| Cutting edge |  In today's newsletter there is an item that suggests that actually listening to patients and them examining them carefully may provide more information on the condition of their cardiovascular systems that putting them on a treadmill and looking at their ECG. The study showed that the predictive value of the exercise stress test - in the participants in the study - was no better than a good history and examination. In other words - clinical skills.
This is, to me, an important study. It shows that a well trained and conscientious doctor is at least as useful as a series of expensive investigations. I am sure that exercise stress testing is not the only investigation that may be less useful than people think.
There is an increasing tendency among doctors to go for investigations - at great cost to the patient and their medical schemes - simply because they are available. And, unfortunately patients have latched onto this to such an extent that extensive investigations are regarded as the norm.
My 86-year-old father-in-law is a case in point. An unnecessary admission to hospital resulted in a series of investigations that showed that he has a particular heart condition that can only be treated by surgery - something for which he is not a suitable candidate. The cardiologist suspected the specific condition after a clinical examination and an echocardiogram (a relatively inexpensive and non-invasive investigation) and went ahead and confirmed it by doing a CT scan - expensive and very uncomfortable for the old man. Given my father-in-law's general poor health, the CT scan should probably not have been done. It didn't change the old man's management in any way and has left him fearful of the consequences of his condition and of any future admissions to hospital.
An investigation is only useful if it is going to change management - keep that in mind when you visit your doctor.
Bridget Farham Editor
https://www.bizcommunity.com
| | Headlines
MedicalManaging insomnia in shift workers - Jenni Newman Public RelationsSome of the most significant industrial accidents in human history - the Exxon Valdez incident, the Chernobyl disaster, the Three Mile Island accident and the Challenger Space Shuttle crash - were caused by human error as a result of fatigue.
CardiologyWally's back to conquer Kilimanjaro Wally Katzke crept into the hearts and homes of many South Africans on Saturday, 2 August 2008 when he became the first heart patient in the world to be televised live undergoing open heart surgery. Now, the former cardiovascular patient is back on track with some ambitious ‘heart challenges' lined up for 2009, including climbing Mount Kilimanjaro during the year. Talking to patients provides more information on heart disease than testsHeart tests offered to many patients with chest pain are of little value in predicting future heart disease, say researchers.
Chronic diseasesMusic is good for the heartLike laughter, music appears to be good for your heart. Rosuvastatin reduces the risk of cardiovascular events in healthy peopleTrial stopped early after rosuvastatin found to cut the risk of heart attack and stroke by 44% in healthy people. How diabetes can affect your feet - Magna CartaPeople generally associate diabetes with insulin injections, maintaining a healthy diet and avoiding sugary foods. The lowdown on Glycaemic Index (GI) and Glycaemic Load (GL) - The Heart and Stroke Foundation SA[Ayesha Seedat] National Diabetes Awareness Week runs form the 10 - 14 November 2008, with the 14th marking World Diabetes Day.
Corporate Social ResponsibilityEducation and awareness key to managing the world's diabetes epidemic - The Write AgencyThis World Diabetes Day, health authorities aim to reach over one billion people to spread diabetes awareness message. Teenagers with diabetes are still teenagers - Jenni Newman Public RelationsThe teenage years are difficult enough without the added burden of being diagnosed with diabetes.
HIV/AIDSAfrica: Mind your languageA guide to HIV slang! Bone marrow transplant may have cured an HIV patientGerman doctors have used bone-marrow from an HIV-resistant person in a transplant. Prevention made in ChinaIt seems Chinese workers when relocating to Angola are merely told “Don't!” when it comes to avoiding HIV/AIDS. Some experts wonder if that is enough.
Infectious diseases1918 Spanish flu records could hold key to preventing future pandemicsAustralian researchers hope that 1918 pandemic records may help them prevent a future outbreak. Ghana: meningitis outbreak kills tenTen people have been confirmed dead and two are hospitalised following an outbreak of meningitis in north-central Ghana. Leprosy still present in the USLong believed to be a disease of biblical times, leprosy, also known as Hansen's disease, continues to be seen in the United States.
MalariaAirport malariaIn a global world, significant factors affect the spread of infectious diseases, including international trade, air travel and globalised food production. New malaria drugs need to become affordable or subsidisedA new study says that unless new compounds to combat malaria are made affordable they will have little effect. SADC ministers mark Malaria Day[Gabi Khumalo] Johannesburg: Health ministers from countries in the Southern Africa Development Community (SADC) are expected to convene at Mamfene in Mkhanyakude District, Northern KwaZulu-Natal on Friday, 14 November 2008, to mark international Malaria Day.
Medical ResearchThe mortal measureA large waistline doubles your risk of premature death, study finds. Overuse of antibiotics makes bacteria more drug resistantIncreasing use of antibiotics at academic centres in the US may have led to drug resistance. Why is TB so resilient?Newly discovered protein may help answer this question.
NutritionEU food labels 'are too big to fit on to packaging'Demands by the EU to fit nutritional information on to food packaging will not work because the labels are too big, food companies have complained.
Obstetrics and GynaecologyBabies from frozen embryos strongerNew research suggests that in vitro fertilisation babies born from frozen embryos are healthier than those born from fresh embryos.
OncologyTreatment for cancer may result in bone lossTreatment for breast and prostate cancer may cause bone loss. Tarceva brings new hope to patients with advanced lung cancer - EvolutionPrStudy confirms earlier Tarceva treatment delays lung cancer progression.
PaediatricsResearchers identify Achilles heel of common childhood tumourResearchers have, for the first time, found a mechanism for the rapid growth of the benign blood vessel tumour known as infantile haemangiomas, the most common tumour found in children. The findings implicate gene mutations that facilitate the abnormal activity of a hormone called VEGF, and suggest that anti-VEGF therapies - already approved for other conditions - may be an effective treatment.
Pharmaceutical companiesPfizer presents new approach to pain management - magna CartaResults from clinical trials show promise for innovative therapies in rheumatoid arthritis and osteoarthritis pain and fibromyalgia.
Public healthKenya: Dump site threatens healthThe Dandora municipal waste site east of Nairobi continues to pose environmental and health risks even after a study recommended its closure, said specialists. Senegal: "Worrying” rise in alcohol abuseAlcohol abuse in Senegal has reached “massive” levels but most addicts are not receiving the help they need, according to experts. SMS could help children stay a healthy weightResearchers in the US have suggested that children's love of SMSes could help to modify behaviour. Personal health records break down the barriers[Christine D. Chang] Personal health records will greatly simplify many of the barriers facing interoperability in healthcare and will play an important role in the exchange of health information. Superbugs on the rise in Canadian hospitalsAlthough infection control has been substantially ramped up in Canadian hospitals since the SARS crisis of 2003, the number of resistant bacterial infections post-SARS have multiplied even faster, a new Queen's University study shows.
Women's healthLiving in a developing country, and depressed?Scientists create therapy programme to treat depression in women in developing countries. |
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