February 18th, 2011 by Mary Knudson in News, Opinion
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This was the Guest Blog at Scientific American on February 16th, 2011.
New wave of MRI-safe pacemakers set to ship to hospitals
This week Medtronic will begin shipping to hospitals in the United States the first pacemaker approved by the FDA as safe for most MRI scans. For consumers, it is a significant step in what is expected to be a wave of new MRI-compatible implanted cardiac devices.
But this is an example of one technology chasing another and the one being chased, the MRI scanner, is changing and is a step ahead of the new line of pacemakers. The pacemaker approved for U.S. distribution is Medtronic’s first-generation pacemaker with certain limitations, while its second-generation MRI-compatible pacemaker is already in use in Europe where approval for medical devices is not as demanding as it is in the U.S. So let’s check out what this is all about — what it means now for current and future heart patients and where it may be headed.
We are all born with a natural pacemaker that directs our heart to beat 60 to 100 times a minute at rest. The pacemaker is a little mass of muscle fibers the size and shape of an almond known medically as the sinoatrial node located in the right atrium, one of four chambers of the heart. The natural pacemaker can last a lifetime. Or it can become defective. And even if it keeps working normally, some point may not function well along the electrical pathway from the pacemaker to the heart’s ventricles which contract to force blood out to the body.
Millions of people in the world whose hearts beat too fast, too slow, or out of sync because their own pacemaker is not able to do the job right, follow their doctors’ recommendation to get an artificial pacemaker connected to their heart to direct its beating. The battery-run pacemaker in a titanium or titanium alloy case the size of a small cell phone, (why can’t it be the size of an almond?) is implanted in the upper left chest, just under the skin, with one or two insulated wire leads connecting to the heart. It can be programmed to run 24/7 or to only operate when the heart reaches a certain state of irregular beating. Read more »
*This blog post was originally published at HeartSense*
February 15th, 2011 by KevinMD in Better Health Network, Opinion
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Abdominal pain is the bane of many emergency physicians. Recently, I wrote how CT scans are on the rise in the ER. Much of those scans look for potential causes of abdominal pain.
In an essay from Time, Dr. Zachary Meisel discusses why abdominal pain, in his words, is the doctor’s “booby prize.” And when you consider that there are 7 million visits annually by people who report abdominal pain, that’s a lot of proverbial prizes.
One reason is the myriad of causes that lead bring a patient to the hospital clutching his abdomen. It can range from something as relatively benign as viral gastroenteritis where a patient be safely discharged home, to any number of “acute” abdominal problems necessitating surgery.
But more importantly, we need to consider how limited doctors actually are in the ER. Consider the ubiquitous CT scan, which is being ordered with increasing regularity:
The pros: CT scans are readily available, able to look at every organ in the abdomen and pelvis, and very good for ruling out many of the immediately life-threatening causes of belly pain. CT scans can also reduce the need for exploratory surgery. The cons: Often, CTs can’t diagnose the actual cause of ER patients’ abdominal pain. Worse, CTs deliver significant doses of radiation to a patient’s abdomen and pelvis (equivalent to between 100 and 250 chest X-rays). Over a lifetime, patients who receive two or three abdominal CT scans are exposed to more radiation than many Hiroshima survivors.
Add that to the fact that patients expect a definitive diagnosis when visiting the hospital — one that doctors can’t always give when it comes to abdominal pain. Read more »
*This blog post was originally published at KevinMD.com*
December 10th, 2010 by Medgadget in Better Health Network, News, Research
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At the Charité Hospital in Berlin, researchers have built a specialty MRI machine with enough space to fit a woman undergoing labor. The Local, a German newspaper in the English language, is reporting that the first images of a baby moving through the birth canal have been captured, and that the mother and child are doing just fine. The clinicians involved in the project hope to be able to study why some women end up requiring a Caesarian section, while others do not.
More at The Local: MRI scans live birth…
*This blog post was originally published at Medgadget*
November 26th, 2010 by RyanDuBosar in Better Health Network, Health Policy, News
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Potential health effects of airport security are being questioned for their possible health consequences, from spreading germs to radiation exposure to the stress that being searched induces.
With cheaper flights available this year and the need for security in air travel, the Transportation Security Administration (TSA) is justifying its full body scans and its pat-downs that rise up travelers’ legs — all the way up.
The scanners use microwaves, leading some to question whether people may be receiving too much radiation. It’s also a concern to activists who may have already undergone a lot of radiation for existing condition, or who have other conditions for which TSA agents may not be trained. (Read one seasoned traveler’s personal experience here.) The TSA reports the scanners expose users less energy than a cell phone.
Some protesters refused the body scans in favor of a pat-down, in an effort to tie up air travel on the day before Thanksgiving and force a review on the issue. But a manual exam spreads germs, say others.
Amid all the speculation of potential health consequences, federal officials are reminding travelers that the security measures are there for passenger safety. However, retorts Jason Mustian‘s Twitter feed, “Body scans and genital fondlings would save more lives if our government was paying to have them done in hospitals rather than airports.”
*This blog post was originally published at ACP Internist*
November 15th, 2010 by GarySchwitzer in Better Health Network, Health Policy, News, Opinion
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Last week, after the National Lung Screening Trial results were released, David Sampson, American Cancer Society director of medical and scientific communications, wrote that “our greatest fear was that forces with an economic interest in the test would sidestep the scientific process and use the release of the data to start promoting CT scans. Frankly, even we are surprised how quickly that has happened.”
And, yes, the marketing has even hit fly-over country in the Twin Cities, with this ad appearing in the Sunday Minneapolis Star Tribune in the “A” section:
Of course, no where in the ad will you read about the potential harms of such scans, the false positive rate, what happens when you get a false positive (unnecessary followup testing and perhaps unnecessary treatment), and more costs. And nowhere in the ad will you read that 300 heavy smokers had to be scanned in order for just one to get a benefit of extending his life. But six clinics in this chain are standing by to take your money and do your scan.
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
