| Cutting edge |  We recently had to take my father-in-law to hospital. He is in his mid-80s and has what is effectively terminal ischaemic heart disease. The cardiologist on call decided to be aggressive in his approach and carried out a number of investigations. Unfortunately, none of them really contributed to my father-in-law's management - particularly the CT scan, which was also very uncomfortable and provoked a lot of anxiety. At the end of all this the medical aid paid only for hospitalisation, quite rightly saying that the investigations were only done to confirm a clinical suspicion.
One of the articles in this week's newsletter covers a study in the US that backs up what other UK studies showed a while ago - scans of all kinds - play no part in the management of acute lower back pain. The source article points out that the number of CT and MRI scans carried out for acute lower back pain has increased markedly in the past few years, according to Medicare statistics. The authors go on to say that these scans are being carried out largely because patients request them and doctors are essentially covering themselves.
I was taught that the most important part of any patient intervention was a good history, followed by a meticulous physical examination and only then - if really necessary - would you start to think about a few directed investigations. The investigations were chosen to actively aid in the management of the patients, not just to confirm a clinical suspicion or to cover your back.
Medical costs are spiralling out of control - you only have to look at what your medical aid is charging you this year in comparison to last year to see that. Doctors need to start to trust the old-fashioned approach to medicine, which is largely about listening to the patient and patients need to start trusting that doctors have skills that allow them to make diagnoses and clinical decisions based on physical examination and, only occassionally, special investigations.
Medical technology is a wonderful thing, but only when it is used appropriately.
Bridget Farham Editor
https://www.bizcommunity.com
| | Headlines
HIV/AIDSCourt victory for South Africa's HIV-positive inmatesAs part of an ongoing battle to secure antiretroviral (ARV) treatment for South Africa's HIV-positive inmates, the AIDS lobby group, Treatment Action Campaign (TAC), has gained access to a controversial report that may shed light on whether or not treatment delays are still costing lives in South African prisons.
MedicalGroundbreaking human evolution book launch to kick start Imperial's Darwin bicentenary celebrations A new book by eminent Darwin historians, which will revolutionise our understanding of Darwin's path to human evolution, will be launched at Imperial College London on Monday 9 February 2009. Be wise - exercise - CANSAAll South Africans need to eat wisely and get active to help fight cancer. This is the message from the Cancer Association of South Africa (CANSA) for World Cancer Day on 4 February 2009 which has the theme, “I love my active healthy childhood”.
Chronic diseasesIntensive Lipitor therapy significantly reduced hsCRP levels further than low-dose Lipitor - Magna CartaPatients treated with Lipitor® (atorvastatin calcium) 80 mg had a significant 55 percent reduction in levels of high-sensitivity C-reactive protein (hsCRP), while those taking Lipitor 10 mg had a significant 21 percent reduction in hsCRP levels at the end of 26 weeks compared to baseline, according to the results from the primary endpoint of a new study.
Infectious diseasesNigeria: Northern states on high alert over meningitisNigerian health authorities have placed northern states on high alert following a meningitis outbreak in neighbouring Niger, which according to the World Health Organization (WHO) killed 17 people and infected 382 in January. Inside Zimbabwe's cholera epidemicI am feeling a little uncomfortable," says the middle-aged man lying in the dirt behind the main hospital in Beitbridge, Zimbabwe. DRC: Ebola outbreak in Kasai Occidental stabilised - WHOAn Ebola outbreak in southern Democratic Republic of Congo's (DRC's) Kasai Occidental Province is now under control, according to a UN official.
Medical ResearchLeukaemia stem cells found to work differently to other blood stem cellsResearch which sheds light on how blood cancer cells work may improve the power of leukaemia treatments. Gene found that shows which malarial mosquitos will be killed by insecticidesUK scientists have identified genetic differences in malarial mosquitoes which may reveal their level of resistance to insecticides. Extensive review finds no relationship between vaccines and autismA review summarising the many studies that refute the claim that vaccines cause autism finds no relationship between vaccination and autism. Obama to lift restrictions on stem cell researchResearchers throughout the US are eagerly awaiting confirmation that restrictions on stem cell research will be lifted by the new administration.
Obstetrics and GynaecologyLink between IVF drugs and cancer ruled outA large Danish study has laid to rest fears of a link between drugs used in IVF treatment and cancer.
OncologyPfizer discontinues global Phase III Trial of axitinib for futility in advanced pancreatic cancer - Magna CartaPfizer Inc announced the discontinuation of a Phase III study of its investigational agent axitinib for the treatment of advanced pancreatic cancer.
OrthopaedicsRoutine use of scans in patients with lower back pain does not improve outcomesResearch from the US says that patients with lower back pain do not require scans to help their management. Good muscle control the key to preventing back painAustralian researchers have shown that people suffering from lower back pain can significantly reduce pain by learning to control their trunk muscles.
PaediatricsA tall tale... that's not a tall taleIn developing countries young children have better survival chances if their mothers are taller, research in the Netherlands has found.
Pharmaceutical companiesPfizer awards $7 million towards global cancer control efforts - Magna CartaPfizer Inc and the Pfizer Foundation announced on February 4, “World Cancer Day”, that they have awarded $7 million in 2009 to help 13 non-governmental organizations (NGOs) focus on improving both treatment and prevention for cancer patients, through its Global Health Partnerships grants program (GHP).
PharmaceuticalsPIASA members welcome government's 13,2% nod - Inzalo CommunicationsPharmaceutical manufacturers have welcomed the health department's decision to allow them to increase medicine prices by up to 13,2%, bringing relief from the margin pressure experienced in 2008 as the CPI climbed and the price of imported raw materials soared against a weakening Rand.
Public healthSouth Africa: The quiet water crisisConcerned with a cholera threat from its northern neighbour, Zimbabwe, South Africa could be overlooking a creeping water crisis of its own, as ageing infrastructure and rising demand spew potentially deadly bacteria into its water systems. Nigeria: Painkiller leaves 84 children deadHealth authorities in Nigeria announced on 4 February that 84 children have died and a further 27 have fallen ill since November as a result of ingesting a pain-relief syrup called ‘My Pikin'. West Africa: When there is no village doctorAn international financial recession threatens to worsen the “severe medical workforce crisis” faced by almost 60 African and Asian countries, according to the UN World Health Organization (WHO). Public health insurance in Uganda still only a dreamThree months ago, Uganda planned to launch a compulsory public health insurance scheme, the first in the country. It didn't happen. Zimbabwe: Urban patients referred to rural mission hospitalsRosa Chimbindi, pregnant with her first child, recently went to Parirenyatwa hospital, one of Zimbabwe's largest referral facilities, located in Harare, the capital, to have her baby.
TuberculosisLiberia: Tuberculosis on the riseThe number of Liberians suffering from tuberculosis rose dramatically in 2008, according to government statistics, and health officials say more needs to be done to educate people about preventing the debilitating disease.
Women's healthNew study shows link between HRT and breast cancerA new study stirs up further controversy over the link between HRT use and breast cancer incidence. | | |
| | News for medical professionals | | Effect of urgent treatment of TIA and minor stroke on subsequent costs
| Long term survival after acute myocardial infarction and revascularisation
| Accupuncture treatment for pain: a systematic review
| The risk of suicide with selective serotonin re-uptake inhibitors: a review
| Clinical criteria can predict co-infection with TB in HIV positive patients
| Heterosexual risk of HIV-1 infection per sexual act
| Women doctors are more likely to follow heart failure guidelines
| | More... | | |
Print - Print any item in this newsletter.
Email - Email any item in this newsletter.
Comment - Comment on any item in this newsletter.
| 
|
| |
Business ServicesMOTORING CORPORATE WELLNESS BUSINESS TRAVEL TECHNOLOGY MANAGEMENT OFFICE EQUIPMENT
|
|
