Arlington Heights, Ill. (October 29, 2013) - Twins who smoke show more premature facial aging, compared to their non-smoking identical twins, reports a study in the November issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).
The study finds significant differences in facial aging between twins with as little as five years' difference in smoking history, says a new report by ASPS Member Surgeon Dr. Bahman Guyuron, Professor and Chairman, Department of Plastic Surgery, University Hospital Case Medical and Case School of Medicine, Cleveland. The results also suggest that the effects of smoking on facial aging are most apparent in the lower two-thirds of the face.
Wednesday, October 30, 2013
Friday, October 11, 2013
COMPLICATIONS HIGHER IN GERIATRIC BLACKS AND HISPANICS
Researchers say pre-existing medical conditions make a difference.
WEDNESDAY, Oct. 2 (HealthDay News) -- Older black and Hispanic patients are more likely than white seniors to have complications after surgery, and pre-existing medical conditions are a major reason for that difference, a large new study suggests.
Researchers examined the rates of 13 common types of complications among more than 587,000 white, black and Hispanic patients aged 65 and older who had general, orthopedic or vascular surgery in 600 hospitals in the United States.
The investigators found that black patients were nearly three times more likely than white patients to develop 12 of the 13 complications. Hispanic patients were twice as likely as white patients to develop nine of the 13 complications but less likely to develop two of the complications.
However, the number of complications among black and Hispanic patients dropped significantly when the researchers accounted for hospital and patient characteristics, according to the study published in the September issue of the Journal of the American Geriatrics Society.
"The risk of developing a postoperative complication may be attributed to a number of factors. Most pronounced, however, was the effect of pre-existing medical conditions," study lead author Dr. J. Margo Brooks Carthon, at the University of Pennsylvania School of Nursing, said in a journal news release.
WEDNESDAY, Oct. 2 (HealthDay News) -- Older black and Hispanic patients are more likely than white seniors to have complications after surgery, and pre-existing medical conditions are a major reason for that difference, a large new study suggests.
Researchers examined the rates of 13 common types of complications among more than 587,000 white, black and Hispanic patients aged 65 and older who had general, orthopedic or vascular surgery in 600 hospitals in the United States.
The investigators found that black patients were nearly three times more likely than white patients to develop 12 of the 13 complications. Hispanic patients were twice as likely as white patients to develop nine of the 13 complications but less likely to develop two of the complications.
However, the number of complications among black and Hispanic patients dropped significantly when the researchers accounted for hospital and patient characteristics, according to the study published in the September issue of the Journal of the American Geriatrics Society.
"The risk of developing a postoperative complication may be attributed to a number of factors. Most pronounced, however, was the effect of pre-existing medical conditions," study lead author Dr. J. Margo Brooks Carthon, at the University of Pennsylvania School of Nursing, said in a journal news release.
Wednesday, October 2, 2013
COMPLICATIONS INCREASE WITH HIGH BLOOD SUGARS
Arlington Heights, Ill. - A new study released today shows that among patients undergoing surgery for chronic wounds related to diabetes, the risk of wound-related complications is affected by how well the patient's blood sugar levels are controlled before surgery. These findings appear in the October issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).
The risk of serious wound complications is more than three times higher for patients who have high blood glucose before and after surgery, and in those with poor long-term diabetes control, according to the study by ASPS Member Surgeons, Drs. Mathew Endara and Christopher Attinger of the Center for Wound Healing at Georgetown University, Washington, DC. The researchers emphasize the need for "tight control" of glucose levels before surgery for diabetic patients at high risk of wound complications.
The risk of serious wound complications is more than three times higher for patients who have high blood glucose before and after surgery, and in those with poor long-term diabetes control, according to the study by ASPS Member Surgeons, Drs. Mathew Endara and Christopher Attinger of the Center for Wound Healing at Georgetown University, Washington, DC. The researchers emphasize the need for "tight control" of glucose levels before surgery for diabetic patients at high risk of wound complications.
Board Certified - Make Sure the Board is Recognized by the ABMS
2013 Legislative Session Delivers a Victory for "Name Your Board" Legislation in Nevada
Posted June 17, 2013 -- As session wrapped up, Nevada joined the growing list of states that limit physician advertising of board certification. On June 1, Gov. Brian Sandoval signed Assembly Bill 456 into law. The bill requires physicians who advertise as "board certified" to disclose the full name of the medical specialty board from which they receive their certificate. The legislation also implements criteria that medical specialty boards must meet in order for physicians to be permitted to advertise as "certified." ASPS worked with stakeholder physician groups and Nevada ASPS member Michael Edwards, MD to champion the proposal as it moved through the legislature. Dr. Edwards worked tirelessly the past two legislative sessions to seek passage of this important measure and was a key player in this victory. The law becomes effective Jan. 1, 2014.Board certification is an important part of a doctor's credentials. The American Board of Medical Specialties (ABMS) is the only recognized organization in designating which boards are legitimate and meet rigorous criteria for their members. Any doctor can advertise as being "board certified" - without being recognized by a legitimate board designated by The American Board of Medical Specialties. A doctor can take a course or undergo abbreviated training and be issued a piece of paper stating they are "board certified"- this means absolutely nothing and is misleading to the public. More states should enact legislation to protect patients from misleading advertising of credentials. Unfortunately, the attorneys and lobbyists many times prevent good legislation.
The American Board of Plastic Surgery is the only board recognized by the ABMS in certifying Plastic Surgeons.
Wednesday, September 25, 2013
SUDDEN CARDIAC ARREST (SCA)
The recent death of James Gandolfini, who played mafia boss Tony Soprano in the hit TV series The Sopranos, and recent malpractice cases are reminders that healthcare providers need to be on alert for the risk factors of sudden cardiac arrest (SCA).
SCA is the unexpected loss of heart function, breathing, and consciousness. In SCA, the electrical system of the heart fails and, at times, a heart attack may occur concurrently.
About half of people who suffer SCA had no previous symptoms, such as fatigue, dizziness, and racing heart rate. Approximately 325,000 people in the U.S. die from SCA annually. People who smoke or have coronary artery disease, have had a previous heart attack, have high cholesterol, and/or have a family history of heart disease have a higher risk.
These tips can help providers avoid misdiagnosis of SCA:
- Consider the possibility of advanced cardiac risk in patients who:
–• Are overweight and unable to control their weight with diet and exercise.
–• Have high blood pressure not responsive to medication.
–• Have evidence of erectile dysfunction.
–• Are glucose intolerant.
–• Have consistently high cholesterol levels.
–• Have a history of alcoholism.
- Take into account other factors associated with SCA, including:
–• Incidence increases with age—men after age 45 and women after age 55.
–• Men are two to three times more likely to have SCA than women.
–• Personal or family history of heart rhythm disorders, congenital heart defects, heart failure, or cardiomyopathy.
–• Use of illegal drugs (amphetamines or cocaine).
–• Nutritional imbalances (low potassium or magnesium levels).
BREAST REDUCTION AND ATHLETIC PERFORMANCE
Now it's not just professional athletes going under the knife. Carly Mortensen, 19, had the surgery to improve her softball game.
"It just felt uncomfortable for me because I had to wear two sports bras every time," she said. "It was emotionally pretty tough." "We are tending to a lot more young patients who realize there's a surgery out there that can help them, help them feel better and to help them become more athletic," plastic surgeon Dr. Michelle Spring said. According to Cosmetic Surgery National Data Bank statistics, more than 100,000 women had similar surgeries last year.
SURVEY ON PROPHYLACTIC MASTECTOMIES
If you’ve been diagnosed with breast cancer, the last thing you want is for it to come back. That sentiment goes a long way toward explaining why as many as 25% of women with breast cancer -- especially young women -- have been opting to have healthy breasts removed.
In an effort to dig deeper into patients’ decision-making process, researchers from Memorial Sloan-Kettering Cancer Center in New York and various schools and hospitals affiliated with Harvard developed a lengthy survey. They sent it to breast cancer survivors who were already part of on ongoing study tracking younger women who have been diagnosed with the disease. Responses from 123 women were included in the study, which was published in Tuesday’s edition of Annals of Internal Medicine.
The women who took the survey were between the ages of 26 and 40 when they got their diagnosis. All of them had breast cancer in just one breast -- most of the tumors were Stage 1 or Stage 2 – and all of them opted to have their healthy breast removed (a procedure known as a contralateral prophylactic mastectomy). When the women took the survey, they were an average of 2.1 years past their surgeries.
At first glance, their responses seem to tell a good-news story: 97% of them said they knew the risks and benefits of all of their options, 96% had a strong sense of which factors were most important to them, and 93% said they were sure that removing their healthy breast was the right decision for them.
Why did they take such drastic action? The desire to essentially eliminate any risk of cancer developing in the other breast was cited an “extremely important” or “very important” reason by 98% of the women. In addition, 95% said removing both breasts would give them peace of mind, and 94% believed that it would increase their odds of beating breast cancer and contribute to a longer life.
That doesn’t mean everything went completely smoothly -- 33% said they wound up needing more surgeries than they had expected, nearly the same proportion felt more self-conscious about their appearance than they'd thought they would, and 42% said their “sense of sexuality” was worse than they had anticipated. Still, 90% of the women said that if they could do it all again, they would still get the surgery.
So what’s the problem? The researchers suspect that at least some of these women decided to remove their healthy breasts under false pretenses. For instance, women who didn’t have any mutations in the BRCA1 or BRCA2 genes that would put them at higher risk of developing breast cancer estimated that they had a 10% chance of finding a new tumor in their healthy breast over the next five years; the actual risk is only 2% to 4%, according to the study.
Similarly, the women did not seem to fully grasp that they could keep their healthy breast and have the same long-term odds of surviving breast cancer. An editorial that accompanied the study noted that over a 20-year period, no more than 1% of those who decide to keep their healthy breast later die because their breast cancer has spread there.
The survey found that 87% of the women recalled being “extremely concerned” or “very concerned” about the prospect of cancer showing up in their healthy breast at the time they made their decision. This anxiety may have colored their decision-making process, the researchers wrote. It probably didn’t help that only 51% said their doctors talked with them about reasons not to have the surgery.
“Anxiety and fear of recurrence probably influence women during the decision-making process,” the researchers concluded. Doctors may not be telling these women that their risk of developing cancer in a healthy breast is “relatively low.” Even if they are told, they may be “unable to comprehend their low risk.”
The editorial, written by two doctors from the University of Minnesota, put things more bluntly: The high levels of “patient satisfaction” in the survey could be due to women’s “erroneous estimations” of their future breast cancer risk.
“With improved patient education, perhaps the CPM [contralateral prophylactic mastectomy] trends in the United States will plateau or be reversed,” they concluded.
The women who took the survey were between the ages of 26 and 40 when they got their diagnosis. All of them had breast cancer in just one breast -- most of the tumors were Stage 1 or Stage 2 – and all of them opted to have their healthy breast removed (a procedure known as a contralateral prophylactic mastectomy). When the women took the survey, they were an average of 2.1 years past their surgeries.
At first glance, their responses seem to tell a good-news story: 97% of them said they knew the risks and benefits of all of their options, 96% had a strong sense of which factors were most important to them, and 93% said they were sure that removing their healthy breast was the right decision for them.
Why did they take such drastic action? The desire to essentially eliminate any risk of cancer developing in the other breast was cited an “extremely important” or “very important” reason by 98% of the women. In addition, 95% said removing both breasts would give them peace of mind, and 94% believed that it would increase their odds of beating breast cancer and contribute to a longer life.
That doesn’t mean everything went completely smoothly -- 33% said they wound up needing more surgeries than they had expected, nearly the same proportion felt more self-conscious about their appearance than they'd thought they would, and 42% said their “sense of sexuality” was worse than they had anticipated. Still, 90% of the women said that if they could do it all again, they would still get the surgery.
So what’s the problem? The researchers suspect that at least some of these women decided to remove their healthy breasts under false pretenses. For instance, women who didn’t have any mutations in the BRCA1 or BRCA2 genes that would put them at higher risk of developing breast cancer estimated that they had a 10% chance of finding a new tumor in their healthy breast over the next five years; the actual risk is only 2% to 4%, according to the study.
Similarly, the women did not seem to fully grasp that they could keep their healthy breast and have the same long-term odds of surviving breast cancer. An editorial that accompanied the study noted that over a 20-year period, no more than 1% of those who decide to keep their healthy breast later die because their breast cancer has spread there.
The survey found that 87% of the women recalled being “extremely concerned” or “very concerned” about the prospect of cancer showing up in their healthy breast at the time they made their decision. This anxiety may have colored their decision-making process, the researchers wrote. It probably didn’t help that only 51% said their doctors talked with them about reasons not to have the surgery.
“Anxiety and fear of recurrence probably influence women during the decision-making process,” the researchers concluded. Doctors may not be telling these women that their risk of developing cancer in a healthy breast is “relatively low.” Even if they are told, they may be “unable to comprehend their low risk.”
The editorial, written by two doctors from the University of Minnesota, put things more bluntly: The high levels of “patient satisfaction” in the survey could be due to women’s “erroneous estimations” of their future breast cancer risk.
“With improved patient education, perhaps the CPM [contralateral prophylactic mastectomy] trends in the United States will plateau or be reversed,” they concluded.
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