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Monthly Archives: November 2009

Swine Flu Vaccine

Gavin LeSueur - November 23, 2009

Preliminary data suggest that the pandemic influenza vaccine is safe, the Therapeutic Goods Administration reports this week, with the rate of adverse reactions being in line with previous flu vaccines. This is good news for the target groups.
The swine flu vaccination program aims to protect those who are most at risk of exposure to the H1N1 Influenza 09 (swine flu) virus. This includes health care workers and people who are more vulnerable to severe health complications from swine flu. This is why the most vulnerable people in our community are encouraged to get the swine flu vaccine first. These include:

* Pregnant women
* People with chronic health conditions such as asthma, heart and lung disease, cancer, diabetes, kidney disease, neurological disease and people with suppressed immune systems
* People with moderate to severe obesity (BMI of 35+)
* Health care workers
* Indigenous people
* Parents and guardians of infants under six months old.

The vaccine is also available for anyone else who wishes to protect themselves from swine flu, including healthy people. Contact your doctor or immunisation provider to make an appointment. The vaccine is free of charge, although your provider may charge you a service fee.

Breast Screening controversy

Gavin LeSueur - November 22, 2009

The media have increased the controversy about the recent changes in the recommendations for Breast Screening Mammography and breast self examination. Basically, the recommendation to have biannual breast mammograms done has changed from 40 to 50 years of age. This is because a thorough study of the screening results, outcomes, complications of investigations and breast cancer survival figures have shown no significant survival difference but higher investigation complications from earlier screening. Stay tuned.
I think this quote is relevant:
“So, what does this mean if you are a woman in your 40s? You should talk to your doctor and make an informed decision about whether a mammography is right for you based on your family history, general health, and personal values.”

Diana Petitti, MD, MPH
Vice Chair, U.S. Preventive Services Task Force
November 19, 2009

Breast screening recommendation change.

Gavin LeSueur - November 20, 2009

The US Preventative Services Task force (USPSTF) is the major US body that makes recommendations related to what screening tests have a benefit. There has been a recent change in what they recommend for women aged 40 to 49 years. The recommendation is as follows:

The USPSTF recommends against routine screening mammography in women aged 40 to 49 years. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient’s values regarding specific benefits and harms.

What does this mean? Basically routine screening if you have no symptoms, no family history or risks is no longer recommended until the age of 50 years. If you decide to have a mammogram prior to this age you should discuss the pros and cons with your Doctor. Why the change? Breast cancer is not common under 50 and many benign changes are discovered on mammograms that necessitate further investigation. To avoid unnecessary investigation the balance is against have routine screening done.

Should I test or screen or is ignorance bliss?

Gavin LeSueur - November 10, 2009

Informed consent is being debated in the medical press at the moment. Preventative health screening can be done for many problems but there are risks in screening. There are ‘false positives’ (a positive result that is really not), complications of screening (pain, bruising and bleeding) and often many people have to be screened to detect the one cancer. For example, a stool specimen bowel cancer screen will detect other causes of bowel bleeding such as non-cancerous polyps. A colonoscopy (needed as further investigation) can cause bowel perforation. These are serious problems and before you progress with a screening procedure you should be aware of them. This is called ‘informed consent’ and is the reason why all our recommendations are designed for you to discuss with your health practitioner.
The recommencdations on are not those of groups with vested interests (ie make money our of you) in having you screened. The recommendations are those of government groups that look at the individual and public impact of screening and those that show definate benefit are listed.

STI screening recommendations

Gavin LeSueur - November 8, 2009

If you are sexually active then consider your risk of having an STI that might not be causing any symptoms. Chlamydia is the commonest undiagnosed sexually transmitted infection and it can be present and you not know it. If you have sex without a condom you are at risk – even if it was only once. Talk to your Doctor about the simple screening tests available. There are good links to STI screening when you put in your details for your annual health checks and exams needed.
Most days in my practice I do STI screens. Most days a new diagnosis is made and a patient is potentially saved the complications of infertility, pelvic inflammatory disease or prostatic infections. This is one of the cases where ignorance is not bliss…

Arthritis in the family?

Gavin LeSueur - November 6, 2009

Joint pain is a common, often debilitating problem. There are many and varied causes and persistent pain should be reviewed by your Doctor. If you have arthritis in the family there are things your should be doing to lessen the risk and impact on your life – good weight control being one of them. Maintaining good fitness and flexibility will reduce the impact of all forms of arthritis. Because many forms of arthritis vary naturally with time if someone is using a ‘therapy’ and is on the natural improvement stage they usually swear that it was the therapy that got them better. This is why there are a million and one alternative therapies for arthritis. If they passed good clinical trials the Medical Profession would take them up. Rarely do they. Arthritis needs a good Doctor to help you diagnose, treat and manage the condition through the ups and downs.

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