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Pitt School Of Nursing Faculty Inducted Into American Academy Of Nursing
Three faculty members from the University of Pittsburgh School of Nursing will be inducted as fellows into the American Academy of Nursing.

Unjust Stigma, Lack Of Physician Training Hinder Market For IUDs, Opinion Piece Says
Intrauterine devices "seem like the perfect form of contraception: simple to use, long-lasting, reversible, hormone-free, economical," Slate columnist Kate Klonick writes. She asks, "So why are American women so late to this party? Perhaps the better question is: Why did they leave the party to begin with?"Klonick explains the benefits of IUDs, calling them a "foolproof method of birth control" and noting that they are 99% effective and "can last up to 10 years." Although IUDs can cost between $300 and $500, it is a one-time expense that is often covered by insurance, according to Klonick. She notes that although efficacy studies show that birth control pills, patches and vaginal rings can be "99% effective in a clinical setting, real-life compliancy -- like forgetting to take the pill at the same time every day -- reduces its success rate." Klonick adds that the availability of hormone-free IUDs makes them an "ideal" option for "women prone to some of the negative effects of hormonal birth control, like weight gain, mood swings, acne or high blood pressure."According to Klonick, IUDs were used by almost 10% of U.S. women taking birth control in the late 1970s but are now used by less than 2% of such women. She writes that Katharine O"Connell, a gynecologist at Columbia University who specializes in contraception, believes IUDs still carry a stigma "due to the erroneous belief that they"re highly dangerous" partly due to a number of deaths that occurred in the early 1970s tied to a specific brand of IUD known as the Dalkon Shield. Because of bad publicity surrounding the devices, "the U.S. pharmaceutical industry abandoned the research and manufacturing of IUDs in the mid-1980s, claiming the devices were no longer profitable," Klonick states. According to O"Connell, most experts now agree that the Dalkon Shield"s problems were related to its design, which made users more susceptible to infection, and a lack of testing for sexually transmitted infections before insertion.There are now two major brands of IUDs -- Mirena and ParaGard -- on the U.S. market, but physican training remains a problem, according to Klonick. She writes that studies show that premedical students are not educated regarding IUDs to the extent they are about oral contraceptive pills. O"Connell also noted that many medical schools limit classes on contraception to one lecture, which often omits IUDs. Klonick writes, "This lack of training can leave many doctors feeling uncomfortable recommending the once-controversial devices to their patients." She adds that many physicians who know how to insert and remove IUDs "still refuse to recommend it to childless patients because of the device"s checkered history." She concludes, "With Mirena advertising on television, the downturn in the economy forcing people to economize, and more women concerned about the long-term effects hormones have on their bodies, perhaps the IUD"s stigma will finally become a thing of the past" (Klonick, Slate, 7/29).
News of the day
Faster, More Cost-effective DNA Test For Crime Scenes, Disease Diagnosis
Scientists in Japan are reporting development of a faster, less expensive version of the fabled polymerase chain reaction (PCR), a DNA test widely used in criminal investigations, disease diagnosis, biological research and other applications. The new method could lead to expanded use of PCR in medicine, the criminal justice system and elsewhere, the researchers say. Their study is scheduled for the July 15 issue of Analytical Chemistry, a semi-monthly journal.
Cardiovascular

Breast Cancer Radiation Guidelines Called Positive Step

The new medical consensus statement on accelerated partial breast irradiation is an important step toward defining patient selection criteria and highlights the importance of targeting radiation, said two of the nation"s leading APBI physicians. The consensus statement, from the American Society for Radiation Oncology (ASTRO) outlines patient selection criteria and best practices for the use of APBI, a simpler, much shorter course of radiation treatment following lumpectomy surgery for breast cancer. It was published in the July 15, 2009, issue of the International Journal of Radiation Oncology*Biology*Physics, the organization"s official journal. "Patient selection for APBI is a critical component of the treatment decision-making process. If inappropriate patients are selected, bad outcomes will occur," said Coral Quiet, M.D. of Arizona Breast Cancer Specialists. The ASTRO consensus statement is a positive step in establishing guidelines for appropriate patient selection." The physicians from Arizona Breast Cancer Specialists said one of the statement"s most significant conclusions was the importance of "limiting the dose to non-target tissue." That goal is now more achievable with radiation treatment delivered inside the breast through multi-catheter breast brachytherapy techniques such as the SAVI™ applicator. SAVI is the only single-entry, multi-catheter device that can customize radiation based on patient-specific anatomy. The five-day radiation treatment minimizes dose to healthy structures like the skin, lungs, heart and chest wall. Clinical studies show that most women with early-stage breast cancer who were previously not able to take advantage of five-day radiation treatments due to the location of the lesion or breast size can now receive treatment with SAVI. "The ASTRO task force identified the importance of physics and dosimetry in delivering APBI," said Robert Kuske, M.D., also of Arizona Breast Cancer Specialists. Dr. Kuske is one of the nation"s leading radiation oncologists and pioneered the use of APBI through a multi-catheter technique. "The margin of error physicians have with APBI is much smaller than whole breast radiation, and mistakes have extremely significant consequences. To avoid the risks associated with increased toxicity, the delivery of radiation needs to be extremely precise." For decades, breast conservation therapy for early-stage breast cancer consisted of a lumpectomy followed by six weeks of whole breast irradiation. There has been growing interest in the use of APBI, which treats only the tumor cavity and surrounding tissue. This reduces treatment from six weeks to just five days and can decrease the amount of radiation delivered to healthy tissue and adjacent structures. The ASTRO consensus statement outlines, among other factors: * Which patients may be considered for APBI; *What constitutes proper informed consent for patients treated with APBI; *Which diagnostic imaging tests are needed for patients treated with APBI; * How to integrate APBI with surgical and chemotherapy treatment; and *How the various techniques for APBI compare with one another. "Though the consensus statement is a relatively conservative interpretation of the existing data, it opens the door for discussion with patients. The more information a patient has to make an informed decision, the better," said Dr. Quiet. Arizona Breast Cancer Specialists

Breast Augmentations commented:

It is nice to find a new step regarding the breast cancer radiatio. I have got a lot of informative stuff in your post. Thanks for the brilliant sharing.

25.04.2012


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