Prophylactic Mastectomy: More women choosing to remove healthy breast after cancer diagnosis

A new study of New York State data finds that the number of women opting for surgery to remove the healthy breast after a cancer diagnosis in one breast is rising, despite a lack of evidence that the surgery can improve survival. The study also finds that despite extensive press coverage of women who choose to have both breasts removed because of a strong family history of cancer, the rate of this surgery is relatively low and has changed little in the last decade. The study appears in Cancer, a peer-reviewed journal of the American Cancer Society.

Prophylactic mastectomy, the removal of a noncancerous breast, is one method for reducing a woman’s risk of developing breast cancer; however, there is little information available on the prevalence of prophylactic mastectomies for preventing breast cancer among high-risk women or on the prevalence of the surgery to prevent tumors in the healthy breast among women whose cancer is limited to one breast.

Researchers led by Stephen B. Edge, M.D., FACS, of the Roswell Park Cancer Institute in Buffalo, NY, examined the frequency of prophylactic mastectomies in New York State between 1995 and 2005 using mandated statewide hospital discharge data combined with data from the state cancer registry. They identified 6,275 female New York residents who underwent prophylactic mastectomies. Eighty-one percent of the women had been diagnosed with cancer in one breast, while 19 percent had no personal history of breast cancer.

The researchers found that the number of prophylactic mastectomies increased during the time period, particularly among women with cancer in one breast. Over the 11-year study period, the prevalence of these contralateral mastectomies more than doubled. The prevalence of bilateral prophylactic mastectomies among women with no personal history of breast cancer increased only slightly.

“These data from New York are the only data on a large population of women that examine the use of bilateral prophylactic mastectomy,” said Dr. Edge. “These data demonstrate that prophylactic mastectomy is an uncommon procedure that is performed most commonly on women with a personal history of breast cancer. Although the total number of prophylactic mastectomies performed per year was small, it appears that the use of the surgery is increasing.” In addition, he noted that women with breast cancer should have careful counseling regarding benefits and risks before proceeding with prophylactic mastectomy of the other breast.

For more information about prophylactic mastectomy and/or breast reconstruction surgery do not hesitate to contact us.

Linking weight loss to less sleep apnea

Temple-led study, the largest of its kind, finds weight loss has significant impact on the disorder

More than 12 million people in the U.S. suffer from sleep apnea, most common among the overweight and obese. More than just loud snoring, it can lead to high blood pressure, stroke, cardiovascular disease and a poor quality of life. For years, doctors have told patients with sleep apnea that their best bet for alleviating it would be to lose weight, but there’s been very little research-based evidence to prove that.

“Existing research has been limited by a number of factors, so there are very few studies that show whether the recommended amount of weight loss – about 10 percent – is enough to sufficiently improve sleep apnea,” said Gary Foster, director of the Center for Obesity Research and Education.

Foster and colleagues from six other universities recently completed the largest randomized study on the effects of weight loss on sleep apnea in patients with type 2 diabetes. They found that among patients with severe sleep apnea, those who lost the recommended weight were three times more likely to nearly eliminate the number of sleep apnea episodes compared to those who did not lose weight. The results are published in the Sept. 28 issue of the Archives of Internal Medicine.

The new study, called Sleep AHEAD, looked at 264 obese patients with type 2 diabetes already enrolled in the Look AHEAD trial, an ongoing 16-site study investigating the long-term health impact of an intensive lifestyle intervention in 5,145 overweight or obese adults with type 2 diabetes. Participants were between 45 and 75 years old.

The 264 participants were broken into two randomized groups: the first received a group behavioral weight loss program developed especially for obese patients with type 2 diabetes, portion-controlled diets, and a prescribed exercise regimen of 175 minutes per week. The second attended three group informational sessions over a one-year period that focused on diabetes management through diet, physical activity and social support.

After one year, members of the first group lost an average of 24 pounds. More than three times as many participants in this group had complete remission of their sleep apnea (13.6 percent compared to 3.5 percent), and also had about half the instances of severe sleep apnea as the second group. Further, participants in the second group only lost about a pound, and saw significant worsening of their sleep apnea, which suggested to Foster and his team that without treatment, the disorder can progress rapidly.

“These results show that doctors as well as patients can expect a significant improvement in their sleep apnea with weight loss,” said Foster, the study’s lead author. “And a reduction in sleep apnea has a number of benefits for overall health and well-being.”

For more information about weight loss benefits don’t hesitate to contact us.

American Society of Plastic Surgeons Hosts 78th Annual Meeting

Showcases Latest Research, Novel Procedures & Emerging Trends; Seattle, Oct. 23-27

Arlington Heights, Ill. – Whether in a quest for beauty or out of necessity, millions of Americans will have plastic surgery this year. To stay ahead of the demand, the hottest topics, technologies, and research will be presented at Plastic Surgery 2009, the annual scientific meeting of the American Society of Plastic Surgeons (ASPS), Oct. 23-27, in Seattle. The meeting, held at the Washington State Convention and Trade Center, will be attended by more than 5,000 doctors, medical personnel and exhibitors in the field of plastic surgery.

“Plastic Surgery 2009 is the complete plastic surgery experience featuring the latest information on cosmetic and reconstructive plastic surgery techniques,” said ASPS President John Canady, MD. “New discoveries on facial aging, novel uses for Botox® to treat chronic pain, concerns about do-it-yourself cosmetic treatments and more will be explored. Amazing reconstructive surgery breakthroughs that will one day allow U.S. soldiers with artificial limbs to feel sensation will be revealed.”

Opening Ceremonies
Keynote speaker and accomplished teacher, writer, and orator, Atul Gawande, MD, will discuss his unique perspective on the practice of medicine and healthcare reform, during Opening Ceremonies on Saturday, Oct. 24 from 4:30 p.m. – 6:00 p.m. The annual Patients of Courage: Triumph Over Adversity awards honoring inspirational reconstructive plastic surgery patients who’ve overcome traumatic illness or injury will also be recognized for their courage and altruism.

Breast Reconstruction Art Exhibit
Created to raise awareness about the many forms of breast reconstruction, the Out of the Shadows…Into the Light art exhibit will be held on Sunday, Oct. 25 – Tuesday, Oct. 27. The exhibit shares the stories of breast cancer patients, through plaster sculptures of their busts, representing various stages of breast cancer. The creator will discuss how she created art from tragedy.

Special Media Event
Hot Topics in Plastic Surgery is one of the most popular panels at Plastic Surgery 2009. For the first time, ASPS is bringing Hot Topics presentations straight to the media during its Hot Topics Overview/Webinar for the Media on Monday, Oct. 26, from 10:30 a.m. – 11:30 a.m. During this dynamic hour, journalists can get answers to questions regarding the latest technologies and procedures and engage in conversation with the experts.

Exhibit Hall
The Exhibit Hall, open Saturday, Oct. 24 – Monday, Oct. 26, will showcase more than 300 companies, featuring products and devices including the latest breast implants, injectable wrinkle fighters, cosmetics/skin care, and body contouring technologies. This array of exhibitors will bring plastic surgeons up-to-date on cutting-edge products and technologies to better care for patients.

Closing Ceremonies
Closing Ceremonies on Tuesday, Oct. 27 from 5:00 p.m. – 6:00 p.m. will feature recognized heart and lung transplant surgeon, the Honorable William H. Frist, MD, who will discuss the future of healthcare in America. He will present his vision of increased availability and affordability of quality healthcare.

Studies, panels, and courses presented at Plastic Surgery 2009 include:

* Hot Topics in Plastic Surgery
* Rejuvenation of the Upper Eyelid – Is Less Really More
* Breast Augmentation with Liposuctioned Fat: A Fifty Patient Study Over Five Years
* Achieving Predictable Outcomes in Buttock Rejuvenation
* Not All Facelifts Created Equal – New Ways to Reshape the Face
* Non-Surgical Rejuvenation – Lasers
* Facial Aging and the Mid-Facelift
* Five Year Outcome of Surgical Treatment of Migraine Headache
* Military Plastic Surgery – A Global Update
* The Efficacy of Botox in the Treatment of Chronic Regional Pain Syndrome
* Composite Tissue Allotransplantation (Face Transplants) – Have We Achieved Liftoff
* The Impact of Breast Reduction on Low Back Compressive Forces and Function
* Functional and Structural Repair of Peripheral Nerve Injury by Adipose-Derived Stem Cells
* Breast Reconstruction Managing Flap Reconstruction
* Carcinoma and Hyperplasia in Breast Reduction Surgery: Increased Sampling Leads to Increased Detection
* Inter-Relationships of Carpal Tunnel Syndrome with Body Mass Indices in the Massive Weight Loss Population

Laser processes promise better artificial joints, arterial stents

West Lafayette, Ind. – Researchers are developing technologies that use lasers to create arterial stents and longer-lasting medical implants that could be manufactured 10 times faster and also less expensively than is now possible.

New technologies will be needed to meet the huge global market for artificial hips and knees, said Yung Shin, a professor of mechanical engineering and director of Purdue’s Center for Laser-Based Manufacturing.

The worldwide population of people younger than 40 who receive hip implants is expected to be 40 million annually by 2010 and double to 80 million by 2030. In addition to speeding production to meet the anticipated demand, Shin said another goal is to create implants that last longer than today’s.

“We have 200,000 total hip replacements in the United States,” he said. “They last about 10 years on average. That means if you receive an implant at 40, you may need to have it replaced three or four times in your lifetime.”

One of the researchers’ techniques works by depositing layers of a powdered mixture of metal and ceramic materials, melting the powder with a laser and then immediately solidifying each layer to form parts. Because the technique enables parts to be formed one layer at a time, it is ideal for coating titanium implants with ceramic materials that mimic the characteristics of natural bone, Shin said.

Findings will be detailed in a presentation this week during the International Medical Device Expo’s Advanced Laser Applications Conference in San Jose, Calif.

“Titanium and other metals do not match either the stiffness or the nature of bones, so you have to coat it with something that does,” Shin said. “However, if you deposit ceramic on metal, you don’t want there to be an abrupt change of materials because that causes differences in thermal expansion and chemical composition, which results in cracks. One way to correct this is to change the composition gradually so you don’t have a sharp boundary.”

The gradual layering approach is called a “functionally gradient coating.”

Researchers used their laser deposition processes to create a porous titanium-based surface and also a calcium phosphate outer surface, both designed to better match the stiffness of bone than conventional implants.

The laser deposition process enables researchers to make parts with complex shapes that are customized for the patient.

“Medical imaging scans could just be sent to the laboratory, where the laser deposition would create the part from the images,” Shin said. “Instead of taking 30 days like it does now because you have to make a mold first, we could do it in three days. You reduce both the cost and production time.”

The laser deposition technique lends itself to the requirement that each implant be designed specifically for each patient.

“These are not like automotive parts,” Shin said. “You can’t make a million that are all the same.”

The process creates a strong bond between the material being deposited and the underlying titanium, steel or chromium. Tests showed the bond was at least seven times as strong as industry standards require, he said.

The researchers use computational modeling to simulate, study and optimize the processes.

Additional research is needed before the techniques are ready for commercialization. Future work will involve studying “shape-memory” materials that are similar to bone and also have a self-healing capability for longer-lasting implants.

The researchers also are developing a technique that uses an “ultra short pulse laser” to create arterial stents, which are metal scaffolds inserted into arteries to keep them open after surgeries to treat clogs. The laser pulses last only a matter of picoseconds, or quadrillionths of a second.

Because the pulses are so fleeting, the laser does not cause heat damage to the foil-thin stainless steel and titanium material used to make the stents. The laser removes material in precise patterns in a process called “cold ablation,” which turns solids into a plasma. The patterns enable the stents to expand properly after being inserted into a blood vessel.

For more information don’t hesitate to contact us.

Medicina Reproductiva en Argentina: Tabaquismo y Fertilidad

Los riesgos del consumo de tabaco son bien conocidos en lo que respecta a las enfermedades de corazón pulmones y vasos sanguíneos. Pero se han detectado efectos sustancialmente dañinos en la fertilidad, que no son generalmente tenidos en cuenta. El consumo de cigarrillos tiene un impacto negativo en la capacidad de la mujer de quedar embarazada tanto como en la de llevar un embarazo a término.

Impacto del tabaquismo en las mujeres

Virtualmente todos los estudios científicos apoyan la conclusión de que fumar tiene un impacto adverso en la fertilidad. La probabilidad de infertilidad es mayor, y el tiempo necesario para concebir también es mayor en mujeres fumadoras comparadas con no fumadoras.

El tabaquismo activo de cada cónyuge presenta efectos adversos, y el impacto de la exposición al tabaquismo pasivo, es sólo levemente menor que en el activo. Los estudios realizados evidencian que fumar es nocivo para los ovarios y que el grado de daño depende tanto de la cantidad consumida como del periodo de tiempo en el que la mujer haya fumado.

El consumo de tabaco acelera la pérdida de ovocitos y el deterioro de la función reproductiva y puede adelantar en varios años el momento de la menopausia.

Los componentes del tabaco han evidenciado interferir en la capacidad de las células ováricas para la formación de estrógeno así como en la formación de ovocitos con tendencia a presentar anomalías genéticas.

El tabaquismo además está fuertemente asociado a un riesgo mayor de aborto espontáneo, así como de embarazo ectópico .
Las embarazadas fumadoras tienen mayor probabilidad de concebir niños de bajo peso al nacer tanto como de provocar partos prematuros.
La incidencia de muerte súbita infantil esta también aumentada en los hogares en los cuáles el niño convive con algún fumador.

Impacto del tabaquismo en los resultados de los tratamientos de reproducción asistida en mujeres:

Los estudios revelan que las mujeres fumadoras requieren casi le doble de intentos de Fertilización in Vitro (FIV) respecto que las no fumadoras para lograr resultados positivos.
Asimismo, los estudios de FIV mostraron que las fumadoras necesitan dosis más elevadas de gonadotrofinas para estimular sus ovarios, que presentan menores ascensos de estradiol, menor cantidad de ovocitos obtenidos, mayor cantidad de ciclos cancelados, menor rango de implantación, y que en general atraviesan mayor cantidad de ciclos no exitosos que las no fumadoras.
El nivel de abortos también aumenta considerablemente.
Los efectos adversos del tabaquismo son mas visibles en las mujeres mayores. Especialmente en cuanto a que la reducción en la fertilidad natural que este hábito provoca en ellas no se ve efectivamente mejorada por la aplicación de técnicas de Reproducción Asistida.

Impacto del tabaquismo en los resultados de los tratamientos de reproducción asistida en hombres:

Los hombres fumadores presentan una cantidad menor de espermatozoides, así como una movilidad menor y un aumento de anormalidades en la forma y la función espermática.
El efecto del tabaquismo en la fertilidad del hombre es de todos modos mas difícil de discernir, ya que no se cuenta con estudios capaces de determinarlo.
A pesar de que el efecto del tabaquismo en la fertilidad masculina permanece sin conclusiones definitivas, el efecto dañino del tabaquismo pasivo en la mujer y la evidencia de efectos adversos en la calidad del esperma sugieren que hábito de fumar en el hombre debe ser visto como un factor de riesgo en la  infertilidad.

Abstención de tabaco como ejemplo de tratamiento en parejas que siguen tratamientos de infertilidad:

Una importante investigación mostró que la abstención de tabaco durante al menos dos meses antes de intentar una Fertilización in Vitro mejora significativamente las probabilidades de lograr la concepción.
A pesar de que el tabaquismo de larga data puede tener efectos irreversibles en la función ovárica, el efecto nocivo puede ser revertido parcialmente si el hábito es interrumpido antes de iniciar un tratamiento para corregir la infertilidad o subfertilidad.

Sumario:

Los mejores datos científicos disponibles indican que el tabaquismo contribuye  fuertemente a la infertilidad.
El tabaquismo debe ser desaconsejado tanto en hombres como en mujeres, especialmente en aquellas parejas con antecedentes de infertilidad o de aborto recurrente.
La abstención puede mejorar tanto la fertilidad natural como los niveles de éxito de los tratamientos de infertilidad o subfertilidad.

Para mayor información no dude en contactarse con nosotros.

Weight-Loss Surgery Can Break a Family’s Cycle of Obesity

New study finds the intrauterine environment may determine whether a child is destined to become obese

Adolescent and young children of obese mothers who underwent weight-loss surgery prior to pregnancy have been found to have a lower prevalence of obesity and significantly improved cardio-metabolic markers when compared to siblings born before the same obese mothers had weight-loss surgery. This new study has been accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM).

Obesity can lead to insulin resistance, cardiovascular disease and pregnancy complications and is a major contributor to causes of death in industrialized nations. Previous studies of obese pregnant women have shown that obesity and its co-morbidities can be transmitted to their children, which indicates that the intrauterine environment may determine whether a child at birth is already destined to become obese.

“Our study confirms previous research showing that the intrauterine environment may be more important than genes and the post-natal environment when it comes to the association between maternal obesity and childhood obesity,” said John Kral, MD, PhD, of SUNY Downstate Medical Center in Brooklyn, N.Y. and co-author of the study. “Any medical or surgical treatment to reduce obesity and existing metabolic disorders before pregnancy can be an investment in the life of future offspring.”

Weight-loss surgery limits the amount of food a person can consume. Some of these operations also restrict the amount of food that can be digested. This particular study focused on women who had undergone biliopancreatic diversion (BPD) prior to becoming pregnant. BPD changes the normal process of digestion by making the stomach smaller and directing food to bypass part of the small intestine resulting in fewer calorie absorption.

Specifically, researchers studied 49 mothers who had undergone BPD surgery and their 111 children (between the ages of 2.5 and 25 years). All mothers in this study had children born before and then after their weight-loss surgery. The research found that children who were born after their mother underwent weight-loss surgery had reduced birth weight and waist circumference and were three times less likely to become severely obese. Furthermore, children born after their mother’s weight-loss surgery had improved cardiovascular markers including reduced insulin resistance and lower cholesterol.

“To our knowledge, our paper is the first to demonstrate that dramatic maternal weight loss causes metabolic improvements in their children,” said Kral. “Our findings show that obese women should be encouraged to lose weight before becoming pregnant, and then, once pregnant, should limit their weight gain. For those women interested in both surgical treatment and having children, we believe surgery should come first. Preventing obesity and treating it effectively in young women could prevent further transmission to future generations.”

Other researchers working on the study include J. Smith, K. Cianflone, S. Simard and Picard Marceau of the Centre de Recherche Institut Universitaire de Cardiologie et Pneumologie de Quebec in Canada; S. Biron, S. Lebel, S. Marceau, O. Lescelleur and L. Biertho of Laval University in Quebec, Canada; and J.G. Kral of SUNY Downstate Medical Center in Brooklyn, N.Y.

The article, “Effects of maternal surgical weight loss on intergenerational transmission of obesity,” will appear in the November 2009 issue of JCEM.

For information about weight loss surgery in Argentina feel free to contact our surgeon Norman Jalil.

Source: The Endocrine Society

Sublimis Receives HON Certification

Sublimis Website is HONcode certified as providing trustworthy health information on the Internet

Córdoba, Argentina – On August 20th, 2009 Sublimis awarded certification by Health On the Net Foundation (HON) for following the HONcode of Conduct, which includes the eight principles to improve the quality of the medical Internet.

The principles are: Authoritative, Complementarity, Privacy, Attribution, Justifiability, Transparency, Financial disclousure and Advetising policy. Which means that Sublimis indicates the qualifications of the authors, respect the privacy and confidentiality of personal data submitted to the site by the visitor, cite the sources of published information, date medical and health pages, has an accessible presentation and an accurate email contact, among other things.

“We are proud to include the HON seal on our website”, Subimis founder Gonzalo López Villagra said.

“When deciding to have medical treatments abroad it is important for patients to seek current information and to have an effective and dependable source for health information on the Internet,” López Villagra added.

About Health On the Net Foundation (HON)

Created in 1995, HON is a non-profit, non-governmental organization, accredited to the Economic and Social Council of the United Nations who promotes and guides the deployment of useful and reliable online health information, and its appropriate and efficient use.

For twelve years, HON has focused on the essential question of the provision of health information to citizens, information that respects ethical standards. To cope with the unprecedented volume of healthcare information available on the Net, the HONcode of conduct offers a multi-stakeholder consensus on standards to protect citizens from misleading health information. For more information visit www.Healthonnet.org.

About Sublimis

Sublimis is a medical organization that specializes in health tourism services in Argentina. Sublimis offers a wide variety of medical treatments, personalized assistance along with the latest technologies, renowned professionals, affordable prices and a pleasant trip. For more information visit www.Sublimis.com or contact info@sublimis.com.