the year in medical media

As we say farewell to 2009, LifeBridge Health is taking a look at some of the major events of the past year. Today, we look at a few of the medical stories that received media attention in 2009.

It is the waning hours of the year, and as such it is customary for many to make "Top xxxx Lists!" as a way of making 2009 into an artificial entity that we will shortly wave a fond farewell to, for better or worse, and leave behind in favor of the uncertain newness of 2010. Trying to craft any such a list for the year in medicine is a mad folly, given the sheer amount of news and discoveries that happened every week of these past 12 months. That noted, what follows is my completely subjective shortlist of medical stories that received media attention in 2009.

The dominant story of the year was clearly the new strain of H1N1 influenza virus. From it's discovery at the end of March, through its spread throughout the world and official classification as a pandemic by the World Health Organization, no other issue came close to the "swine flu's" saturation of the media. Unfortunately, much popular news coverage of the outbreak has ranged from barely adequate to frankly horrible (ABC2's H1N1 Day of Answers was an excellent event, and a notable exception to this). Often focused on fearful hype or dismissive ignorance, many media reports chose to sensationalize and misrepresent certain aspects of the pandemic (vaccines side effects, for one) while not actually doing their job - objectively reporting facts in an informed way. Coupled with some poor choices in government communication to the general public, and a failure of manufacturers to deliver vaccine on the promised timetable, the end result was unnecessary public fear, confusion, and public health inadequacy where there should have been a smooth, strong response. In this, we are fortunate that the 2009 H1N1 strain is less virulent than it might have been. I'll be taking a much closer look at the pandemic to date, and future prospects, next week.

If there is one thing that rivaled influenza in terms of media coverage this year, it was the process to craft legislation for United States health care reform. As I type this, both the US House of Representatives and the Senate have passed separate reform bills after months of deliberation, and now face the difficult prospect of merging them together. To call what has led up to this point a "debate" would be particularly generous - the amazing variety of agenda-driven nonsense that has spewed out from various political factions and interest groups is staggering, and has often threatened to drown out the basic facts involved. Add to this that said basic facts are rather complex, and that there is no "right answer", and you end up with a media message that just cannot report the issues involved adequately. The process, and the conversations it has generated, say alot about we as a people, and both the strengths and weaknesses of our political process. Our current health system (cue cutting glare at most insurance companies here) is quite deficient in some ways, and the proposed legislation is an imperfect tool to bring about needed change, but it is a start.

In the midst of this incendiary health care mess, the US Preventative Services Task Force released a long-prepared update to their mammography screening guidelines in November. Based on solid science and cost-benefit analyses, they changed their recommendations to be that women at low risk of breast cancer should start discussing mammograms with their physicians at age 40 and get them routinely starting at age 50 (as opposed to just starting at age 40), and once started, getting them every two years instead of annually. What was done in order to reduce the costs and harms (due to false positive results leading to unnecessary surgery, among other things) to a population of women in whom mammography as a screening tool doesn't work as well to detect breast cancer was then portrayed by some elements of the media as a womens' rights issue or an example of healthcare rationing (neither being true). The fundamental point that many seemed to miss is that guidelines such as these for certain populations of people are not mandates for individual patients or physicians. At the end of the day, it is unlikely that many physicians will change their breast cancer screening practices based on these recommendations alone, and hopefully more women will have informed discussions with their physicians about mammography. I'll also be going into more detail on these and other screening recommendations in future weeks.

The last two medical media-related stories on my hit list have to do with interesting research that was reported to be far more significant than it actually was. October saw headlines about a study from Thailand that finally demonstrated an "effective" and "promising" HIV vaccination strategy using a combination of vaccines. Upon examining the study however, the results were that 31% less of the patients that had the vaccine combination acquired HIV when compared with those who did not, and after correction for leaving out some who were already HIV infected, this dropped to a 26% difference. This is a potentially interesting result, but given the variables and statistics involved, hardly qualifies for language like "promising" or "effective." October also brought reporting on another paper that described a virus called XMRV that was reported to be associated with chronic fatigue syndrome. The study described finding this pathogen in 3.7% of healthy patients, but in 67% of people diagnosed with CFS. While the paper itself was appropriately conservative in suggesting the association, several news outlets and at least one of the paper's authors were outspoken on this being a clear infectious link to a rather unclear syndrome. The problem with such bold statements here is that this study, while interesting, is certainly not definitive; patients labeled as having chronic fatigue syndrome may comprise multiple groups of people with different underlying disorders; XMRV is a poorly understood virus; and as with life in general, in medicine it is vastly important not to confuse correlation (saying that the virus is there in many of the patients that have the syndrome) equals causation (saying that the virus is the cause of the syndrome). Both of these stories do have merit behind them, and I look forward to further progress here in the coming year.

2009 has been a whirlwind of new medical information, hampered by frequently poor media dissemination of that information. Just as it is incumbent on various news outlets to embark on informed, non-sensationalistic science reporting, it is equally critical for the medical community and the lay public to seek out rational facts about medical issues, and evaluate media reports with a skeptical eye. May 2010 see better medicine reporting, for the more knowledgeable health of us all.

Krieger Eye Institute Hosts Cataract Screening

What does Latin etymology have to do with your eyes?

In Latin, the word cataracta means "waterfall." That's the feeling many people have when there are cataracts in their eyes - the clouding of the lens of the eye is similar to the distortion you'd see if you were looking through a waterfall. Other symptoms are

• Frequent eyeglass prescription changes
• Double vision in one eye
• Need for brighter light to read
• Poor night vision
• Fading or yellowing of colors

According to a report from National Eye Institute and Prevent Blindness America, cataracts affect nearly 20.5 million Americans age 40 and older. By age 80, more than half of all Americans have cataracts.

While surgery is the only way to remove a cataract, new eyeglasses may also help. If you or a loved one suspect you may have cataracts, a free screening is being offered Tuesday by the Krieger Eye Institute. The screening is from 5 p.m. to 7 p.m. at the Quarry Lake Office, 2700 Quarry Lake Drive. Call 410-601-WELL (9355) to register.

Breast Cancer Screening Offered

If you're a woman, mark your calender for Wednesday, October 7. That's when we're inviting you to join us for an evening of frank and honest discussion about women’s breast health hosted by WJZ-TV 13 news anchor Mary Bubala.

Clinical breast exams will be offered on a first come basis, and all are encouraged to take tours of the new, spa-like Samuelson Breast Care Center. Light refreshments will be served.

SPEAKER PROGRAM

Dawn Leonard, M.D.
Breast surgeon
Medical director, Herman & Walter Samuelson Breast Care Center

Dr. Leonard will open the evening’s program with a discussion about regular screening and early detection of breast cancer.

Deb Kirkland, B.S.N., M.P.H.
Breast nurse navigator, Herman & Walter Samuelson Breast Care Center
Deb will talk about the importance of breast self exams/breast self awareness, especially in younger women. As a survivor, she will share her personal experience with breast cancer and how it evolved into the role of Nurse Navigator for breast cancer patients in the Breast Care Center.

Shannan DeLany Dixon, M.S., C.G.C.
Genetic counselor, LifeBridge Health
Assistant professor, Department of Pediatrics, Division of Human Genetics, University of Maryland School of Medicine
Shannan will discuss the key risk factors and warning signs of hereditary breast cancer. She will focus on the importance of a family history of cancer and talk about two key genes, BRCA 1 and 2. She will also cover what genetic testing can and cannot tell us, and how this information is useful to doctors and patients.

SCHEDULE

5:30 – 7:00 p.m. Registration, clinical breast exams and self-guided tours.
7:00 – 8:00 p.m. Speaker program and question and answer session.
8:00 – 8:30 p.m. Clinical breast exams and self-guided tours.

To register for a screening and/or the speaker program, call 410-601-WELL (9355).

Screenings Available at Northwest Hospital

Health screenings at Northwest Hospital can help you learn about your heart.

The screenings, held next weekend, include blood pressure, body composition analysis, heart health lifestyle assessment, lipid panel, and comprehensive metabolic blood profile. There is a $20 fee.

The comprehensive metabolic profile includes glucose, creatinine, sodium, potassium, chloride, carbon dioxide, alkaline, phosphatase, total protein, albumin, anion gap, calcium, and total bilirubin. The lipid panel includes HDL cholesterol, LDL, total cholesterol and triglycerides.

Pre-registration is required, call 410-601-9355. Participants must fast 12 hours. You should drink 8 ounces of water prior to the screening in order to have an accurate body composition analysis. Please wear loose clothing. Blood will be drawn from your arm.

Results will be mailed to you in 4-5 weeks. Also included in your fee is a 2-week free membership to LifeBridge Health & Fitness.

These screenings are not intended to be used as a substitute for your regular doctor exam,
but as an added checkup. All results should be shared with your physician.

Appointments begin at 9 a.m. on Saturday, September 12 and Sunday, September 13 at the Northwest Hospital Education Center, 5401 Old Court Road in Randallstown.

For women's heart health, knowledge is power

While breast cancer gets plenty of attention, more women die of heart attacks. The fact is more than 500,000 women die from cardiovascular disease each year, according to the American Heart Association. That is about twice as many than from all types of cancer. One in 2.5 women will die of cardiovascular disease every year compared with one in every 30 women dying from breast cancer.

Women, and the people who love them, must be proactive in knowing their risk factors in keeping their hearts healthy. For example, women's symptoms for a heart attack are often different from those suffered by men. Some women may not have chest pain when having a heart attack but may have difficulty breathing and/or unusual and unexplained fatigue.

For more information about cardiovascular disease, consider attending a LifeBridge Health Women's Heart Screening on Tuesday, June 16, at the Woodlawn Community Center at 9 a.m. For just $10, you will receive a blood pressure screening, cholesterol screening, glucose testing, body composition analysis, heart health risk assessment based upon results, and brief counseling with a registered nurse. A cardiologist will review results with certain risk factors.

Click here for more information or to sign up today.