Tag Archives: Guidelines

U.S. doctors in training to work longer hours under new guidelines

U.S. doctors in training to work longer hours under new guidelinesBeginning July 1, doctors in their first year of training after medical school may once again care for patients for up to 24 hours at a time and work a total of 80 hours per week, the Accreditation Council for Graduate Medical Education (ACGME) announced on Friday. In 2011, the group restricted these first-year residents to 16 hours at a stretch over concerns that patient care could suffer if trainees were overly tired. Opponents at the time argued the restrictions did not protect patients and limited educational opportunities for trainees.



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Trump administration working on trans bathroom guidelines

Trump administration working on trans bathroom guidelinesWASHINGTON (AP) — The Trump administration is working on a new set of directives on the use of school bathrooms by transgender students, the White House said Tuesday.



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New Homeland Security guidelines aggressively crack down on illegal immigration

New Homeland Security guidelines aggressively crack down on illegal immigrationUnder the new guidelines, outlined in a pair of memos, the agency plans to hire thousands of additional enforcement agents, expand the pool of immigrants who are prioritized for removal, enlist local law enforcement to help make arrests, and speed up deportation hearings – directives that would replace nearly all guidelines put in place by previous administrations. Since taking office in January, President Trump has come under fire for what immigrant rights advocates have denounced as unprecedented action against undocumented people in the United States.



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New Guidelines Say Radiation Can Lower Risk of Breast Cancer Recurrence After a Mastectomy

WEDNESDAY, Sept. 21, 2016 (HealthDay News)—New guidelines issued by three leading cancer organizations suggest that more breast cancer patients should consider radiation therapy after a mastectomy.

Overall, the guidelines say there’s enough evidence to show radiation treatment after a mastectomy decreases the risk of breast cancer recurrence, and that even women with smaller tumors and three or fewer lymph nodes involved can benefit from the therapy.

“The new guidelines say there is clear evidence that the benefit of [post-mastectomy radiation therapy] extends to women with limited lymph node involvement,” said Dr. Stephen Edge. He is vice president for health care outcomes and policy at Roswell Park Cancer Institute in Buffalo, N.Y. Edge was co-chair of the panel that developed the new guidelines.

One radiation treatment expert welcomed the updated recommendations.

“The guideline is timely,” said Dr. Janna Andrews, an attending physician in radiation medicine at Norwell Health Cancer Institute, in Lake Success, N.Y. “The field of post-mastectomy radiation is changing. It’s always up for discussion now as to who needs [post-mastectomy radiation therapy].”

The new guidelines help clarify what used to be a gray area, Andrews explained. “In the past, if a woman had a small tumor, less than 5 centimeters, and not more than three or four positive lymph nodes, many doctors would say she does not need [post-mastectomy radiation therapy],” she said.

The guidelines don’t offer a single formula for which patients need radiation therapy, Edge noted. But they do focus on the group of women for whom there is the most debate about the value of radiation.

“There is a great deal of controversy about whether women with one, two or three lymph nodes [with cancer] have sufficient risk to warrant radiation,” he said. “For women with four or more lymph nodes involved, everyone would recommend radiation.”

The guidelines also strongly support input from all specialists who treat breast cancer in making the decision about radiation treatment. That typically includes the surgeon, radiation physician and an oncologist.

Doctors need to weigh the risks and benefits, Edge added. Side effects can include redness of the skin, swelling and skin breakdown severe enough to compromise future breast reconstruction, he explained.

Edge said that doctors need to consider patients individually. For instance, he explained, ”a woman 65 who has microscopic involvement in a single lymph node and an estrogen-receptor positive cancer would be very different from a 38-year-old who has three lymph nodes involved and so-called triple-negative breast cancer.” The younger woman, he said, would typically be advised to get radiation.

The older woman, because her risk is lower, should have a discussion with her doctor to decide if the benefit outweighs the risk, Edge noted.

Andrews said that one take-home message for patients is to expect the surgeon to have consulted with the radiation oncologist and others on her team. If a woman’s doctor tells her she does not need radiation after a mastectomy, the woman should be told why and she should ask if the radiation oncologist weighed in on the decision.

Edge was a panel representative from the American Society of Clinical Oncology, which created the guidelines along with the American Society for Radiation Oncology and the Society of Surgical Oncology.

All three groups published the guidelines online this week in their respective journals: the Journal of Clinical Oncology, Practical Radiation Oncology and the Annals of Surgical Oncology.

More information

To learn more about radiation in breast cancer treatment, visit BreastCancer.org.


www.health.com/breast-cancer/more-breast-cancer-patients-should-get-radiation-new-guidelines-say “>
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New Guidelines Set Safe Surgery Margins for Some Breast Cancers

FRIDAY, Aug. 12, 2016 (HealthDay News) — New surgery guidelines for certain breast cancer patients could reduce both unnecessary surgeries and recurrence rates, three U.S. cancer groups say.

The guideline is for treatment of women with ductal carcinoma in situ (DCIS) who undergo breast-conserving surgery with whole breast radiation. DCIS is an early stage cancer.

“The use of a 2-millimeter margin as the standard for an adequate margin in DCIS treated with whole breast radiation therapy is associated with low rates of recurrence of cancer in the breast and has the potential to decrease re-excision rates, improve cosmetic outcome and decrease health care costs,” according to the guideline from the Society of Surgical Oncology, the American Society for Radiation Oncology and the American Society of Clinical Oncology.

“Margins more widely clear than 2 millimeters do not further reduce the rates of recurrence of cancer in the breast and their routine use is not supported by evidence,” the guidelines stated.

The guidelines are published in the three groups’ journals, the Annals of Surgical Oncology, Practical Radiation Oncology and the Journal of Clinical Oncology.

The guideline writing panel reviewed current evidence, including 30 studies with nearly 7,900 patients.

“With this guideline, it is our two-pronged goal to help physicians improve the quality of care they provide to women undergoing surgery for DCIS, and ultimately improve outcomes for those patients. We hope the guideline also translates into peace of mind for women who will know that future surgeries may not be needed,” panel member Dr. Mariana Chavez-MacGregor, from the University of Texas MD Anderson Cancer Center, said in a news release from the three groups.

More information

The U.S. National Cancer Institute has more on breast cancer treatment.


www.health.com/news/new-guidelines-set-safe-surgery-margins-some-breast-cancers “>
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WHO releases health guidelines for travel to Rio during the Olympics

The Rio 2016 Olympic GamesThe World Health Organization has released a raft of health and safety advisories for travelers headed to Brazil for the Olympic games. In addition to routine vaccines (diphtheria, tetanus, polio, measles, hepatitis B, mumps etc) which vary from country to country, the WHO also recommends travelers get vaccinated against Hepatitis A, B, Typhoid fever, rabies and yellow fever. Likewise, travelers are advised to practice safe sex or to abstain altogether during their stay in Brazil and eight weeks following their return.



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Organizations issue joint guidelines for breast cancer survivors

By Lisa Rapaport (Reuters Health) – Most breast cancer survivors require routine mammograms and physical exams to check for new tumors, but they don’t need additional imaging or lab tests unless symptoms suggest malignancies may have returned, according to new joint guidelines from two leading U.S. cancer groups. The guidelines issued today by the American Cancer Society and the American Society of Clinical Oncology (ASCO) provide an updated road map to help women and their primary care doctors navigate not just surveillance for new tumors but also a range of mental and physical health problems that can accompany survivorship. “Women with a history of breast cancer are at higher risk than women without a history of breast cancer for many issues, including obesity, heart disease and sexual health issues,” two authors of the guidelines, Dr. Carolyn Runowicz of Florida International University in Miami and Corinne Leach of the American Cancer Society in Atlanta, said in a joint email.
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WHO Revises Guidelines For HIV-Positive Patients

WHO Revises Guidelines For HIV-Positive PatientsLONDON (AP) — The World Health Organization has revised its HIV guidelines to recommend that anyone who tests positive for the virus that causes AIDS should be treated immediately.That guidance fits with what is already recommended in many developed nations, including the United States.The U.N. health agency had previously said doctors should…



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U.S. group issues stroke prevention guidelines just for women

By Julie Steenhuysen CHICAGO (Reuters) – While stroke is common in both men and women, guidelines released on Thursday for the first time address factors such as pregnancy, birth control pills and menopause that put women at particular risk for the deadly condition. Issued by the American Heart Association and the American Stroke Association, the guidelines are designed to help doctors and patients recognize stroke risk factors early, when there is time to act. “If you are a woman, you share many of the same risk factors for stroke with men, but your risk is also influenced by hormones, reproductive health, pregnancy, childbirth and other sex-related factors,” said Dr Cheryl Bushnell, author of the new scientific statement published in the American Heart Association journal Stroke. According to the report, stroke is the fifth-leading cause of death in men and the third-leading cause of death in women.
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CDC Issues New Guidelines to Ward Off Gonorrhea Superbug

The U.S. Centers for Disease Control and Prevention issued new guidelines on Friday outlining how doctors should treat the sexually transmitted disease gonorrhea. The guidelines are an update to a similar document that the CDC issued in 2010, in light of the fact that the agency has discovered that the disease is becoming more difficult to treat.
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