There are certainly times where I probably don’t need to make a patient physically come in to the office.
As part of trying to figure out where telehealth and video visits fit into the primary care setting, this week I got an amazing tour from the director of our emergency department, during which he showed me the program they’ve developed over the past year.
An incredible system, they take patients from triage who report to the emergency department with nonemergent issues, and move them to a consultation room off to the side of their urgent care space. There they are linked via video to an emergency provider who is located elsewhere in the hospital, who can go over their (hopefully) nonemergent issue and come to a quicker, safer, more efficient, and likely less expensive solution than a day in the ER.
They told me they get things like rashes that have been there for months, travelers who’ve arrived in New York City and have run out of their medications, simple musculoskeletal issues — the list goes on and on.
Through a video link-up, the provider can take a look at a rash, and look at various other things, pretty much anything that falls short of the laying on of hands or a diagnostic instrument. And certainly nothing that involves any invasive tests like labs or imaging.
Bladder cancer is the fourth leading cause of cancer death in males and the most common site of cancer in the urinary system. An estimated 74,000 new cases of bladder cancer are expected to be diagnosed in the USA in 2015 and 16,000 deaths are estimated. Non-muscle-invasive bladder cancer (NMIBC) has a high rate of recurrence and also a risk of progression that requires patients to undergo regular monitoring with cystoscopy after transurethral resection of the bladder tumor (TURBT). Current standard of care uses white-light cystoscopy (WLC) to map and resect all visible tumors. This blog will give an overview of the use of fluorescent cystoscopy in the management of NMIBC and review the evidence for its use.
Blue-light cystoscopy (BLC), also referred to as fluorescent cystoscopy or photodynamic diagnosis (PDD), is a procedure in which a photosensitizer medication is instilled in the bladder prior to cystoscopy. This photosensitizer is part of the heme biosynthesis pathway (that makes red blood cells) and causes an accumulation of photoactive porphyrins in neoplastic cells. These porphyrins preferentially accumulate in neoplastic cells due to the increased metabolic activity in these cells. When excited with blue-light in the 360-450 nm wavelength, the porphyrins emit a red light that can easily be seen during cystoscopy (Figure 1). There are two main photosensitizers that have been used in studies looking at fluorescent cystoscopy: 5-aminolevulinic acid (5-ALA) and hexaminolevulinate (HAL). HAL is the only photosensitizer that has been approved for use in the USA and Europe. In the USA it is marketed under the brand name Cysview, and in Europe under the brand name Hexvix.
The media continues to publish articles that reinforce the memes that prostate cancer is an old man’s disease and that annual PSA (prostate specific antigen) screening causes more harm than good.
I don’t believe this is true and the stories that were collected in the Prostate Cancer Pony Express Memorial Journal prove that prostate cancer strikes young men as well.
Read the entry below, written by this 59 year old man, and make your own mind if he would have preferred to have been diagnosed while he still had the full range of treatment options available to him:
Read Complete Blog at Prostate Cancer Pony Express Stories and PC Myths
Binod Sinha, M.D., F.A.C.S.
Dr. Sinha finished his urology residency training at the University of Minnesota in Minneapolis June, 1985 and was Board Certified in 1988. He is affiliated with Robert Wood Johnson University Hospital as an active attending and clinical assistant professor in the Department of Urology at UMDNJ. He is actively involved in teaching urology residents.
Dr. Sinha believes that total health involves the understanding of each patient’s physical, emotional and spiritual needs. He spends a lot of time with the patient counseling and discussing all of the alternative treatments. He believes in early diagnosis and preventive medicine. He regularly attends national urology meetings to keep current on the diagnosis and treatment of genitourinary diseases. Dr. Sinha organizes several CME meetings in Central New Jersey. He was invited to present papers in Berlin, Germany in September 2008. He was invited as Course Director for Office Based Surgery in April 2009 for the Chicago American Urology Association (AUA) meeting.
Nearly every man over the age of 50 experiences symptoms of prostate gland enlargement. The symptoms are going to the bath room frequently, poor force of the urine stream, dribbling after urination and perhaps the most troublesome of all is getting up at night to urinate. Every night, between 12 and 15 million men in the U.S. are likely to have loss of sleep because of an enlarged prostate gland. This article will discuss the purpose of the prostate gland and what treatment options are available for this common condition.
The prostate gland is typically the size and shape of a walnut and is located in the lower part of the pelvis, below the bladder. It envelops the urethra, the tube through which urine flows from the bladder out of the body. When the prostate gland grows bigger – which happens to virtually every man as he ages – it can compress the urethra and make it difficult to pass urine.
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Majority of men are not aware of Prostate gland. They might hear it from the doctor while experiencing any problem or disease related to Prostate gland. What is the function of this gland? What problems can we might get with this gland? When it’s appropriate time to call the doctor when having a problem? These are common questions arising in the minds of men. So, the best way is to get information to deal this aspect of men’s health. Here, we briefly explain the basics of Prostate gland and Benign Prostatic Hyperplasia – a common condition associated with this gland.
WHAT IS PROSTATE GLAND?
It is a small gland and an important part of male reproductive system. It has a walnut like shape and size. It exists below the bladder and in front of the rectum. It surrounds urethra, a tube in the penis carrying urine from the bladder out of the body.
A COMPLETE OVERVIEW
Urology Care of Central New Jersey
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