Use of Gastric Bypass Surgery for the Treatment of Type 2 Diabetes Mellitus

Over the past decade, the incidence of type 2 diabetes mellitus (T2DM) has increased significantly. Evidence has shown that a clear association exists between obesity and diabetes development. This association has inspired researchers to explore bariatric surgery as an option for diabetes management and possible disease reversal. Improvement of T2DM using Roux-En-Y gastric bypass (RYGB) is thought to result from from a combination of weight loss, decreased caloric intake, hormonal changes and rearrangement of the gastrointestinal anatomy. Positive outcomes resulting from the procedure include decreased mortality rates, normalization of HbA1c levels, decreased dependence on diabetic medications, and increased insulin sensitivity. Gastric bypass, specifically RYGB, appears to be a promising treatment for T2DM. Due to possible complications and limited research in some populations, treatment should be restricted to patients with a BMI \u3e 35 with concurrent diabetes. Patients with diabetes who qualify should be counseled on the potential benefits of gastric bypass as a viable option for diabetes management

Options for Breast Cancer Prevention in High-Risk Patients

Breast cancer is the most frequently diagnosed non-skin cancer in women, and one in eight women will develop breast cancer within their Iifetimes. Unfortunately, the strongest risk factors for breast cancer (i.e. age, family history, hormonal factors) are not easily modified. There is some evidence that chemopreventative drugs may be able to prevent breast cancer in high-risk patients. Tamoxifen and raloxifene have been shown to reduce the risk of breast cancer in high-risk women but may be associated with several serious adverse events. Clinical trials are currently in progress to determine if aromatase inhibitors are a viable alternative for breast cancer prevention, as they may be considered effective in the early treatment of breast cancer. For patients with BRCA1 and BRCA2 mutations, a bilateral prophylactic mastectomy may be an option. This article discusses the risks and benefits of available treatment options for breast cancer prevention in high-risk patients

Role of the Pharmacist In Improving Treatment for Children with Concurrent Gastrointestinal and Autism Spectrum Disorders

Over the last several years, a noteworthy association between gastrointestinal (GI) disorders and autism spectrum disorders (ASD) has been documented, although no large population-based studies exist. GI disorders in ASD children may stem from the underlying behavioral, communication, sensory or neurological issues intrinsic to the autistic disorder itself; therefore, the incorporation of alternative therapies, including behavioral modification, may be compelling treatment additions to the GI care traditionally recommended in children. To improve GI symptoms and quality of life in ASD children, a multidisciplinary approach is optimal, with pharmacists playing an active role in determining appropriate pharmacotherapy. Although there is a need for additional clinical trials to determine if specialized treatments for GI disorders are necessary in this unique pediatric population, this article reviews the currently available published information

Implications and Concerns Regarding the Mammogram Debate

Screening procedures that detect breast cancer in its early stages are an important element of preventative health care for all women. When official guidelines and recommendations for screening are modified, their changes impact health care at both the population and individual patient levels. Recently, the United States Preventive Service Task Force (USPSTF) has developed new recommendations regarding when to start mammogram screening for breast cancer in women of average risk for the development of breast cancer. This article discusses the rationale behind the updated USPSTF recommendations and also presents the current American Cancer Society (ACS) guidelines