Articles Posted in Testing

spinning-300x200Although many sports enthusiasts relish the summer as a peak time to train hard to get especially fit, wise athletes for safety’s sake may wish to build their way up to exhausting workouts, and to ensure they’re staying hydrated in healthful ways, while also recognizing that endurance competitions may alter their bodies in ways that they should at least be aware of.

The New York Times has posted an eyebrow-raising story on the perils to hard-driving jocks, male and female, of “rhabdo,” aka rhabdomyolysis, a “rare but life-threatening condition often caused by extreme exercise. It occurs when overworked muscles begin to die and leak their contents into the bloodstream, straining the kidneys and causing severe pain.”

Two doctors say they treated three recent, severe rhabdo cases brought on when novices in not great shape leaped into intense spinning classes, demanding exercise regimens lasting around an hour and involving specialized stationery bicycles. They found in medical literature 46 other, documented rhabdo cases, with 42 tied to novices’ spinning.

ExpiredDrug-300x225Americans each year needlessly toss hundreds of millions of dollars in costly, valuable, and still potent drugs, a wasteful practice driven by a “myth,” the mistaken belief in and scrupulous adherence to already debunked product expiration dates.

Drug discards, including of medications that may be in short supply nationwide, occur all along the distribution chain, from corner druggists up to giant health system pharmacies.

The practice flies in the face of known evidence, much of it developed, verified, and shared by the same force that presses for expired meds to get tossed: Uncle Sam.

dna-208x300Pathologists are the medical specialists whom few patients ever meet, but they play increasingly important roles in treatment decisions. Some new reports raise concerns about systematic errors in the path lab.

The New York Times painted a surprisingly distanced picture of the work of pathologists in a recent report on these medical doctors who are trained to interpret an array of laboratory tests and often microscopic materials to determine the care for complex diseases.

The paper found that the specialists and their labs mislabeled and mixed up patient samples and results, as well as sometimes contaminating them—yes, rarely, but with potentially significant harms. Erroneous results could lead to misdiagnoses, resulting in patients getting wrong or ineffective treatment, especially for cancers, experts say.

acurian-300x175When consumers around the country started getting letters from a company that they had never heard of, inviting them to participate in clinical trials for medical conditions that they hadn’t disclosed to many or didn’t even have, the alarms started to sound, quietly at first but with increasing urgency. Were doctors, hospitals, or other providers breaching medical privacy laws? Had there been a serious but unpublicized leak or unwelcome disclosure of patient data?

Kudos to the information site Buzzfeed for digging in and finding out how Acurian Health, a firm with an address in a rural county outside of Philadelphia, exploits state-of-the-art Internet marketing and data-mining techniques to learn, in creepy fashion, about Americans and their illnesses.

It does this by buying marketing information that a range of companies collect on customers, some of it volunteered and others extracted from data points like zip codes, purchasing patterns, and available demographics: Do you live in an upscale or modest neighborhood? Are you and your neighbors most likely to be highly educated professionals or blue-collar laborers?

thyroid-300x222Check the neck? If you’re doing so routinely, especially if you lack worrisome symptoms or haven’t had past problems, please reconsider: Regular thyroid cancer screenings received a “D” grade from a blue-ribbon panel of experts. The exams can cause more harm than good, says the U.S. Preventive Services Task Force, which does periodic, evidence-based reviews of common medical screens.

Its most recent review finds cause for concern that doctors and hospitals, pushed by a prominent patient advocacy group that Big Pharma’s helping to underwrite, keep recommending and subjecting patients to unneeded thyroid cancer screens. The screens, with ultrasound and physician exams, too often lead to more tests, and then to painful, invasive, and costly procedures.

Doctors worldwide are detecting thyroid cancer at increasing rates, with the found incidences going up by 5 percent annually in this country. But at the same time, the relatively small numbers of thyroid cancer deaths haven’t budged. They’re neither rising nor falling. (See the diagram).

Prostate-e1492269148971-483x1024A burst of bad headlines and not so great news reports may have confused some men. But to put it in lay terms:  The use of the common test for routine prostate cancer screening got a dim grade of C for many men, up from a dismal D, in a re-evaluation by independent experts who assess the nation’s preventive medical services.

That blunt review of regular prostate-specific antigen (PSA) tests, despite some reports to the contrary, keeps with how the influential U.S. Preventive Services Task Force (USPTF) looked at annual  screening for this most common form of cancer for men when it issued its first guidelines in 2012, notes healthnewsreview.org.

The health information site says the USPTF earlier had surprised many, downgrading routine prostate cancer screening to a D, and noting, “There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits.” It now says it rates a C for many men younger than 70, meaning physicians should “Offer or provide this service for selected patients depending on individual circumstances,” and that “There is at least moderate certainty that the net benefit is small.”

peanutsAlthough many of us would like nothing better than to dote on a favorite baby all day long, medical experts have offered some surprising turnarounds and concessions for the new year about what they do and don’t know about infant care-giving.

They have made a 180-degree reversal on their advice to parents on dealing with the rising problem of peanut allergies, while also suggesting that a familiar product may be more useful than thought to combat a common skin woe. And they have said that 90 percent of the medications given to newborns aren’t approved for such uses by the federal Food and Drug Administration.

Feed the baby peanuts, docs now say

knee-replacement-300x240Uncle Sam is struggling to figure how best to ensure the safety, quality, and accessibility of a major surgery for a sharply rising number of seniors who need it and want the government, through Medicare, to pay for it. Baby boomers, after decades of running, dancing, aerobics, football, basketball, zoomba, and all manner of joint-stressing activity, are lining up for knee replacements. Where should these procedures occur and how should they be paid for and evaluated?

The New York Times has reported that surgeons, some in hospitals and some in free-standing surgical centers, are riven by proposed rule changes that would allow patients 65 and older with Medicare to undergo complex, extensive knee replacement operations on an outpatient basis.

The surgeons who now do these operations in hospitals say this is a risky move for patients, who now typically spend several days hospitalized in recovery. The “hospital” docs say knee replacement is a complex procedure, with high risk of infection and post-operative complications, because, for example, patients receive powerful clot-busting drugs and potent painkillers as part of the surgical regimen.

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Celebrity is a powerful force in public opinion, and it often has been pursued by medical experts eager to tap its do-good potential. But a pair of recent star turns on preventive testing have caused consternation over their unintended and unwelcome outcomes. Have Angelina Jolie and Ben Stiller led their fans astray, prompting some to misunderstand the best, most current, evidence-based thinking on cancer care and others even to undergo unnecessary, invasive, and costly screenings?

New research, published in the peer-reviewed and well-respected British Medical Journal (aka the bmj), examined the aftermath of Jolie’s disclosure, in a New York Times Op-Ed three years ago, that she had been tested and found to carry the BRCA gene mutation that predisposes some women to breast and ovarian cancer.

She urged women to be screened for BRCA and told how, prophylactically, she had decided to undergo a double mastectomy and reconstructive surgery. She said she did not make this decision lightly and did so only based on her mother’s early cancer death and after Jolie received extensive medical counsel. To Jolie’s credit, her Op-Ed was thoughtful, careful, and nuanced. It was more disclosure than advocacy by one of the globe’s mega-stars, partly explaining her prolonged absence from the spotlight’s glare. Although the piece said the BRCA mutation is not common and the decisions can be complex about surgery and other means to deal with its potential effects, did that message get through?

mdmaMental health experts aren’t suffering Sixties flashbacks. But they are seeing a new day for Molly (aka MDMA, Ecstasy, or 3,4-Methylenedioxymethamphetamine) and magic mushrooms (psilocybin). These hallucinogenic drugs are getting serious consideration in helping those with post-traumatic stress disorder (PTSD) and depression and anxiety due to cancer.

The federal Food and Drug Administration, which won’t comment on the matter, has approved Phase 3 clinical trials (large-scale human research) of MDMA for treatment of PTSD, according to  Multidisciplinary Association for Psychedelic Studies (MAPS).  

MAPS is a nonprofit research and educational organization that “develops medical, legal, and cultural contexts for people to benefit from the careful uses of psychedelics and marijuana.”

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