| Contents
of Current Issue |
Colorectal Cancer Screening
Colon
cancer kills more than 56,000 people each year, and screening
could prevent more than half of those deaths. Unfortunately, the
vast majority of Americans older than 50 do not undergo colon
cancer screening even though current guidelines recommend it. In
data from the 1998 National Health Survey, only 20-30% of
respondents 50 years of age or older reported having had fecal
occult blood testing during the preceding 2 years, and only
5-20% had a screening endoscopy during the preceding 3 years.
Colorectal screening and polyp removal have the unique
distinction among cancer screening methods of being able not
only to reduce deaths from colorectal cancer, but also to
prevent the disease from developing. Given that colon cancer is
the 2nd leading cause of cancer death in the U.S., that the
cumulative lifetime risk for colon cancer in this country
exceeds 5%, and that each year more than 140,000 new cases are
found, the availability of screening tools that can virtually
eliminate cancer risk raises the question, Why are so many
people not screened? WHAT ABOUT YOU?
American College of Gastroenterology (ACG) recommends: For
patients with average risk, begin screening at age 50 with a
preferred screening strategy of colonoscopy every 10 years. An
alternative strategy is flexible sigmoidoscopy every 5 years
plus annual FOBT (fecal occult blood testing). When risk
increases from average to moderate, for instance when the family
history is significantly positive, then screeening should be
done more aggressively--although the specifics are beyond the
scope of this article.
Detailed
discussion of guidelines
|
| |
Greetings!
Internal Medicine Associates of Grand Junction, P.C.,
is now publishing a newsletter for our patients. It will
come out once a month.The newsletter includes current
medical news, and will also answer medical questions
frequently asked by our patients.
In addition, this newsletter will be posted on the
website of Rick Castellini, after first being discussed
on his radio show "Castellini on Computers."
(http://www.HelpMeRick.com)
|
| |
| |
| |
- New Cervical Cancer Screening Guidelines
|
| |
The
US Preventive Services Task Force (USPSTF) has issued
updated guidelines on cervical cancer screening. The
major points include recommendations that:
Cervical cancer screening be conducted in women who
have been sexually active and have a cervix. Routine
screening cease in women older than 65 who have had
regular screening in the past and who are not at high
risk for cervical cancer. Routine Pap smear screening
stop in women who have had a total hysterectomy for
benign disease. Thus in our medical office we are no
longer performing routine pap smears for women over the
age of 65. Getting old is not all bad!
A
summary of the guideline is available on the Internet at
this link.
|
| |
- C-Reactive Protein: Not for Most People
|
| |
Atherogenesis
appears to be an inflammatory response to cardiovascular
and cerebrovascular risk factors. In response, the CDC
and the American Heart Association published a
scientific statement recommending the use of
high-sensitivity C-reactive protein (hs-CRP) testing in
selected patients to precisely identify those who might
benefit from more aggressive medical therapy. Reference:
Pearson TA, Mensah GA, Alexander RW, et al. Markers of
inflammation and cardiovascular disease: application to
clinical and public health practice: a statement for
healthcare professionals from the Centers for Disease
Control and Prevention and the American Heart
Association. Circulation. 2003;107:499- 511.
Levels of hs-CRP have a dose-response relationship
with cardiovascular disease-a statistical relationship
that is maintained after controlling for other
cardiovascular risk factors. Determinations of hs-CRP
seem to add predictive value over and above that
provided by traditional risk factors. The Scientific
Statement Writing Group now recommends that hs-CRP
values be used to refine risk predictions for patients
in whom multiple risk factor screening projects a
10-year cardiovascular risk of 10% to 20%. The hs-CRP
information can be used as a basis for intensifying
medical treatment and for motivating patients to lose
weight, stop smoking, exercise, and make similar
lifestyle changes. Levels of hs-CRP may decrease in
patients who take statins, fibrates, and niacin. Weight
loss, increased exercise, and moderate alcohol
consumption may also be associated with reductions in hs-CRP
levels. Because many questions about hs-CRP and other
inflammatory markers remain unanswered, the panel
recommended against universal screening. In addition,
screening is not recommended for patients assessed as
having either a low or high risk of cardiovascular
disease. A patient known to be at low risk (less than
10% in 10 years) is unlikely to have an elevated hs-CRP
level, and information about hs-CRP will not change
treatment in a patient known to be at high risk (greater
than 20%). (According to the panel, hs-CRP should be
measured twice either in the fasting or in the
nonfasting state. Low-, average-, and high-risk
categories correspond to hs-CRP levels that are lower
than 1.0 mg/L, 1.0 to 3.0 mg/L, and higher than 3.0
mg/L, respectively.)
|
| |
- Innovations Can Keep Wounded Troops Alive on
Battlefield
|
| |
Our
soldiers are wearing bullet-proof vests that offer
decent protection from torso wounds. Wounds to the limbs
have become more common, and blood loss from such wounds
remains a major cause of death in the field. A person
can die within one hour if the blood loss is 100
milliliters a minute, the equivalent of just three shot
glasses.
One new tool in medic's bag is a fast-working
bandage. This new bandage contains clotting agents that
help to quickly stop bleeding. Laboratory animal tests
show that when the bandage is applied for just two
minutes, the clotting agents stop the bleeding (unless
the bleeding is from certain injuries such as arterial
rupture).
CNN
article from 1/31/03 on battlefield medical tools
(includes video)
|
| |
- Fruit Juice Intake Tied to Reduced Risk of UTI
|
| |
Have
you heard that cranberry juice may help women with
urinary tract infections (UTIs)? New evidence shows that
consumption of fresh juices and fermented milk products
may protect women from UTIs. Investigators based in
Finland found that women who regularly drink fresh
juices and eat yogurt and cheese may be less likely than
others to develop UTIs. The authors found that women who
drank at least one daily glass of fresh juice were 34%
less likely than other women to develop an UTI. Women
appeared especially protected from UTIs if they drank
juices made from berries, the report notes.
Women who reported eating milk products that contain
probiotic bacteria--such as yogurt and cheese--at least
three times each week were almost 80% less likely to
have developed a UTI than women who ate these foods less
frequently. "Dietary habits seem to be an important
risk factor for UTI recurrence in fertile women, and
dietary guidance could be a first step toward
prevention," Dr. Tero Kontiokari, from the
University of Oulu in Finland, and colleagues note. Dr.
Kontiokari and colleagues base their findings on surveys
of the eating habits of 139 women who had developed a
UTI within 2 weeks prior, and 185 women who had not
experienced UTIs within the past 5 years. Study
participants' average age was 30 years.nt UTI reported
higher consumption of fresh fruit juices and milk
products containing probiotic bacteria. The authors
speculate that certain foods and drinks may ward off
UTIs by modifying the stool's bacterial content, which
may in turn reduce the risk of UTIs. Am J Clin Nutr
2003;77:600-604
Link
to website on urinary infections, reviewed favorably in
my radio show archives.
|
| |
|
|
| |
Do
you need to continue getting a tetanus vaccination every
few years for the rest of your life? Not if you are over
the age of 50 and have had proper tentanus vaccinations
earlier in your life. At the age of 50, you can get your
final tentanus booster shot, and be done with it.
|
| |
|
