Medical Imaging

Medical imaging has revolutionized screening and diagnosis, but this technology is not risk-free. As use of advanced imaging has grown, attention has increasingly focused on the risks of radiation exposure, the anxiety associated with incidental findings, and the costs of such imaging. This issue of the NCMJ will address the pros and cons of medical imaging and will discuss how this technology can be used more safely and effectively. TABLE OF CONTENTS | FULL ISSUE (pdf) »

  • 75(3) Data-driven care
  • 75(4) Cancer
  • 75(5) Long-term care

The Impact of Maltreatment on the Developing Child

INVITED COMMENTARY Child maltreatment represents an extreme traumatic insult to the developing child. Chronic traumatic exposure during childhood may lead to persistent changes in brain structure and chemistry that contribute to long-term dysfunction.

Respiratory Diseases: Meeting the Challenges of Screening, Prevention, and Treatment

ISSUE BRIEF Respiratory conditions, both acute and chronic, continue to have a significant impact on worldwide health because of their high prevalence, the high disease burden they place on individual health, and their enormous cost to the health care system. There are also unmeasured indirect economic costs due to loss of productivity. Despite advances in our understanding of the complex pathophysiology of respiratory diseases, as well as the availability of relatively straightforward primary prevention measures, the prevalence of chronic respiratory diseases continues to rise. In addition, periodic outbreaks of acute infectious respiratory conditions result in significant cost and even mortality, and the incidence of these conditions fluctuates widely from year to year. Although we have seen recent developments in medical therapies for respiratory diseases, and there are established and well-publicized disease management guidelines, morbidity and mortality remain high. One intervention that has lagged behind has been smoking prevention and cessation, which is the mainstay of prevention for chronic obstructive pulmonary disease and lung cancer. The persistence of these conditions underscores vulnerabilities within our national and regional health care systems. Several of the articles in this issue of the NCMJ describe innovative programs to address these challenges.

Direct-to-Consumer Genomic Testing Offers Little Clinical Utility but Appears to Cause Minimal Harm

INVITED COMMENTARY Direct-to-consumer genomic testing is available to anyone willing to pay for it. We investigated the reliability and reproducibility of such testing by sending DNA samples to 2 popular companies and by reviewing current literature on this topic. The concerns that were initially raised about direct-to-consumer genomic testing still seem valid.

Breast Cancer Screening

INVITED COMMENTARY Mammography remains the primary technique for breast cancer screening. Women with dense breast tissue may benefit from digital mammography and tomosynthesis, and women at high risk may benefit from magnetic resonance imaging. However, false-positive results are problematic. The North Carolina breast density law necessitates education about screening options for women with dense breasts.