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Leading Authority On Alzheimer's Disease To Present At Community Lecture
Jason Karlawish, M.D., associate professor of medicine, University of Pennsylvania, will share the latest information on Alzheimer"s disease at a community lecture at 1 p.m., Wednesday, June 10 at Rodef Shalom Congregation, 4905 Fifth Ave., Shadyside. The event is free and open to the public.
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A New Take On Growth Factor Signaling In Tamoxifen Resistance
Differences in growth factor (GF) signaling may cause the poor prognosis in some breast cancer cases. A new study, published in the open access journal BMC Medical Genomics, suggests that some estrogen receptor-positive breast cancers respond poorly to tamoxifen because of increased GF signaling.
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N.C. Bill Gives Students 'Vital Access' To Accurate Sex Education Instruction, Editorial States
A bill (S. 221) approved by the North Carolina Legislature that would require a public school sex education curriculum covering abstinence, contraception and sexually transmitted infections "will be the most comprehensive and science-based approach the state has used" for sex education, a Charlotte Observer editorial states, adding that Gov. Bev Perdue (D) "should sign it." The bill would require all public school districts in the state to teach a curriculum that focuses on abstinence but also includes information on preventing pregnancy and STIs. Parents would be able to have their children removed from the comprehensive portions of instruction. According to the editorial, the measure "still gives parents a choice in deciding what kind of sex education their children will receive." The editorial adds, "It also finally provides a curriculum that gives N.C. students vital access to age-appropriate, science-based information critical to their health, safety and well-being," which is "the kind of information that can help them make smart choices in serious situations."Parents are "often the best people for kids to turn to for advice and information" on sex, but "not all children have parents who can provide it, or are even willing to," and "not all children [who] go to their parents adhere to their advice," the editorial states. It continues, "The schools provide another avenue to get this critical advice and information -- and state lawmakers are right to make it available." According to the Observer, North Carolina has the ninth-highest teenage pregnancy rate in the U.S., and about "20,000 teenagers will get pregnant in North Carolina this year." A "comprehensive, science-based education program can help reduce the number of unintended teen pregnancies" and help reduce the spread of STIs, the editorial says. It concludes, "By reaching agreement on this matter, state lawmakers have given the children of this state vital tools to safeguard their health and welfare. ... Perdue should sign this bill and make it law" (Charlotte Observer, 6/26).
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Newer, Minimally Invasive Surgical Procedure For Treatment Of Sciatica Does Not Result In Better Outcomes

A comparison of surgical treatments for sciatica finds that the minimally invasive procedure known as tubular diskectomy does not provide a significant difference in improvement of functional disability compared to the more common surgery, conventional microdiskectomy, according to a study in the July 8 issue of JAMA. Sciatica or lumbosacral radicular syndrome affects millions of individuals worldwide and is typically caused by disk herniation. Surgery is offered to patients with persistent pain that is not responding to conservative treatment, with the common surgical procedure being microdiskectomy (removal of injured disk tissue and pieces). The minimally invasive technique of transmuscular tubular diskectomy was introduced in 1997. "The rationale behind replacing the conventional subperiosteal muscle dissection by the muscle-splitting transmuscular approach of tubular diskectomy is less tissue damage, resulting in a faster rate of recovery but with similar long-term outcomes. Patients are expected to have reduced postoperative back pain, thus allowing quicker mobilization and contributing to shorter hospitalization and faster resumption of work and daily activities," the authors write. Although this procedure was introduced to increase the rate of recovery, there is a lack of evidence, according to background information in the article. Mark P. Arts, M.D., of the Medical Center Haaglanden, the Hague, the Netherlands, and colleagues conducted a multicenter trial to determine the outcomes and time to recovery in patients with lumbar disk herniation treated with tubular diskectomy or conventional microdiskectomy. The study included 328 patients age 18 to 70 years who had persistent leg pain (greater than 8 weeks) due to lumbar disk herniations. Patients were randomized to either tubular diskectomy (n = 167) or conventional microdiskectomy (n = 161). Functional ability, pain and self-report of recovery were measured via a questionnaire or surveys. The researchers found: "The expected treatment benefit of a faster rate of recovery from sciatica after tubular diskectomy could not be reproduced by this double-blind study. This study revealed evidence that the rates of recovery for the minimally invasive tubular diskectomy and conventional microdiskectomy were similar. In contrast, the overall differences in pain intensity and recovery rates favored the conventional microdiskectomy approach." At 1 year, 107 of 156 patients (69 percent) assigned to tubular diskectomy reported a good recovery vs. 120 of 151 patients (79 percent) assigned to conventional microdiskectomy. "Although the minimally invasive technique of tubular diskectomy seemed to be an attractive surgical method for treating sciatica, our data do not support a higher rate of recovery when compared with conventional microdiskectomy. On the contrary, patients who underwent tubular diskectomy fared worse with regard to leg and back pain and fewer patients reported complete recovery at 1 year," the authors conclude. JAMA. 2009;302[2]:149-158. Journal of the American Medical Association


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