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Recurrence rate using non-Mohs technique for BCC excision
MEDICAL ABSTRACTS Andrew S. Gurwood, O.D.
Coffee consumption as a public health strategy? vanDam RM, Hu FB. Coffee consumption and risk of type 2 diabetes. JAMA 2005;294(1):97-104. Type 2 diabetes is a chronic disease associated with high rates of morbidity and premature mortality. Coffee is among the most widely consumed beverages in the world. This study examined the potential beneficial effects of coffee consumption against the risk of type 2 diabetes. The researchers searched Medline through January 2005 by using the key words coffee and caffeine in combination with diabetes, glucose, and insulin and examined the reference lists of the retrieved articles. The researchers found an inverse association between coffee consumption and glucose intolerance among type 2 diabetics in various populations in the United States, northern Europe, southern Europe, and Japan. They distinguished 4 levels of coffee consumption (1) the highest category of coffee consumption, greater than 6 to 7 cups per day; (2) second highest coffee consumption, 4 to 5 cups per day; (3) third highest category of coffee consumption, 1 to 3 cups per day; and (4) reference category of 0 cups per day. This meta-analysis of the cohort supported a significant inverse association between coffee consumption and risk of type 2 diabetes. Participants who drank 4 to 6 cups of coffee per day and more than 6 to 7 cups of coffee per day had a 28% and 35% lower risk of type 2 diabetes, respectively, compared with those who drank less than 2 cups per day. Most of the coffee that was consumed was noted in the reports to be of the caffeinated filtered drip variety. The United States data also looked at
filtered decaffeinated coffee and found a reduction in type 2 diabetes. In the Swedish portion of the study, adding sugar to coffee was associated with lower insulin sensitivity, and adding milk or cream showed no association with insulin sensitivity. Coffee has been shown to be a major contributor to the total in vitro antioxidant capacity of the diet. This is relevant because oxidative stress can contribute to the development of type 2 diabetes. Coffee has chlorogenic acid, quinides, and magnesium, substances known to affect glucose metabolism. This review supports the hypothesis that habitual coffee consumption is associated with a substantially lower risk of type 2 diabetes. Despite what appears to be good news, it is premature to recommend increasing coffee consumption as a public health strategy. Connie Chronister, O.D. doi:10.1016/j.optm.2006.05.006
Recurrence rate using non-Mohs technique for BCC excision Hamada S, Kersey T, Thaller VT. Eyelid basal cell carcinoma: nonMohs excision, repair, and outcome. Br J Ophthalmol 2005;89(8):992-4. Basal cell carcinoma (BCC) is the most common form of skin cancer and has a high predilection to form on the head, neck, and periocular region. Mohs surgery is the standard to which most excisions of BCC are compared, but with its cost and time-consuming methods, physicians have been prompted to find alternative techniques
1529-1839/06/$ -see front matter © 2006 American Optometric Association. All rights reserved.
Andrew S. Gurwood, O.D. requiring less expertise while yielding similar prevention of reoccurrence rates. Researchers set out to analyze the recurrence rate when BCC was excised using a non-Mohs micrographic surgical technique. The study included 162 patients of a total 223 patients, with BCC diagnosed between 1987 and 2004. Each tumor was given a 4-mm safety zone when excising it except when its size or location required a smaller zone. Patients were seen over a 3- to 6-month period then annually for a minimum of 5 years. There was approximate equal male-to-female participation (85:77), and the mean age was 71.2 years. Pathology reports of the tissue showed that 84% of the tumors were excised completely, and of the remaining lesions requiring re-excision of tissue, 53% were negative for any BCC. During the 5-year followup there was an overall 4.35% reoccurrence rate. There was a zero reoccurrence rate for nodular basal cell carcinomas, and the 3 recurrences were infiltrative
Medical Abstracts in nature. Direct closure of the wound was attempted in 72% of the cases. Granulomas and trichiasis were the 2 most common complications. This study found a zero reoccurrence rate in noninfiltrative BCC us-
381 ing a subregional non-Mohs surgical technique, all while maintaining good function and cosmetic appearance of the periocular region. Successful removal of nodular BCC may not require long-term followup; how-
ever, infiltrative and recurrent BCC should be monitored periodically. Stephen E. Hess, O.D.
doi:10.1016/j.optm.2006.05.007
Coffee consumption as a public health strategy? vanDam RM, Hu FB. Coffee consumption and risk of type 2 diabetes. JAMA 2005;294(1):97-104. Type 2 diabetes is a chronic disease associated with high rates of morbidity and premature mortality. Coffee is among the most widely consumed beverages in the world. This study examined the potential beneficial effects of coffee consumption against the risk of type 2 diabetes. The researchers searched Medline through January 2005 by using the key words coffee and caffeine in combination with diabetes, glucose, and insulin and examined the reference lists of the retrieved articles. The researchers found an inverse association between coffee consumption and glucose intolerance among type 2 diabetics in various populations in the United States, northern Europe, southern Europe, and Japan. They distinguished 4 levels of coffee consumption (1) the highest category of coffee consumption, greater than 6 to 7 cups per day; (2) second highest coffee consumption, 4 to 5 cups per day; (3) third highest category of coffee consumption, 1 to 3 cups per day; and (4) reference category of 0 cups per day. This meta-analysis of the cohort supported a significant inverse association between coffee consumption and risk of type 2 diabetes. Participants who drank 4 to 6 cups of coffee per day and more than 6 to 7 cups of coffee per day had a 28% and 35% lower risk of type 2 diabetes, respectively, compared with those who drank less than 2 cups per day. Most of the coffee that was consumed was noted in the reports to be of the caffeinated filtered drip variety. The United States data also looked at
filtered decaffeinated coffee and found a reduction in type 2 diabetes. In the Swedish portion of the study, adding sugar to coffee was associated with lower insulin sensitivity, and adding milk or cream showed no association with insulin sensitivity. Coffee has been shown to be a major contributor to the total in vitro antioxidant capacity of the diet. This is relevant because oxidative stress can contribute to the development of type 2 diabetes. Coffee has chlorogenic acid, quinides, and magnesium, substances known to affect glucose metabolism. This review supports the hypothesis that habitual coffee consumption is associated with a substantially lower risk of type 2 diabetes. Despite what appears to be good news, it is premature to recommend increasing coffee consumption as a public health strategy. Connie Chronister, O.D. doi:10.1016/j.optm.2006.05.006
Recurrence rate using non-Mohs technique for BCC excision Hamada S, Kersey T, Thaller VT. Eyelid basal cell carcinoma: nonMohs excision, repair, and outcome. Br J Ophthalmol 2005;89(8):992-4. Basal cell carcinoma (BCC) is the most common form of skin cancer and has a high predilection to form on the head, neck, and periocular region. Mohs surgery is the standard to which most excisions of BCC are compared, but with its cost and time-consuming methods, physicians have been prompted to find alternative techniques
1529-1839/06/$ -see front matter © 2006 American Optometric Association. All rights reserved.
Andrew S. Gurwood, O.D. requiring less expertise while yielding similar prevention of reoccurrence rates. Researchers set out to analyze the recurrence rate when BCC was excised using a non-Mohs micrographic surgical technique. The study included 162 patients of a total 223 patients, with BCC diagnosed between 1987 and 2004. Each tumor was given a 4-mm safety zone when excising it except when its size or location required a smaller zone. Patients were seen over a 3- to 6-month period then annually for a minimum of 5 years. There was approximate equal male-to-female participation (85:77), and the mean age was 71.2 years. Pathology reports of the tissue showed that 84% of the tumors were excised completely, and of the remaining lesions requiring re-excision of tissue, 53% were negative for any BCC. During the 5-year followup there was an overall 4.35% reoccurrence rate. There was a zero reoccurrence rate for nodular basal cell carcinomas, and the 3 recurrences were infiltrative
Medical Abstracts in nature. Direct closure of the wound was attempted in 72% of the cases. Granulomas and trichiasis were the 2 most common complications. This study found a zero reoccurrence rate in noninfiltrative BCC us-
381 ing a subregional non-Mohs surgical technique, all while maintaining good function and cosmetic appearance of the periocular region. Successful removal of nodular BCC may not require long-term followup; how-
ever, infiltrative and recurrent BCC should be monitored periodically. Stephen E. Hess, O.D.
doi:10.1016/j.optm.2006.05.007