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Hi Mike, The 400 that came to the stroke fair last year were not the group
we had obviously hoped for. 5 out of 400.The very young and the very old
often do not have any carotid plaques. We all know how many people have
strokes every year and more that 75% of most of our patients have less than
a 50% stenosis on any given day in a lab.
Or maybe it is just California stats.  We did not refer any patient for an
exam that had a noticable intimal thickening and nor do you measure anything
with a screen. I encourage you to look at the general public that shows up
for a free scan and see how many have disease. It just may surprise you. We
are having our stroke fair again Oct 5th. I will report our finds if anyone
would be interested.

Denise Levy, RVT, RDMS, RDCS
San Jose, CA Regional Medical Center
Registered since 1975.

On 9/27/07, Mike Elkins <[log in to unmask]> wrote:
>
>  "*5 out of 400*" or "*very little disease*" is misleading.  If you're
> screening for carotid lesions and not looking at IMT, you're missing many
> patients at high risk for stroke or MI.  2 out of 3 of ALL OF US will die
> from CVD.  We lose 50% of men and 66% of women in the transition from
> primary to secondary care.  Finding carotid lesions at a "screening" is like
> finding last year's eggs at an easter egg hunt.
>
>
>
> IMT will show subtle but significant changes EARLY in the life cycle of
> the disease.  Crestor is expected to get new labeling for regression.  How
> are you going to track changes?
>
>
>
> Mike
>  ------------------------------
>
> *From:* UVM Flownet [mailto:[log in to unmask]] *On Behalf Of *Denise
> Levy
> *Sent:* Wednesday, September 26, 2007 9:38 PM
> *To:* [log in to unmask]
> *Subject:* Re: Screening??
>
>
>
> I highly recommed a screening event in your community. We have a Health
> Fair or Stroke Fair at our hospital annually. We have 2 machines and 2 lines
> of visitors for screening. I follow the guidelines of ICVAL and a simple
> check is added to the carotid screen with a no mention to their doctor of
> the degree of disease.  We scanned 400 visitors from 11-4 PM and only 5 were
> referred to their doctors on the sheet.
>
> Read over the ICVAL guidelines and scan the visitor looking at the screen
> while sitting in a chair. It is a great tool for educating the public and
> the majoirity of visitors that they are have very little disease. You should
> only do a quick up and down transverse and only sagittal if you see plaque.
> No pictures are taken nor any percentage of stenosis is given. Remember it
> is just a free look and open to the public. I would like to eventually apply
> for the ICVAL screening, we have several catagories of ICVAL testing.
>
>
>
> Denise Levy, RVT, Regional Medical Center, San Jose, CA
>
>
>
> On 9/25/07, *Kerrie Cumming* <[log in to unmask]> wrote:
>
> The subject was brought up today if I would be interested in doing
> vascular screening tests at my current place of work.  I work for a vascular
> surgeons office and currently do "full" diagnostic vascular testing.  I'm
> not sure what to think, but I don't know if I could simply do a "screening"
> test.  I'm so used to being as thorough as possible, it would be hard for me
> to draw the line.  Although I feel "screening tests" are probably good for
> the public because you might catch something serious.  But then where would
> the results be sent? To the primary care doctor's office?  Who's
> responsible? Would the patients come back here to have the full test?  Would
> that be strange?  would we run into legality issues being a "full service"
> lab and a "screening" lab?  Any input would be welcome.  I hear ICAVL is
> going to try and set up accreditation for screening labs.
>
>
>  ------------------------------
>
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