Need for long-term follow-up for CAD in breast cancer survivors
Young women treated with radiation therapy for left-sided breast cancer have over twice the risk of coronary artery disease (CAD) as women treated with radiation therapy for right-sided breast cancer.
According to an analysis of 972 participants in the Women’s Environmental Cancer and Radiation Epidemiology Study, the overall incidence of CAD was 10.5% for women who received left-sided radiation therapy after a diagnosis of breast cancer between 1985 and 2008.
This compared to 5.8% for women who underwent right-sided radiation therapy.
For younger women diagnosed between 25-39 years of age, those who received left-sided radiation therapy had a 5.9% incidence of CAD while those receiving right-sided radiation therapy reported no CAD.
Women diagnosed between 40-54 years of age experienced an 18.7% incidence of CAD after undergoing left-sided radiation therapy and 6.8% after undergoing right-sided radiation therapy.
One of the authors, Dr Gordon Watt from Memorial Sloan Kettering Cancer Center, said the good news was that modern techniques and computerised treatment planning have reduced the amount of radiation that reaches the heart.
An accompanying editorial said the findings reaffirm the role of prolonged surveillance for CAD in younger survivors.
Telehealth MBS items now available for hospital inpatients
New MBS telehealth items have been introduced to cover in-hospital services for private admitted patients receiving specialist care where the doctor is unable to attend due to the COVID-19 pandemic.
Available from 15 September 2021, the 40 temporary items (valid until 31 December) for specialists cover video and phone consultations for a specialist who is located in COVID-19 hotspot, or in isolation or quarantine.
According to Medicare, private health insurance rebates and gapcover schemes do not apply for these telehealth attendances.
Out of pocket costs for the new items will count towards the patient’s Medicare Safety Nets (original and extended).
In its Factsheets, Medicare says MBS specialist telehealth items do not need to be bulk billed, although this is encouraged
“The fee structure for the new items aligns with equivalent face-to-face items and existing COVID-19 telehealth specialist items introduced from March 2020,” it says.
MICA celebrates 50 years of bringing coronary care into the street’
Cardiologist Dr Graeme Sloman’s Mobile Intensive Care Ambulance (MICA) service is celebrating its 50th year providing coronary and intensive care via first responders in the community.
Founded by Dr Sloman and ambulance officers Wally Byrne and Wally Ross in 1971, the program has grown from one team in a converted mid-70s Dodge to 600 paramedics in cities, rural areas and the air, according to Ambulance Victoria. In its three-month pilot, the ambulance attended 93 cases, mostly coronary care and road trauma patients. Within a few years, it was attending 250 cases a month, Ambulance Victoria wrote.
Dr Sloman’s creation was the first MICA service in Australia and only the third in the world.
““The advent of MICA brought coronary care and intensive care into the streets, homes and workplaces of Victorians who needed urgent medical help,” said Ambulance Victoria CEO Professor Tony Walker, who is also a MICA paramedic.
“Year on year MICA has continued to deliver even better care to the community. It has saved the lives of countless patients across the state and touched the lives of many more,”