geoffrey modest medical blogs

  A Swedish study found that following men with a high PSA with an MRI seemed to be a reasonable approach for risk-stratifying patients, decreasing false positive results and without leading to significant delays in diagnosis of significantprostate cancer, in the Gothenburg-2 trial, a large, population-based, screening trial (see psa MRI followup NEJM2024  in dropbox, or DOI:10.1056/NEJMoa2406050). Special thanks to Brittany Berk (a really smart urologist and, it just so happens, my daughter-in-law) for some comments and suggestions.....   Details: -- about 80,000 men who were 50 to 60 years of age in Gothenburg (aka “Goteborg”), Sweden were eligible for participation in the trial, from which 38,316 men were randomly selected and invited for screening, a population-based trial that started in 2015 -- those who accepted the invitation were assigned in a 1:1:1 manner to 1 of 3 groups:     -- those with low PSA levels of 1.8-3.0 ng/mL....

  this is the second blog on long covid, highlighting a couple of studies documenting long-term pathologic organ abnormalities in some individuals with long covid, and these abnormalities may explain some of their long-term symptoms:  see  https://journals.sagepub.com/doi/epub/10.1177/01410768231154703 , or  covid long covid organ impairment JRoyalAcadMed 2023  in dropbox)   Details: -- 536 individuals in a UK study who had recovered form acute covid infection but had long covid symptoms 6 and 12 months after their initial infection -- mean age 45, 73% female, 89% white, 32% health care workers, 13% having had acute Covid hospitalization (ie mostly mild-moderate cases) -- BMI 25, smoking never 65%/current 3%/past 32%; hypertension 10%; diabetes 2%; heart disease 1%; asthma 19% -- organ assessment was by 40-minute MRI scans, blood work or other incidental findings; all assessed both initially and at 6 month follow-up     -- MRI targeted 49 organ-sp...