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Point-Counterpoint Debate: Surgery vs. Medical Treatment for the Management of Obesity.
J Clin Endocrinol Metab
December 2024
Departments of Internal Medicine and Human Nutrition, University of Michigan.
Obesity is a chronic, relapsing condition with severe health risks and a huge economic burden. Effective interventions for severe obesity include bariatric or metabolic surgery and high-intensity medical management involving lifestyle changes and pharmacotherapy. This article summarizes the debate between Drs.
View Article and Find Full Text PDFExtracorporeal Cardiopulmonary Resuscitation: Life-saving or Resource Wasting?
US Cardiol
August 2024
Division of Cardiology, New York University Grossman School of Medicine New York, NY.
Article Synopsis
- - The rates of illness and death are high for patients experiencing cardiac arrest, as traditional CPR methods don't effectively maintain blood flow.
- - Extracorporeal cardiopulmonary resuscitation (eCPR) using venoarterial extracorporeal membrane oxygenation is suggested as a better way to improve blood circulation during cardiac arrest.
- - This article presents a debate on the benefits and drawbacks of current eCPR research, highlighting uncertainties and proposing ideas for future studies.
GRAPPA Point-Counterpoint: Should Biologics Be Used for Mild Psoriasis?
J Rheumatol
October 2024
K. Callis Duffin, MD, MS, Department of Dermatology, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA.
Article Synopsis
- - Psoriasis (PsO) is categorized as mild, moderate, or severe primarily based on body surface area (BSA), and mild cases typically receive topical treatments; however, there's debate over when to use biologics as first-line options even for mild cases.
- - At the GRAPPA 2023 meeting, proponents of biologics highlighted cases like psoriatic arthritis (PsA) and significant symptoms on sensitive areas (such as the scalp or genitals) as reasons to consider biologic therapy for mild PsO.
- - Critics argue that true mild PsO shouldn't include patients with PsA or major quality of life issues, advocating instead for topical treatments that are safer and more cost-effective, especially with newer options
Point/Counterpoint #2: Current Clinical Considerations With Nonoperative Management of Rectal Cancer.
Cancer J
July 2024
From the Department of Radiation and Cellular Oncology.
Locally advanced rectal cancer has historically been treated with multimodal therapy consisting of radiation therapy, chemotherapy, and total mesorectal excision. However, recent prospective trials and registry studies have demonstrated similar disease outcomes with nonoperative management for patients who experience an excellent clinical response to radiation and chemotherapy. This article reviews data regarding nonoperative management for rectal cancer, and highlights current challenges and limitations in a point-counterpoint format, in the context of two clinical cases.
View Article and Find Full Text PDFFor decades, the standard neoadjuvant therapy regimen for locally advanced rectal cancer consisted of chemoradiation, surgical resection, and consideration of adjuvant systemic therapy. Additional data have emerged suggesting neoadjuvant systemic therapy as a reasonable alternative to chemoradiation in selected patients. In addition, a total neoadjuvant therapy approach integrating both chemotherapy and chemoradiation results in superior cancer outcomes and the potential for consideration of nonoperative management in patients with a clinical complete response.
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