Summary of Recommendations:

1. The USPSTF recommends screening mammography for women aged 50 to 74 years every other year.
2. The decision to start regular, biennial screening mammography before the age of 50 years should be an
individual one and take patient context into account, including the patient’s values regarding specific
benefits and harms.
3. The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and
harms of screening mammography in women 75 years or older.
4. The USPSTF recommends against teaching breast self-examination (BSE).
5. The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and
harms of clinical breast examination (CBE) beyond screening mammography in women 40 years or older.
6. The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and
harms of either digital mammography or magnetic resonance imaging (MRI) instead of film mammography as
screening modalities for breast cancer.

The first two recommendations represent a significant shift from the recommendations issued in 2002 and are where most of the controversy is centered. Previously, the USPSTF recommended screening mammography, with or without clinical breast examination, every one to two years for women ages 40 and older. The new recommendations also differ from what is currently recommended by the American Cancer Society, American College of Obstetricians and Gynecologists, American College of Radiology (ACR), and the Society of Breast Imaging (SBI) who all recommend annual screening mammography starting at age 40 for most women, and even earlier in those with high risk. So, what does this mean if you are a woman in your 40s or over 75? The decision about whether mammography is right for you should be based on your family history, general health, and personal values. There are risks associated with screening mammography such as over treatment and exposing the breast to radiation, so careful consideration of what is right for you is warranted. Perhaps, the only thing that the recommendations and the controversy surrounding them make clear is that there is a need for further research in breast cancer prevention. We at Kernersville Primary Care encourage you to discuss the risks and benefits of screening mammography with your doctor and decide what measures are best for you.

The problem lies in their sweetness and its effect on the complex pathways that regulate body weight. Overconsumption of hyper-intense artificial sweeteners may cause taste preferences to revert to an infantile state and decrease tolerance of complex flavors such as those found in vegetables. Also, since diet beverages contain no calories they may cause dissociation between sweet tastes and calorie content which could disrupt the pathways regulating hunger.

In rodent studies, artificial sweeteners when compared to glucose caused diminished calorie compensation ability, increased caloric intake, and increased body weight. Rodents also preferred saccharin solutions over cocaine, highlighting the potentially addictive nature of these sweeteners. Some studies in humans have also shown relationships between diet drink consumption and obesity, metabolic syndrome, and type-2 diabetes. However, further research needs to be conducted before these relationships can be considered causal.

Although further research is need to confirm the long term health effects of artificially sweetened beverages, their potential health hazards warrant reconsidering their consumption. The authors of the JAMA article conclude that for now diet drinks may best be considered an aid to transition from high-calorie sugar sweetened beverages, such as regular soda, to minimally sweetened beverages such as water, mineral waters, teas, and coffee (with out sugar of course).

(not listed in order of priority)
-pregnant women;
-household contacts of infants under 6 months;
-healthcare and emergency-services workers;
-young people between 6 months and 24 years of age;
-and nonelderly adults with underlying risk conditions, such as diabetes and chronic lung disease.

If you are a patient at Kernervsville Primary Care, fall into one or more of the above groups, and wish to receive the H1N1 vaccine please call our office at 336-993-1618 to schedule an appointment. This vaccine is expected to be a two dose series, with injections given 21 days apart.

The H1N1 vaccine does not cover seasonal influenza and people who receive the H1N1 vaccine still need to have a regular seasonal flu vaccination. Anyone who wants to reduce the likelihood of becoming ill with influenza or spreading influenza to others may receive the regular seasonal flu vaccine. We strongly recommend that the following groups be vaccinated:

-all children from 6 months through 18 years of age;
-anyone 50 years of age or older;
-women who will be pregnant during influenza season;
-anyone with long-term health problems;
-anyone with a weakened immune system;
-residents of nursing homes and other chronic-care facilities;
-anyone who lives with or cares for people at high risk for influenza including health care providers, household contacts and caregivers of children less that 5 years of age or people 50 years and older;
-people who provide essential community services;
-people living in dormitories, correctional facilities, or under other crowded conditions;

We are currently receiving our supply of seasonal flu vaccine and expect to begin vaccinating on October 1. If you would like to receive this vaccine you may also call our office at 336-993-1618 to schedule an appointment.

For more information about the H1N1 virus see the following link: http://www.cdc.gov/h1n1flu/