On July 9 2021, results from the STHLM3MRI study were presented in The New England Journal of Medicine, indicating that over-diagnosis could be reduced by substituting traditional prostate biopsies with magnetic resonance imaging (MRI) and targeted biopsies. The new results, now published in The Lancet Oncology, show that the addition of the Stockholm3 test, which was developed by researchers at Karolinska Institutet, can be an important complement. It is a blood test that uses an algorithm to analyze a combination of protein markers, genetic markers and clinical data.Karolinska Institutet. “New blood test improves prostate cancer screening.” ScienceDaily. http://www.sciencedaily.com/releases/2021/08/210813100313.htm (accessed August 14, 2021).
Results Some 88 013 patients who were FIT positive complied with colonoscopy (males: 56.1%; aged 50–59 years: 49.1%) while 23 410 did not (males: 54.6%; aged 50–59 years: 44.9%).
The 10-year cumulative incidence of CRC was 44.7 per 1000 (95% CI, 43.1 to 46.3) among colonoscopy compliers and 54.3 per 1000 (95% CI, 49.9 to 58.7) in non-compliers, while the cumulative mortality for CRC was 6.8 per 1000 (95% CI, 5.9 to 7.6) and 16.0 per 1000 (95% CI, 13.1 to 18.9), respectively. The risk of dying of CRC among non-compliers was 103% higher than among compliers (adjusted HR, 2.03; 95% CI, 1.68 to 2.44).
Conclusion The excess risk of CRC death among those not completing colonoscopy after a positive faecal occult blood test should prompt screening programmes to adopt effective interventions to increase compliance in this high-risk population.Non-compliance with colonoscopy after a positive faecal immunochemical test doubles the risk of dying from colorectal cancer — https://gut.bmj.com/content/early/2021/03/30/gutjnl-2020-322192?rss=1
Help me understand human behavior. You get a positive FOBT or Cologuard test and your doctor says you need a colonoscopy but you decide not to follow up and follow through with the scope.
Point-of-care lung ultrasound is better than chest x-ray for diagnosis of COVID-19 pneumonia, according to new research.Lung Ultrasound Beats Chest X-Ray for COVID-19 Diagnosis – Medscape – Nov 06, 2020 — https://www.medscape.com/viewarticle/940563?src=rss
Sex Differences in Coronary Artery Calcium and Mortality From Coronary Heart Disease, Cardiovascular Disease, and All Causes in Adults With Diabetes: The Coronary Calcium Consortium
RESULTS Among 4,503 adults with diabetes (32.5% women) aged 21–93 years, 61.2% of women and 80.4% of men had CAC >0. Total, CVD, and CHD mortality rates were directly related to CAC; women had higher total and CVD death rates than men when CAC >100. Age- and risk factor–adjusted hazard ratios (HRs) per log unit CAC were higher among women versus men for total mortality (1.28 vs. 1.18) (interaction P = 0.01) and CVD mortality (1.47 vs. 1.27) (interaction P = 0.04) but were similar for CHD mortality (1.48 and 1.48). For CVD mortality, HRs with CAC scores of 101–400 and >400 were 3.67 and 6.27, respectively, for women and 1.63 and 3.48, respectively, for men (interaction P = 0.04). For total mortality, HRs were 2.56 and 4.05 for women, respectively, and 1.88 and 2.66 for men, respectively (interaction P = 0.01).
CONCLUSIONS CAC predicts CHD, CVD, and all-cause mortality in patients with diabetes; however, greater CAC predicts CVD and total mortality more strongly in women.Sex Differences in Coronary Artery Calcium and Mortality From Coronary Heart Disease, Cardiovascular Disease, and All Causes in Adults With Diabetes: The Coronary Calcium Consortium — Diabetes Care 2020 Oct; 43(10): 2597-2606. https://doi.org/10.2337/dc20-0166
CVCT CardioBrief published online earlier this week a letter from a group of “clinicians, researchers and imaging specialists” who are concerned about the “presentation, interpretation and media coverage of the role of cardiac magnetic resonance imaging in the management of asymptomatic patients recovered from COVID-19.” It’s short and sweet but makes many excellent points. Let’s…Cardiac Testing Post COVID-19: Of Echos and MRIs — The Skeptical Cardiologist
Excellent post. Thanks for sharing your expertise Dr. Pearson.
I mentioned in my post entitled “Should You Utilize A Home Pulse Oximeter During COVID-19?” that I had purchased a home pulse oximeter and had used it to monitor my oxygen saturation (SpO2) levels during the time I had COVIDesque symptoms recently. Personally, I felt the device was returning accurate information and was helpful in…How Accurate Are Pulse Oximeters Labeled Not For Medical Use? — The Skeptical Cardiologist
And if you decide not to read Dr. Pearson’s entire article here’s your take home message:
During my illness I would measure my SpO2 twice daily and at times when I felt short of breath. When I felt the worst I noted the SpO2 had dropped to 95%. Within 24 hours it rebounded and I recorded >96% thereafter.
If the SpO2 had progressively dropped and consistently showed values <90% I would have contacted my primary care physician and described the constellation of signs (pulse rate, respiratory rate, BP, and SpO2) and symptoms (shortness of breath, cough, headache, fatigue, etc.) that I had and seek his advice on what to dohttps://theskepticalcardiologist.com/2020/09/12/how-accurate-are-pulse-oximeters-labeled-not-for-medical-use/
I encourage all to read the entire article, links provided above.
Thanks for the research Dr. Pearson.
A study published yesterday in JAMA has the skeptical cardiologist very concerned about the long-term cardiac effects of COVID-19 infection. The investigators performed cardiac MRI (CMR) on 100 patients with documented COVID-19. Cardiac MRI is now considered the gold-standard for noninvasively measuring pathologic changes in cardiac muscle. In this study of a cohort of German…
via It’s Now Time to Worry About Long-Term Cardiac Consequences of COVID-19 — The Skeptical Cardiologist
Thank you Dr. Pearson.
And the following is a link to the Medscape article:
A finding of any type of polyp in the colon increases the risk for colorectal cancer (CRC), according to new findings from a large Swedish study.
At 10 years, the cumulative colorectal cancer incidence was 1.6% among patients with hyperplastic polyps, 2.5% among those with sessile serrated polyps, 2.7% for tubular adenomas, 5.1% for tubulovillous adenomas, and 8.6% for villous adenomas, as compared with 2.1% for the control group.
However, a higher risk for colorectal-related death was only observed in patients with sessile serrated polyps, tubulovillous adenomas, or villous adenomas.
The study was published online March 16 in Lancet Gastroenterology & Hepatology.
Boldface sections are mine.
I had my first virtual visit with my physician yesterday. I mentioned that I was postponing my colonoscopy this year for pandemic reasons. She said that’s fine, don’t worry about it. I read this article today. Now I know why I’m on a three year callback.
For far too long, many patients have undergone a cardiac test that carries grave risks with the misunderstanding that they are getting the definitive assessment of their coronary arteries. Chances are if you have visited an emergency room in the USA with chest pain and you weren’t clearly having an acute heart attack, you ended up…
Thank you Dr. Pearson.