Quotes of the Week

It has been a long time between Web Letters. I apologize for the extended hiatus and I won't offer any boring excuses. I plan to seriously address this project and try to write a Web Letter every two weeks.

I obtain most of my material from a Journal Club that I attend weekly. This should assure that the Letter will contain diversified and current topics which have not previously been presented to the lay public. The format has not changed. I will paraphrase the articles in non scientific language and editorially comment on their practicality and significance.

Type 2 Diabetus Mellitus
An interesting article from the Finnish Diabetus Prevention Study Group was published in the May 3,2001 issue of The New England Journal of Medicine. Dr. Jaakko Tuomilehto, et. al. studied a group of 522 overweight men and women with impaired glucose tolerance which made them at risk for type 2 diabetus mellitus. The investigators found that by changing the lifestyles-diet, weight loss, and exercise-of half of the group; type 2 diabetus mellitus could be prevented when compared to a control group.
     Ed. This is a significant finding. Type 2 diabetus is rampant in the U.S. because of obesity and sedentary life style. It's not too late for change.

Low Back Pain
Lumbar disk disease (LDD) is a common cause of low back pain and represents about 5 % of all musculoskeletal disorders. An article in the April 11, 2001 issue of The Journal of the American Medical Association (JAMA), again from Finland, reported that Dr.s Petteri Paassilta et. al. were able to demonstrate a "novel common genetic risk factor" for LDD and they concluded that the factor played a significant role in the etiology of this problem.
     Ed. It was only present in 4% of Finnish patients with LDD. The practicality of this in Americans remains to be seen.

Breast Cancer in the Elderly
There has been much discussion in the surgical literature on treatment of Breast Cancer in elderly patients. Some authorities believe that they should be treated like younger patients and their treatment not compromised because of age. A recent report by Dr.s Paul I. Tarter et. al. Published in the J Am Coll. Surg 2001;192:698-707 showed that when elderly patients were treated with breast conservation surgery alone rather than routinely adding axillary dissection (removal arm pit lymph glands) and radiation, there was no statistically significant difference in outcomes from those patients who received conventional treatment.
     Ed. I have always been an advocate of individualizing treatment. This article shows that if the elderly patient is undertreated because of associated co-morbid medical problems that prevent the use of conventional treatment the long term results are not affected. The authors also thought that Tamoxifen improved results in all patients.

Second Hand Smoke
Hem/Onc Today reported an interesting study by Kristin E. Anderson, PhD, MPH from the University of Minnesota. Dr. Anderson and her group demonstrated biological evidence of a tobacco-specific lung carcinogen (NNK) in the blood of non smoking spouses who were married to smoking husbands. Those women exposed to second hand smoke had levels of NNK six times the values of those females not breathing passive smoke.
     Ed. Studies have estimated that the risk for lung cancer in women exposed to second hand smoke is 20% higher than the risk in women who do not have to breathe contaminated air.

Blood Biopsy
An exciting report came from the 92nd meeting of The American Association for Cancer Research (AACR) in New Orleans, LA. Dr.Ts'o, Professor of Biochemistry at John Hopkins School of Hygiene and Public Health, described a test which his lab developed. This process, called a blood biopsy, can detect carcinoma cells in circulating blood. His group is studying the significance and practicality of the procedure together with it's clinical significance.
     Ed. If this works out then it will allow early detection of recurrent and metastatic cancer. In addition it has the potential of monitoring the effectiveness of treatment.

"The aim of medicine is surely not to make men virtuous; it is to safeguard and rescue them from the consequences of their vices."
     - H.L. Meneken (1880-1956), Prejudices, Types of Men; the Physician

"Medicine is for the patient. Medicine is for the people. It is not for the profits."
     - George Merck (1894-1957)
     Ed. I wonder if the current Pharmaceutical Industry is making him turn in his grave.

Take care until next time,
RJT, Editor.

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