Medical Tests & Procedures Archive

Research we're watching

Contrary to conventional wisdom, most people with older implanted cardiac devices may be able to safely get a magnetic resonance imaging (MRI) scan, according to a study in the Feb. 23, 2017, New England Journal of Medicine.

The devices, which include pacemakers and implantable cardioverter-defibrillators (ICDs), help regulate and restore the heart's normal rhythm. Concerns that the powerful magnets in MRIs could damage these battery-operated devices led to the development of newer, MRI-safe devices. But an estimated two million people in the United States have one of the older devices, and at least half of them might need an MRI in the future.

In the journals

People who suffer from migraines have increased risks of stroke and hospital readmission within 30 days after having surgery, according to research published online Jan. 10, 2017, by BMJ.

The study included 124,558 patients (45% of whom were men), who had a history of migraines, either with or without aura (a period of symptoms, such as flashes of light or facial tingling, that precedes the migraine). The researchers monitored the condition of all the patients after either inpatient or outpatient surgery. They then looked at how many had strokes and how many were readmitted to the hospital over the following 30 days.

In the journals

Prostate-specific antigen (PSA) tests are used to help identify men who may have a higher risk of prostate cancer. But a study published online Jan. 12, 2017, by JAMA Oncology, describes a new way to use PSA that may pinpoint men who are likely to die early from prostate cancer that returns after initial treatment.

The researchers used data from a randomized trial of 157 men whose localized cancer was treated with either radiation alone or radiation along with six months of androgen deprivation therapy. The men were then followed for 16 years.

Ask the doctor

Q. I have been smashed, squashed, pulled, and tugged annually for 25 years. Why isn't there a better way to take a mammogram?

A. We hear you! Compression mammography has been the "gold standard" for decades for one reason — it works. Flattening the breast makes ductal tissue easier to distinguish and reduces the amount of radiation required to do so. Studies have demonstrated that it is the most effective approach to breast cancer screening.

The predictive powers of a cholesterol test only go so far. If your LDL is low, your C-reactive protein may be a better sign of impending heart trouble.

The gap between knowing what's good for you and actually doing it can be huge, especially when it comes to something like getting exercise. (Never underestimate the appeal of the sedentary life.) Many of us need a warning-some might say a bit of a kick in the pants-before we'll change our ways and get with a heart-healthy program.

Cholesterol Tests

For decades, cholesterol testing has served as that warning for many. An elevated level of "bad" LDL cholesterol has been just the warning people needed to change their ways. It has played that role for several reasons. People like tests because the results seem objective. Reliable measurement of cholesterol is easy and relatively inexpensive. It makes sense biologically. LDL cholesterol, a protein-wrapped package containing fat and cholesterol, tends to slip out of the bloodstream and lodge in blood vessel walls, forming the plaque that leads to clots and heart attacks.

Women with early cancer in one breast may opt to remove the other, healthy breast because they overestimate their risk of a second cancer.

Cardiorespiratory fitness may soon be considered as a vital sign on par with blood pressure and heart rate.

 Image: © iStock

Three decades' worth of solid evidence linking a sedentary lifestyle to higher risk of cardiovascular disease, cancer, and early death has silenced even the most ardent exercise deniers. Nonetheless, a metric quantifying a person's level of aerobic fitness has yet to make it into the set of tools commonly used to predict heart disease.

But that may soon change. The American Heart Association recently released a statement calling for cardiorespiratory fitness (CRF) to be considered a clinical vital sign, similar to how blood pressure, heart rate, and tobacco use are treated now. Assessing fitness level at your annual visit would help your doctor get a better picture of your underlying heart health and risk of disease down the road.

In older people, angioplasty done through an artery starting in the wrist may have fewer complications than conventional angioplasty done through a vessel starting in the leg.

If you don't mind pricking a finger, you can check your cholesterol without sitting around in a doctor's waiting room or laboratory. Devices available in pharmacies or through the Internet make this easy to do at home. But is it worth doing?

The makers of home cholesterol tests rightly tout their products as faster than visiting a doctor. You prick your finger, gently squeeze a few drops of blood onto a test strip or into a small "well," and you get the results in a few minutes, instead of waiting a few days.