4:59 pm - Wed, Jul 23, 2014

Tuesday September, 23 - Transitioning Into and Within the Medical Device Industry

Have you thought about entering the medical device industry? Are you now working in the industry and have considered moving to another company—or using your skills in an entirely new area? The medical device industry is ripe with opportunities for people who want to help bring new medical products to market. It is a diverse industry that develops and manufactures devices to diagnose or treat the spectrum of diseases and afflictions. Companies range in size from small start-ups to large corporations.

Join us for an inspiring evening to discuss transitions: both into and within this exciting industry. Our panel of industry veterans will talk about their varied experiences with transitions and provide insights to help you in your career. This session is designed for those looking to enter the medical device industry as well as medical device veterans. Historically, this is the most well-attended MDG networking event of the year, so register early.

Be prepared for an interactive session and excellent networking opportunities.

4:31 pm - Thu, Oct 3, 2013
1 note

Free Workouts for Furloughed Government Employees during Government Shutdown

Stress can have negative effects on your health, resulting in headaches, chest pain, high blood pressure, upset stomach, and sleep problems. Boston, New York, Washington, and Philadelphia Sports Clubs are doing their part during the government shutdown by opening their doors to any government employee currently out of work. By showing their government ID, furloughed employees can work out and attend group classes for free for the duration of the shutdown.

Studies show that forty-three percent of all adults suffer from stress-related health issues and up to 90% of all doctor’s visits are for stress-related ailments. Stress is a serious issue for government employees facing the prospect of weeks without pay while Congress debates the new spending bill. In addition to sleepless nights, stress can leave its victims feeling physically ill and incapable of completing tasks.

Despite too much stress often being stated as the number one reason why people don’t exercise, exercise has been shown to significantly decrease stress. This is both for physical reasons—exercise releases endorphins into your brain and gives you a natural high—and for mental reasons—exercise gets you out of the house and distracts you from your troubles.

Government employees in Boston, New York, Washington, and Philadelphia can take a break from their current stressors at their local Sports Clubs. Any government employee 18 and older can work out for free from now until the shutdown ends. This includes attending popular classes such as yoga and zumba. The membership is available all hours except for Monday through Friday, 4:30-7:30pm.  

If you need stress relief during the next few weeks of down time, visit www.mysportsclubs.com for more information or check here to see if there’s a club near you.

4:31 pm - Thu, Sep 26, 2013

Endurance Of Total Knee Replacements In Younger Patients With Juvenile Arthritis

When you think of knee replacement surgery, you generally envision an older adult with painful arthritis. But the procedure is also used for younger patients with juvenile idiopathic arthritis (JIA) whose joints have been severely damaged by the disease. Because the surgery in younger patients is relatively rare, little data exist on the longevity of knee replacements in JIA patients. 

An international, multi-center study led by researchers at Hospital for Special Surgery (HSS) has found that total knee replacements in younger patients with juvenile arthritis last at least 10 years in 92 percent of cases. More than 75 percent of the implants lasted 20 years or more. 

"The surgery in this patient population, although performed by only a small number of highly specialized orthopedic surgeons nationwide, is life-changing for JIA patients," said Dr. Mark P. Figgie, senior author of the study and chief of the Surgical Arthritis Service at HSS. "Joint replacement can free patients - many of them adolescents - from a life of unrelenting pain. It can enable those in a wheel chair to walk again, giving many a new lease on life." 

Read the full article here

Photo: UKaid

4:31 pm - Tue, Sep 24, 2013
1 note

Revised Clinical Practice Guideline On The Treatment Of Osteoarthritis Of The Knee

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The American Academy of Orthopaedic Surgeons (AAOS) recently released its revised clinical practice guideline (CPG) on the treatment of osteoarthritis of the knee, addressing two key changes. Most of the remaining recommendations provided in the 2009 CPG go unchanged. CPGs are not meant to be stand-alone documents, but rather serve as a point of reference and educational tool for both primary care physicians and orthopaedic surgeons. 

The original guideline, as well as this revised version, was developed to include only treatments which are less invasive than knee replacement surgery. Osteoarthritis (OA) is a common condition that can affect any joint in the body particularly after years of use. It is also known as “wear and tear” arthritis and most commonly occurs in people who are 65 years of age or older. Some 33 million Americans are affected by osteoarthritis, and it is the leading cause of physical disability. 

The two primary changes recommended in the 2013 guidelines that differ from the 2009 CPG include:

  • Acetaminophen: The recommended dosage was reduced from 4,000 mg to 3,000 mg a day. This is not a change made by AAOS specifically for OA patients, but an overall change made by the FDA since 2009 for individuals who use acetaminophen.
  • Intra-articular Hyaluronic Acid (HA): Intra-articular hyaluronic acid is no longer recommended as a method of treatment for patients with symptomatic osteoarthritis of the knee. The 2009 guidelines review was inconclusive regarding this treatment method.

"Fourteen studies assessed intra-articular hyaluronic acid injections," said David S. Jevsevar, MD, MBA, chair of the AAOS Evidence Based Practice Committee which oversees the development of clinical practice guidelines. "Although a few individual studies found statistically significant treatment effects, when combined together in a meta-analysis the evidence did not meet the minimum clinically important improvement thresholds." 

Other important recommendations that remain in the revised guideline include:

  • Patients who only display symptoms of osteoarthritis and no other problems, such as loose bodies or meniscus tears, should not be treated with arthroscopic lavage.
  • Patients with a Body Mass Index (or BMI) greater than 25 should lose a minimum of five percent of their body weight.
  • Patients should begin or increase their participation in low-impact aerobic exercise.

"One of the best ways for a patient to reduce his or her pain and realize better health is to be proactive," said Dr. Jevsevar, who also is an orthopaedic surgeon in St. George, Utah. "For instance, if a patient is overweight, losing weight is probably the best thing he or she can do to slow the progression of osteoarthritis of the knee." 

Read the full article here

Photo: Stewart Black

4:30 pm - Thu, Sep 19, 2013
1 note

Moderate Physical Activity Does Not Increase Risk of Knee Osteoarthritis

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Adults age 45 and older who engaged in moderate physical activity up to two and a half hours a week did not increase their risk of developing knee osteoarthritis over a 6-year follow-up period, a new study finds. Study participants who engaged in the highest levels of physical activity – up to 5 hours a week – did have a slightly higher risk of knee osteoarthritis, but the difference was not statistically significant.

Those findings taken together are good news, said Joanne Jordan, MD, MPH, senior study author and director of the Thurston Arthritis Research Center in the University of North Carolina School of Medicine“This study shows that engaging in physical activity at these levels is not going to put you at a greater risk of knee osteoarthritis,” she said. “Furthermore, we found this held true no matter what a person’s race, sex or body weight is. There was absolutely no association between these factors and a person’s risk.”

Read the full article here

Photo: Nick Page

4:31 pm - Tue, Sep 17, 2013

Lateral Wedge Insoles Not Associated with Improvement of Knee Pain in Osteoarthritis

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Although a pooling of data from 12 studies showed a statistically significant association between use of lateral wedge insoles and lower pain in medial knee osteoarthritis, among trials comparing wedge insoles with neutral insoles, there was no significant or clinically important association between use of wedge insoles and reduction in knee pain, according to a study in the August 21 issue of JAMA.

Matthew J. Parkes, B.Sc., of the University of Manchester, England, and colleagues conducted a meta-analysis to assess the efficacy of lateral wedge treatments (shoes and insoles designed to reduce medial knee compartment loading) in reducing knee pain in patients with medial knee osteoarthritis. The authors conducted a search of the medical literature to identify randomized trials that compared shoe-based treatments (lateral heel wedge insoles or shoes with variable stiffness soles) aimed at reducing medial knee load, with a neutral or no wedge control condition. The wedge needed to be of 5° to 15° of angulation, which is a level shown in previous studies to reduce external knee adduction moment (torque). Studies must have included patient-reported pain as an outcome. Twelve trials met inclusion criteria with a total of 885 participants of whom 502 received lateral wedge treatment.

The researchers found, when considering all 12 trials, the overall effect estimate was a standard mean difference in pain between interventions that showed a moderately significant effect of a lateral wedge on pain reduction. However, the findings were highly heterogeneous across studies. Larger trials with a lower risk of bias suggested a null association.

Read the full article here

Photo: Robert S. Donovan

10:42 am
64 notes
ucsdhealthsciences:

Scanning electron micrograph of prostate cancer cells. Image courtesy of Anne Weston, Wellcome Images. 
It’s Prostate Cancer Awareness Month: A Q&A with Drs. Kane and Parsons
After skin cancer, prostate cancer is the second most common cancer among males. More than 217,000 new cases are diagnosed annually. One in six American men will be told they have the disease at some point in their lives. By age 85, it is estimated three-quarters of all men have prostate cancer.
Yet prostate cancer remains an especially confounding disease. It grows so slowly that symptoms may not appear until late in life, if ever. Yet it’s also indisputably deadly. At least 32,000 American men die from it each year.
We asked two leading physician-scientists to talk about the study and treatment of prostate cancer: Christopher Kane, MD, chair of the Department of Urology and professor of surgery at the UC San Diego School of Medicine and J. Kellogg Parsons, MD, MHS, associate professor of surgery at UC San Diego Moores Cancer Center and vice chair of the National Comprehensive Cancer Network Expert Panel on Clinical Guidelines for the Early Detection of Prostate Cancer.
Question: The risk of prostate cancer increases with age. Most doctors recommend healthy men over the age of 50 be screened for the disease annually. The American Urological Association suggests starting at age 40.
Kane: The best argument in favor of screening is that more than 30,000 men die from prostate cancer each year in the United States. If you get screened, you can get treatment, if needed. Screening is gaining information about whether or not a person has prostate cancer and, if they do, the stage, grade and severity of the disease. Fortunately, most men who are diagnosed young are diagnosed at a stage where they can be cured, experience fewer side effects, and are more likely to benefit from treatment.
Parsons: Most urologists agree that beginning at age 45 to 55 years, men should get a PSA blood test and prostate exam every 1 to 2 years. Regular screening is particularly important for men who either have a family history of prostate cancer (even just one first-degree relative) or men who come from an African-American family. In African-American men, prostate cancer tends to be more aggressive at a younger age.
Q: What is the PSA test?
Kane: PSA stands for prostate specific antigen — a fluid which is normally present in semen. Elevated levels of PSA in blood serum are associated with benign prostatic hyperplasia (prostate enlargement) and prostate cancer. A test for PSA may be used to screen for prostate cancer and to monitor treatment of the disease.
Q: Last year, the United States Preventive Services Task Force said healthy men should no longer receive the PSA blood test for prostate cancer because the screening does not save lives overall and often leads to unnecessary, debilitating tests and treatments. What’s your opinion of the panel’s reasoning and decision?
Kane: I disagree with the task force’s conclusion, as do major health organizations. It’s true that PSA is an imperfect test. Although it is sensitive, meaning that most men with prostate cancer do have an elevated PSA, it is not specific for prostate cancer, meaning many men with an elevated PSA don’t have cancer. So the concern of the task force is that men with elevated PSAs go through additional diagnostic tests that can be uncomfortable and often don’t show cancer.
The other concern is that many men with slow-growing prostate cancer don’t necessarily need to be treated and “overtreatment” can lead to adverse sexual and urinary side effects. What the task force seems to minimize is that prostate cancer is the second leading cause of death in American men and many men with prostate cancer detected by PSA do have life threatening cancers and can be cured with current treatments.
Q: The lower the PSA test score, the better. What is a worrisome PSA number?
Kane: One of the popular misconceptions is that a normal PSA is anything under four. This is not true for everyone. PSA must be used in the context of age and ethnicity. An average PSA for a man in his 40s is about 0.8 nanograms per milliliter. An average PSA for a man in his 50s is about 0.9-1.0 ng/ml and really should be under 2.5. PSA velocity – the rate of change of PSA – is a very strong predictor of prostate cancer. PSA velocity is also correlated with grade and severity of cancer. A PSA history that suddenly changes is a more valuable indicator of disease than a single elevated PSA.
Q: For healthy men over age 50, is there a viable alternative to a PSA screening?
Kane: No, for prostate cancer screening, both a PSA and a digital rectal examination are the best tests for men to catch prostate cancer in its most treatable stage. I continue to recommend screening and risk stratification of whether a man has aggressive or more slow-growing prostate cancer. We should then institute safe, effective, curative therapy, usually with surgery or radiation therapy for men with aggressive prostate cancers, and carefully follow, without treatment, men with more indolent, non-aggressive cancers.
Q: What about prevention? Does diet play a role?
Parsons: We have followed large groups of patients in epidemiological studies, and, over time, based on what they tell us they eat, we have been able to make conclusions about what would be some of the most advantageous dietary changes.

Read More

ucsdhealthsciences:

Scanning electron micrograph of prostate cancer cells. Image courtesy of Anne Weston, Wellcome Images.

It’s Prostate Cancer Awareness Month: A Q&A with Drs. Kane and Parsons

After skin cancer, prostate cancer is the second most common cancer among males. More than 217,000 new cases are diagnosed annually. One in six American men will be told they have the disease at some point in their lives. By age 85, it is estimated three-quarters of all men have prostate cancer.

Yet prostate cancer remains an especially confounding disease. It grows so slowly that symptoms may not appear until late in life, if ever. Yet it’s also indisputably deadly. At least 32,000 American men die from it each year.

We asked two leading physician-scientists to talk about the study and treatment of prostate cancer: Christopher Kane, MD, chair of the Department of Urology and professor of surgery at the UC San Diego School of Medicine and J. Kellogg Parsons, MD, MHS, associate professor of surgery at UC San Diego Moores Cancer Center and vice chair of the National Comprehensive Cancer Network Expert Panel on Clinical Guidelines for the Early Detection of Prostate Cancer.

Question: The risk of prostate cancer increases with age. Most doctors recommend healthy men over the age of 50 be screened for the disease annually. The American Urological Association suggests starting at age 40.

Kane: The best argument in favor of screening is that more than 30,000 men die from prostate cancer each year in the United States. If you get screened, you can get treatment, if needed. Screening is gaining information about whether or not a person has prostate cancer and, if they do, the stage, grade and severity of the disease. Fortunately, most men who are diagnosed young are diagnosed at a stage where they can be cured, experience fewer side effects, and are more likely to benefit from treatment.

Parsons: Most urologists agree that beginning at age 45 to 55 years, men should get a PSA blood test and prostate exam every 1 to 2 years. Regular screening is particularly important for men who either have a family history of prostate cancer (even just one first-degree relative) or men who come from an African-American family. In African-American men, prostate cancer tends to be more aggressive at a younger age.

Q: What is the PSA test?

Kane: PSA stands for prostate specific antigen — a fluid which is normally present in semen. Elevated levels of PSA in blood serum are associated with benign prostatic hyperplasia (prostate enlargement) and prostate cancer. A test for PSA may be used to screen for prostate cancer and to monitor treatment of the disease.

Q: Last year, the United States Preventive Services Task Force said healthy men should no longer receive the PSA blood test for prostate cancer because the screening does not save lives overall and often leads to unnecessary, debilitating tests and treatments. What’s your opinion of the panel’s reasoning and decision?

Kane: I disagree with the task force’s conclusion, as do major health organizations. It’s true that PSA is an imperfect test. Although it is sensitive, meaning that most men with prostate cancer do have an elevated PSA, it is not specific for prostate cancer, meaning many men with an elevated PSA don’t have cancer. So the concern of the task force is that men with elevated PSAs go through additional diagnostic tests that can be uncomfortable and often don’t show cancer.

The other concern is that many men with slow-growing prostate cancer don’t necessarily need to be treated and “overtreatment” can lead to adverse sexual and urinary side effects. What the task force seems to minimize is that prostate cancer is the second leading cause of death in American men and many men with prostate cancer detected by PSA do have life threatening cancers and can be cured with current treatments.

Q: The lower the PSA test score, the better. What is a worrisome PSA number?

Kane: One of the popular misconceptions is that a normal PSA is anything under four. This is not true for everyone. PSA must be used in the context of age and ethnicity. An average PSA for a man in his 40s is about 0.8 nanograms per milliliter. An average PSA for a man in his 50s is about 0.9-1.0 ng/ml and really should be under 2.5. PSA velocity – the rate of change of PSA – is a very strong predictor of prostate cancer. PSA velocity is also correlated with grade and severity of cancer. A PSA history that suddenly changes is a more valuable indicator of disease than a single elevated PSA.

Q: For healthy men over age 50, is there a viable alternative to a PSA screening?

Kane: No, for prostate cancer screening, both a PSA and a digital rectal examination are the best tests for men to catch prostate cancer in its most treatable stage. I continue to recommend screening and risk stratification of whether a man has aggressive or more slow-growing prostate cancer. We should then institute safe, effective, curative therapy, usually with surgery or radiation therapy for men with aggressive prostate cancers, and carefully follow, without treatment, men with more indolent, non-aggressive cancers.

Q: What about prevention? Does diet play a role?

Parsons: We have followed large groups of patients in epidemiological studies, and, over time, based on what they tell us they eat, we have been able to make conclusions about what would be some of the most advantageous dietary changes.

Read More

5:07 pm - Thu, Sep 12, 2013

Christopher Kwolek, M.D., is a vascular/endovascular surgeon at Massachusetts General Hospital and directs the clinical training program that trains future vascular/endovascular specialists. He is pioneering a revolutionary treatment for severe blood clots. We had a chance to interview him at the 2012 Veith Symposium. 

Full transcript of this video here.

4:30 pm

Lower Rates Of Complications In Hip And Knee Replacement Using Regional Anesthesia Technique

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A highly underutilized anesthesia technique called neuraxial anesthesia, also known as spinal or epidural anesthesia, improves outcomes in patients undergoing hip or knee replacement, according to a new study by researchers at Hospital for Special Surgery. The study, which appears in the May issue of the journal Anesthesiology, found that neuraxial anesthesia, a type of regional anesthesia, reduced morbidity, mortality, length of hospital stay and costs when compared with general anesthesia. 

"The influence that the type of anesthetic can have on perioperative outcomes has been vastly underestimated. Indeed, our study suggests that the type of anesthesia chosen may have important impacts on all kind of medical and economic outcomes in orthopedic surgical patients," said Stavros Memtsoudis, M.D., Ph.D., director of Critical Care Services at Hospital for Special Surgery, New York City. "It is not something to be taken lightly." The findings of this comparative effectiveness research could be applied to over one million patients undergoing joint arthroplasty in the United States each year. 

Read the full article here

Photo: isafmedia

5:38 pm - Wed, Sep 11, 2013
1 note

Scars from Childhood Cancer Can Affect Adult Quality Of Life

Scars left behind by childhood cancer treatments are more than skin-deep. The increased risk of disfigurement caused by childhood cancer and treatment is associated with emotional distress and reduced quality of life in adulthood, according to a new study led by a Northwestern Medicine advanced practice nurse, Karen Kinahan, and based on data from the Childhood Cancer Survivor Study (CCSS). 

The largest study of its kind, published in the Journal of Clinical Oncology, compared adult survivors, who were scarred or disfigured by childhood cancer, to their siblings, who were not childhood cancer survivors. The study found that survivors with a head, neck, arm, or leg disfigurement had increased risk of depression.

"The results of this study help illustrate the complex chain of events childhood cancer can have on quality of life as an adult," said senior author Kevin Krull, Ph.D., an associate member in the St. Jude Children’s Research Hospital departments of epidemiology and cancer control and psychology. "We have long been aware that radiation therapy is associated with increased risk for emotional distress and social problems, though we did not fully understand the process this involves. The current study begins to map this process."

Read the full article here

Photo: Steven Depalo

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