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January 2013 Archives

FDA Cautions Metal-on-Metal Hip Implant Use

Metal-on-Metal hip implants received an extensive set of cautionary guidelines for use from the FDA based on an FDA Orthopedic and Rehabilitation Advisory Panel Meeting in June 2012. The source of the problem with Metal-on-Metal (MoM) implants is metal release that causes bone and soft tissue damage, known as "adverse local tissue reaction" (ALTR). When bone and soft tissue damage from metal particles occurs, it leads to pain, implant loosening and the need for revision surgery. However, the metal ions can also enter the bloodstream, travel to other organs and trigger systemic illness such as rash, cardiomyopathy and renal dysfunction. The FDA is unable to define level of metal concentrations in blood or body that produce adverse effects, because different patients have different levels of reactivity to them.

Breast Cancer and Sexual Well-Being

Breast cancer causes both immediate and long lasting injuries to women. A recent study in Australia reports that adverse changes to sexual well-being and intimacy are the most problematic issues for women after the diagnosis. The study examined changes to sexuality and intimate relationships in such patients. Decreases in sexual frequency, response and satisfaction were caused by a number of factors related to the disease and its treatment. Tiredness and pain, psychological distress and a poor body image develop. Medical and/or surgical menopause to stop hormonal stimulation of the cancer causes vaginal dryness, hot flushes and weight gain. These emotional and physical changes that occur cause feelings of unattractiveness, loss of femininity and have negative impact on relationships with spouses and partners.

New Alzheimer's Dementia Screening Guidelines

The Alzheimer's Association has released new recommendations in Alzheimer's and Dementia for detecting cognitive impairment during Medicare Annual Wellness visits. Primary care physicians have not received any comprehensive guidance on how to screen for cognitive diseases. There are a 5 million Americans with Alzheimer's Dementia but only half have been diagnosed. The guidelines will help primary care physicians detect dementia earlier, allow for earlier intervention and management that will improve these patients and their families' lives. These patients often end up in nursing homes and dependent on total care being provided for them at great cost to the patients' families and society. 

New Cervical Cancer Screening Guidelines

New guidelines for cervical cancer screening have been released by the American Cancer Society in conjunction with the U.S. Preventive Task Force (USPTF) that are based on new understanding of the role that human papillomavirus (HPV) infection plays in the development of this disease. The guidelines recommend less frequent testing across all age groups and are aimed at detecting early cellular abnormalities while at the same time reducing unnecessary biopsy procedures and the anxiety caused by false positive PAP smears. Vaccination against HPV has reduced the incidence of cervical malignancy but the vaccine only protects against for 70% of cervical malignancies. The decreased recommendations for screening may cause women to reduce the frequency of their gynecologic visits and consequently cause missed opportunities for the detection of other women's health issues that are detected during routine visits.

Cancer Screening Down in United States

Cancer screening rates in the United States declined over the last ten years, and the only testing in conformance with Health People 2010 (HP2010) goal of 50% or more was for colorectal . Adherence rates for screenings have generally declined for all other types and are below HP2010's target. On the other hand, survival met goals for all types except cervical cancer. Increased prevention efforts are needed if the United States is going to continue to meet its survival goals into the future. Despite earlier diagnosis and more effective treatments that increase survival, it is still a leading cause of death and chronic illness, with deaths in the United States exceeding 570,000 in 2011.

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