Disease

Ever since the Women’s Health Initiative (WHI) trials of hormone replacement therapy (HRT) for post-menopausal women was halted early because of an observed increased risk of breast cancer, there has been confusion about the positive and negative effects of this treatment, as we discussed here. Early on, it was thought that HRT would reduce a woman’s chance of cardiovascular disease — but the results didn’t show that. Now, HRT is primarily suggested for women who suffer from extreme menopause-related symptoms such as hot flashes. A new analysis of the long-term results of the WHI should provide some additional guidance to women and their physicians.

To review: the WHI was a randomized, double-blind trial...

It's pretty common knowledge that obesity increases the chance that a woman will develop breast cancer, and how her excess adiposity is distributed on her body can be a clue to her risk. A new study from China increases our understanding of one possible mechanism by which this can occur.

First, some words about body shapes. Most men tend to be "apples" in that they carry most of their weight above the waist. Most women, on the other hand, are "pears", carrying more of their weight in the hips and thighs, as shown in the figure above. However, some women are more like apples, and their weight is distributed more like that of men. And if apples and pears become obese, these differences are accentuated. An apple will have a higher ratio of waist to hip circumference than will a...

Fifty or so years ago a woman diagnosed with breast cancer was almost sure to be treated aggressively — with a radical mastectomy. That surgery involved removing, not only the affected breast tissue, but also the underlying muscle and many if not all of the nearby lymph nodes. Not only was that surgery disfiguring, it also caused various morbidities such as lymphedema (1) and difficulty in using the arm. More recently, of course, we have moved on and no longer need to take such draconian measures as often as before — we have a larger armamentarium of systemic treatments (e.g. chemotherapy) and more targeted radiation treatments.

Today, a woman presenting with an early stage breast lesion which has spread to some degree to nearby (sentinel) lymph nodes, could be treated with...

An aggressive type of cancer surgery that's grown increasingly popular – and controversial – during the last decade is largely determined by patient preference, and not necessarily by sound medical reasoning.

However, a new study reveals that that crucial decision – whether a woman should undergo a double mastectomy when only one breast is affected – is heavily influenced by her surgeon's recommendation.

That significant finding, published today in JAMA Surgery, was announced by doctors at the University of Michigan, who analyzed the decision-making process relating to the procedure, called contralateral prophylactic mastectomy, or CPM.

For surgeons "who most favored initial breast conservation and were most reluctant to perform CPM," only 4% of...

For the vast majority of people who live in the developed world, infectious disease is an afterthought.

Sure, we still catch colds and (if we're old or immunocompromised) can die of influenza, pneumonia, or food poisoning. Antibiotic resistance is scary -- and directly responsible for about 23,000 deaths in the U.S. each year -- but it hasn't quite become the apocalypse we all feared. In general, the microbial world is just not something the average person has to think about very much.

That luxury of modern life is due to the strong defense provided by the "pillars" of our public health system. According to Dr. Michael Osterholm, these...

My heart sank when I received the news.

Nearly two years ago, my friend and colleague, Sam Chi, called to tell me that he had pancreatic cancer. I knew that was a death sentence.

There are various kinds of pancreatic cancer, and his was the most common type: adenocarcinoma. It was stage III, which meant that even though the cancer had not metastasized to other organs, it was locally advanced. The cancer had engulfed nearby blood vessels, making it inoperable.

Even under the best of circumstances, the five-year survival rate for pancreatic adenocarcinoma is devastating. According to the...

Even though colorectal cancer (CRC) is the second-leading cause of cancer death in the US, and even though the US Preventive Services Task Force says that screening for CRC earns a grade A recommendation (the strongest one) for people in the ages of 50 to 75 without risk factors, it seems that people a)don't get screened as they should, and b) don't follow up with additional tests as recommended after normal or abnormal findings. So the question arises, how can we encourage people to first, get screened and second to follow up as appropriate?

Dr. Amit G. Singal from...

New reports out of Australia contain some sobering news. The number of influenza cases this year is 2.5-times that of the same time period last year. Since the flu season down under begins in July, these data may give us a glimpse of what to expect in the US this winter.  New South Wales, which has the highest population of any state in the country, had more than 35,000 confirmed flu cases in August. To put this in perspective, the previous record for most cases in a month was 16,686 this past July. August 2016 had 13,602 cases and August 2015 had 12,901. (Figure 1, below)

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The utility of mammography screening for breast cancer has been a bone of contention, but for some women it has been a life-saver. Indeed, the US Preventive Services Task Force currently recommends that women ages 50-74 should get a mammogram every 2 years. These recommendations are for women who have not been previously diagnosed with the disease, who have no family history or known mutation (e.g BRCA1 or 2) that increases their risk.

The CDC recently reported that the rate for screening tests...

In the United States, we are largely sheltered from some diseases which have a great disease burden globally. Tuberculosis (TB) is one such disease, accounting for nine million newly diagnosed cases and two million deaths annually. TB is second to Human Immunodeficiency Virus (HIV) as the top causes of death from an infectious disease according to the World Health Organization (WHO) and it is not uncommon for people with HIV to be co-infected with TB.

Even in this day and age, there is still a problem with delays in obtaining a timely clinical diagnosis. With a disease like TB, time is of the essence....