Like a scene out of Star Trek, someday our doctors may simply wave a handheld device over our bodies and instantly diagnose any malady. In the meantime, however, it’s important to keep abreast of the latest tests that can help us stay healthy—especially those that uncover risks before symptoms actually occur. The following five tests are not yet considered as routine as cholesterol or blood-sugar tests, but chances are your doctor already is familiar with them. Not every test is necessary at every visit, and your insurance company may not pay unless it considers a particular test “medically necessary.” Still, ask about them. Here’s why they may be important to you.
CRP, or C-reactive protein
This is a simple blood test that measures the amount of inflammation in your body. In many ways, CRP is the best “crystal ball” of health ever devised in a single blood test. Elevated CRP levels have been shown to precede and predict heart attack, stroke, colon cancer, diabetes, high blood pressure, Alzheimer’s disease, aneurysms, sudden cardiac death, abnormal heart rhythms like atrial fibrillation and even macular degeneration, a leading cause of blindness.
CRP is a protein made by our immune system that fuels the fire of inflammation in our bodies. The higher your CRP level, the more at risk you are to develop problems. Optimal levels—less than 0.7 milligrams per liter—predict good health.
It’s important to understand that CRP doesn’t diagnose any particular conditions—it’s not specific. It just identifies whether you’re at risk for illness. It’s best to check your CRP during your routine annual physical, when you feel fine. If you’re sick with something, your CRP probably will be elevated.
The good news is that CRP levels can be lowered by exercise, modest weight loss, taking a multivitamin, eating a diet rich in fruits and vegetables, and certain medications such as aspirin and statins (cholesterol-lowering drugs).
Vitamin D level
Vitamin D is essential for healthy bones because it’s needed for calcium absorption. But new research also is identifying an important role for vitamin D in the immune system and in the prevention of cancer, including breast and prostate.
Studies show that more than half of American women don’t get enough vitamin D. It’s known as the “sunshine vitamin,” because your skin makes it when you’re out in the sun. That’s why people who lack daily sun exposure or who use sunblock when outdoors may be deficient in the vitamin. It’s almost impossible to get adequate amounts from foods, despite fortification of dairy and some soy foods. All multivitamins contain vitamin D, but for most people even that is not sufficient. You may need to take a vitamin D supplement. Most people should get between 1000 and 1500 IU of vitamin D3 daily. (D3 is the natural form of vitamin D. It’s more easily absorbed and stays in the body longer.) The best way to know if you’re getting enough vitamin D is to get a blood test.
H. pylori test
About 20% of Americans may unknowingly be infected with the bacteria responsible for stomach cancer, heartburn, ulcers and even eye disorders. The discovery of H. pylori (Helicobacter pylori) infection as the primary cause of stomach ulcers worldwide earned Australian researchers Robin Warren and Barry Marshall the Nobel Prize in medicine for 2005. The bacteria also have been found to cause stomach cancer.
H. pylori is a chronic, potentially lifelong infection of the stomach. It can cause stomach pain, heartburn or indigestion, but it’s often silent, causing no symptoms. Infection typically occurs when a person eats contaminated food and ingests the bacteria. The infection can be cured with a combination of antibiotics and antacids.
A blood-antibody test can show if you’ve ever been infected, and a stool test or breath test can identify if you currently have an active infection. Fortunately, successful treatment of H. pylori eliminates the increased risk of stomach cancer, ulcers and related disorders.
Aspirin has been shown to be a powerful preventive measure for people at risk for heart attack and stroke as well as for colon cancer, and it’s estimated that as many as 50 million Americans take aspirin daily to prevent a heart attack. What’s not clear is the optimal dose of aspirin for prevention. Most people are taking a baby aspirin (81 milligrams), but research has shown that 10% to 20% of people are resistant to aspirin and require higher dosages in order to benefit from its protective effects.
An aspirin check is a test that determines the effectiveness of the daily aspirin for an individual. This is important for people who are taking aspirin therapeutically for cardiovascular disease as well as those at increased risk for heart disease who are taking aspirin for prevention. The test can be ordered by your doctor but also is available directly from an online lab.
Type 2 diabetes is characterized by an excess of insulin production in response to eating. The glucose tolerance test has long been the standard way to identify someone with diabetes. Until recently, glucose tolerance tests measured only blood sugar, or glucose levels, which are raised when a person has diabetes. But measuring your body’s insulin-production levels improves the test by being able to identify your risk of diabetes long before symptoms emerge.
Typically, to do the test, your blood is drawn twice—first after fasting, then again two hours later after a glucose drink. Your insulin levels are recorded. If the results indicate that you’re at a higher risk for diabetes, the good news is that you also have time to take action. Type 2 diabetes can be prevented by adopting a lifestyle that includes daily exercise, weight control and a low-glycemic diet that reduces the intake of sugar, refined grains and starches.
ST. JOHN’S — The work of a suspended Newfoundland radiologist was so poor that he missed glaring problems such as tumours, broken bones and cases of pneumonia, the chief of the province’s largest health board said yesterday after an in-depth review of nearly 3,800 patient records.
As a result, some patients of Fred Kasirye may have missed potentially life-saving treatment, said Louise Jones, interim chief executive officer of the Eastern Health Authority.
“There have been pneumonias that have been missed, there’s been fractures that have been missed, there’s been some tumours that have been missed,” Ms. Jones said during a news conference. “We did not go back to quantify that. We had over 5,000 reports that were going out and we left that in the hands of the physicians and the patients themselves.”
Dr. Kasirye was hired at the Burin Peninsula Health Centre in southern Newfoundland last November. But in May, he was suspended without pay after colleagues at the hospital raised concerns over his procedures and decision-making.
The provincial government then ordered Eastern Health to review the 6,412 X-rays, CT scans, ultrasounds and fluoroscopies under Dr. Kasirye’s purview. The review, conducted by more than 20 radiologists, found that Dr. Kasirye misread 708 exams. It also concluded that 21 patients whose exams were misread have died, but not as a result of the errors.
“We recognize that the review took some time to complete, however, this was a very complex process and it was necessary for us to take the time to ensure that we had accurate information to report to our patients, physicians and their families,” Ms. Jones said.
“We provide great health care … the full review that we did was to ensure that people had the best health care that they possibly could.”
Dr. Kasirye is believed to be outside the country and could not be reached for comment. He is appealing his suspension. His lawyer, Liam O’Brien, did not return messages.
In recent months, Eastern Health, which oversees 290,000 patients, has been reeling from questions surrounding the quality of its health care and its willingness to release information to the public. Days before it announced Dr. Kasirye’s suspension, sworn affidavits filed with the Newfoundland and Labrador Supreme Court showed that flawed breast cancer test results were given to more than 300 patients.
George Tilley, then the health board’s CEO, apologized for the “confusion” that came about after the results of a review that discovered the botched breast cancer tests were not fully disclosed. He later resigned.
Eastern Health is now the subject of a judicial inquiry and class-action lawsuit over the breast cancer tests.
Scientific literature suggests that between 2 per cent and 20 per cent of radiology tests can be inaccurate. The review into Dr. Kasirye’s work found his error rate to be 11 per cent.
“There is no consensus in the literature,” said Benvon Cramer, chairwoman of the discipline of radiology at Memorial University.
Beginning in January, Eastern Health will implement random peer audits in an effort to cut down on the number of misread radiology tests.
“Our radiologists believe that a program such as this will reduce the range of acceptable variance for radiology reports,” Ms. Jones said. “In this particular instance, this is a very good thing. We are really ahead of the pack.”
Canada currently has no quality assurance programs for radiology tests.
The neonatal intensive care unit that handles some of the sickest, most fragile babies in Toronto remains closed today after a baby died of serratia — a bacteria that normally doesn’t kill adults or healthy children but can be deadly if contracted by premature infants.
Mount Sinai Hospital officials said the two-week old baby, who weighed between 500 and 1,500 grams, died last weekend. They won’t release the name or sex of the infant for privacy reasons. Read More….
Monday, May 21st, 2007 – I almost spilled my cup of jasmine tea, I was laughing so hard.
I had just been viewing the first part of a DVD video documentary called “Dying to Have Known,” and I had to stop the thing right there, and rewind, to see if what I had just seen really had happened. Yup, it did.
So I stopped it again, went and got my wife Jan and said “You’ve got to come and watch this.” It’s worth re-playing again and again. MORE
We all make mistakes, even doctors from time to time. And in theory, it’s good to admit it when we make a mistake.
But when it comes to doctors, a recent study suggests they’re more likely to say it’s important in theory to disclose a medical error to patients than they are to actually `fess up.
The study, published online by the Journal of General Internal Medicine, was based on survey responses from 538 faculty, resident physicians and medical students at teaching hospitals in the Midwest, Mid-Atlantic and Northeast.
Researchers at the University of Iowa found that while nearly all respondents – 97 percent – said they would disclose a hypothetical medical error that resulted in minor medical harm, 93 percent said they would disclose an error even if it had caused disability or death.
But only 41 percent said they had actually disclosed a minor medical error they made, and just 5 percent said they had revealed a major error during their career. Moreover, 19 percent said they had made a minor medical error but not disclosed it; 4 percent said they had made a major error and not disclosed it. Read More on this topic….