Perception of Breast Cancer Risk in Over 11,000 Patients During Routine Mammography Exam.

To assess women's knowledge of personal breast cancer risk. Additionally, we aimed to determine how often physicians are discussing individualized risk assessments of breast cancer with their patients, and if those discussion affected risk perception. Surveys were distributed in radiology centers in New York and made available to patients presenting for routine mammography. As exact number of patients who viewed the survey is unknown, response rate could not be assessed. Data from the survey was used to calculate each patient's personal breast cancer risk using the National Cancer Institute Breast Cancer Risk Assessment Tool. Each patient's actual breast cancer risk was compared to her perceived risk. 15,006 subjects submitted the survey and 11,365 were included in the final analysis. Fourteen percent of women were accurate in their 5-year estimation as compared to calculated risk, and only 7% of respondents were accurate in their estimation of risk by 90 years of age. There was no association between time since discussion of breast cancer risk and accuracy of estimating personal breast cancer risk (p = 0.17). There was no difference in risk estimation accuracy between women who had ever or had never discussed risk with her physician (p = 0.1064). Patients' perceived personal risk of developing breast cancer does not match the Gail model calculated risk. These findings hold true whether or not her physician had discussed personal breast cancer risk with her in the past. Further studies should determine effective strategies to educate patients about their breast cancer risk.

Application of the Evidence-Based Practice Model by Physical Therapy Clinical Practitioners.

The evidence-based practice (EBP) model has served as a framework for clinical reasoning since Sackett first defined it in the late 1990s. Since then, this model has been implemented within various clinical healthcare settings by an array of healthcare practitioners including physical therapists. In the case of the latter, it is not clear how practicing physical therapists perceive the usefulness of this model within the clinical setting, nor to what extent they are able to apply it. The current study assessed practicing physical therapists on their perceptions of EBP as well as their general statistical knowledge. Although all participants agreed upon the import of the EBP model in their clinical skillset, not all could identify its common definition (75% provided correct responses), and responded their understanding of research methods were "strong" or "good" (90%), but for statistical methods were less so by comparison (76%). The majority of the respondents could not answer five questions assessing general knowledge in statistical design, with percent frequency of correct responses ranging from 7%, 24%, 0%, 31%, and 31%, respectively. These findings suggest support is warranted for practicing clinicians for appropriate application of the EBP model to occur within the clinical setting.

Stability of Metabolic Factor Before and After Bariatric Surgery.

BACKGROUND: A new metric called metabolic factor (resting metabolic rate/weight) has previously been established that can differentiate between people who are obese, overweight, and of normal weight. Previous studies were re-analyzed and found that people who lost weight did not experience a change in their metabolic factor. MATERIALS AND METHODS: The current study measured the metabolic factor of 18 individuals before and after bariatric surgery. RESULTS: As expected, individuals lost nearly 100 lb and therefore lowered their resting metabolic rate from 2614.3 to 1954.4 kcal (p < 0.05). However, the pre-operative metabolic factor of 8.1 (1.1) cal/lb did not change significantly as it slightly increased to 8.6 (0.88) after surgery (p = 0.19). Weight loss was not statistically significantly correlated with change in metabolic factor (r = 0.22). The follow-up metabolic factor negatively correlated with post-operative BMI, r = -0.48 (p < 0.05), indicating the higher the metabolic factor, the lower the post-operative BMI. CONCLUSIONS: This study seems to establish the possibility that metabolic factor is not simply a function of one's current weight, but instead might be a stable characteristic unique to each individual.

Effectiveness of green tea in a randomized human cohort: relevance to diabetes and its complications.

Epidemiological studies have argued that green tea could mitigate diabetes and its complications. This study investigated the phytophenolic profile of Mauritian green tea and its antioxidant propensity. The effect of green tea on the risk factors: waist-hip ratio, glucose level, arterial pressure, antioxidant status, and alanine aminotransferase (ALT) in prediabetics was assessed. The experimental group consumed 3 cups of green tea daily for 14 weeks followed by a 2-week washout period. The control group followed a water regimen. Green tea contained high level of phenolics related to its antioxidant power. Green tea suppressed waist-hip ratio of women from a significant increase and suppressed mean arterial pressure of men and women from a significant decrease after week 14. It reduced ALT level in women by 13.0% (P < 0.1) while increasing the antioxidant potential of men and women sera by 2.7% (P < 0.1) and 5.1% (P < 0.1). The study timescale may have been too short to enable demonstration of effects on fasting plasma glucose and HbA1c outcomes. Green tea regimen could form part of a healthy lifestyle that might ameliorate features of metabolic syndrome and subsequent risks for diabetes and its complications. This trial is registered with ClinicalTrials.gov NCT01248143.

Effects of a short term supplementation of a fermented papaya preparation on biomarkers of diabetes mellitus in a randomized Mauritian population.

OBJECTIVE: Clinical evidence and cellular models have shown an inverse relationship between the intakes of plant and fruit based diets and oxidative stress, suggesting the suitability of natural antioxidants in the management of diabetes mellitus and its complications. METHOD: A randomized controlled clinical trial was conducted at the Cardiac Centre, SSRN Hospital, Pamplemousses, (Mauritius) to determine the effect of a short term supplementation of a fermented papaya preparation (FPP®) on biomarkers of diabetes and antioxidant status in a multi-ethnical neo-diabetic population from November 2010 to March 2011. RESULT: Supplementation of 6g FPP®/day for a period of 14 weeks could improve the general health status of several organs targeted by oxidative stress during diabetes. When comparing experimental to control groups with independent samples t-test, C-reactive protein levels significantly decreased (P=0.018), LDL/HDL ratio was considerably changed (P=0.042), and uric acid levels were significantly improved (P=0.001). ANOVA results also validated the same findings with significant differences in C-reactive protein, LDL/HDL ratio, uric acid and in serum ferritin levels. CONCLUSION: FPP® may present a novel, economically feasible nutraceutical supplement for the management of diabetes and for those at risk for cardiovascular disease, neurological disease and other conditions worsened by overt inflammation and oxidative stress.