Common Questions and Topic of Interest
Questions and Answers About the Pap Test
Comments by Dr. Castellanos: The approach our practice takes to pap smears is the “enhanced pap testing” which takes advantage of new technologies that increase the effectiveness of Pap testing. Unilab is now using the TriPath AutoPap® system to evaluate conventional pap smears as well as the Cytyc ThinPrep® PapTest™, which is a liquid based collection system. The ThinPrep test is able to eliminate problems that regularly plague the conventional pap smear. By using the ThinPrep test, cellular material is kept well preserved and free of air-drying artifacts, as well as nearly eliminating the obscuring of cellular detail due to inflammation, blood, or thickness.
The ThinPrep sample can also test for Human Papillomavirus (HPV) and we will test for HPV when medically indicated. To read more about the connections between HPV and pap smears, as well as other resources regarding pap smear tests can be found at the American Society for Colposcopy and Cervical Pathology’s patient education page.
In addition to providing our patients with “enhanced pap testing” we also provide colposcopic evaluations. A colposcope is an instrument that allows us to magnify the face of the cervix in order to visually identify malignancies. Often times a coposcopy can allow us to identify lesions visually, before they would appear on the results of a pap smear. Therefore we offer colposcopy to our patients on a regular basis, and are able to diagnose early pre-cancerous and cancerous changes involving the cervix, vaginal wall, and entroitus.
For more information regarding the pap smear please visit the following links:
Questions and Answers about the Pap Test from the United Kingdom’s National Cancer Institute
Questions and Answers about Pap Test results from Estronaut, a forum for women’s health
Questions and Answers About the Treadmill Tests Administered by Dr. Castellanos
Comments by Dr. Castellanos: The treadmill stress test is used to evaluate a patient’s level of exercise fitness in a safe manner. This test entails following a protocol that all physicians west of the Mississippi adhere to known as Bruce’s Protocol. What this protocol involves is calculating 85% of the patient’s maximum predicted heart rate, and use this number as a guide to help avoid overexertion by the patient. We also try to keep patients from exceeding a systolic blood pressure of 200 for safety reasons.
Traditionally doctors are trained to go through five stages of Bruce’s Protocol. These stages start at 1.7 miles per hour at a 10% grade, then increase in increments to 5 miles per hour at a 18% grade. What we do in the office is to modify this protocol in order to see what the patient’s level of fitness is, in order to insure that the exercise program they are following as part of their lifestyle change program, is a safe amount of exercise.
Our experience here in the office has been that when a patient returns to repeat the Treadmill Stress Test after a year, they are often able to perform at higher levels of intensity and/or higher stage levels of the protocol. These performance gains are due to the reversal of vascular disease, weight loss, lower blood pressure and having less of a reliance on medications.
When we need more information in terms of stress testing we refer to other testing including full scale treadmill stress testing, thallium scan treadmill testing, echocardiograms, and also ask for a cardiac consultation when necessary.
Using the above approach of stress testing in the office, we have not had any incidents of injury, heart attacks or strokes, while patients are performing these tests.
For more information about the Treadmill Stress Test please visit the following link: Medline Plus Encyclopedia entry for Exercise Stress Test (a service of the U.S. National Library of Medicine and the NIH)
Organizations and Others Resources
The American Academy of Family Physicians (AAFP), a national medical organizations representing more than 93,700 family physicians, family practice residents and medical students.
A useful guide to Over-the-Counter Medicines/Drug Information – search for prescription or over-the-counter drug information
Dictionary of medical and health terms
WebMD blends award-winning expertise in medicine, journalism, health communication and content creation to bring you the best health information possible.
MayoClinic.com – Mayo Clinic is a not-for-profit medical practice dedicated to the diagnosis and treatment of virtually every type of complex illness.
American Heart Association – Our mission is to build healthier lives, free of cardiovascular diseases and stroke. That single purpose drives all we do. The need for our work is beyond question.
The New York Times Health Guide – Comprehensive reference and special reports about diseases, conditions, tests, injuries and surgeries
PRIMED Patient Education Center – The mission of the Pri-Med Patient Education Center is to provide patients with multimedia access to reliable medical information at and beyond the point of care.
Discovery Health – Discovery Channel’s Companion Health Site
National Institute of Diabetes and Digestive and Kidney Diseases
Baby Center – The leading destination on the Internet for new and expectant parents.
KidsHealth.org – KidsHealth is the largest and most-visited site on the Web providing doctor-approved health information about children from before birth through adolescence. Created by The Nemours Foundation’s Center for Children’s Health Media.
AIDSinfo – AIDSinfo is a U.S. Department of Health and Human Services (DHHS) project that offers the latest federally approved information on HIV/AIDS clinical research, treatment and prevention, and medical practice guidelines for people living with HIV/AIDS, their families and friends, health care providers, scientists, and researchers.
DailyStrength – Most everyone has a serious personal challenge themselves or has someone close to them that does. DailyStrength is a collection of safe, anonymous, online support groups focused on over 500 specific challenges to help people overcome their personal challenge or support a loved one through theirs.
NIH’s Medline Plus – MedlinePlus brings together authoritative information from NLM, the National Institutes of Health (NIH), and other government agencies and health-related organizations.
NIH’s National Center for Complementary and Alternative Medicine – The mission of NCCAM is to: Explore complementary and alternative healing practices in the context of rigorous science. Train complementary and alternative medicine researchers and Disseminate authoritative information to the public and professionals.
WholeHealthMD – Dedicated to providing the best in complementary and alternative medicine. All of our information is developed by a team of leading board- certified doctors and specialists.
Lab Tests Online – Lab Tests Online has been designed to help you, as a patient or family caregiver, to better understand the many clinical lab tests that are part of routine care as well as diagnosis and treatment of a broad range of conditions and diseases.
Vaccine Information – The Immunization Action Coalition works to increase immunization rates and prevent disease by creating and distributing educational materials for health professionals and the public that enhance the delivery of safe and effective immunization services.
National Institutes of Health – NIH is the steward of medical and behavioral research for the Nation. Its mission is science in pursuit of fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to extend healthy life and reduce the burdens of illness and disability.
Health on the Net Foundation MedHunt – HON has become one of most respected not-for-profit portals to medical information on the Internet.
Health on the Web: Finding Reliable Information – “Don’t believe everything you read.” It’s an old warning that is especially true for health-related information you find on the World Wide Web. The Web can be a great resource when you want to learn about a specific disease or health condition. You can also find tips on staying healthy. But among the millions of Web sites that offer health-related information, there are many that present myths and half-truths as if they are facts.
The Medical Library Association’s User’s Guide to Finding and Evaluating Health Information on the Web – This guide outlines the collective wisdom of medical librarians who surf the Web every day to discover quality information in support of clinical and scientific decision making by doctors, scientists, and other health practitioners responsible for the nation’s health.
Academy of Anti-Aging Medicine
American Society for Colposcopy & Cervical Pathology
Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women
Women and Cardiovascular Disease
Organizations Working to Fix the American Health Care System
Alliance for Health Reform – This is a non-partisan information source dedicated to the premise that every citizen of the United States should have access to affordable health care.
Families USA – This is a watchdog group that moniters government actions regarding health care, as well as publishing reports that analyze and present solutions to the health care problems in America.
