geoffrey modest medical blogs

  A recent study  found that there was efficacy for both clinical breast exams (CBE) performed by a clinician and patient breast self-exams (BSE): see  breast ca screening CBE and BSE help Cureus2023  in dropbox, or  doi:  10.7759/cureus.22464     Details:  -- retrospective cross-sectional study of 2019 medical records from the   Epic medical record system of women with breast lumps, from 2 clinics in Galveston, Texas  -- mean age 42yo (58 in those with cancer and 41 in those without), 23% with family history of breast cancer (12% in those with cancer and 23% without)  -- primary outcomes: detection of cancer, and positive ultrasound findings    Results:  -- 462 breast masses were detected:       --  BSE : women found 391 (85%) themselves          -- 69 had positive ultrasound findings, 26 had cancer               -- cancers detected: 10 of the cancers were early stage (stage 0 and 1)                 -- overall, 96% of the cancers and 81% of the positive ultrasound results were detecte

  A recent analysis found that an FDA mandate limiting acetaminophen co-prescription with opiates did lead to impressive decreases in acetaminophen hepatotoxicity, though there was no significant difference in hepatotoxicity from acetaminophen by itself despite a black box warning and patient education (see   opiates dec combo with acetamin dec liver failue JAMA2023   in dropbox, or doi:10.1001/jama.2023.1080)     Details :  -- two databases were accessed:      -- National Inpatient Sample (NIS): the largest publicly available all-payer US inpatient database with discharge data on more than 7 million inpatient stays annually      -- Acute Liver Failure Study Group (ALFSG): a prospective, 32 center cohort of adult patients with acute liver failure (ALF), defined by an INR >1.5, hepatic encephalopathy, no prior chronic liver disease, and disease duration < 26 weeks  --  the FDA issued a mandate to limit the amount of acetaminophen in prescription combinations meds (including with o