Prostatic Specific Antigen Testing

Is it an effective method for screening for Prostate Cancer?

Prostate Cancer is the most frequently diagnosed cancer in men and one of the leading causes of cancer related deaths.   According to The American Cancer Society about 238,590 new cases of prostate cancer will be diagnosed and about 29,720 men will die of prostate cancer in 2013.  It’s primarily detected in men over the age of 40 and it is the second leading cause of cancer-related death in African American men.  Although prostate cancer is an extremely life-threatening disease, the survival rate is over 90%.  The most commonly used screenings for Prostate Cancer are: Digital rectal exam (DRE) and Prostatic Specific Antigen (PSA) testing.  A PSA test measures the blood level of PSA, which is a protein produces by the prostate gland.  Since the 1980’s doctors have been using this test to screen men between the ages of 40-75 for prostate cancer.

Recently many professional organizations are beginning to question the effectiveness of PSA testing.  They feel the benefits of the screening do not outweigh the risks.  When higher PSA levels are detected, it alerts doctors that cancer may be present.  “False positives” are common with PSA test and many times the tumors detected by PSA screening may not develop into life threatening tumors.  There are also situations when PSA test produce “false negatives” due to rapidly growing prostate cancers not producing sufficient PSA.  

Men who choose to be treated (better safe than sorry) and undergo one of many Prostate Cancer treatments are exposed to side-effects such as: Urinary dysfunction, Bowel dysfunction, erectile dysfunction, hormonal changes and infertility that can last up to 10 years after treatment. The severity of the side-effects depends significantly on the individual and his state of health. 

Although controversial for “over diagnosis” and “overtreatment”, “diagnosis and treatment of prostate cancer were radically improved after the discovery of the prostatic-specific antigen”, as noted in the MDLinx article on “screening for Prostate Cancer”.    Currently most insurance companies as well as Medicare will cover annual PSA screenings.  If a PSA screening detects elevates PSA levels, it’s important to get a biopsy done before starting treatment to accurately determine whether or not Prostate Cancer is evident. Researchers are currently trying to improve the PSA Test.  To learn more about the developments in PSA testing visit http://www.mdlinx.com/oncology/. 

Are you killing yourself? Think Before You Indulge...

Are you killing yourself? Think Before You Indulge...

We’ve all heard it before- just one cigarette can shave 3 minutes off your life. Well, what if this formula could be applied to all of your guilty pleasures? A study published by the British Medical Journal has linked life expectancy to activities such as having a couple of drinks and even watching TV; activities that to most Americans come as second nature. Did the beers you consumed during Sunday’s Super Bowl shorten your lifespan? 

University of Cambridge statistician Professor David Spiegelhalter sought to find a way to communicate the impact of human behavior on our lifespan in a simple and effective formula. In this analysis, Spiegelhalter further expands on the concept of aging slower/ faster, first introduced through the study of cigarettes on life expectancy more than a decade ago. He explicitly expresses the effect of our daily lifestyle habits as half hours of life expectancy or “microlives.” Through the use of population studies he was able to deduce that on average over a lifetime habit of behavior, that smoking two cigarettes or being 10 pounds overweight, or even watching two hours of TV, equates to the loss of a “microlife.” The idea that watching the Ravens win the Super Bowl could have cost you thirty minutes of your life is alarming to most, considering the inherent concern most humans have with their own mortality.

However, Spiegelhalter’s “microlife”  formula isn’t just a penalty system for life’s indulgences. In contrast, Spiegelhalter says, each day of positive behavior such as exercising or sticking to just one alcoholic beverage will help you gain “microlives” at an even faster rate. He cites that this positive behavior can add up to two hours to your life.

But before you start tracking your behavior and counting “microlives” as if they were calories, read Spiegelhalter’s entire explanation of the concept. He explains that this formula for life expectancy is not definitive but based on a number of assumptions, and should be treated as an approximation. The crux of his article supports the old adage, “Everything in moderation.” 

In Spiegelhalter’s words: "Of course, evaluation studies would be needed to quantify any effect on behavior, but one does not need a study to conclude that people do not generally like the idea of getting older faster."

 

 

 

 

 

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5 Things to Consider When Choosing a Medical School Application Consulting Company

Sahil Mehta MD has worked in medical school application consulting for the last 6 years and founded MedSchoolCoach, a medical school application consulting company dedicated to helping students get into medical school.

For many people applying to medical school can be a tough and confusing process. College premed offices are often swamped with students and have a bad habit of providing generic, and sometimes outright bad advice to their students. So, naturally, many students applying to medical school turn to medical school admissions consulting services in order to better understand the overall process as well as what institutions are looking for in the medical school personal statement, AMCAS application, secondary essays, and the interview. If you count yourself among those that plan utilizing such a consulting service, there are a couple things to keep in mind when combing through possible firms.

1. Choose a company that specializes in medical school applications.

The first thing, and the most important, is to realize that many companies partake in medical school admissions consulting, but that very few actually specialize in it. While there is nothing wrong with choosing a consulting company that is also helping others get through business or law schools, people generally find that that working with somebody that has intimate knowledge of the med school application process, and even medicine in general, is simply more advantageous. Raise your chances and go with a consulting firm that specializes in medical school applications.

2. Know who you will be working with (and make sure it’s someone with a medical background)

The next thing to look for is who your advisors are. You want to be sure that your advisors are folks that you can work with, that you get along with, that you can be honest with, and that will provide you timely and constructive feedback. Furthermore, look for advisors who understand and know medicine inside and out (i.e. an actual physician!) Remember, the application process is unique and different compared to all others so it is not suitable for you to have somebody who is simply an essay editor, but not a physician, helping you through the process.

3. Know what is offered

Make sure to dig deep into what's included in the medical school consulting packages that are offered by the various companies. For example, will you be able to come up with the perfect personal statement draft in two edits? If not, you might want to look into a package that includes unlimited edits so that you don’t get stuck without any direction after limited editing sessions. We all know a great essay takes many revisions, not just two.

4. Look for multiple physician advisors

It’s important to look for a medical school application consulting company that has more than one physician advisor. The reason for this is that when you go to practice for your interview you’ll want multiple perspectives in your feedback. In the same way that there are multiple physicians on admissions committees with multiple points of view, you’ll want your practice board to have multiple physicians to tell you what they think.

5. Make a connection

Most important of all, be sure that you connect well with the person you're working with. You will come up with a much stronger application if your consultant is somebody who can and will truly get to know you, and who will work with you every step of the way as you get ready to enter medical school.

Sexual Dysfunction and Diabetes

Is there a correlation?

 

Diabetic nerve damage and blood vessel damage resulting from high blood sugar can lead to sexual dysfunction in both men and women.  Many medical professional most often associate sexual dysfunction and diabetes with erectile dysfunction/ impotence, but the problem quite often persist in women as well.  Although there are many other factors that play a role in sexual dysfunction, studies have shown a direct correlation between diabetic men and women and sexual dysfunction.  The blood vessels damaged by diabetes control erection in men and the nerves damaged by diabetes prevent women from achieving an orgasm. 

 

According to an article found on mdlinx.com, published in The Journal ofSexual Medicine, female sexual dysfunction is more frequent in diabetic women.  Women may experience symptoms such as: lack of interest in sexual relations, no sensation in the genital area, or pain and discomfort during sex due to dryness in the vaginal area. 

 

On average more than 50% of diabetic men over age 50 and 90% of men over age 70 will experience a degree of erectile dysfunction or impotence. 

Although this is a serious issue that many diabetics are forced to cope with, there are many ways to help reduce the risk of sexual dysfunction.  Always check with your doctor for the safest options. 

 

Tips to lower you risk of sexual dysfunction

• Control blood glucose, blood pressure and cholesterol levels
• Exercise or engage in some type of physical activity that helps maintain healthy weight
• If you are a smoker, QUIT
• Vacuum constriction devices (VCDs)
• Ask your doctor about other treatment options, such as Cialis

 

 

Prostatic Specific Antigen Testing for Prostate Cancer

Is it an effective method for screening for Prostate Cancer?

Prostate Cancer is the most frequently diagnosed cancer in men and one of the leading causes of cancer related deaths.   According to The American Cancer Society about 238,590 new cases of prostate cancer will be diagnosed and about 29,720 men will die of prostate cancer in 2013.  It’s primarily detected in men over the age of 40 and it is the second leading cause of cancer-related death in African American men.  Although prostate cancer is an extremely life-threatening disease, the survival rate is over 90%.  The most commonly used screenings for Prostate Cancer are: Digital rectal exam (DRE) and Prostatic Specific Antigen (PSA) testing.  A PSA test measures the blood level of PSA, which is a protein produces by the prostate gland.  Since the 1980’s doctors have been using this test to screen men between the ages of 40-75 for prostate cancer.

Recently many professional organizations are beginning to question the effectiveness of PSA testing.  They feel the benefits of the screening do not outweigh the risks.  When higher PSA levels are detected, it alerts doctors that cancer may be present.  “False positives” are common with PSA test and many times the tumors detected by PSA screening may not develop into life threatening tumors.  There are also situations when PSA test produce “false negatives” due to rapidly growing prostate cancers not producing sufficient PSA.  

Men who choose to be treated (better safe than sorry) and undergo one of many Prostate Cancer treatments are exposed to side-effects such as: Urinary dysfunction, Bowel dysfunction, erectile dysfunction, hormonal changes and infertility that can last up to 10 years after treatment. The severity of the side-effects depends significantly on the individual and his state of health. 

Although controversial for “over diagnosis” and “overtreatment”, “diagnosis and treatment of prostate cancer were radically improved after the discovery of the prostatic-specific antigen”, as noted in the MDLinx article on screening for Prostate Cancer.    Currently most insurance companies as well as Medicare will cover annual PSA screenings.  If a PSA screening detects elevates PSA levels, it’s important to get a biopsy done before starting treatment to accurately determine whether or not Prostate Cancer is evident. Researchers are currently trying to improve the PSA Test.  To learn more about the developments in PSA testing visit http://www.mdlinx.com/oncology/.

Directly Out of Med School: The Appeal of Becoming a Pediatric Locum Tenens

Directly Out of Med School: The Appeal of Becoming a Pediatric Locum Tenens

About the Author: Vance Hobbes is a freelance writer and former medical researcher. He writes about many facets of the medical field and works with CompHealth. When he's not writing the day away, he spends his free time tending to his prizewinning garden and attending any Knicks game he can find.

For many would-be pediatricians just about to graduate medical school, working as a traveling children’s health doctor has traditionally never been at the top of their list of goals and aspirations (more popular are usually family medicine jobs of some kind). However, locum tenens work is gaining in popularity—not only in the area of child health, but all across the board—and many graduates are taking the leap and becoming locum tenentes instead of applying at local practices. Here’s why:

Experience Pediatric locum tenens that are well-traveled tend to have a more expanded knowledge base of practical procedures that are applicable to specific regional ailments and diseases. Not only does this help the pediatrician be a better doctor, it can also help permanent practices in the process of hiring new doctors. If an applying pediatrician that has done locum tenens work is compared side by side with an applicant that is equal in all ways but has not worked as a traveling pediatrician, who do you think will be the one that gets hired?

Travel One of the appeals to being a traveling pediatrician is just that—you are a traveling pediatrician. Plenty of people become locum tenentes because they want to get out and experience something new in the world. It’s dependent on the agency that you contract through, but some locum tenentes are able to move from temporary location to location within weeks of one another. For those that have the itch to get out and see a little more of the world, locum jobs are great places to start.

Variety One of the nice things about work as a traveling children’s health doctor is the amount of variety that finds its way into the locum’s life. Not only does a locum tenens have the opportunity to scope out places that they may like to live in the future, they are able to experience a variety of administrations and the way that they handle day-to-day functions in the practice. Out of all of the locum tenentes that I’ve met, the opportunity to encounter different administrative styles has always been one of the most valuable takeaways from the locum experience.

Opportunity With the way that the economy fluctuates and depending on where you are and what the concentration of pediatricians in your area is like, it may be easier to get a job, initially, as a locum tenens pediatrician. There is also the possibility that you will come across a practice that will allow you to slide into a full-time position after your work as a locum tenens with them is over.

Career Some people become traveling pediatricians with a temporary aim in mind and end up with a permanent position. The appeal lies in the romanticism of roaming, the majority of living expenses being food and entertainment, and the ability to help out a wide demographic and population of people. Locum work is great for people that prefer not to stay tied down but love to lend a helping hand in improving children’s health.

Those considering work as a traveling doctor should look deeply into the topic before settling on it. The lifestyle of a pediatric locum tenens is not for everyone and the experience will differ for everybody, depending on a number of things. Nevertheless, the locum experience generally proves to be a rewarding one that most look back upon with nostalgic satisfaction.

What are Rheumatologists Really Doing Online

What are Rheumatologists Really Doing Online? We know, and we want to tell you. Did you know that M3 MDLinx is the leading digital provider of clinical news and information to over 85% of all US Rheumatologists?. Did you know that M3 MDLinx is the leading digital provider of clinical news and information to over 85% of all US Rheumatologists? Did you know that majority of Rheumatologists actually spend more time online engaged in activities that support care for their patients than on seeking information about new medical advances in their field? Did you think the two were the same? According to Rheumatologists, they aren't. spending their time on and offline, and what matters most to them. We surveyed over 100 Rheumatologists in the United States, who see at least 200 patients per month, and discovered not just how doctors are communicating with pharma companies, their peers and their patients, but much more. We asked them: How do you want pharma and biotech companies to communicate with you in comparison to how they communicate with you today? Do your pharma and biotech reps provide you with the tools and knowledge you need to best do your job? What can they do better? How often and through what outlets do you interact online for research, news, social, and informational purposes? How often, in what forms and for what reason do you use technology most? How can pharma brands better utilize technology? If you want a basic study with stock answers that vary slightly from year to year, you shouldn't call us. But if you want the inside scoop on what Rheumatologists really want and need, and insight on how they get information and how they share it, you should contact us today. To learn more about the details of The CompleteRheumatologist Study or purchase the report, contact MDLinx marketing@mdlinx.com to learn more. Contact: marketing@mdlinx.com

Serum B-cell activating factor assessment in a population of Egyptian patients with systemic sclerosis

International Journal of Rheumatic Diseases, 12/19/2012

Abdo MS et al. – To assess serum B–cell activating factor (BAFF) levels in patients with systemic sclerosis and to correlate this with disease features and disease severity. Serum BAFF levels were significantly elevated in patients with systemic sclerosis irrespective of disease subtype, disease duration or age of patients. This elevation in serum BAFF significantly related to gastrointestinal track involvement and methotrexate therapy.

Methods

• This is a case-control study in which patients with the established diagnosis of SSc were recruited.

• The diagnosis of SSc was established according to the American Rheumatology Association 1980 criteria for the classification of scleroderma.

• Patients' assessment included evaluation of skin involvement using the Modified Rodnan score and disease severity using the Medsger score.

• Twenty-five healthy matching controls were included.

• The sandwich enzyme-linked immunosorbent assay technique was used for direct assessment of serum BAFF in patients and controls

Results

• The study included 60 patients (54 female and 6 male), with a mean age of 38.18±12.06 years, with mean disease duration of 7.85±4.075 years.

• Serum BAFF in patients ranged 98.2-5015 pg/mL with mean BAFF 1100±835.4 pg/mL.

• In controls serum BAFF levels ranged 188.5-2314 pg/mL with mean BAFF 546.1±471.1 pg/mL, showing a statistically significant elevation of serum BAFF levels in SSc patients (P=0.0001) with insignificant correlation to skin disease or total Medsgar Score of the study population (P>0.05).

• Serum BAFF levels showed significant correlation with episodes of pseudo-obstruction and methotrexate (MTX) use in the patients studied (P<0.05)

Dr Reem Hamdy A. Mohammed (12/18/2012) comments:

It is really great and we as authors are proud of having our article selected in this great scientific citation, Mdlinx team have been also active, nonreluctant and enthausiastic in encouraging spread of scientific knowledge and anchorage of research knowledge allover

More articles in rheumatology at MDLinx.com

Dexmedetomidine sedation in painful posterior segment surgery

Clinical Ophthalmology, 12/18/2012

Mansour A et al. – When a surgeon has planned to do a pars plana vitrectomy under topical anesthesia and the surgical situation dictates the addition of cryopexy, scleral buckle, or intense laser retinopexy, then sedation with dexmedetomidine can help in the control of ocular pain in the majority of cases, with good intraoperative and immediate postoperative hemodynamic control with the possibility of supplemental rescue analgesia. Dexmedetomidine, a sedative analgesic, is devoid of respiratory depressant effects, and its use in posterior segment surgery under topical anesthesia is reported here for the first time.

Methods

• A prospective review of cases that had posterior segment surgery under topical anesthesia and that needed sedation.

• Dexmedetomidine-loading infusion was 1 mcg/kg over 10 minutes, followed by a maintenance infusion (0.5 mcg/kg/h)

Results

• Nine patients were operated on under topical anesthesia: two scleral buckle, five cryopexy, one scleral laceration, and one pars plana vitrectomy with very dense laser therapy in an albinotic fundus; six patients had retinal detachment.

• General or local anesthesia were not possible due to medical or ocular morbidities, use of anticoagulants, or the surgery plan changed intraoperatively when new pathologies were discovered.

• The surgeon achieved good surgical control in eight of nine cases, with one patient having ocular and bodily movements that were disturbing.

• Six patients had no pain, while three patients reported mild pain.

• No adverse effects were noted and all patients had successful surgical outcomes.

• Heart rate, blood pressure, and oxygen saturation were well controlled throughout the procedures.

• The most frequent adverse reactions of dexmedetomidine reported in the literature in less than 5% (hypotension, bradycardia, and dry mouth) were not recorded in the present study

Ahmad Mansour (12/18/2012) comments:

Dexmedetomidine is potent highly selective alpha(2)-adrenoreceptor agonist with excellent sedation/analgesia, anxiolytic with little respiratory depression and good hemodynamic stability. Hence it has been used widely in Ophthalmologic surgeries under general anesthesia to reduce opioids, propofol, and benzodiazepines requirements and very efficacious safe adjuvant to other sedative and anesthetic medications. We extended its use in topical anesthesia for very painful surgeries especially retinopexy. For example, performing retinal cryopexy is one of the most painful surgical procedures in ophthalmology. With dexmedetomidine infusion set beforehand, this procedure can be well tolerated especially when the eyeball has high risk for retrobulbar anesthesia (high myopia with possible staphyloma, shallow orbits, poor ocular perfusion in diabetics and carotid artery disease or central retinal vein occlusion). However, the surgeon needs to plan for possible dexmedetomidine use and discuss this plan with the anesthesiologist in the operating room and even better schedule the case mentioning the possibility of dexmedetomidine usage. With more experience by ophthalmic surgeons and ophthalmic anesthesiologists, we have and we will see more usage of this medication. For those who object to its small additional cost, this medication can be cost effective and time saving vis-a-vis the anesthesia, medical, and ocular risks of both general and local anesthesia as outlined.

More articles in pain management at MDLinx.com

Nonsuicidal Self-injury as a Gateway to Suicide in Young Adults

Journal of Adolescent Health, 12/18/2012

Whitlock J et al. – NSSI prior to suicide behavior serves as a “gateway” behavior for suicide and may reduce inhibition through habituation to self–injury. Treatments focusing on enhancing perceived meaning in life and building positive relationships with others, particularly parents, may be particularly effective in reducing suicide risk among youth with a history of NSSI.

Janis Whitlock (12/18/2012) comments:

We intended this study to assist clinical service providers in understanding the role nonsuicidal self-injury (NSSI) plays in later development of suicide and in differentiating between those NSSI experienced youth who are and are not at risk for suicidality. We find that NSSI is a risk factor for suicide thoughts and behaviors and may lower inhibitions to suicide by allowing for "practice" damaging the body. Individuals who have high lifetime NSSI prevalence (>20 incidents) and who are struggling with a sense of life meaning and compromised relationships, particularly with parents, are a much higher risk of concurrent or later suicide. NSSI is often dismissed as a purely attention seeking behavior. Our study shows that NSSI possesses clinical value in assessing suicide risk and should be included in standard risk assessments.

More articles in psychiatry at MDLinx.com