Doctor Henri Vaquez, Cardiologist

Dr. Jeanette Smith analyzes in the Art of JAMA the work of the French painter Édouard Vuillard who studied at the Académie Julian and the École des Beaux-Arts in Paris. It was in Paris Vuillard associated with a group, the Nabis, who were influenced by Paul Gauguin. Vuillard after experimenting with the visualization of hues in nature, eventually he returns to an approach more in keeping with an appreciation for naturalism.

Vuillard’s was drafted in the World War I and served in the region of the Vosges, chronicling conditions of military life.  As life in Europe moved to the post-war era, Vuillard turned increasingly to portrait individuals in common surroundings, as it is seen in The Doctor Henri Vaquez (1860-1936) Cardiologist, in which a group gathers at the bedside of a patient.  In the painting, we observe a physician’s touching the patient’s shoulder, a gesture that conveys caring and reassurance, something senior physicians are familiar with and it is so welcoming to patients and their families. While the patient appears frail there is calmness in the room while a person, a relative or passerby, is seen outside the hospital window. Sunlight filtering in through the window and the autumn leaves are soothing and contribute to a sense of tranquility.

The sentiment seen in Vuillard’s treatment of fellow humans speaks of his respect for the individual, similar to that of physicians who care for their patients in all stages of life, even when they are very sick or terminal in a hospital's room.

New Guidelines for Colon Cancer Screening Tests.

Colorectal cancer is the second leading cause of cancer death in the United States. In 2016, an estimated 134 000 persons will be diagnosed with the disease, and about 49 000 will die from it. Colorectal cancer is most frequently diagnosed among adults aged 65 to 74 years; the median age at death from colorectal cancer is 68 years.

The United States Preventive Services Task Force (USPSTF) reviewed the evidence on the effectiveness of screening with colonoscopy, flexible sigmoidoscopy, computed tomography colonography, the guaiac-based fecal occult blood test, the fecal immunochemical test, the multi-targeted stool DNA test, and the methylated SEPT9 DNA test in reducing the incidence of and mortality from colorectal cancer or all-cause mortality; the harms of these screening tests; and the test performance their characteristics for detecting adenomatous polyps, advanced adenomas based on size, or both, as well as colorectal cancer.

The USPSTF concluded with high degree of certainty that screening for colorectal cancer in average-risk, asymptomatic adults aged 50 to 75 years is of substantial net benefit. Multiple screening strategies are available to choose from, with different levels of evidence to support their effectiveness, as well as unique advantages and limitations, although there are no data to demonstrate that any of the reviewed strategies provide a greater net benefit.

USPSTF recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years (A recommendation).  Individuals should pick the screening test they feel the most comfortable with.  The decision to continue screen for colorectal cancer in adults aged 76 to 85 years should be an individual one, taking into account the patient’s overall health and prior screening history (C recommendation).