scout

All News

Doctors as engineers

There are two fundamentally different ways of thinking about complex social systems: the economic approach and the engineering approach.

As adoption of electronic health records (EHRs) continues to grow, there still exists a gap in the ability of some providers and vendors to ensure successful implementation. This starter-kit of resources can help you take advantage of government incentives and prepare you for EHR adoption.

Is the healthcare debate stressing you out? Check out this raft of political cartoons courtesy of Kaiser Health News.

Earlier this month two senators introduced the “Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2010.” Sens. Mike Enzi (R-Wyo.) and Tom Harkin (D-Iowa) hope through this legislation to guarantee that staff who perform medical imaging and radiation therapy are appropriately qualified by establishing standards for these personnel. It makes sense. Who wants unqualified personnel performing procedures involving ionizing radiation?

Almost everyone says that it is. Conservatives. Liberals. Republicans. Democrats. A vast swath of the health policy community. With near unanimous agreement among everybody who knows anything about health economics, how could we even ask the question?

We cannot escape the realities of biology. Just as children rescued from leukemia and lymphoma live to grow into adults who must confront the adverse effects of their curative treatment, people rescued from AIDS by HAART (highly active antiretroviral therapy) are showing a substantially increased risk of cancers other than the "AIDS-defining" malignancies designated by the Centers for Disease Control in the 1980s: Kaposi sarcoma, non-Hodgkin lymphoma (NHL), and cervical cancer.

Yoga, first described in the Vedic texts of India, has been practiced for millennia. It involves regulated breathing, moving through various postures known as asanas, and meditation, aimed at achieving physical and psychological well-being. Many styles of yoga encompass some or all of these components. Yoga can have a positive impact on quality of life (QOL) in people with and without cancer, by reducing stress and fatigue and improving symptoms of certain inflammatory conditions. In the cancer setting alone, there are at least 10 randomized trials documenting the benefits of yoga on patients’ QOL.

The treatment of cancer of the anal canal has changed significantly over the past several decades. Although the abdominoperineal resection (APR) was the historical standard of care, a therapeutic paradigm shift occurred with the seminal work of Nigro, who reported that anal canal cancer could be treated with definitive chemoradiation, with APR reserved for salvage therapy only. This remains an attractive approach for patients and physicians alike and the standard of care in this disease. Now, nearly four decades later, a similar approach continues to be utilized, albeit with higher radiation doses; however, this strategy remains fraught with considerable treatment-related morbidities. With the advent of intensity-modulated radiation therapy (IMRT), many oncologists are beginning to utilize this technology in the treatment of anal cancer in order to decrease these toxicities while maintaining similar treatment efficacy. This article reviews the relevant literature leading up to the modern treatment of anal canal cancer, and discusses IMRT-related toxicity and disease-related outcomes in the context of outcomes of conventionally treated anal cancer.

Complications of the bone remain a major clinical problem in oncology, resulting in significant morbidity and increased risk of death.