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CRC & Follow-Up Screening

Patients with colorectal cancer (CRC) who undergo potentially curative surgery have been shown to have an increased risk of disease recurrence. To reduce this risk, several professional societies have issued guidelines that specify a combination of regularly scheduled office visits, colonoscopy, and the carcinoembryonic antigen (CEA) test to detect changes that could indicate a recurrence. The hope is that early detection of recurrence can enable clinicians to treat patients appropriately and prolong their lives. Unfortunately, studies show that some patients may not receive these services as recommended. In fact, others may be sent for CT or PET scans even though they...

Conference Highlights: The AHA 2008 Annual Meeting

The American Heart Association held its 2008 Scientific Sessions from November 8-12 in New Orleans. The features below highlight just some of the news emerging from the meeting. For more information on these items and other research that was presented, go to http://scientificsessions.americanheart.org/. JUPITER The Particulars: Increased levels of high-sensitivity C-reactive protein (CRP) can help predict cardiovascular events. Statins have been proven to lower CRP levels as well as cholesterol. JUPITER (Justification for Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin) was a large, multinational, long-term, double-blind, placebo-controlled, randomized clinical trial intended to evaluate whether healthy individuals with normal LDL cholesterols but elevated CRP levels would benefit from statin therapy (rosuvastatin 20 mg/day). Data Breakdown: Researchers randomly assigned 17,802 healthy men and women with LDL cholesterol levels less than 130 mg/dL and high-sensitivity CRP levels of 2.0mg/L or higher to 20 mg/day of rosuvastatin or placebo. Participants were evaluated for the occurrence of the combined primary end point of myocardial infarction, stroke, arterial revascularization, hospitalization for unstable angina, or death from cardiovascular causes. At 12 months follow-up, the rosuvastatin group showed a decrease in median LDL cholesterol levels from 108 mg/dL to 55 mg/dL. CRP levels decreased from 4.2 mg/L to 2.2 mg/L, and triglyceride levels dropped by 17%. At 1.9 years follow-up, rosuvastatin was associated with a 44% reduction in cardiovascular events when compared with placebo. Take Home Pearl: Use of statin therapy in individuals with low LDL but elevated high-sensitivity CRP significantly reduced the incidence of major cardiovascular events. TIMACS The Particulars: Optimal timing of an invasive strategy is still unknown in the management of...

Making the Case for Point-of-Care Testing

The Piccolo xpress (Abaxis) comprehensive metabolic panel (CMP) recently became the first CMP to be granted Clinical Laboratory Improvement Amendments (CLIA)-waived status by the FDA. With this waiver, providers can now conduct comprehensive, lab-accurate chemistry analyses at the point-of-care in minutes under a simple certificate of waiver from the Centers for Medicare and Medicaid Services. The waiver eliminates some of the barriers that kept many physician offices from performing point-of-care blood analysis, allowing them to improve patient care and increase office efficiency. CMP test results give physicians a comprehensive health assessment that provides critical information for accurate diagnosing and triage of patients during their initial office visit. Instead of waiting multiple days for tests results from reference laboratories, physicians can ascertain an accurate assessment of health at the point-of-care. On-site testing also gives physicians the ability to check the effectiveness of an existing treatment plan and make adjustments in realtime. In addition to the CMP, eight other Piccolo xpress panels have been granted CLIA-waived status, including the lipid, lipid plus, liver plus, and kidney check panels. Considering that lipid-lowering agents are commonly prescribed, having the ability to perform rapid, point-of-care lipid tests combined with liver and kidney function tests is a great advance. The liver panel waiver is beneficial because many patients on lipid-lowering therapies are required to have their liver function tested every 4 to 6 months. The kidney check panel, used primarily in radiology centers for assessing renal function prior to MRI and CT procedures, gives radiologists the ability to safeguard against potential kidney and cardiac damage from contrast medium injections. Improve Efficiency Point-of-care testing also helps...

Preventing CVD in Women: A Focus on Lifetime Risk & Lifestyle

In 1999, the American Heart Association (AHA) published its first Guide to Preventive Cardiology in Women. The guide synthesized the most recent clinical research data and highlighted unique aspects of risk factor management in women. Subsequently, in 2003, a systematic review was conducted, and evidence-based guidelines for the prevention of cardiovascular disease (CVD) in women were released. Since that time, numerous clinical trials have been conducted to evaluate differences that exist between men and women in relation to CVD diagnosis and prevention. A 2007 guideline update provides the most current clinical recommendations for preventing CVD in women aged 20 and older. They are based on a systematic search of the highest quality science interpreted by experts in the fields of cardiology, epidemiology, family medicine, gynecology, internal medicine, neurology, nursing, public health, statistics, and surgery. The 2007 Guidelines for Preventing Cardiovascular Disease in Women were published in a special...
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