Mammograms may be missing some breast cancers, study shows
Adjunct Screening With Tomosynthesis or Ultrasound in Women With Mammography-Negative Dense Breasts: Interim Report of a Prospective Comparative Trial, American Society of Clinical Oncology, doi: 10.1200/JCO.2015.63.4147, March 9, 2016.
Debate on adjunct screening in women with dense breasts has followed legislation requiring that women be informed about their mammographic density and related adjunct imaging. Ultrasound or tomosynthesis can detect breast cancer (BC) in mammography-negative dense breasts, but these modalities have not been directly compared in prospective trials. We conducted a trial of adjunct screening to compare, within the same participants, incremental BC detection by tomosynthesis and ultrasound in mammography-negative dense breasts.
Patients and Methods
Adjunct Screening With Tomosynthesis or Ultrasound in Women With Mammography-Negative Dense Breasts is a prospective multicenter study recruiting asymptomatic women with mammography-negative screens and dense breasts. Eligible women had tomosynthesis and physician-performed ultrasound with independent interpretation of adjunct imaging. Outcome measures included cancer detection rate (CDR), number of false-positive (FP) recalls, and incremental CDR for each modality; these were compared using McNemar’s test for paired binary data in a preplanned interim analysis.
Among 3,231 mammography-negative screening participants (median age, 51 years; interquartile range, 44 to 78 years) with dense breasts, 24 additional BCs were detected (23 invasive): 13 tomosynthesis-detected BCs (incremental CDR, 4.0 per 1,000 screens; 95% CI, 1.8 to 6.2) versus 23 ultrasound-detected BCs (incremental CDR, 7.1 per 1,000 screens; 95% CI, 4.2 to 10.0), P = .006. Incremental FP recall occurred in 107 participants (3.33%; 95% CI, 2.72% to 3.96%). FP recall (any testing) did not differ between tomosynthesis (FP = 53) and ultrasound (FP = 65), P = .26; FP recall (biopsy) also did not differ between tomosynthesis (FP = 22) and ultrasound (FP = 24), P = .86.
Mammograms may be missing some breast cancers, study shows, theguardian, 9 March 2016.
The Adjunct Screening With Tomosynthesis or Ultrasound in Women With Mammography-Negative Dense Breasts’ interim analysis shows that ultrasound has better incremental BC detection than tomosynthesis in mammography-negative dense breasts at a similar FP-recall rate. However, future application of adjunct screening should consider that tomosynthesis detected more than 50% of the additional BCs in these women and could potentially be the primary screening modality.
Privacy Policies of Android Diabetes Apps and Sharing of Health Information
Privacy Policies of Android Diabetes Apps and Sharing of Health Information, JAMA. 2016;315(10):1051-1052. doi:10.1001/jama.2015.19426, March 8, 2016.
This march 2016 study examines the privacy risks and the relationship between privacy disclosures and practices of health apps.
Mobile health apps can help individuals manage chronic health conditions. One-fifth of smartphone owners had health apps in 2012, and 7% of primary care physicians recommended a health app. The US Food and Drug Administration has approved the prescription of some apps.
Health Apps May Share Your Data, Study Finds, livescience, March 08, 2016.
Health apps can transmit sensitive medical data, including disease status and medication compliance. Privacy risks and the relationship between privacy disclosures and practices of health apps are understudied.
Once sensitive medical information is leaked, then the consumer has totally lost control over it and they can never take it back
Worldwide, women continue to contribute to social, economic, cultural and political achievement.
And we have much to celebrate today. But progress towards gender parity has slowed in many places.
The World Economic Forum predicted in 2014 that it would take until 2095 to achieve global gender parity. Then one year later in 2015, they estimated that a slowdown in the already glacial pace of progress meant the gender gap wouldn’t close entirely until 2133.
Bruxelles fait face à des critiques de plus en plus fortes pour son laxisme dans la régulation des substances toxiques
C’est une nouvelle pièce à charge dans le lourd dossier des pesticides. Dans une décision datée du 18 février, le médiateur européen recadre sèchement la Commission de Bruxelles, pour son laxisme en matière d’autorisation de mise sur le marché des produits phytosanitaires. Elle lui fixe un délai de deux ans pour remettre un rapport sur la mise en place de nouvelles pratiques.
En savoir plus
Pesticides : le laxisme de l’Europe épinglé, Le Monde, 2016/02/22.
Big drop in chemical levels in teen girls who switched to safer cosmetics
Reducing Phthalate, Paraben, and Phenol Exposure from Personal Care Products in Adolescent Girls: Findings from the HERMOSA Intervention Study, Environ Health Perspectives; DOI:10.1289/ehp.1510514, 7 March 2016.
Personal care products are a source of exposure to potentially endocrine disrupting chemicals such as phthalates, parabens, triclosan, and benzophenone-3 (BP-3) for adolescent girls.
We enrolled 100 Latina girls in a youth-led, community-based participatory research intervention study to determine whether using personal care products whose labels stated they did not contain these chemicals for three days could lower urinary concentrations. Pre- and post-intervention urine samples were analyzed for phthalate metabolites, parabens, triclosan and BP-3 using high-performance liquid chromatography/tandem mass spectrometry.
Teen girls see big drop in chemical exposure with switch in cosmetics, news.berkeley.edu, 7 March 2016.
Urinary concentrations of mono-ethyl phthalate (MEP) decreased by 27.4% (95% Confidence Interval (CI): -39.3, -13.2) on average over the 3 day intervention; no significant changes were seen in urinary concentrations of mono-n-butyl phthalate (MnBP) and mono-isobutyl phthalate (MiBP). Methyl and propyl paraben concentrations decreased by 43.9% (95% CI: -61.3, -18.8) and 45.4% (95% CI: -63.7, -17.9), respectively. Unexpectedly, concentrations of ethyl and butyl paraben concentrations increased, although concentrations were low overall and not detected in almost half the samples. Triclosan concentrations decreased by 35.7% (95% CI: -53.3, -11.6) and BP-3 concentrations decreased by 36.0% (95% CI: -51.0, -16.4).
Study Links Cosmetics Use to Altered Body Chemistry, fairwarning, 7 March 2016.
This study demonstrates that techniques available to consumers, such as choosing personal care products that are labelled to be free of phthalates, parabens, triclosan, and BP-3, can reduce personal exposure to possible endocrine disrupting chemicals. Involving youth in the design and implementation of the study was key to recruitment, retention, compliance, and acceptability of the intervention.
Provision of social norm feedback to high prescribers of antibiotics in general practice: a pragmatic national randomised controlled trial
Provision of social norm feedback to high prescribers of antibiotics in general practice: a pragmatic national randomised controlled trial, thelancet, doi.org/10.1016/S0140-6736(16)00215-4, 18 February 2016.
A trial involving over 1,500 GP practices found that writing to GPs about their antibiotics prescribing resulted in 73,000 fewer prescriptions (a 3.3% reduction) over 6 months. This equates to direct savings of over £92,000 in prescription costs.
The trial was a collaboration between Chief Medical Officer Dame Sally Davies, Public Health England, and the Behavioural Insights Team.
We know that drug resistant infections are one of the biggest health threats we face. This innovative trial has shown effective and low cost ways to reduce unnecessary prescribing of antibiotics which is essential if we are to preserve these precious medicines and help to save modern medicine as we know it.
Professor Dame Sally Davies said.
There were 2 groups involved in the trial, GPs and patients. GPs were sent a letter saying ‘80% of practices in your local area prescribe fewer antibiotics per head than yours’, and were provided with 3 ways to make sure any antibiotics prescriptions were necessary.
Patients were targeted with leaflets and posters about why reducing the use of antibiotics is important.
GPs who received the letter reduced their rate of antibiotic prescriptions to 127 per 1,000 compared to 131 per 1,000 by GPs who did not receive the letter. There was no significant difference in the rate of antibiotics prescriptions in the patient targeted group.
Direct Effects of Low-to-Moderate CO2 Concentrations on Human Decision-Making Performance
Associations of Cognitive Function Scores with Carbon Dioxide, Ventilation, and Volatile Organic Compound Exposures in Office Workers: A Controlled Exposure Study of Green and Conventional Office Environments, EHP DOI:10.1289/ehp.1510037, October 2015.
The indoor built environment plays a critical role in our overall well-being, both due to the amount of time we spend indoors (~90%) and the ability of buildings to positively or negatively influence our health. The advent of sustainable design or green building strategies reinvigorated questions regarding the specific factors in buildings that lead to optimized conditions for health and productivity.
To simulate indoor environmental quality (IEQ) conditions in “Green” and “Conventional” buildings and evaluate the impacts on an objective measure of human performance – higher order cognitive function.
Twenty-four (24) participants spent 6 full work days (9 a.m. – 5 p.m.) in an environmentally controlled office space, blinded to test conditions. On different days, they were exposed to IEQ conditions representative of Conventional (high volatile organic compound (VOC) concentration) and Green (low VOC concentration) office buildings in the U.S.
Additional conditions simulated a Green building with a high outdoor air ventilation rate (labeled Green+) and artificially elevated carbon dioxide (CO2) levels independent of ventilation.
What scientists are discovering about the air you breathe indoors, washingtonpost, February 29 2016.
On average, cognitive scores were 61% higher on the Green building day and 101% higher on the two Green+ building days than on the Conventional building day (p<0.0001).
VOCs and CO2 were independently associated with cognitive scores.
Conclusions: Cognitive function scores were significantly better in Green+ building conditions compared to the Conventional building conditions for all nine functional domains. These findings have wide ranging implications because this study was designed to reflect conditions that are commonly encountered every day in many indoor environments.
Economic, Environmental and Health Implications of Enhanced Ventilation in Office Buildings, mdpi, 2015
The health benefits associated with enhanced ventilation rates far exceed the per-person energy costs relative to salary costs. Environmental impacts can be mitigated at regional, building, and individual-level scales through the transition to renewable energy sources, adoption of energy efficient systems and ventilation strategies, and promotion of other sustainable policies.