This week I've been doning my anaesthetics attachment. One of the patients undergoing a general anaesthetic whom I followed was a 76 year old man who had presented with a massive abdominal aortic aneurysm. I read this article on the BMJ about screening for AAA. I had not known previously that this was done but it definitely gave me the impression that abdominal aortic aneurysms are much more common than perceived!
26th June 2009 - Screening prevents aneurysm deaths but questions remain over cost-effectiveness.
Screening is an interesting public health topic and one that we quite often grapple with one the medical course. Of course it is only useful screening for diseases if they are treatable. It is clearly now thought in the UK that a National Screening programme for this for over 65s will prevent about half of all aneurysm deaths (approx 6,000 men die from a ruptured AAA every year). In order to calculate cost-effectiveness, one study used QALY - a combined measure of quantity and quality of life). They found that infact the cost-effectiveness of the screening was not as true as the reporters had suggested.
Another interesting article which I read this week was on the BBC News website. They compiled a news report that in the UK there was widespread inappropriate tube feeding of patients.
6th January 2010. 'Jane Dreaper. Inappropriate tube feeding of patients 'widespread'. BBC News.
The Royal College of Physicians maintained that every effort needs to made to ensure that feeding is by mouth for as long as possible, but that with increasining numbers of patients with dementia, feeding difficulties were becoming a 'growing problem'. It was re-iterated once again that the patient must come first in these circumstances. It is perceived that in some places 'tube feeding' is carried out because it is possibly 'easier'. This is a suggestion which The Alzheimers Society repute and say is unacceptable. As doctors I think that it is important that we put the patient first, considering their needs, and advocate oral feeding for as long as possible in caring for patients with dementia.
And just on another note - this week the elective flights have been booked!
I'm flying Virgin Atlantic, Glasgow to Barbados, Grenada on Saturday 10th July.
Returning from Havana to London on Monday 6th September. Something to definitely look forward to over the next 6 months!
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