Bismillah, alhamdulillah.

Right, time to write. The threat of rain seems to have done wonders for patient numbers as the clinic is quite sparse for a Wednesday PM! Time to have another look at my ongoing summary of 2010:

Mammography under 50?: More or less? The Americans are still trying to decide. It is very nice to see the USPSTF trying to be as independent as possible and the reaction of the ‘experts’ and interested parties in the work generated speaks volumes for any independent observer. Medscape offered a good debate n the issue here.  In my opinion the USPSTF represent the bRight side of this debate – no routine exams needed for under 50’s.

Goodbye Sibutramine – Guess what? Another drug gets withdrawn because it caused more CVAs and MIs. Health warning: a repeat episode is likely in the future with he next drug to make super millions for its par/tent holder. Just remember some basic physiology – there is no known physiological mechanism for weight loss known to the human body. Loosing weight is a pathological process. We are giving drugs to push people into pathology, physiologically speaking. Food tax is the only way.

Looking for an excuse to eat more chocolate? The good news from this systematic review is that your stroke risk and risk of dying all go down if you eat chocolate (22% & 40%). The bad news the amounts are very small compared to what the real world eats and the study is not well powered and ends with the famous research line: we need another study.

Screen heavy smokers for lung cancer: A large shows potential benefit, but the big screening questions remain as the following quote shows:

… a 7% reduction in all-cause mortality among people who were screened by CT, compared with those screened by chest x-ray. About 25% of all the deaths were due to lung cancer; the other deaths were related to causes such as cardiovascular disease…

Take home message, doing helical low-dose CTs reduces your mortality from non-lung cancer causes more than it reduces lung cancer caused mortality. And this is a heavy smokers screening program. Does anyone know who is selling the low dose helical scanners – perhaps their share value might be heading north.


3 thoughts on “Medical Review of 2010 – Part 2

  1. Assalamu alaikum

    Jazakallahu khairun for that review…actually all CT scanners are able to perform low dose…it is a question of adjusting the parameters.
    I have been advocating the use of low dose CT for selected patients for a long time but it is a question of a change in culture.

    In the US there has been publicity regards this issue for the past few years so there is a big impetus to lower the dose…unfortunately there is a lack of awareness on the risks associated with scans in the middle east..hence the lack of impetus; certainly an issue I would like to target

    Unfortunately, by lowering the dose parameters, it affects the image quality and radiologists are reluctant to do this because studies become less diagnostic, this study is shot in the arm for low dose CT, …the drive however needs to come from the clinician , especially in pediatrics to request low dose CT…



  2. Just wondering the helical CT even at low dose wouldn’t that be a lot of radiation. I believe smoking cessation and alert GPs in identifying the right/high risk cases will remain as the most important defence line against Lung CA

  3. Advising patients to stop smoking ideal. However, they often do not and we are left with the costs of treating them with chemoradiotherapy and expensive treatment options whereas if discovered early it may be more cost effective.

    With regards radiation, these scans are in high risk selected patients . The low dose is almost a tenth of the normal dose administered so is of much lower risk.

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