FED: CheckUp medical column for Friday, April 18

AAP General News (Australia)
04-18-2008
FED: CheckUp medical column for Friday, April 18

Check Up: A weekly column on issues affecting your health

By AAP Medical Writer Tamara McLean



HEAVY BODIES STRAIN PATHOLOGISTS

Pathologists say that almost 30 per cent of the bodies they perform autopsies on are
now obese, placing the industry under heavy strain.

Adelaide forensic pathologist Professor Roger Byard said mortuary staff risk serious
back injury trying to manoeuvre large bodies, and specialists have difficulty performing
procedures on them.

Dissections were technically difficult due to layers of fat and were sometimes not
possible on standard trolleys or tables, Prof Byard writes in the Journal of Forensic
and Legal Medicine.

"Autopsies have been performed on floors, or with a pathologist leaning from a ladder,
or actually standing on the trolley over a body," said Prof Byard, who is calling for
specialist equipment designed for heavy bodies.



ONE IN FIVE DIAGNOSES WRONG

Doctors misdiagnose their patients in at least 20 per cent of cases, and poor communication
or lack of sleep are to blame.

This is the claim of an international expert in human error in patient treatments,
Professor Pat Croskerry, whose controversial findings have made headlines in his home
country of Canada.

While visiting Australia recently, the specialist gave a lecture in Melbourne saying
that the rate of wrong diagnosis was "surprisingly high".

"Autopsy findings have consistently shown a 20 per cent discrepancy rate with the pre-death
diagnosis, and a third of these autopsies would not be taking place if the true diagnosis
had been known," said Prof Croskerry, from Dalhousie University.

"In some cases where there is existing uncertainty in diagnoses, the discrepancy rate
can be higher."

He said more needs to be done to teach doctors how to improve their cognitive skills,
emergency responses and critical thinking to avoid making fatal mistakes.



HORMONE THERAPY DOESN'T BLOCK DEMENTIA

Using hormone therapy will not reduce a woman's risk of developing dementia, US researchers says.

Scientists followed about 2,900 women aged over 75 years - half of whom were taking
hormones - for four years, regularly performing tests to assess their thinking ability.

After accounting for age, education and medical history, hormone use did not affect
the risk of dementia, concluded Dr Valerie Crooks, of Kaiser Permanente Southern California.

"This study also determined that no protective effect against dementia was found for
women who initiated hormone therapy at or near menopause," Dr Crooks said.

She said it was not fully understood how hormone therapy affected dementia.

But this study, published in the American Journal of Epidemiology, added to the evidence
that hormone use does not prevent the development of dementia in older women, the specialist
said.



SMALLER BRAINS FOR BUBS OF SUBSTANCE ABUSERS

A mother's substance use during pregnancy can mean a smaller brain for her child, according
to a new US study.

Among 35 children aged 10 to 14, those whose mothers had used cocaine, drank alcohol
or smoked tobacco or marijuana while they were pregnant tended to have a smaller head
circumference than their peers who weren't exposed to those substances prenatally.

The differences seen with use of a single substance were not statistically significant,
but became so when a child was exposed to two or more of them, according to the study
in the journal Paediatrics.

While the findings suggested no single substance had a "devastating" effect on the
foetal brain, Dr Michael Rivkin of Children's Hospital and Harvard Medical School in Boston
said they did show that a combination of them quite possibly would.

"There is no smoking gun," Dr Rivkin said.

"Although firm conclusions about the discrete individual effects of prenatal cocaine,
alcohol or cigarettes on brain volume in the children of our small sample cannot be made,
these data are consistent with a possible, lasting effect of each."



GENE STOPS RAPID GROWTH INSIDE TUMOURS

Australian scientists have discovered a new way to stop rapid growth of blood vessels
that "feed" deadly tumours, paving the way for a new cancer therapy.

Fast-growing blood vessels are essential in helping tumours grow and spread, but a
team from Western Australia revealed they could halt the process by switching off a master
gene.

Turning off the gene, called RGS5, forces vessel growth to return to normal and gives
the immune system a better chance of getting to the tumour and destroying it.

The world-first discovery, reported in the international journal Nature, was made in
mice, but the researchers and other cancer experts say it offers hope as a bold new therapy
if the process can be replicated in humans.

"By understanding what is actually going on in the tumour itself, the ultimate hope
is that we'll be able to work on making current therapeutic approaches even more successful
and reducing side effects of them," said Professor Ruth Ganss, of the Western Australian
Institute for Medical Research.

Prof Ganss and her team were studying the behaviour of blood vessels when they realised
the gene could reverse so-called angiogenesis, the growth of blood vessels inside the
tumour.

AAP tam/srp/mn

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