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September 02, 2015
When a woman has bothersome bladder leakage and is seeking to get her bladder back under her control, the first thing her provider will diagnose is whether the leakage is stress-type incontinence ("drips" small amount of urine with cough, sneeze, exercise), or urge-type incontinence (loses large volume of urine, "gullywashers" soaking pads and clothing). Stress-type drip patterns are more common, but urge incontinence can put a huge dent in your quality of life and can be terribly bothersome. Urge incontinence is also called overactive bladder, and may involve a spectrum of symptoms with urinary frequency, urgency, and leakage. Many women have a combination of symptoms and both types of leakage patterns, i.e. mixed-incontinence, and this situation can pose a dilemma to providers since the treatments for stress or urge incontinence are different - which to treat first?
August 28, 2015
Millions of Americans suffer from some form of mental health problems. It is estimated that in the U.S., about 40 million adults suffer from anxiety, about 20 million adults suffer from depression, and another 8 million suffer from PTSD. Many more people, about 78 million, report suffering from high levels of stress with poor health in self or a family member being the primary reason for the stress. Unfortunately research consistently shows that two-thirds of these people do not seek out treatment for their problems. And those who are interested in help often run into barriers that prevent them from receiving treatment. Barriers can include lack of or inadequate health insurance, lack of mental health resources in rural or impoverished areas or the stigma of getting help for mental health problems.
Apps on smart phones could help address some of these barriers. There are hundreds of apps focused on helping people with anxiety, depression, PTSD, stress and other symptoms.
August 27, 2015
Neuromyelitis optica (NMO) is a neuroinflammatory disorder characterized by optic neuritis and extensive myelitis. Like multiple sclerosis (MS), it can have a relapsing remitting disease course. Some of the NMO patients tend to run a more aggressive disease course. Most patients with NMO have Ig G antibodies to the aquaporin-4 water channel (AQP4).
In July 2015, experts from International Panel for NMO Diagnosis (Wingerchuk DM et al. Neurology 2015 Jul 14) provided updated consensus recommendations for NMO spectrum disorders (NMOSD).
August 26, 2015
Research shows that 90% of all local breast cancer recurrences happen within one centimeter from where the cancer was removed. Could we focus the radiation treatment into that area at highest risk but spare the remaining breast tissue?
I am excited to report that we have recently added a new breast cancer radiation treatment alternative for patients treated at the Swedish Cancer Institute. SAVI is a form of accelerated partial breast radiation that provides an alternative to the 6 weeks of treatment usually recommended to breast cancer patients. About a week after surgery, once we know that the cancer has been completely removed, a catheter is placed into the breast to deliver radiation treatment directly into the surgical cavity. Treatment now is delivered over five days instead of the standard 6-7 weeks of daily sessions.
August 24, 2015
In a previous blog post
, I mentioned that the U.S. Food and Drug Administration (FDA) is making changes to nutrition facts labels (originally introduced 20 years ago to help consumers make informed and healthy food choices).
On July 27, 2015, the FDA added a supplement
to the initially proposed changes (originally published March 2015). It proposes that food manufacturers not only list the grams of added sugar, but also declare the percent daily value (%DV) for added sugars, which is a major step forward in aligning with international standards for sugar intake
, and a totally novel concept in terms of food labelling in the U.S.
August 21, 2015
On August 20, 2015, the New York Times published an article with the provocative title, “Doubt is Raised Over Value of Surgery for Breast Lesion at Earliest Stage.” In it they reference a study by Narod reported in JAMA Oncology that looked at breast cancer death after a DCIS diagnosis.
But, the questions addressed by the article were different than the questions generated by the research.
August 20, 2015
For the fourth year in a row, the committed riders of Bike the US for MS
arrived at the Peddler Brewing Co. in Ballard this month to present a $25,000 gift to the Swedish MS Center
in honor of its excellence in MS care.
August 18, 2015
Urinary tract infections (UTIs) are very common and becoming harder to treat due to antibiotic resistant bacteria. Where are these resistant bacteria coming from? Overuse of oral antibiotics for any suspected infection has historically been thought to be a culprit, but now there's increasing evidence that resistant bacteria are coming from the global food chain, and in particular the poultry industry. Antibiotics are commonly used in poultry feed on chicken farms to reduce the risk of E.coli infections. Drug-resistant E.coli UTIs are increasing in women who are otherwise healthy and living in the community and have no other risk factors for developing drug-resistant infections. There is increasing evidence that drug-resistant E.coli from antibiotic-treated chicken meat, then ingested by women, may contribute to the emergence of drug-resistant community-acquired UTIs.
August 18, 2015
There has been debate about how to switch patients with multiple sclerosis (MS) from Tysabri to other medications. This happens most often when patients on Tysabri become positive for antibodies to the JC virus. Patients that have these antibodies are at increased risk of a serious infection called progressive multifocal leukoencephalopathy (PML).
New research has studied varying timelines for starting a new medication after Tysabri.
August 17, 2015
Being scheduled for a surgical or sedated procedure can be a nerve wracking experience for children and their families. Knowing what to expect when you visit the hospital can help relieve many common fears and concerns. At Swedish, Child Life Specialists help children and families cope with the hospital process. Child Life Specialists are available to help educate and prepare children and families prior to surgery.
The pre-operative tour is a great place to start.