Results of Scalp Cooling to Prevent Chemotherapy-Induced Alopecia

By Charbel C. Khoury, MD
August 8, 2015

Being diagnosed with cancer can be devastating and life-changing. Furthermore, the side effects of chemotherapy are often very distressing, and hair loss is one of the more feared complications. When a patient, and particularly a woman, loses her hair to chemotherapy, she is faced with the stigma of the disease, and may feel that she is losing her identity, femininity, and sexuality.1 Patients with chemotherapy-associated alopecia are confronted with the lethal nature of cancer, and a minority of patients even choose to avoid chemotherapy for fear of losing their hair. Continue reading “Results of Scalp Cooling to Prevent Chemotherapy-Induced Alopecia”

Bariatric Surgery or Intensive Medical Therapy for Diabetes?

By Charbel C. Khoury, MD
May 11, 2017

Obesity has grown at epidemic rates over the past few decades. According to the most recent data from the Behavioral Risk Factor Surveillance System, adult obesity prevalence now exceeds 35% in four US states, 30% in 25 states and is above 20% in all states.1 Numerous studies have established excess weight as a risk factor for type 2 diabetes, thus adding to the morbidity and mortality of obese patients. While dieting, behavioral approaches, and tight glucose control can limit the long-term complications of diabetes, sustaining adherence is often difficult for most patients. Continue reading “Bariatric Surgery or Intensive Medical Therapy for Diabetes?”

Interpreting Hemoglobin A1c in African Americans with Sickle Cell Trait

By Charbel C. Khoury, MD
March 16, 2017

Hemoglobin A1c (HbA1c) testing is mainstay in screening, diagnosis, and management of diabetes mellitus.1 Since it measures the glycation of hemoglobin occurring over the entire lifespan of a red blood cell, the HbA1c is a very practical measure for clinicians and can be used to surmise the mean blood glucose over the previous 8 to 12 weeks.2 Nonetheless, several patient-specific factors such as iron/vitamin B12/folate deficiency anemias, chronic kidney disease, cirrhosis, and erythropoietin treatment have been known to affect the reliability of this assay, due to variations in red cell turnover.2  Moreover, HbA1c levels may vary with race. In fact, numerous studies have suggested that African Americans may have higher HbA1c levels than non-Hispanic whites with the same fasting and post-glucose load glucose levels.3 Continue reading “Interpreting Hemoglobin A1c in African Americans with Sickle Cell Trait”