ALCOHOL DEATHS HAVE REACHED A NEW HIGH

US alcohol deaths have reached a 35-year high, CDC finds

The Washington Post (12/23, Ingraham) “Wonkblog” reports that US alcohol deaths have reached a “35-year high.” In 2014, some “30,700 Americans died from alcohol-induced causes, including alcohol poisoning and cirrhosis.” Excluded from this figure are “deaths from drunk driving, other accidents, and homicides committed under the influence of alcohol.” Were those deaths to be “included, the annual toll of deaths directly or indirectly caused by alcohol would be closer to 90,000, according to” a CDC report published Dec. 18 in the Morbidity and Mortality Weekly Report.

        TIME (12/23, Chan) points out, “Excessive alcohol use is a leading cause of preventable death, according to the” CDC, accounting “for about 88,000 deaths each” year “from 2006 to 2010, health officials said.”

RECENT STUDY CONFIRMS THE SAFETY OF SILICONEGEL FILLED BREAST IMPLANTS

A recent report published on November 9 in the Annals of Internal Medicine states the newest findings on the debate considering the safety of the beauty surgery. And, the good thing is the research conducted by Dr Ethan Balk, of the Brown University School of Public Health in Providence, Rhode Island confirmed that silicone breast implants are not linked to any long-term health effects, according to Web Md.

The product, which came in the US market in the 1960s, was questioned and had a moratorium in 1992, when the public raised concerns on the possibility of health risks (e.g. breast cancer, rheumatoid arthritis and fibromyalgia) later on in case of a ruptured silicone implant.
However, they were reintroduced in the market in 2006.
"Owing to inconsistencies among the studies reviewed, further investigation is required to determine whether any true associations exist between silicone gel implants and long-term health outcomes," Dr. Ethan Balk said in a report by Mail Online.
The recent research made use of 5,000 studies investigating the health outcomes of breast augmentation surgery.
Women participants are from North America, Europe and Australia said to have gone under the knife between 1964 and 2003.
Meanwhile, the study did not include to consider other factors like alcohol consumption and smoking. Also, it is criticized for being too general as not to focus on the effects of silicone breast implants, HNGN said.
To answer this, upcoming studies planned to register patients who got the operation and record their health conditions the moment they had the surgery until they decide to replace the implants.
"Hopefully it'll show what the implants do in five, 10 or 15 years, because that's what's lacking in the current data," Dr. Rod Rohrich from the University of Texas Southwestern Medical Center in Dallas said.
In 2014, a total of 286,000 women are recorded to have availed of the surgery in the United States according to the American Society of Plastic Surgeons making the operation to be one of the most-common cosmetic surgery in the country.



Read more: http://www.counselheal.com/articles/15350/20151112/silicone-breast-implant-breast-implant-health-problems-breast-cancer-cancer.htm#ixzz3s3CTVfat

ABDOMINOPLASTY HAS HIGHER RISKS AND COMPLICATIONS THAN OTHER COSMETIC PROCEDURES

Background: Among aesthetic surgery procedures, abdominoplasty is associated with a higher complication rate, but previous studies are limited by small sample sizes or single-institution experience.

Methods: A cohort of patients who underwent abdominoplasty between 2008 and 2013 was identified from the CosmetAssure database. Major complications were recorded. Univariate and multivariate analysis was performed evaluating risk factors, including age, smoking, body mass index, sex, diabetes, type of surgical facility, and combined procedures.

Results: The authors identified 25,478 abdominoplasties from 183,914 procedures in the database. Of these, 8,975 patients had abdominoplasty alone and 16,503 underwent additional procedures. The number of complications recorded was 1,012 (4.0 percent overall rate versus 1.4 percent in other aesthetic surgery procedures). Of these, 31.5 percent were hematomas, 27.2 percent were infections and 20.2 percent were suspected or confirmed venous thromboembolism. On multivariate analysis, significant risk factors (p < 0.05) included male sex (relative risk, 1.8), age 55 years or older (1.4), body mass index greater than or equal to 30 (1.3), multiple procedures (1.5), and procedure performance in a hospital or surgical center versus office-based surgical suite (1.6). Combined procedures increased the risk of complication (abdominoplasty alone, 3.1 percent; with liposuction, 3.8 percent; breast procedure, 4.3 percent; liposuction and breast procedure, 4.6 percent; body-contouring procedure, 6.8 percent; liposuction and body-contouring procedure, 10.4 percent).

Conclusions: Abdominoplasty is associated with a higher complication rate compared with other aesthetic procedures. Combined procedures can significantly increase complication rates and should be considered carefully in higher risk patients.

COMBINATION DRUG THERAPY OFFERS ADVANTAGE IN MELANOMA

The FDA has approved the combination of vemurafenib (Zelboraf) and cobimetinib (Cotellic) as a treatment for patients with BRAF-positive metastatic or unresectable melanoma, based on an extension in progression-free survival (PFS) in the phase III coBRIM study.

In the data submitted to the FDA, the median PFS with the combination was 12.3 versus 7.2 months for vemurafenib alone (HR, 0.58). At a 17-month analysis, 65% of patients receiving the combination remained alive compared with 50% for vemurafenib. The objective response rate (ORR) with the combination was 69.6% compared with 50% for vemurafenib alone.

"As we continue to advance our knowledge of tumor biology, we have learned that cancer cells have a remarkable ability to adapt and become resistant to targeted therapies. Combining two or more treatments addressing different cancer-causing targets may help to address this challenge," Richard Pazdur, MD, director of the Office of Hematology and Oncology Products in the FDA’s Center for Drug Evaluation and Research, said in a statement. "Today’s approval provides a new targeted treatment that, when added to vemurafenib, demonstrates greater benefit than vemurafenib alone in patients with BRAF mutation-positive melanoma."

SMALLER BREAST IMPLANTS

More women trading in large implants for smaller sizes Demand is growing for "explant" procedures -- removal of implants altogether or in exchange for smaller sizes, according to the American Society of Plastic Surgeons. Demand grew by almost 10% from 2010 to 2014, and nearly 24,000 women had an explant procedure last year. "Surgeons are seeing a definite shift in the look many women are asking for, away from the very round, prominent 'stripper boob' toward something more in keeping with their natural shape," said American Society for Aesthetic Plastic Surgery President-Elect Daniel Mills.

NEW MEDICATION FOR MELANOMA

FDA approves first-of-its-kind skin cancer medication

Bloomberg News (10/28, Chen) reports that the Food and Drug Administration approved Imlygic (talimogene laherparepvec), Amgen Inc.’s “treatment for melanoma lesions in the skin and lymph nodes that can’t be removed completely by surgery.” Imlygic, also known as T-vec, “uses a modified version of the herpes simplex virus to attack cancer cells.” The drug will have an average cost of about $65,000 annually, according to the company.

        The Boston Globe (10/28, Tedeschi) reports in “Stat” that the drug is “the first tumor-killing virus to receive the FDA’s blessing” and it could “usher in a new wave of immune-stimulating viral therapies.” Other immune-stimulating viral therapies include “a genetically tweaked poliovirus being tested in patients with brain tumors, while another, based on a version of the common cold virus, is now under evaluation in people with bladder cancer.”

        The AP (10/28) reports that “despite the drug’s groundbreaking approach, FDA officials stressed it has not been shown to extend life,” but rather has been demonstrated to shrink tumors.

HOSPITALS ACQUIRING DOCTORS' PRACTICES - MORE COSTS TO PATIENTS

The Boston Globe (10/20, Boodman) reports the study, conducted by Harvard Medical School researchers, “found that when small doctors’ practices join large hospitals, their patients pay an average of $75 more every year for outpatient services like check-ups.” The article adds that the “steady march of doctors into hospitals could continue thanks to the Affordable Care Act,” which “encouraged the integration of different parts of the health care system in the hope that it will reduce costs.”

HOSPITALS HIRING PHYSICIANS MAY NOT BE HEALTHY

Whistleblower offers warning as hospitals hire more physicians

Kaiser Health News (10/8) reports that a third of physicians “now work directly for hospitals or for practices with at least partial hospital ownership, estimates the American Medical Association.” Dr. Michael Reilly, a Florida surgeon who filed a whistleblower lawsuit against Broward Health for engaging in “improper financial relationships” with physicians, is worried that this trend will lead to higher health costs and worse care for patients. According to the article, not “only does hospital employment ‘dramatically’ boost chances that a doctor will refer to that hospital, but it also raises odds that patients will end up at a higher-cost, lower-quality facility, finds a recent study from Stanford University researchers.”

ADVANCED MELANOMA TREATMENT

FDA approves ipilimumab-nivolumab combination for melanoma treatment

The Wall Street Journal (10/2, Loftus, Winslow, Subscription Publication) reports that the FDA approved a combination of Yervoy (ipilimumab) and Opdivo (nivolumab) to be taken together for advanced melanoma treatment, drugs expected to cost each patient $256,000 in their first year. The article highlights the high price of drug treatment cocktails, citing the annual cost by Novartis as $226,428 per patient.

        Reuters (10/2, Berkrot, Nathan) notes that Merck is testing Keytruda (pembrolizumab) to work as part of a melanoma treatment cocktail in at least ten studies. The article points out that bought separately Opdivo and Yervoy would cost around $295,000.

        Bloomberg News (10/2, Koons) explains that in May’s Yervoy-Opdivo trial, “58 percent of those who received both drugs had significant tumor shrinkage, compared with 44 percent in the group that took Opdivo alone and 19 percent for just Yervoy.” Yet, there was “a 36 percent dropout rate due to side effects,” as the combination precipitated “diarrhea and elevated liver enzymes.”

RHINOPLASTY DATES BACK TO THE SIXTH CENTURY B.C.

The rhinoplasty, colloquially known as the nose job, is now popular enough that it’s considered minor plastic surgery. Still, the procedure earns comment when the proboscis being shaped is a famous one and plenty of people express concern over the current boom in cosmetic surgeries. Yet nose jobs aren’t new. The earliest recorded schnoz shaping happened in ancient India in the 6th century B.C., The ancient Indian procedure included taking a flap of skin from the patient’s cheek and reshaping it into a new nose. The ayurvedic physician Sushruta describes that procedure in his Sushruta samhita, now considered a foundational Sanskrit text on medicine.Still, rhinoplasty didn’t enter the limelight in the West until syphilis struck Europe in the late 16th century.

One of the unfortunate symptoms of advanced syphilis is soft-tissue decay, which affects the nose and leaves a gaping hole in the middle of one’s face. Such a disfigurement carried the social stigma of disease and infection, even if the afflicted had lost their nose by another means. Different methods were employed to recreate noses. One of the most popular procedures involved taking skin from the patient’s arm and grafting it to their face in an effort to make a new nose (or something resembling one, anyway).

People have long sought out rhinoplasties to address cosmetic concerns and conform to society’s beauty ideals. Some of that led people to try and make their features look less like that of a racial minority in America (still a motivating factor today). But not all nose jobs were motivated by beauty standards. Facial surgery experienced a real boom during the two World Wars, as soldiers with injuries to their jaws, lips and noses became the proving ground for surgeons experimenting with reconstruction techniques. In her book, excerpted by The New York Times, Harken writes of surgeons who pioneered ways to build up noses, rather than reduce them. So-called "saddle-nose" could be caused by syphilis, but also could be inherited or caused by trauma or infection. A surgeon observed in 1926 that ""Many persons with a saddle nose ... are suspected of having inherited disease and are greatly handicapped, both in their social and business relations."Building up the nose presented the challenge of figuring out what to build with. The human body rejects many substances, such as ivory, that were used for other protheses. For a time, surgeons in the early 20th century settled on paraffin, but over time the substance tended to move, especially if people spent time in the sun and frequently caused cancer.Then, as now, plastic surgery was sometimes ridiculed, but still the demand increased. A pioneer in the field, Charles Conrad Miller, noted that the serious surgeon should not turn away patients seeking facial surgery. The rise of unskilled, untrained "surgeons" to fill that need presented a professional dilemma. Harken writes:

For this, Miller blamed neither the charlatans nor the gullible patients, but the physicians who did not take seriously their patients' needs. "Physicians cannot longer disregard the effect of the `Beauty Columns,'" Miller insisted. "Every practitioner who laughs at the patient who questions him regarding an operation for improving the appearance of the face takes the chance of seeing that patient return from the advertiser disfigured for life."

 

NICOTINE ADDICTION

Low-nicotine cigarettes may motivate smokers to quit, study finds

The AP (10/1, Marchione) reports on a study published Oct. 1 in the New England Journal of Medicine suggesting that “smokers who switched to special low-nicotine ones wound up smoking less and were more likely to try to quit.” For the study, special cigarettes with nicotine levels of as little as 0.4 milligrams of nicotine per gram of tobacco were made, compared to the usual 15.8 mg of nicotine per gram of tobacco. The study covered “about 800 people who smoked five or more cigarettes a day.” Participants were given cigarettes ranging in nicotine levels of 0.4 mg up to 15.8 mg for six weeks. Those who received the lower concentrations of nicotine “were a little more likely to smoke some regular cigarettes,” yet they all “reported fewer symptoms of nicotine dependence.”

        The Los Angeles Times (10/1, Healy) reports in “Science Now” the study explained that “smokers restricted to very low nicotine cigarettes will not smoke more, nor inhale more deeply, to get the same addictive hit.” Researchers found that participants with low-nicotine cigarettes “did not experience some of the extreme withdrawal symptoms — constipation, distraction, increased appetite — that cause many would-be quitters to turn back.”

        Reuters (10/1, Emery) reports that those who were given the lowest levels of nicotine were more likely to report that they tried to quit smoking altogether within 30 days of the study concluding.

        USA Today (9/30, Szabo) reports that the researchers are now conducting a longer-term, five-month study, as some say the FDA should refrain from regulations until there is additional research proven over time.

THE EPIDEMIC OF OBESITY

Americans eat up to 15 hours a day, study says

The Los Angeles Times (9/25, Healy) reports a study by researchers at the Salk Institute in La Jolla “that detailed the consumption patterns of just over 150 nondieting, non-shift-working people in and around San Diego for three weeks,” showed “that a majority of people eat for stretches of 15 hours or longer most days – and fast for fewer than nine hours a night.” The study suggests that “Americans’ erratic, round-the-clock eating patterns...have probably contributed to an epidemic of obesity and Type 2 diabetes.”

PRODUCTION LEADS TO BETTER HEALTH

Seniors who work longer are healthier, study suggests

The Los Angeles Times (9/25, Kaplan) reports a recent study concluded that seniors who keep working are healthier than those who are retired. “Researchers from the University of Miami and their colleagues examined data on more than 83,000 Americans,” all of who “were at least 65 years old when they were interviewed, and 13% of them were still working part time or full time,” according to the LA Times. Of those still working, 61% held white-collar jobs. The study found that “compared to people with white-collar jobs, those who were unemployed or retired were 2.75 times more likely to report their health as ‘poor’ or ‘fair.’”

"DO YOUR HOMEWORK"

Lawsuit alleged that patient-safety education and messaging caused direct financial damage to non-plastic surgeons

For Immediate Release: 09/02/2015

Find Your Surgeon

Find Your Surgeon

The 10th District U.S. Court of Appeals on Aug. 31 affirmed the September 2013 dismissal of a lawsuit filed by a group of non-plastic surgeons calling themselves “cosmetic surgeons” against the Utah Plastic Surgery Society, ASPS, the American Board of Plastic Surgery (ABPS) – as well as 19 individual plastic surgeons – that alleged patient-safety education advertisements amounted to monopolistic efforts and messaging that caused direct financial damage to the non-plastic surgeons.
The plaintiffs claimed that the Utah Society’s advertising – specifically billboards and media interviews modeled after the ASPS “Do Your Homework” campaign – were in violation of the Sherman Antitrust Act and asserted false advertising claims in violation of the Lanham Act. The plaintiffs claimed the campaign was deceptive by indicating that cosmetic surgery is safer when performed by ABPS-certified plastic surgeons rather than ” cosmetic surgeons.”
The Appeals Court concluded that the plaintiffs failed to show any plausible antitrust or deceptive advertising violation and affirmed the previous ruling in favor of UPSS, ASPS, ABPS and the individual plastic surgeons named in the lawsuit.
“This decision further confirms the value and importance of our efforts to provide public awareness on the distinctions between ABPS-certified plastic surgeons and lesser-trained physicians who present themselves as similarly skilled,” says UPSS President Brian Brzowski, MD. “We were helped tremendously by ASPS through its early financial and material support and its guidance in crafting the overall ‘Do Your Homework’ effort.”
“The public safety education campaign was modeled largely after the ASPS campaign,” adds UPSS immediate past President Trenton Jones, MD. “And it’s a huge win for the patient-safety efforts in our state.”
ASPS acknowledges Dr. Brzowski, Dr. Jones and the Utah Plastic Surgery Society for their efforts to both bring the ASPS “Do Your Homework” campaign to their state and defend the patient-education efforts.

NON-BOARD CERTIFIED "PLASTIC SURGEONS"

Recent Article in the International Business Times Investigated the Performance of Plastic Surgery Procedures by Non-Board Certified Plastic Surgeons

For Immediate Release: 09/18/2015

Find Your Surgeon

Find Your Surgeon

American Society of Plastic Surgeons President Scot B. Glasberg, MD, recently responded to an International Business Times article titled "Medical Turf Wars," which investigated the performance of plastic surgery procedures by non-board certified plastic surgeons. Below is his full letter to Editor Peter S. Goodman.

---

Dear Mr. Goodman,
As the president of the American Society of Plastic Surgeons, I found your recent article investigating the performance of plastic surgery procedures by non-board certified plastic surgeons ("Medical Turf Wars" - September 7, 2015) disgracefully unbalanced. I am deeply disappointed and, frankly, shocked that the article did not include any input from the American Society of Plastic Surgeons (ASPS), the largest plastic surgery organization in the world, and the subject of serious negative accusations throughout the piece. I feel compelled to address some egregiously presented points.

The article, inspired by the recent dismissal of a case against ASPS for the implementation of a public service campaign encouraging consumers to "Do Your Homework" when considering plastic surgery, points out that physicians who perform cosmetic procedures without the benefit of being board certified in plastic surgery charge board certified plastic surgeons with protectionism.
We are not interested in protectionism. We are interested in protection—of patients, of the reputation of our specialty, and of an essential component of our mission—advancing the highest standards of training, ethics and physician practice.
By educating consumers on the importance of choosing a board certified plastic surgeon, ASPS believes we are not only guarding the specialty of plastic surgery from the indelible mark of illegally performed, often fatal procedures by non-physicians, but also protecting patients and assuring they make choices that assure the safest, highest quality of care.
This objective is the foundation of our Do Your Homework and "truth-in-advertising" efforts. The current president of the American Board of Cosmetic Surgery (ABCS) asserts that our objective is financial, but this is not the case. (I would note, however, that ABCS is conducting a nationwide campaign to undermine the sort of truth-in-advertising, described below, that ASPS is seeking to instate. The benefit for ABCS if they are successful? More money.) He claims that ASPS is seeking to prevent physicians who are not board certified plastic surgeons from providing cosmetic surgery. This is simply false. In reality, such a pursuit would be an antitrust violation. What our efforts are aimed at is instead preventing under-trained, under-qualified physicians from acquiring a substandard "certification"—like, for example, the certification offered by ABCS—and then advertising themselves to the general public as "board certified."
While our members can look at the ABCS training requirements and see that they are lacking, the general public typically doesn't have a nuanced understanding of just how dramatically quality in medical training can vary. However, what they do understand is that the phrase "board certified" is a sign of excellence. We seek only to maintain that truth and, in doing so, maintain patient safety.
Through the messages of the ASPS's Do Your Homework public service announcements, consumers learn that board-certified plastic surgeons are certified by the American Board of Plastic Surgery—the specialty board in plastic surgery that is overseen by the American Board of Medical Specialties (ABMS), an organization that is widely recognized as the gold standard in specialty certification. They learn that board-certified plastic surgeons undergo vast, specific training in plastic surgery that includes residencies and fellowships that are certified by the Accreditation Council for Graduate Medical Education (ACGME), the body responsible for accrediting the majority of graduate medical training programs, and have passed rigorous oral and written board exams to demonstrate that their training and education have successfully prepared them to practice plastic surgery.
While the article clearly states that members of the American Board of Cosmetic Surgery also receive education and training (a "fellowship" and the completion of 300 cosmetic procedures) it fails to mention the most important piece of information about that training—it is substandard.
Think of it this way: there are 38 ABMS specialty board certifications and 88 subspecialty certifications available, and there are 38 AOA specialty board certifications, 25 certifications of special qualifications, and 40 certifications of added qualification. Nowhere among this huge number of potential certification options is one for the practice of "cosmetic surgery." This is the case because there are no ACGME-accredited cosmetic surgery fellowship programs in existence.
That's not to say that cosmetic surgery is not a legitimate component of medicine or that physicians cannot be well-trained cosmetic surgeons. Instead, this reflects the fact that cosmetic surgery is a component of the comprehensive training board-certified plastic surgeons receive. It is not a discipline unto itself. And when board-certified plastic surgeons receive cosmetic training—and this is the key—it is a part of an ACGME-accredited program. Because its standards are so high, ACGME accreditation is one of the driving forces behind the quality of American medicine, and its independence ensures that participating training programs must strive to meet those standards.
The ABCS certification programs, on the other hand, create their own criteria, their own training qualifications, and their own standard for what is an acceptable level of training. Since when does the student write the test? It all comes down to quality
Sadly, patients are bombarded with confusing messages about their choices when seeking a plastic surgery provider. Ambiguous promotions made by physicians who are not board certified in plastic surgery maintain that their training is equal or even superior to that of a board-certified plastic surgeon. For the earned esteem of the plastic surgery specialty and more importantly for the safety and quality of the care provided to plastic surgery patients.
I stand by the ASPS's mantra that patients should do their homework. Respected publications reporting on this important consumer healthcare issue should, perhaps, do a bit more homework, as well.
Respectfully,
Scot B. Glasberg, M.D.

CHEMOTHERAPY

All types of cancer involve Uncontrolled Cellular Division.  Cancer fighting drugs can vary in their mechanism of action and side affects.

Most chemotherapeutic drugs fall into three categories:
(1) Cytotoxic
(2) Targeted Therapy
(3) Immunotherapy

Cytotoxic drugs can not distinguish normal cells from cancer cells, and thus, these drugs kill or damage all types of cells, even healthy cells. Mechanisms of action may relate to preventing the cells from replicating (Alkylating agents); interference with RNA or DNA replication (Anti-metabolites & anti-tumor antibiotics); disrupting the activities of enzymes that aid in the separation of DNA strands during DNA replication (Topoisomerase inhibitors); and drugs that stop mitosis - a process where a single cell splits into two cells (Mitotic Inhibitors).  These drugs typically have significant side effects to include hair loss, nausea and vomiting, fatigue and nerve damage.

Targeted therapy is more selective.  These drugs disrupt the activity of specific molecules that promote the growth of cancer cells. Mechanisms of action may relate to blocking enzymes that signal cancer cells to divide (Signal transduction inhibitors); controlled and targeted cell death in cancer cells (Apoptosis inducers); blocking formation of new blood vessels to tumors, thus "starving" the tumors from oxygen and nutrition which results in cancer cell death (Angiogenesis Inhibitors); blocking hormone production that may stimulate the growth of certain cancers (Hormone Therapies);
a molecular cytotoxic drug or radioactive agent is linked to a monoclonal antibody that targets and kills cancer cells (Antibody-drug conjugates). Targeted therapy drugs tend to have less serious side effects, but can result in diarrhea, fever, blood clotting issues, wound healing problems and skin problems, hypertension and liver problems.

Immunotherapy drugs stimulate the body's natural immune system to fight cancer. Interferons boost the ability of the body's immune cells to fight cancer or infections.  Interleukins help immune cells to grow and replicate more quickly, thus allowing the body to fight the cancer more efficiently. Some immunotherapies may cause flu-like symptoms, rashes or hypotension.

Many times, combining the different categories of chemotherapeutic drugs to treat certain cancers add benefit and reduces the chance of resistance to chemotherapy.

For some cancers, surgery is the first line treatment.  For other types of cancer, radiation is the preferred treatment.  Some cancers are treated by chemotherapy alone.  Other cancers are better treated with a  combination of surgery, radiation and chemotherapy.

NEW MEDICATIONS FOR TREATING ADVANCED BASAL CELL CARCINOMA

Two new medications are now available to treat metastatic or locally advanced Basal Cell Carcinoma.  Erivedge (Vismodegib) and Odomzo (Sonidegib)  have been approved by the F.D.A. and have similar mechanisms of action.

Oral medication used to treat metastatic B.C.C., or locally-advanced B.C.C.
  that has recurred following surgery or in patients who are not candidates
  for surgery and are not candidates for radiation therapy

Dosage: 150 mg p.o. daily for Erivedge and 200 mg. p.o. daily for Odomzo

Cost:       $11,268.79 for a 28 day treatment for Erivedge

Mechanisms of action: B.C.C. may be associated with mutations in Hedgehog pathway components. Hedgehog regulates cell growth and differentiation in embryogenesis;  while generally not active in adult  tissue, Hedgehog mutations associated with B.C.C. can activate the pathway resulting in unrestricted proliferation of skin basal cells. Erivedge is a selective Hedgehog pathway inhibitor.

Adverse Reactions:
Teratogenic effects
Fatigue
Alopecia
Muscle Spasms
Gastrointestinal

DO NOT TRY THIS!

A Honduran woman carrying 3.3 lbs of liquid cocaine in her breast implants was arrested at the airport in Colombia's capital Bogota.

Paola Deyanira Sabillon, 22, was attempting to travel to Spain when her apparent nervousness aroused suspicion in the security line, airport police colonel Diego Rosero told journalists.

X-rays revealed a recent surgery on Sabillon's breasts and she confessed that an unknown substance had been implanted which she was meant to take to Barcelona, police added.

Authorities said a preliminary investigation showed that the surgery took place at a clandestine clinic in the city of Pereira, in western Colombia.

The implants were removed at a Bogota hospital where Sabillon is also being treated for an infection.

Some 300 tons of cocaine are produced per year in Colombia, long a hub for drug production and trafficking.

TREATMENT OF METASTATIC MELANOMA

Combination of ipilimumab and nivolumab may benefit patients with advanced melanoma.

In a 1,000-word article, the New York Times (6/1, B3, Pollack, Subscription Publication) reports that a study presented at the American Society of Clinical Oncology meeting found that “the combination of two immune-boosting” medications – Yervoy (ipilimumab) and Opdivo (nivolumab) – “is more effective than either drug alone in treating advanced melanoma.” Those “treated with both drugs went a median of 11.5 months before their disease worsened.”

        The Washington Post (5/31, Bernstein) “To Your Health” blog reports, “Nivolumab alone gave patients 6.9 months, and ipilimumab provided 2.9 months.” The data indicated that “more than 70 percent of the patients given both drugs had some kind of positive response to the combination therapy.”

        Bloomberg News (5/31, Langreth) reports, however, that “patients in the combination group had a far higher rate of toxic side effects including diarrhea and elevated liver enzymes.”

MELANOMA INCIDENCE ON THE RISE

CDC: Incidence of melanoma has doubled in the US in the last 30 years.

The Los Angeles Times (6/3, Kaplan) “Science Now” blog reports that “the incidence of melanoma...has doubled in the U.S. in the last 30 years and is on track to remain high unless Americans take more precautions to protect themselves from ultraviolet radiation, the Centers for Disease Control and Prevention said” yesterday. The “Vital Signs study” was “published in the Morbidity and Mortality Weekly Report.” The blog adds that while “Melanomas account for only 2% of skin cancers...they are the deadliest kind, according to the National Cancer Institute.”

        On its website, CBS News (6/3, Cohen) reports that in a statement, Dr. Lisa Richardson, the director of the CDC’s Division of Cancer Prevention and Control, said, “If we take action now, we can prevent hundreds of thousands of new cases of skin cancers, including melanoma, and save billions of dollars in medical costs.”

        Melanoma rates up among US children, young adults. Health Day (6/3, Dallas) reports that research indicates that “melanoma...has increased by 250 percent among U.S. children and young adults since the 1970s.” The findings were presented at the American Society of Clinical Oncology meeting.

ALCOHOL EPIDEMIC

Study: Thirty-three million US adults may be affected by problem drinking.

The AP (6/4, Tanner) reports, “Alcohol problems affect almost 33 million adults and most have never sought treatment,” according to a study published online June 3 in JAMA Psychiatry. The research conducted by investigators at the National Institute on Alcohol Abuse and Alcoholism also suggests that “rates have increased in recent years.” NIAAA director George Koob, PhD, “said it’s unclear why problem drinking has increased but that many people underestimate the dangers of excessive alcohol.” Koob also pointed out that effective behavioral treatments and medications exist to help people overcome problem drinking. He said, “There’s a lore that there’s only Alcoholics Anonymous out there and that’s not true.”

Dimensional Nipple-Areolar Tattooing

Vinnie Myers, tattoo artist based at "Little Vinnie's Tattoos" in Finksburg, Maryland, has taken nipple areolar tattooing to a new level.

Myers takes time and effort to create realistic, 3D replicas by matching skin tone and selecting shape and location. Careful shading guarantees that each set of tattoos, like each survivor, is unique.
“Every patient or case that comes in is kind of like a small engineering feat, because we have to tailor the process to meet their specific needs based on incision patterns, skin or flap thickness and if they’ve had radiation or not,” said Trent Wyczawski, tattoo artist with the team. “Most women are very excited and are ready to make it a fun day. It’s the last step in the [healing] process.”
Since the endeavor began, the team has successfully tattooed thousands of women from all over the world. Wyczawski was carefully selected by Myers as part of his tattooing trio, which also includes artist Paul Bessette. Members of the team are now traveling outside of Maryland to make the service available to more women nationwide.

ENHANCE OUR YOUTH

If we do not plant knowledge when young, it will give us no shade when we are old."

-- Lord Chesterfield,
statesman

OBESITY INCREASES COMPLICATIONS

Study: Obesity affects cosmetic surgery complication rate
Obese patients are more likely than their healthy-weight peers to be admitted to a hospital or require emergency department care after cosmetic surgery, according to a study published in the journal Plastic and Reconstructive Surgery. Obese and overweight patients should be counseled about their elevated risk for complications before undergoing surgery, the researchers wrote.

SUCCESS STARTS WITH CONFIDENCE AND BELIEF

In any project, the important factor is your belief. Without belief, there can be no successful outcome."

-- William James,
philosopher and psychologist

INJECTABLE DEOXYCHOLIC FOR DISOLVING NECK FAT

FDA approves injectable designed to eliminate 'double chins' by destroying fat cells
Deoxycholic acid injectable developed by Kythera reportedly targets fat cells while sparing the surrounding tissue, but the procedure is claimed to work best on younger patients with good skin elasticity.

A QUOTE FROM A GREAT BOXER

Only a man who knows what it is like to be defeated can reach down to the bottom of his soul and come up with the extra ounce of power it takes to win when the match is even."

-- Muhammad Ali,

TRIPLE NEGATIVE BREAST CANCER (ER/PR/HER-2 NEU. NEGATIVE) - A MORE AGGRESSIVE CANCER

Chemo before lumpectomy cuts recurrence risk in triple-negative cancer
Breast-conserving surgery has a 90% success rate in women with triple-negative breast cancer who are treated first with chemotherapy, according to a study presented at the annual meeting of the American Surgical Association. Despite the success rate, 31% of the women who are eligible for breast-conserving surgery chose mastectomy instead. "We don't have an answer for why this is the case, but we hope that this work encourages more patients and clinicians to think about why this is happening and what we can do to address this," said study leader Mehra Golshan, director of breast surgical services at Dana-Farber/Brigham and Women's Cancer Center. HealthDay News (4/23)

INCREASED DETECTION OF BREASTCANCER

Study predicts breast cancer incidence will grow by 50% in 15 years
A study presented at the American Association for Cancer Research meeting predicted breast cancer incidence in the U.S. will rise by 50% from 2011 to 2030. Longer life spans and increased detection of cancers, including in-situ lesions that may not need treatment, will contribute to the trend, experts say, noting it isn't always clear which tumors can go without treatment. The data suggest the percentage of treatment-responsive estrogen-receptor-positive cases will grow, highlighting opportunities to identify "smarter screening and kinder, gentler and more effective treatment," said researcher Philip Rosenberg. Time.com (4/20)

BEWARE OF "SPICE"

Illnesses, hospitalizations linked to synthetic marijuana use may be on the rise.

USA Today (4/24, Hughes) reports that “poison-control experts and public health officials are warning about a new spike in illnesses and hospitalizations caused by people using the drug ‘spice,’ a catch-all name for a type of synthetic marijuana.” USA Today adds, “Through last week, poison centers across the country received 1,900 calls from people seeking help after experiencing adverse reactions to these drugs – four times the number of calls as the same period the year before.”

BRCA MUTATIONS: INCREASE RISKS FOR BREAST AND OVARIAN CANCERS

Removing ovaries in patients with breast cancer and BRCA1 mutation may reduce risk of dying from the disease.

TIME (4/24, Sifferlin) reports that research published in JAMA Oncology suggests that “in women who have both breast cancer and the BRCA1 mutation, having surgery to remove the ovaries can significantly lower their risk of dying from the disease.”

        The New York Daily News (4/24, Pearson) reports that investigators “looked at the cases of more than 600 women with the BRCA 1 gene mutation who had been diagnosed with stage 1 or 2 breast cancer.” The researchers “found that those who had their ovaries removed at some point following diagnosis were 62% more likely to be living in 20 years than those who did not.”

WORDS TO LIVE BY

Don't get mad. Don't get even. Get stronger, faster and more powerful. Fill yourself with knowledge and empathy and an indomitable spirit, because no one else can do that for you. In the end, it's your life, your choice and your world. Give 110%, always."

-- Apolo Ohno,
American speed skater

ANOTHER "RELATIONSHIP" WEBSITE

There’s a dating website exclusive to those members deemed “beautiful” enough, and now some are going as far as to get plastic surgery for a shot at being allowed into this elite club.

On BeautifulPeople.com, new users are allowed to upload one photo. Then members of the site vote on whether the person in the photo looks gorgeous enough to stay or gets the boot. Women vote on men, and men vote on women. If your photo doesn’t get enough votes in the first 48 hours, you’re kicked off.

“BeautifulPeople is based on a fundamental principle of human nature,” said Greg Hodge, the website’s US managing director. “We all initially at least want to be with someone we find attractive... It might not be politically correct, but it’s certainly very honest.” 

“If the online dating market was a nightclub, BeautifulPeople would be the VIP room,” he added.

Some people who were rejected from the site decided to get work done, and then returned to the site to upload their “after” photos in hopes they would be accepted.

One user named Tawnie Lynn said she was rejected the first time she tried to sign up, so she got a nose job. After going under the knife, Lynn said she uploaded another photo and was accepted.

“It did help me get on the site,” she said. “I wasn’t accepted before the nose job, so I think afterwards if I was accepted I’d blame it on the nose.”

Sal Vance, one of the BeautifulPeople.com mentors, said he spent $10,000 on his teeth before signing up.

“I learned to play the rules of the game. The rules of the game are, I was a buck-toothed kid. I got my teeth done,” Vance said.

“A lot of people want to get on the website,” he added. Man you’d be surprised... [I’ve seen a] face lift on a woman who honestly wasn’t ever 30 years old yet.”

For those who have gone to extremes to join the club, they claim the site is a motivator for people to live well and take care of themselves. But some experts have their doubts.

“The fact that a woman would go undergo plastic surgery ... to be deemed attractive on some website makes me very, very scared for what’s going on in our hearts and in our minds,” said sex therapist Dr. Laura Berman. “We’re becoming so focused on immediate gratification and initial impulse decision and immediate reactions to the external that we are going to get lost somewhere along the way.”

BeautifulPeople.com launched in Denmark in 2003, and has since gone global with 800,000 members. The acceptance rate hovers just under 30 percent. Seven million people, and counting, have been rejected from the site since its inception.

“If a woman is not necessarily beautiful, not in the classical sense, if she looks kind of sexy or showing a bit of skin, she’s got a good chance of getting in,” Hodge said. “Men are dogs. Women look at the overall picture, ‘does this guy look like he has money?’”

And once you’re in, you’re still not safe. Profiles are reviewed periodically.

“We have removed numerous people over the years for letting themselves go,” Hodge said.

While it all seems like a backwards way for “beautiful people” to stick together, Hodge said the rejection model actually hurts profits.

“What bothers me is that so few people get in,” he said. “From a business perspective when people get turned away, it’s bye, bye dollar signs, isn’t it, at the end of the day.”

BREAST IMPLANTS AND ANAPLASTIC LARGE CELL LYMPHOMA

Background: Despite increased cases published on breast implant–associated anaplastic large cell lymphoma (BIA-ALCL), important clinical issues remain unanswered. We conducted a second structured expert consultation process to rate statements related to the diagnosis, management, and surveillance of this disease, based on their interpretation of published evidence.

Methods: A multidisciplinary panel of 12 experts was selected based on nominations from national specialty societies, academic department heads, and recognized researchers in the United States.

Results: Panelists agreed that (1) this disease should be called “BIA-ALCL”; (2) late seromas occurring >1 year after breast implantation should be evaluated via ultrasound, and if a seroma is present, the fluid should be aspirated and sent for culture, cytology, flow cytometry, and cell block to an experienced hematopathologist; (3) surgical removal of the affected implant and capsule (as completely as possible) should occur, which is sufficient to eradicate capsule-confined BIA-ALCL; (4) surveillance should consist of clinical follow-up at least every 6 months for at least 5 years and breast ultrasound yearly for at least 2 years; and (5) BIA-ALCL is generally a biologically indolent disease with a good prognosis, unless it extends beyond the capsule and/or presents as a mass. They firmly disagreed with statements that chemotherapy and radiation therapy should be given to all patients with BIA-ALCL.

Conclusions: Our assessment yielded consistent results on a number of key, incompletely addressed issues regarding BIA-ALCL, but additional research is needed to support these statement ratings and enhance our understanding of the biology, treatment, and outcomes associated with this disease.

TISSUE GLUE

FDA approves first tissue adhesive for internal use.

The Philadelphia Inquirer (2/5, McCullough) reports that the FDA has approved TissuGlu, “the first tissue adhesive for internal use in the body.” Surgeons can use it “to reconnect the big sheets of tissue created during abdominoplasties, or ‘tummy tucks,’ in which excess fat and skin are cut away.” William Maisel, Chief Scientist and Deputy Center Director for Science at FDA’s Center for Devices and Radiological Health, said the approval “will help some abdominoplasty patients get back to their daily routine after surgery more quickly than if surgical drains had been inserted.” Reuters (2/5, Penumudi) and Medscape (2/5, Lowes) also cover the story.