Academic and community cancer centers demonstrated similarly high rates of sociodemographic disparities in prostate cancer treatment patterns, a study showed.

Specifically, black, Hispanic, and uninsured patients were less likely to receive definitive therapy for high-risk prostate cancer at community and academic cancer centers than were white or privately insured patients. In addition, white patients began receiving therapy earlier than black and Hispanic patients at both community and academic medical centers.

©Mark Kostich/Thinkstock

“The finding that disparities exist across cancer care centers, regardless of academic versus community center structure, suggests that there may be something intrinsic about systemic, provider-level, or patient-level issues that may be interfering with treatment,” wrote Brandon Mahal, MD, of Brigham and Women’s Hospital in Boston and his associates (Cancer. July 2016. doi:10.1002/cncr.30205).

Dr. Mahal and associates identified 138,019 patients with high-risk prostate cancer who had a definitive treatment history available through the National Cancer Data Base. Definitive therapy was defined as either prostatectomy or radiation therapy plus androgen-deprivation therapy. High-risk disease was defined as having a prostate-specific antigen score above 20 ng/mL, a Gleason score of 8-10, or a clinical tumor classification of cT3a.

The investigators found black, Hispanic, and uninsured patients were less likely to receive definitive therapy at community cancer centers than were white or privately insured patients (adjusted odds ratios: 0.60, 0.69, and 0.25; 95% confidence intervals: 0.56-0.64, 0.61-0.78, and 0.22-0.30 for black, Hispanic, and uninsured patients; P less than .001). This finding was also true for patients who received treatment at academic cancer centers (AOR: 0.50, 0.56, and 0.31; 95% CI: 0.46-0.54, 0.50-0.64, and 0.28-0.36; P less than .001 for all).

At academic centers, the median time until receipt of definitive treatment was 83 days for white patients, 102 days for black patients, and 94 days for Hispanic patients. At community centers, the median time until receipt of treatment was 77 days for white patients, 92 days for black patients, and 87 days for Hispanic patients.

This study was supported by David and Cynthia Chapin, Hugh Simons, the Campbell Family, the Prostate Cancer Foundation, Fitz’s Cancer Warriors, the Scott Forbes and Gina Ventre Fund, and a grant from an anonymous foundation. Three investigators reported receiving financial compensation from multiple companies.

[email protected]

On Twitter @jessnicolecraig

Academic and community cancer centers demonstrated similarly high rates of sociodemographic disparities in prostate cancer treatment patterns, a study showed.

Specifically, black, Hispanic, and uninsured patients were less likely to receive definitive therapy for high-risk prostate cancer at community and academic cancer centers than were white or privately insured patients. In addition, white patients began receiving therapy earlier than black and Hispanic patients at both community and academic medical centers.

©Mark Kostich/Thinkstock

“The finding that disparities exist across cancer care centers, regardless of academic versus community center structure, suggests that there may be something intrinsic about systemic, provider-level, or patient-level issues that may be interfering with treatment,” wrote Brandon Mahal, MD, of Brigham and Women’s Hospital in Boston and his associates (Cancer. July 2016. doi:10.1002/cncr.30205).

Dr. Mahal and associates identified 138,019 patients with high-risk prostate cancer who had a definitive treatment history available through the National Cancer Data Base. Definitive therapy was defined as either prostatectomy or radiation therapy plus androgen-deprivation therapy. High-risk disease was defined as having a prostate-specific antigen score above 20 ng/mL, a Gleason score of 8-10, or a clinical tumor classification of cT3a.

The investigators found black, Hispanic, and uninsured patients were less likely to receive definitive therapy at community cancer centers than were white or privately insured patients (adjusted odds ratios: 0.60, 0.69, and 0.25; 95% confidence intervals: 0.56-0.64, 0.61-0.78, and 0.22-0.30 for black, Hispanic, and uninsured patients; P less than .001). This finding was also true for patients who received treatment at academic cancer centers (AOR: 0.50, 0.56, and 0.31; 95% CI: 0.46-0.54, 0.50-0.64, and 0.28-0.36; P less than .001 for all).

At academic centers, the median time until receipt of definitive treatment was 83 days for white patients, 102 days for black patients, and 94 days for Hispanic patients. At community centers, the median time until receipt of treatment was 77 days for white patients, 92 days for black patients, and 87 days for Hispanic patients.

This study was supported by David and Cynthia Chapin, Hugh Simons, the Campbell Family, the Prostate Cancer Foundation, Fitz’s Cancer Warriors, the Scott Forbes and Gina Ventre Fund, and a grant from an anonymous foundation. Three investigators reported receiving financial compensation from multiple companies.

[email protected]

On Twitter @jessnicolecraig

Academic and community cancer centers demonstrated similarly high rates of sociodemographic disparities in prostate cancer treatment patterns, a study showed.

Specifically, black, Hispanic, and uninsured patients were less likely to receive definitive therapy for high-risk prostate cancer at community and academic cancer centers than were white or privately insured patients. In addition, white patients began receiving therapy earlier than black and Hispanic patients at both community and academic medical centers.

©Mark Kostich/Thinkstock

“The finding that disparities exist across cancer care centers, regardless of academic versus community center structure, suggests that there may be something intrinsic about systemic, provider-level, or patient-level issues that may be interfering with treatment,” wrote Brandon Mahal, MD, of Brigham and Women’s Hospital in Boston and his associates (Cancer. July 2016. doi:10.1002/cncr.30205).

Dr. Mahal and associates identified 138,019 patients with high-risk prostate cancer who had a definitive treatment history available through the National Cancer Data Base. Definitive therapy was defined as either prostatectomy or radiation therapy plus androgen-deprivation therapy. High-risk disease was defined as having a prostate-specific antigen score above 20 ng/mL, a Gleason score of 8-10, or a clinical tumor classification of cT3a.

The investigators found black, Hispanic, and uninsured patients were less likely to receive definitive therapy at community cancer centers than were white or privately insured patients (adjusted odds ratios: 0.60, 0.69, and 0.25; 95% confidence intervals: 0.56-0.64, 0.61-0.78, and 0.22-0.30 for black, Hispanic, and uninsured patients; P less than .001). This finding was also true for patients who received treatment at academic cancer centers (AOR: 0.50, 0.56, and 0.31; 95% CI: 0.46-0.54, 0.50-0.64, and 0.28-0.36; P less than .001 for all).

At academic centers, the median time until receipt of definitive treatment was 83 days for white patients, 102 days for black patients, and 94 days for Hispanic patients. At community centers, the median time until receipt of treatment was 77 days for white patients, 92 days for black patients, and 87 days for Hispanic patients.

This study was supported by David and Cynthia Chapin, Hugh Simons, the Campbell Family, the Prostate Cancer Foundation, Fitz’s Cancer Warriors, the Scott Forbes and Gina Ventre Fund, and a grant from an anonymous foundation. Three investigators reported receiving financial compensation from multiple companies.

[email protected]

On Twitter @jessnicolecraig

An autoinjector for subcutaneously administering abatacept (Orencia) has been approved by the Food and Drug Administration for the treatment of rheumatoid arthritis, making it the third delivery method available for patients to use the biologic.

Courtesy Wikimedia Commons/FitzColinGerald/Creative Commons License

Abatacept is also available for intravenous infusion and subcutaneous administration with a prefilled syringe. With a single button push, the new Orencia ClickJect autoinjector delivers 125 mg of the drug over the course of 15 seconds and also confirms the injection. The autoinjector’s design is meant to allow patients with rheumatoid arthritis to firmly hold, operate, and control the device, according to an announcement from the manufacturer, Bristol-Myers Squibb.

Although abatacept is approved to treat polyarticular juvenile idiopathic arthritis in patients aged 6 years and older, subcutaneous formulations of the drug have not been studied in patients younger than 18 years.

[email protected]

An autoinjector for subcutaneously administering abatacept (Orencia) has been approved by the Food and Drug Administration for the treatment of rheumatoid arthritis, making it the third delivery method available for patients to use the biologic.

Courtesy Wikimedia Commons/FitzColinGerald/Creative Commons License

Abatacept is also available for intravenous infusion and subcutaneous administration with a prefilled syringe. With a single button push, the new Orencia ClickJect autoinjector delivers 125 mg of the drug over the course of 15 seconds and also confirms the injection. The autoinjector’s design is meant to allow patients with rheumatoid arthritis to firmly hold, operate, and control the device, according to an announcement from the manufacturer, Bristol-Myers Squibb.

Although abatacept is approved to treat polyarticular juvenile idiopathic arthritis in patients aged 6 years and older, subcutaneous formulations of the drug have not been studied in patients younger than 18 years.

[email protected]

An autoinjector for subcutaneously administering abatacept (Orencia) has been approved by the Food and Drug Administration for the treatment of rheumatoid arthritis, making it the third delivery method available for patients to use the biologic.

Courtesy Wikimedia Commons/FitzColinGerald/Creative Commons License

Abatacept is also available for intravenous infusion and subcutaneous administration with a prefilled syringe. With a single button push, the new Orencia ClickJect autoinjector delivers 125 mg of the drug over the course of 15 seconds and also confirms the injection. The autoinjector’s design is meant to allow patients with rheumatoid arthritis to firmly hold, operate, and control the device, according to an announcement from the manufacturer, Bristol-Myers Squibb.

Although abatacept is approved to treat polyarticular juvenile idiopathic arthritis in patients aged 6 years and older, subcutaneous formulations of the drug have not been studied in patients younger than 18 years.

[email protected]

SAN DIEGO – A process intended to optimize blood management led to a 30% reduction in blood use and a savings of $2 million, results from a single-center study showed.

“Blood is a limited resource and we have a responsibility as a health care provider to optimize the use of a resource that is difficult to get and only available through altruistic donations,” lead study author Barbara J. Martin, RN, said in a press release. The study was presented in a poster session at the American College of Surgeons/National Surgical Quality Improvement Program National Conference.

ksena32/ThinkStock

In an effort to evaluate how they could implement evidence-based guidelines around restrictive transfusion, Ms. Martin and her colleagues at Vanderbilt University Medical Center, Nashville, Tenn., first changed provider orders to support a single unit order and then follow-up order for more blood if necessary. The previous process was to order two units of blood, which was at times more blood than was needed. “The data on restrictive transfusion has been out for years documenting that patients have better outcomes with a more restrictive transfusion strategy,” Ms. Martin, of the Vanderbilt Center for Clinical Improvement, said in the press release. “We were looking at whether we could guide providers to treat symptomatic anemia with a single unit of blood rather than the usual two units.”

The researchers enhanced the Computerized Provider Order Entry (CPOE) system to allow blood ordering practices to be based on a specific assessment of each case rather than on a standard order of two units. As a result, red blood cell transfusions at Vanderbilt declined from 675 units per 1,000 discharges in 2011 to 432 units per 1,000 discharges in 2015, a decrease of more than 30%.

In an effort to reduce inefficiencies in the way blood is ordered, transported, and stored, Ms. Martin and her multidisciplinary team developed the following guidelines for perioperative handling:

• When more than one unit of blood is ordered, it is sent in a cooler rather than the pneumatic tube.

• Coolers are reconfigured to optimize temperature management.

• A specific staff member is tasked with “ownership” of the blood products, including returning unused product to the blood bank.

• Individual unit wastage is reported to clinical leaders for review; aggregate data are reported monthly.

After implementation of these practices, fewer than 80 units of blood were wasted at Vanderbilt in 2015, a drop from 300 in 2011. Collectively, the blood management strategies resulted in a savings of $2 million. Ms. Martin said that such guidelines can be implemented at other medical centers, but “you have to prioritize what your initiatives are. At Vanderbilt we had a lot of opportunities with blood transfusion and blood wastage and we made huge gains. Any incremental improvement would take additional resources.”

The researchers reported having no relevant disclosures.

[email protected]

SAN DIEGO – A process intended to optimize blood management led to a 30% reduction in blood use and a savings of $2 million, results from a single-center study showed.

“Blood is a limited resource and we have a responsibility as a health care provider to optimize the use of a resource that is difficult to get and only available through altruistic donations,” lead study author Barbara J. Martin, RN, said in a press release. The study was presented in a poster session at the American College of Surgeons/National Surgical Quality Improvement Program National Conference.

ksena32/ThinkStock

In an effort to evaluate how they could implement evidence-based guidelines around restrictive transfusion, Ms. Martin and her colleagues at Vanderbilt University Medical Center, Nashville, Tenn., first changed provider orders to support a single unit order and then follow-up order for more blood if necessary. The previous process was to order two units of blood, which was at times more blood than was needed. “The data on restrictive transfusion has been out for years documenting that patients have better outcomes with a more restrictive transfusion strategy,” Ms. Martin, of the Vanderbilt Center for Clinical Improvement, said in the press release. “We were looking at whether we could guide providers to treat symptomatic anemia with a single unit of blood rather than the usual two units.”

The researchers enhanced the Computerized Provider Order Entry (CPOE) system to allow blood ordering practices to be based on a specific assessment of each case rather than on a standard order of two units. As a result, red blood cell transfusions at Vanderbilt declined from 675 units per 1,000 discharges in 2011 to 432 units per 1,000 discharges in 2015, a decrease of more than 30%.

In an effort to reduce inefficiencies in the way blood is ordered, transported, and stored, Ms. Martin and her multidisciplinary team developed the following guidelines for perioperative handling:

• When more than one unit of blood is ordered, it is sent in a cooler rather than the pneumatic tube.

• Coolers are reconfigured to optimize temperature management.

• A specific staff member is tasked with “ownership” of the blood products, including returning unused product to the blood bank.

• Individual unit wastage is reported to clinical leaders for review; aggregate data are reported monthly.

After implementation of these practices, fewer than 80 units of blood were wasted at Vanderbilt in 2015, a drop from 300 in 2011. Collectively, the blood management strategies resulted in a savings of $2 million. Ms. Martin said that such guidelines can be implemented at other medical centers, but “you have to prioritize what your initiatives are. At Vanderbilt we had a lot of opportunities with blood transfusion and blood wastage and we made huge gains. Any incremental improvement would take additional resources.”

The researchers reported having no relevant disclosures.

[email protected]

SAN DIEGO – A process intended to optimize blood management led to a 30% reduction in blood use and a savings of $2 million, results from a single-center study showed.

“Blood is a limited resource and we have a responsibility as a health care provider to optimize the use of a resource that is difficult to get and only available through altruistic donations,” lead study author Barbara J. Martin, RN, said in a press release. The study was presented in a poster session at the American College of Surgeons/National Surgical Quality Improvement Program National Conference.

ksena32/ThinkStock

In an effort to evaluate how they could implement evidence-based guidelines around restrictive transfusion, Ms. Martin and her colleagues at Vanderbilt University Medical Center, Nashville, Tenn., first changed provider orders to support a single unit order and then follow-up order for more blood if necessary. The previous process was to order two units of blood, which was at times more blood than was needed. “The data on restrictive transfusion has been out for years documenting that patients have better outcomes with a more restrictive transfusion strategy,” Ms. Martin, of the Vanderbilt Center for Clinical Improvement, said in the press release. “We were looking at whether we could guide providers to treat symptomatic anemia with a single unit of blood rather than the usual two units.”

The researchers enhanced the Computerized Provider Order Entry (CPOE) system to allow blood ordering practices to be based on a specific assessment of each case rather than on a standard order of two units. As a result, red blood cell transfusions at Vanderbilt declined from 675 units per 1,000 discharges in 2011 to 432 units per 1,000 discharges in 2015, a decrease of more than 30%.

In an effort to reduce inefficiencies in the way blood is ordered, transported, and stored, Ms. Martin and her multidisciplinary team developed the following guidelines for perioperative handling:

• When more than one unit of blood is ordered, it is sent in a cooler rather than the pneumatic tube.

• Coolers are reconfigured to optimize temperature management.

• A specific staff member is tasked with “ownership” of the blood products, including returning unused product to the blood bank.

• Individual unit wastage is reported to clinical leaders for review; aggregate data are reported monthly.

After implementation of these practices, fewer than 80 units of blood were wasted at Vanderbilt in 2015, a drop from 300 in 2011. Collectively, the blood management strategies resulted in a savings of $2 million. Ms. Martin said that such guidelines can be implemented at other medical centers, but “you have to prioritize what your initiatives are. At Vanderbilt we had a lot of opportunities with blood transfusion and blood wastage and we made huge gains. Any incremental improvement would take additional resources.”

The researchers reported having no relevant disclosures.

[email protected]

CHICAGO - A study examining the genes of more than 120,000 people from Europe, Asia, Africa and the Americas has offered the clearest picture yet of the genes that drive type 2 diabetes.

The study, published July 11 in the journal Nature, puts to rest a decades-long debate over the genetics that influence the risk of diabetes, which affects one in 10 people over the course of their lifetime.

And it has identified more than a dozen specific genes directly involved in the development of type 2 diabetes that might serve as potential drug targets.

"There was a whole furious debate that arose about this," said Dr. Francis Collins, director of the National Institutes of Health, one of more than 300 scientists collaborating on the work.

Prior studies turned up more than 80 spots in the genome associated with the development of adult-onset diabetes, but most of these genetic errors were common, meaning they occurred frequently in the population, and they explained only a small fraction of disease risk.

These discoveries were based on genome-wide association studies or GWAS, which used gene chips that scan thousands of genes at a time. Researchers used these to scan DNA from large populations of individuals with a specific disease and compare them with DNA from similar groups of healthy people.

Critics, including geneticist Dr. David Goldstein at Columbia University, argued that such studies were a waste of resources because they only found common variants that explained just a small fraction of the risk for disease.

He said the really important drivers of common diseases such as diabetes and schizophrenia were more likely to be found in extremely rare genes, those occurring in individuals or in families, not those shared by large populations of people.

Goldstein "argued very persuasively that it was all about rare variants and we were all going down the wrong road looking at the common ones," Collins said in a telephone interview.

The new study took a deeper look, using next-generation sequencing to search the entire genetic code of 2,657 people with and without diabetes to assess the contribution of both rare and common genes driving diabetes.

They also sequenced all of the protein-making genes in 12,940 people, and used statistical methods to estimate risk in another 111,548 people with less complete DNA data.

They found that, indeed, most of the genetic risk for type 2 diabetes is caused by common mistakes in the genetic code, with each mistake contributing only a small portion of an individual's risk for developing the disease.

"What this study says quite definitively for diabetes is the vast majority of hereditary risk variants are in fact these common ones, and the rare ones, while they pop up here and there, are a much smaller contribution," Collins said.

The study also turned up more than a dozen examples where variants alter the way proteins are made, suggesting that these gene variants have some direct impact on the development of type 2 diabetes.

"These represent promising avenues for efforts to design new ways to treat or prevent the disease," said Mark McCarthy, a senior author of the study from Oxford University.

All of the data will be made publicly available online through the Accelerating Medicines Partnership, a public-private partnership between the NIH, the U.S. Food and Drug Administration, 10 drug companies and several nonprofits.

Goldstein said the work was "a careful, solid investigation" that does not change his view much overall, adding that it was time to "quit arguing."

"What I care about now is finding the exact variants that infer risk, and understanding how they do so," he said.

SOURCE: http://go.nature.com/29DlL5i

Nature 2016.

CHICAGO - A study examining the genes of more than 120,000 people from Europe, Asia, Africa and the Americas has offered the clearest picture yet of the genes that drive type 2 diabetes.

The study, published July 11 in the journal Nature, puts to rest a decades-long debate over the genetics that influence the risk of diabetes, which affects one in 10 people over the course of their lifetime.

And it has identified more than a dozen specific genes directly involved in the development of type 2 diabetes that might serve as potential drug targets.

"There was a whole furious debate that arose about this," said Dr. Francis Collins, director of the National Institutes of Health, one of more than 300 scientists collaborating on the work.

Prior studies turned up more than 80 spots in the genome associated with the development of adult-onset diabetes, but most of these genetic errors were common, meaning they occurred frequently in the population, and they explained only a small fraction of disease risk.

These discoveries were based on genome-wide association studies or GWAS, which used gene chips that scan thousands of genes at a time. Researchers used these to scan DNA from large populations of individuals with a specific disease and compare them with DNA from similar groups of healthy people.

Critics, including geneticist Dr. David Goldstein at Columbia University, argued that such studies were a waste of resources because they only found common variants that explained just a small fraction of the risk for disease.

He said the really important drivers of common diseases such as diabetes and schizophrenia were more likely to be found in extremely rare genes, those occurring in individuals or in families, not those shared by large populations of people.

Goldstein "argued very persuasively that it was all about rare variants and we were all going down the wrong road looking at the common ones," Collins said in a telephone interview.

The new study took a deeper look, using next-generation sequencing to search the entire genetic code of 2,657 people with and without diabetes to assess the contribution of both rare and common genes driving diabetes.

They also sequenced all of the protein-making genes in 12,940 people, and used statistical methods to estimate risk in another 111,548 people with less complete DNA data.

They found that, indeed, most of the genetic risk for type 2 diabetes is caused by common mistakes in the genetic code, with each mistake contributing only a small portion of an individual's risk for developing the disease.

"What this study says quite definitively for diabetes is the vast majority of hereditary risk variants are in fact these common ones, and the rare ones, while they pop up here and there, are a much smaller contribution," Collins said.

The study also turned up more than a dozen examples where variants alter the way proteins are made, suggesting that these gene variants have some direct impact on the development of type 2 diabetes.

"These represent promising avenues for efforts to design new ways to treat or prevent the disease," said Mark McCarthy, a senior author of the study from Oxford University.

All of the data will be made publicly available online through the Accelerating Medicines Partnership, a public-private partnership between the NIH, the U.S. Food and Drug Administration, 10 drug companies and several nonprofits.

Goldstein said the work was "a careful, solid investigation" that does not change his view much overall, adding that it was time to "quit arguing."

"What I care about now is finding the exact variants that infer risk, and understanding how they do so," he said.

SOURCE: http://go.nature.com/29DlL5i

Nature 2016.

CHICAGO - A study examining the genes of more than 120,000 people from Europe, Asia, Africa and the Americas has offered the clearest picture yet of the genes that drive type 2 diabetes.

The study, published July 11 in the journal Nature, puts to rest a decades-long debate over the genetics that influence the risk of diabetes, which affects one in 10 people over the course of their lifetime.

And it has identified more than a dozen specific genes directly involved in the development of type 2 diabetes that might serve as potential drug targets.

"There was a whole furious debate that arose about this," said Dr. Francis Collins, director of the National Institutes of Health, one of more than 300 scientists collaborating on the work.

Prior studies turned up more than 80 spots in the genome associated with the development of adult-onset diabetes, but most of these genetic errors were common, meaning they occurred frequently in the population, and they explained only a small fraction of disease risk.

These discoveries were based on genome-wide association studies or GWAS, which used gene chips that scan thousands of genes at a time. Researchers used these to scan DNA from large populations of individuals with a specific disease and compare them with DNA from similar groups of healthy people.

Critics, including geneticist Dr. David Goldstein at Columbia University, argued that such studies were a waste of resources because they only found common variants that explained just a small fraction of the risk for disease.

He said the really important drivers of common diseases such as diabetes and schizophrenia were more likely to be found in extremely rare genes, those occurring in individuals or in families, not those shared by large populations of people.

Goldstein "argued very persuasively that it was all about rare variants and we were all going down the wrong road looking at the common ones," Collins said in a telephone interview.

The new study took a deeper look, using next-generation sequencing to search the entire genetic code of 2,657 people with and without diabetes to assess the contribution of both rare and common genes driving diabetes.

They also sequenced all of the protein-making genes in 12,940 people, and used statistical methods to estimate risk in another 111,548 people with less complete DNA data.

They found that, indeed, most of the genetic risk for type 2 diabetes is caused by common mistakes in the genetic code, with each mistake contributing only a small portion of an individual's risk for developing the disease.

"What this study says quite definitively for diabetes is the vast majority of hereditary risk variants are in fact these common ones, and the rare ones, while they pop up here and there, are a much smaller contribution," Collins said.

The study also turned up more than a dozen examples where variants alter the way proteins are made, suggesting that these gene variants have some direct impact on the development of type 2 diabetes.

"These represent promising avenues for efforts to design new ways to treat or prevent the disease," said Mark McCarthy, a senior author of the study from Oxford University.

All of the data will be made publicly available online through the Accelerating Medicines Partnership, a public-private partnership between the NIH, the U.S. Food and Drug Administration, 10 drug companies and several nonprofits.

Goldstein said the work was "a careful, solid investigation" that does not change his view much overall, adding that it was time to "quit arguing."

"What I care about now is finding the exact variants that infer risk, and understanding how they do so," he said.

SOURCE: http://go.nature.com/29DlL5i

Nature 2016.

October 20-22, 2016
Radisson Blu Aqua Hotel
Chicago, IL

Course Directors
David H. Adams
Steven F. Bolling
Robert O. Bonow
Howard C. Herrmann

Nurse Planner
Michele Mistovich

Course Overview
The American College of Cardiology and the American Association for Thoracic Surgery are again partnering to bring together cardiologists and surgeons in a cooperative, case-based course to address the rapid advances in the treatment of valvular heart disease (VHD).

Focusing on interactivity and practical decision-making, this unique conference will engage participants in discussions, debates and potential controversies using real-world cases. Its renowned faculty will include experts on the cutting edge of clinically relevant VHD data.

The interdisciplinary course emphasizes clinical decision-making with medical, surgical and interventional options for patient care, taking into account that constantly changing management tools can impact the surgical team. There will be breakout sessions for cardiologists, cardiac surgeons, nurses and physician assistants designed to help specialists manage their unique challenges from a team perspective.

Target Audience
Cardiologists, interventional cardiologists, cardiothoracic surgeons, internists, nurses, physician assistants and health care professionals involved in VHD evaluation, diagnosis and/or management.

More Information

Registration/Housing

October 20-22, 2016
Radisson Blu Aqua Hotel
Chicago, IL

Course Directors
David H. Adams
Steven F. Bolling
Robert O. Bonow
Howard C. Herrmann

Nurse Planner
Michele Mistovich

Course Overview
The American College of Cardiology and the American Association for Thoracic Surgery are again partnering to bring together cardiologists and surgeons in a cooperative, case-based course to address the rapid advances in the treatment of valvular heart disease (VHD).

Focusing on interactivity and practical decision-making, this unique conference will engage participants in discussions, debates and potential controversies using real-world cases. Its renowned faculty will include experts on the cutting edge of clinically relevant VHD data.

The interdisciplinary course emphasizes clinical decision-making with medical, surgical and interventional options for patient care, taking into account that constantly changing management tools can impact the surgical team. There will be breakout sessions for cardiologists, cardiac surgeons, nurses and physician assistants designed to help specialists manage their unique challenges from a team perspective.

Target Audience
Cardiologists, interventional cardiologists, cardiothoracic surgeons, internists, nurses, physician assistants and health care professionals involved in VHD evaluation, diagnosis and/or management.

More Information

Registration/Housing

October 20-22, 2016
Radisson Blu Aqua Hotel
Chicago, IL

Course Directors
David H. Adams
Steven F. Bolling
Robert O. Bonow
Howard C. Herrmann

Nurse Planner
Michele Mistovich

Course Overview
The American College of Cardiology and the American Association for Thoracic Surgery are again partnering to bring together cardiologists and surgeons in a cooperative, case-based course to address the rapid advances in the treatment of valvular heart disease (VHD).

Focusing on interactivity and practical decision-making, this unique conference will engage participants in discussions, debates and potential controversies using real-world cases. Its renowned faculty will include experts on the cutting edge of clinically relevant VHD data.

The interdisciplinary course emphasizes clinical decision-making with medical, surgical and interventional options for patient care, taking into account that constantly changing management tools can impact the surgical team. There will be breakout sessions for cardiologists, cardiac surgeons, nurses and physician assistants designed to help specialists manage their unique challenges from a team perspective.

Target Audience
Cardiologists, interventional cardiologists, cardiothoracic surgeons, internists, nurses, physician assistants and health care professionals involved in VHD evaluation, diagnosis and/or management.

More Information

Registration/Housing

October 20-22, 2016
Hyatt Regency O’Hare
Chicago, IL

Program Directors
David H. Harpole, Jr
Marco A. Zenati

This course is an intensive, interactive training program for cardiothoracic surgeons across all subspecialties. It will permit them to acquire the critical skills necessary for effective clinical trial design and implementation. The course is particularly suited for professionals who are planning to apply for clinical trial funding, allowing them to better understand the complex nature of preparing and submitting clinical trial proposals.

Invited faculty includes currently funded clinical trial leading investigators and experts in the field of biostatistics and health sciences research. The program will offer a process in which the clinical trial protocol development can be streamlined. Interactive features will include hands-on focus groups and mock study sessions.

Register Today! Space available for only 40 participants.

Registration/Housing/Preliminary Program

October 20-22, 2016
Hyatt Regency O’Hare
Chicago, IL

Program Directors
David H. Harpole, Jr
Marco A. Zenati

This course is an intensive, interactive training program for cardiothoracic surgeons across all subspecialties. It will permit them to acquire the critical skills necessary for effective clinical trial design and implementation. The course is particularly suited for professionals who are planning to apply for clinical trial funding, allowing them to better understand the complex nature of preparing and submitting clinical trial proposals.

Invited faculty includes currently funded clinical trial leading investigators and experts in the field of biostatistics and health sciences research. The program will offer a process in which the clinical trial protocol development can be streamlined. Interactive features will include hands-on focus groups and mock study sessions.

Register Today! Space available for only 40 participants.

Registration/Housing/Preliminary Program

October 20-22, 2016
Hyatt Regency O’Hare
Chicago, IL

Program Directors
David H. Harpole, Jr
Marco A. Zenati

This course is an intensive, interactive training program for cardiothoracic surgeons across all subspecialties. It will permit them to acquire the critical skills necessary for effective clinical trial design and implementation. The course is particularly suited for professionals who are planning to apply for clinical trial funding, allowing them to better understand the complex nature of preparing and submitting clinical trial proposals.

Invited faculty includes currently funded clinical trial leading investigators and experts in the field of biostatistics and health sciences research. The program will offer a process in which the clinical trial protocol development can be streamlined. Interactive features will include hands-on focus groups and mock study sessions.

Register Today! Space available for only 40 participants.

Registration/Housing/Preliminary Program

SAN DIEGO – Women diagnosed with ovarian cancer waited about 38 days, on average, from the initial concerning imaging test to initiation of treatment, according to a study analyzing health care transit times at a single community hospital.

“Ovarian cancer is such a hard disease to diagnose early,” Christopher J. LaFargue, MD, lead study author, said in an interview at the annual meeting of the Society of Gynecologic Oncology. “Once it’s diagnosed, it’s imperative that women get in to see the gynecologic oncologist [and] make sure their treatment care isn’t lagged for any reason.”

Doug Brunk/Frontline Medical News

In an effort to characterize the length of time between critical points in the care of women with ovarian cancer and determine the impact of patient demographics, Dr. LaFargue and his associates retrospectively evaluated the medical records of 45 women who were diagnosed with ovarian cancer at Long Beach (Calif.) Memorial Medical Center between January 2012 and May 2015.

They examined patient demographics, including preoperative CA-125. Time points of interest were first concerning imaging test, first gynecologic oncology appointment, initiation of treatment, and adjuvant therapy. They used univariate analyses to determine associations between specific patient demographics and the time intervals of interest.

Dr. LaFargue, a resident in the department of obstetrics and gynecology at the University of California, Irvine, reported that the mean age of patients was 61 years, and the mean driving distance to the hospital from the patients’ home was 11 miles. More than half of the patients were white (58%) and 62% of patients were diagnosed with stage III or IV disease. Preoperative CA-125 exceeded 200 U/mL in 62% of patients. Medicare enrollees with supplemental insurance made up less than half of the group (44%).

The researchers found that the average time from initial concerning imaging to start of treatment was about 38 days. The average time from initial imaging to the first office visit with a gynecologic oncologist was about 18 days. The time from that appointment to initial treatment was 19 days, on average. The time from the start of neoadjuvant chemotherapy to interval cytoreductive surgery was 103 days, on average.

The only factor that significantly impacted transit time was a patient’s CA-125 level. Those who had a level of 200 U/mL or greater were more likely to receive surgery or treatment quicker, compared with those who had a CA-125 level less than 200 U/mL. No other statistically significant associations between patient demographics and length of time intervals were observed.

“It would have been nice to have seen a correlation with insurance status,” Dr. LaFargue said. “That’s kind of what we were hoping for, because then you can make an argument with insurance payers that patients who have Medicare aren’t getting treated as quickly as those who have a PPO, for example.”

He acknowledged certain limitations of the study, including its small sample size, lack of outcomes data, and the fact that it was conducted in a community hospital setting.

Dr. LaFargue reported having no financial disclosures.

[email protected]

SAN DIEGO – Women diagnosed with ovarian cancer waited about 38 days, on average, from the initial concerning imaging test to initiation of treatment, according to a study analyzing health care transit times at a single community hospital.

“Ovarian cancer is such a hard disease to diagnose early,” Christopher J. LaFargue, MD, lead study author, said in an interview at the annual meeting of the Society of Gynecologic Oncology. “Once it’s diagnosed, it’s imperative that women get in to see the gynecologic oncologist [and] make sure their treatment care isn’t lagged for any reason.”

Doug Brunk/Frontline Medical News

In an effort to characterize the length of time between critical points in the care of women with ovarian cancer and determine the impact of patient demographics, Dr. LaFargue and his associates retrospectively evaluated the medical records of 45 women who were diagnosed with ovarian cancer at Long Beach (Calif.) Memorial Medical Center between January 2012 and May 2015.

They examined patient demographics, including preoperative CA-125. Time points of interest were first concerning imaging test, first gynecologic oncology appointment, initiation of treatment, and adjuvant therapy. They used univariate analyses to determine associations between specific patient demographics and the time intervals of interest.

Dr. LaFargue, a resident in the department of obstetrics and gynecology at the University of California, Irvine, reported that the mean age of patients was 61 years, and the mean driving distance to the hospital from the patients’ home was 11 miles. More than half of the patients were white (58%) and 62% of patients were diagnosed with stage III or IV disease. Preoperative CA-125 exceeded 200 U/mL in 62% of patients. Medicare enrollees with supplemental insurance made up less than half of the group (44%).

The researchers found that the average time from initial concerning imaging to start of treatment was about 38 days. The average time from initial imaging to the first office visit with a gynecologic oncologist was about 18 days. The time from that appointment to initial treatment was 19 days, on average. The time from the start of neoadjuvant chemotherapy to interval cytoreductive surgery was 103 days, on average.

The only factor that significantly impacted transit time was a patient’s CA-125 level. Those who had a level of 200 U/mL or greater were more likely to receive surgery or treatment quicker, compared with those who had a CA-125 level less than 200 U/mL. No other statistically significant associations between patient demographics and length of time intervals were observed.

“It would have been nice to have seen a correlation with insurance status,” Dr. LaFargue said. “That’s kind of what we were hoping for, because then you can make an argument with insurance payers that patients who have Medicare aren’t getting treated as quickly as those who have a PPO, for example.”

He acknowledged certain limitations of the study, including its small sample size, lack of outcomes data, and the fact that it was conducted in a community hospital setting.

Dr. LaFargue reported having no financial disclosures.

[email protected]

SAN DIEGO – Women diagnosed with ovarian cancer waited about 38 days, on average, from the initial concerning imaging test to initiation of treatment, according to a study analyzing health care transit times at a single community hospital.

“Ovarian cancer is such a hard disease to diagnose early,” Christopher J. LaFargue, MD, lead study author, said in an interview at the annual meeting of the Society of Gynecologic Oncology. “Once it’s diagnosed, it’s imperative that women get in to see the gynecologic oncologist [and] make sure their treatment care isn’t lagged for any reason.”

Doug Brunk/Frontline Medical News

In an effort to characterize the length of time between critical points in the care of women with ovarian cancer and determine the impact of patient demographics, Dr. LaFargue and his associates retrospectively evaluated the medical records of 45 women who were diagnosed with ovarian cancer at Long Beach (Calif.) Memorial Medical Center between January 2012 and May 2015.

They examined patient demographics, including preoperative CA-125. Time points of interest were first concerning imaging test, first gynecologic oncology appointment, initiation of treatment, and adjuvant therapy. They used univariate analyses to determine associations between specific patient demographics and the time intervals of interest.

Dr. LaFargue, a resident in the department of obstetrics and gynecology at the University of California, Irvine, reported that the mean age of patients was 61 years, and the mean driving distance to the hospital from the patients’ home was 11 miles. More than half of the patients were white (58%) and 62% of patients were diagnosed with stage III or IV disease. Preoperative CA-125 exceeded 200 U/mL in 62% of patients. Medicare enrollees with supplemental insurance made up less than half of the group (44%).

The researchers found that the average time from initial concerning imaging to start of treatment was about 38 days. The average time from initial imaging to the first office visit with a gynecologic oncologist was about 18 days. The time from that appointment to initial treatment was 19 days, on average. The time from the start of neoadjuvant chemotherapy to interval cytoreductive surgery was 103 days, on average.

The only factor that significantly impacted transit time was a patient’s CA-125 level. Those who had a level of 200 U/mL or greater were more likely to receive surgery or treatment quicker, compared with those who had a CA-125 level less than 200 U/mL. No other statistically significant associations between patient demographics and length of time intervals were observed.

“It would have been nice to have seen a correlation with insurance status,” Dr. LaFargue said. “That’s kind of what we were hoping for, because then you can make an argument with insurance payers that patients who have Medicare aren’t getting treated as quickly as those who have a PPO, for example.”

He acknowledged certain limitations of the study, including its small sample size, lack of outcomes data, and the fact that it was conducted in a community hospital setting.

Dr. LaFargue reported having no financial disclosures.

[email protected]

Medicaid status did not significantly affect costs for children who were hospitalized because of asthma, according to Jeffrey H. Silber, MD, and his associates.

In a study of 17,739 matched pairs of children with and without Medicaid who were hospitalized because of asthma, the median cost for Medicaid patients was $4,263; for non-Medicaid patients, it was $4,160. The median difference in cost between Medicaid and non-Medicaid patients was $84, and the mean difference in cost was $49.

Both Medicaid and non-Medicaid patients had similar lengths of stay, with a median of 1 day for both groups. Intensive care unit use was similar, with 10.1% of Medicaid patients visiting the ICU, compared with 10.6% of non-Medicaid patients.

“Our study should serve to provide potential benchmarks for use and reimbursement standards, with implications for care and payment even when children are hospitalized outside the [Pediatric Hospital Information System],” the investigators wrote.

Find the full study in Pediatrics (doi: 10.1542/peds.2016-0371).

[email protected]

Medicaid status did not significantly affect costs for children who were hospitalized because of asthma, according to Jeffrey H. Silber, MD, and his associates.

In a study of 17,739 matched pairs of children with and without Medicaid who were hospitalized because of asthma, the median cost for Medicaid patients was $4,263; for non-Medicaid patients, it was $4,160. The median difference in cost between Medicaid and non-Medicaid patients was $84, and the mean difference in cost was $49.

Both Medicaid and non-Medicaid patients had similar lengths of stay, with a median of 1 day for both groups. Intensive care unit use was similar, with 10.1% of Medicaid patients visiting the ICU, compared with 10.6% of non-Medicaid patients.

“Our study should serve to provide potential benchmarks for use and reimbursement standards, with implications for care and payment even when children are hospitalized outside the [Pediatric Hospital Information System],” the investigators wrote.

Find the full study in Pediatrics (doi: 10.1542/peds.2016-0371).

[email protected]

Medicaid status did not significantly affect costs for children who were hospitalized because of asthma, according to Jeffrey H. Silber, MD, and his associates.

In a study of 17,739 matched pairs of children with and without Medicaid who were hospitalized because of asthma, the median cost for Medicaid patients was $4,263; for non-Medicaid patients, it was $4,160. The median difference in cost between Medicaid and non-Medicaid patients was $84, and the mean difference in cost was $49.

Both Medicaid and non-Medicaid patients had similar lengths of stay, with a median of 1 day for both groups. Intensive care unit use was similar, with 10.1% of Medicaid patients visiting the ICU, compared with 10.6% of non-Medicaid patients.

“Our study should serve to provide potential benchmarks for use and reimbursement standards, with implications for care and payment even when children are hospitalized outside the [Pediatric Hospital Information System],” the investigators wrote.

Find the full study in Pediatrics (doi: 10.1542/peds.2016-0371).

[email protected]

Subtotal fenestrating cholecystectomy with drain placement appears optimal, compared with the reconstituting procedure, for experienced surgeons seeking a “bailout” operation in both open and minimally invasive cholecystectomy where the critical view of safety (CVS) is not easily attainable, according to a report written on behalf of the SAGES Safe Cholecystectomy Task Force 2015.

The rise in laparoscopic cholecystectomy has been associated with an increase in the rate of bile duct injury, most commonly when secure ductal identification using CVS is not possible because of an inflamed hepatocystic triangle occluding the cystic duct, cystic artery, and cystic plate. In such cases, a safe and effective bailout technique (one not requiring a second operation) must be decided upon in preference to simply closing and proceeding to a later open procedure, according to Steven M. Strasberg, MD, of Washington University in Saint Louis and his colleagues (J Am Coll Surg. 2016;222:89-96).

In order to clarify the two most common and effective “partial cholecystectomy” procedures being performed, Dr. Strasburg and his colleagues have suggested the use of the term “subtotal” in place of “partial” and the terms “fenestrating” vs. “reconstituting,” to define whether there is an open or closed gallbladder remnant, respectively, after the procedure.

In subtotal fenestrating cholecystectomy, the free peritonealized portion of the gallbladder is excised, except for a tip at the lowest portion that acts as a shield to protect against inadvertently entering the hepatocystic triangle, according to the authors. There is no sealed lumen remaining, thus the cystic duct requires closure. The cystic duct may be closed from the inside with a purse-string suture. Attempts to ligate the cystic duct outside the gallbladder may injure the common bile duct and can potentially result in fistulas.

In subtotal reconstituting cholecystectomy, the free peritonealized portion of the gallbladder is excised, but the lowest portion of the gallbladder is closed with sutures or staples and reconstitutes an intact lumen in which stones may be re-formed, which can in turn require reoperation.

“Whether the subtotal cholecystectomy is ‘fenestrating’ or ‘reconstituting’ depends on whether the lowest part of the gallbladder is left open (fenestrating) or closed (reconstituting) and not on the amount of gallbladder that is left attached to the liver,” according to the authors.

Subtotal fenestrating cholecystectomy is most likely done when an open approach is used, whereas subtotal reconstituting cholecystectomies are probably easier to do laparoscopically and are preferred by surgeons doing minimally invasive procedures, they said.

Despite the fact that there have been no head-to-head comparisons of fenestrating vs. reconstituting techniques, the authors said they prefer the fenestrating method, although the technique chosen may be based on the experience of the surgeon, they noted.

“The principle is that a subtotal fenestrating cholecystectomy is a standard operation that should be used liberally when surgeons encounter difficulty getting to the CVS,” the authors wrote. “We believe that clarification of the procedures and what they are called will help to choose which type of procedure to select, and it will also facilitate the performance of clinical studies in this area,“ they concluded.

The authors reported having no relevant financial disclosures.

A transcript of an interactive discussion of this paper and topic is available online (www.journalacs.org/RAS-ACS-discussion-2016).

[email protected]

Subtotal fenestrating cholecystectomy with drain placement appears optimal, compared with the reconstituting procedure, for experienced surgeons seeking a “bailout” operation in both open and minimally invasive cholecystectomy where the critical view of safety (CVS) is not easily attainable, according to a report written on behalf of the SAGES Safe Cholecystectomy Task Force 2015.

The rise in laparoscopic cholecystectomy has been associated with an increase in the rate of bile duct injury, most commonly when secure ductal identification using CVS is not possible because of an inflamed hepatocystic triangle occluding the cystic duct, cystic artery, and cystic plate. In such cases, a safe and effective bailout technique (one not requiring a second operation) must be decided upon in preference to simply closing and proceeding to a later open procedure, according to Steven M. Strasberg, MD, of Washington University in Saint Louis and his colleagues (J Am Coll Surg. 2016;222:89-96).

In order to clarify the two most common and effective “partial cholecystectomy” procedures being performed, Dr. Strasburg and his colleagues have suggested the use of the term “subtotal” in place of “partial” and the terms “fenestrating” vs. “reconstituting,” to define whether there is an open or closed gallbladder remnant, respectively, after the procedure.

In subtotal fenestrating cholecystectomy, the free peritonealized portion of the gallbladder is excised, except for a tip at the lowest portion that acts as a shield to protect against inadvertently entering the hepatocystic triangle, according to the authors. There is no sealed lumen remaining, thus the cystic duct requires closure. The cystic duct may be closed from the inside with a purse-string suture. Attempts to ligate the cystic duct outside the gallbladder may injure the common bile duct and can potentially result in fistulas.

In subtotal reconstituting cholecystectomy, the free peritonealized portion of the gallbladder is excised, but the lowest portion of the gallbladder is closed with sutures or staples and reconstitutes an intact lumen in which stones may be re-formed, which can in turn require reoperation.

“Whether the subtotal cholecystectomy is ‘fenestrating’ or ‘reconstituting’ depends on whether the lowest part of the gallbladder is left open (fenestrating) or closed (reconstituting) and not on the amount of gallbladder that is left attached to the liver,” according to the authors.

Subtotal fenestrating cholecystectomy is most likely done when an open approach is used, whereas subtotal reconstituting cholecystectomies are probably easier to do laparoscopically and are preferred by surgeons doing minimally invasive procedures, they said.

Despite the fact that there have been no head-to-head comparisons of fenestrating vs. reconstituting techniques, the authors said they prefer the fenestrating method, although the technique chosen may be based on the experience of the surgeon, they noted.

“The principle is that a subtotal fenestrating cholecystectomy is a standard operation that should be used liberally when surgeons encounter difficulty getting to the CVS,” the authors wrote. “We believe that clarification of the procedures and what they are called will help to choose which type of procedure to select, and it will also facilitate the performance of clinical studies in this area,“ they concluded.

The authors reported having no relevant financial disclosures.

A transcript of an interactive discussion of this paper and topic is available online (www.journalacs.org/RAS-ACS-discussion-2016).

[email protected]

Subtotal fenestrating cholecystectomy with drain placement appears optimal, compared with the reconstituting procedure, for experienced surgeons seeking a “bailout” operation in both open and minimally invasive cholecystectomy where the critical view of safety (CVS) is not easily attainable, according to a report written on behalf of the SAGES Safe Cholecystectomy Task Force 2015.

The rise in laparoscopic cholecystectomy has been associated with an increase in the rate of bile duct injury, most commonly when secure ductal identification using CVS is not possible because of an inflamed hepatocystic triangle occluding the cystic duct, cystic artery, and cystic plate. In such cases, a safe and effective bailout technique (one not requiring a second operation) must be decided upon in preference to simply closing and proceeding to a later open procedure, according to Steven M. Strasberg, MD, of Washington University in Saint Louis and his colleagues (J Am Coll Surg. 2016;222:89-96).

In order to clarify the two most common and effective “partial cholecystectomy” procedures being performed, Dr. Strasburg and his colleagues have suggested the use of the term “subtotal” in place of “partial” and the terms “fenestrating” vs. “reconstituting,” to define whether there is an open or closed gallbladder remnant, respectively, after the procedure.

In subtotal fenestrating cholecystectomy, the free peritonealized portion of the gallbladder is excised, except for a tip at the lowest portion that acts as a shield to protect against inadvertently entering the hepatocystic triangle, according to the authors. There is no sealed lumen remaining, thus the cystic duct requires closure. The cystic duct may be closed from the inside with a purse-string suture. Attempts to ligate the cystic duct outside the gallbladder may injure the common bile duct and can potentially result in fistulas.

In subtotal reconstituting cholecystectomy, the free peritonealized portion of the gallbladder is excised, but the lowest portion of the gallbladder is closed with sutures or staples and reconstitutes an intact lumen in which stones may be re-formed, which can in turn require reoperation.

“Whether the subtotal cholecystectomy is ‘fenestrating’ or ‘reconstituting’ depends on whether the lowest part of the gallbladder is left open (fenestrating) or closed (reconstituting) and not on the amount of gallbladder that is left attached to the liver,” according to the authors.

Subtotal fenestrating cholecystectomy is most likely done when an open approach is used, whereas subtotal reconstituting cholecystectomies are probably easier to do laparoscopically and are preferred by surgeons doing minimally invasive procedures, they said.

Despite the fact that there have been no head-to-head comparisons of fenestrating vs. reconstituting techniques, the authors said they prefer the fenestrating method, although the technique chosen may be based on the experience of the surgeon, they noted.

“The principle is that a subtotal fenestrating cholecystectomy is a standard operation that should be used liberally when surgeons encounter difficulty getting to the CVS,” the authors wrote. “We believe that clarification of the procedures and what they are called will help to choose which type of procedure to select, and it will also facilitate the performance of clinical studies in this area,“ they concluded.

The authors reported having no relevant financial disclosures.

A transcript of an interactive discussion of this paper and topic is available online (www.journalacs.org/RAS-ACS-discussion-2016).

[email protected]

Complementary and alternative medicine has a definite adjunctive and even at times primary role in the medical management of patients. Its prevalence in the United States is estimated to be 38% and it is used to treat dermatologic conditions in 6% of patients (Harris et al; Smith et al). Acupuncture, a component of traditional Chinese medicine, has a prevalence of 0.6% to 1.4% and is used to treat 0.6% of dermatologic conditions (Smith et al; Cooper et al).

Acupuncture involves stimulation of specific points usually located along meridians. The source of stimulation on the skin can be elicited using needle points, pressure, or heat. Diseases disturb the body’s vital energy (qi), and stimulation along the appropriate meridian channel achieves balance and cures disease by restoring the normal circulation of the body’s qi.

Ma and Sivamani (J Altern Complement Med. 2015;21:520-529) performed a systematic review of articles indexed for MEDLINE, EMBASE, and the Cochrane Central Register using acupuncture therapy or acupuncture and skin diseases or dermatology as search terms to synthesize the evidence on the use of acupuncture as a primary treatment modality for dermatologic conditions. Twenty-four studies met inclusion criteria; of them, 17 showed statistically significant improvements (P<.05) in outcome measures. Specifically, acupuncture improved the outcome measures in the treatment of several dermatologic conditions including chloasma, dermatitis, facial elasticity, hyperhidrosis, pruritus, and urticaria.

What’s the issue?

Patients often have insight into potential available therapies for their medical problems. Hence, it is not unexpected that individuals with dermatologic conditions may not only be aware of complementary and alternative medicine approaches, such as acupuncture, but also seek dermatologists who can provide them with these possible therapeutic options. Although the frequency and duration of acupuncture treatments may not allow it to be a practical modality for all individuals, this treatment appears to be effective for reducing the severity of itch in patients with atopic dermatitis.

Should dermatologists incorporate acupuncture into their therapeutic armamentarium? Should national dermatology meetings provide courses on acupuncture technique? Should dermatology residency programs add competency in acupuncture management to their curriculum?

We want to know your views! Tell us what you think.

Complementary and alternative medicine has a definite adjunctive and even at times primary role in the medical management of patients. Its prevalence in the United States is estimated to be 38% and it is used to treat dermatologic conditions in 6% of patients (Harris et al; Smith et al). Acupuncture, a component of traditional Chinese medicine, has a prevalence of 0.6% to 1.4% and is used to treat 0.6% of dermatologic conditions (Smith et al; Cooper et al).

Acupuncture involves stimulation of specific points usually located along meridians. The source of stimulation on the skin can be elicited using needle points, pressure, or heat. Diseases disturb the body’s vital energy (qi), and stimulation along the appropriate meridian channel achieves balance and cures disease by restoring the normal circulation of the body’s qi.

Ma and Sivamani (J Altern Complement Med. 2015;21:520-529) performed a systematic review of articles indexed for MEDLINE, EMBASE, and the Cochrane Central Register using acupuncture therapy or acupuncture and skin diseases or dermatology as search terms to synthesize the evidence on the use of acupuncture as a primary treatment modality for dermatologic conditions. Twenty-four studies met inclusion criteria; of them, 17 showed statistically significant improvements (P<.05) in outcome measures. Specifically, acupuncture improved the outcome measures in the treatment of several dermatologic conditions including chloasma, dermatitis, facial elasticity, hyperhidrosis, pruritus, and urticaria.

What’s the issue?

Patients often have insight into potential available therapies for their medical problems. Hence, it is not unexpected that individuals with dermatologic conditions may not only be aware of complementary and alternative medicine approaches, such as acupuncture, but also seek dermatologists who can provide them with these possible therapeutic options. Although the frequency and duration of acupuncture treatments may not allow it to be a practical modality for all individuals, this treatment appears to be effective for reducing the severity of itch in patients with atopic dermatitis.

Should dermatologists incorporate acupuncture into their therapeutic armamentarium? Should national dermatology meetings provide courses on acupuncture technique? Should dermatology residency programs add competency in acupuncture management to their curriculum?

We want to know your views! Tell us what you think.

Complementary and alternative medicine has a definite adjunctive and even at times primary role in the medical management of patients. Its prevalence in the United States is estimated to be 38% and it is used to treat dermatologic conditions in 6% of patients (Harris et al; Smith et al). Acupuncture, a component of traditional Chinese medicine, has a prevalence of 0.6% to 1.4% and is used to treat 0.6% of dermatologic conditions (Smith et al; Cooper et al).

Acupuncture involves stimulation of specific points usually located along meridians. The source of stimulation on the skin can be elicited using needle points, pressure, or heat. Diseases disturb the body’s vital energy (qi), and stimulation along the appropriate meridian channel achieves balance and cures disease by restoring the normal circulation of the body’s qi.

Ma and Sivamani (J Altern Complement Med. 2015;21:520-529) performed a systematic review of articles indexed for MEDLINE, EMBASE, and the Cochrane Central Register using acupuncture therapy or acupuncture and skin diseases or dermatology as search terms to synthesize the evidence on the use of acupuncture as a primary treatment modality for dermatologic conditions. Twenty-four studies met inclusion criteria; of them, 17 showed statistically significant improvements (P<.05) in outcome measures. Specifically, acupuncture improved the outcome measures in the treatment of several dermatologic conditions including chloasma, dermatitis, facial elasticity, hyperhidrosis, pruritus, and urticaria.

What’s the issue?

Patients often have insight into potential available therapies for their medical problems. Hence, it is not unexpected that individuals with dermatologic conditions may not only be aware of complementary and alternative medicine approaches, such as acupuncture, but also seek dermatologists who can provide them with these possible therapeutic options. Although the frequency and duration of acupuncture treatments may not allow it to be a practical modality for all individuals, this treatment appears to be effective for reducing the severity of itch in patients with atopic dermatitis.

Should dermatologists incorporate acupuncture into their therapeutic armamentarium? Should national dermatology meetings provide courses on acupuncture technique? Should dermatology residency programs add competency in acupuncture management to their curriculum?

We want to know your views! Tell us what you think.