June 16th, 2010 by Davis Liu, M.D. in Better Health Network, Health Policy, Health Tips, News, Opinion, Research
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The Associated Press has been running a fantastic series of must reads with the latest article highlighting the consequence of too many imaging studies, like X-rays and CT scans, which are the biggest contributor to an individual’s total radiation exposure in a lifetime. Americans get more imaging radiation exposure and testing than people from other industrialized countries.
Reasons for doing too many tests include malpractice fear, patient demands for imaging, the difficulty in obtaining imaging results from other doctors or hospitals, as well as advanced technologies, like coronary angioplasty, which have increased radiation but avoid a far more invasive surgery like heart bypass. Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
May 28th, 2010 by Toni Brayer, M.D. in Better Health Network, Health Tips, Research
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The British Medical Journal reported on a study of toothbrushing and found that people with poor oral hygiene had an increased risk of cardiovascular disease and heart attack.
We’ve known for the last two decades that inflammation plays an important role in atherosclerosis. Markers of low-grade inflammation like C-reactive protein are also shown to be higher in heart disease.
The Scottish Health researchers looked at the general population and followed a large subset with questions about their oral health. They asked about frequency of dentist visits, toothbrushing, and controlled for many co-variables such as general activity, hypertension, smoking, height and weight. They also collected blood for studies of C-reactive protein as a marker of inflammation. They removed from the analysis participants who had no natural teeth (edentulous) and those with existing cardiovascular disease.
This elaborate and lengthy study showed that toothbrushing is associated with cardiovascular disease, and that subjects who brushed their teeth less than once a day had a 70 percent increase in heart disease compared with people who brushed twice a day. The inflammation that periodontal disease causes is directly related to increased C-reactive protein and increased heart attacks.
Leave it to the Scotts and the Brits to remind us to brush and floss every day.
REFERENCE: British Medical Journal, 2010; 340: c2451.
*This blog post was originally published at EverythingHealth*
May 17th, 2010 by Bryan Vartabedian, M.D. in Better Health Network, Health Policy, Opinion, Research
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I recently stumbled onto the “Minimally Disruptive Medicine” blog maintained by Dr. Victor Montori from the Mayo Clinic. I have to admit that the name caught my attention so I scoped it out.
According to Dr. Montori, “minimally disruptive medicine refers to the practice of medicine that seeks to design effective treatment programs for patients while minimizing the burden of treatment.” He describes this as an emerging field.
I have to admit that I was simultaneously puzzled and intrigued. After all, how is this different from the way good medicine is practiced? I, for one, like to think that I create individually-tailored programs that meet my patients’ needs while minimizing their treatment burden. Read more »
*This blog post was originally published at 33 Charts*
March 27th, 2010 by Peggy Polaneczky, M.D. in Better Health Network, News, Opinion, Research
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A well-done analysis in the BMJ this week calls into question previous research that has been used to tout mammography as an effective tool for lowering breast cancer mortality in Denmark. That previous study compared breast cancer death rates in Copenhagen, where women were offered screening mammography in 1991, to areas in Denmark where mammograms were not offered until 17 years later, and concluded that the introduction of mammogram screening resulted in a 25 % reduction in breast cancer mortality in screened areas.
The new study adds an additional county where screening was offered (with a little implication that perhaps the previous researchers should have included this other area, but I’ll stay out of the academic finger pointing) and then reanalyzes the data. Read more »
*This blog post was originally published at The Blog that Ate Manhattan*
