A Kline, professor5, Carlos A Torres6, Deborah B Diercks, professor7, Russell Jones, assistant professor8, Kelly P Owen, assistant professor8, Zachary F Meisel, assistant professor9, Michel Demers, patient adviser10, Annie Leblanc, research collaborator and caregiver adviser2 11, Nilay D Shah, associate professor11, Jonathan Inselman, statistical programmer analyst3, Jeph Herrin, biostatistician13, Ana Castaneda-Guarderas, resident1 2 14, Victor M Montori, professor2 15Author affiliationsCorrespondence to: E P Hess firstname.lastname@example.orgAccepted 3 November 2016 Abstract Objective To compare the effectiveness of shared decision making with usual care in choice of admission for observation and further cardiac testing or for referral for outpatient evaluation in patients with possible acute coronary syndrome. Design Multicenter pragmatic parallel randomized controlled trial.
Symptoms attributed to Chronic Lyme Disease Dr. Ric Arseneau (biography and disclosures) Disclosure: Dr. Arseneau is the Director of Program Planning and a clinician at the Complex Chronic Diseases Program (CCDP). Mitigating Potential Bias: Recommendations are consistent with current practice patterns. What I did before Watchful Waiting: When Treatment Can Wait In today's fast-paced world, waiting — whether it's at the doctor's office, in line at the grocery store or for an Internet connection — is rarely considered a good thing. But when it comes to certain medical conditions, delaying treatment while regularly monitoring the progress of disease — a strategy doctors refer to as "watchful waiting," active surveillance or expectant management — may benefit some patients more than a rush to pharmaceutical or surgical options. Patients want to know what they're waiting for, says urologic oncologist E. David Crawford, MD, chairman of the Prostate Conditions Education Council and associate director of the University of Colorado Comprehensive Cancer Center. The purpose is to watch in order to see whether a condition progresses.
Section 3: Place and Identity - The People, Place, and Space Reader Likewise, geographer Kay J. Anderson describes how race and class privilege infused the social production of space in late 19th-century Vancouver, Canada. Anderson’s work examines the variety of material and social practices through which both racialized space and constructed notions of racialized difference were produced and naturalized. Her research looks at how “Chinatowns” were fabricated in many cities by white Europeans and Anglo- Americans in the 19th century.
Rethinking cellulitis From the February ACP Hospitalist, copyright © 2017 by the American College of Physicians By Amy Karon Busy hospitalists and emergency department physicians frequently diagnose their patients with cellulitis. But they are often mistaken, research shows. Comparing Traditional and Participatory Dissemination of a Shared Decision Making Intervention Project Information Principal Investigator Hazel Tapp, PhD, BSc Project End Date Click Here! Includes the Research Project Period and may be subject to modification to allow other research-related activities such as peer review. IgG tests promise to reveal food sensitivities. But are they science or science-ish? Viola Dessanti has just gotten back the results of her young daughter’s IgG test—a blood test that looks for food sensitivities. “I have mixed feelings about it,” she says. Dessanti’s naturopath shared the results with her a few hours before she spoke to Healthy Debate. Her two-and-a-half-year-old daughter had elevated antibodies for three foods, and was borderline for six. Dessanti, who hopes the test will help uncover food triggers for her daughter’s asthma, is worried about its limitations.