web1_Lahmel-Cephas-WBTwpPD-03242019.jpg

Police: Three arrested for passing counterfeit cash

web1_Kingston-Police.jpg

Police: Teacher told student to send nude pictures

<p>What screening tests, when?</p><p>No, this isn&#8217;t another story about Scouting merit badges; although for the Home Repairs badge, I did have to replace the mesh screening in a few aluminum storm window screens of my parents&#8217; home.</p><p>I remember being somewhat surprised and then dismayed at the hardware store that there were so many options regarding the screen material and its size as well as the size and shape of the rubber piping that held the material in the frame&#8217;s groove by friction. But dealing with these conundrums was worth it because I had a great reason to acquire a wonderfully designed, task appropriate tool.There&#8217;s a rolling disc with a groove on its perimeter with a wooden handle that greatly simplifies getting the otherwise quite annoying piping firmly squeezed into its groove (again, assuming you bought the right size piping!) I HAD to have it. I&#8217;ve never again used it; but I&#8217;m ready!</p><p>You see, even in those tender teenage years I was slowly becoming addicted to acquiring hand tools. The more elegantly engineered the better; not necessarily more complex, but remarkably designed to the task at hand.</p><p>This is just like your medical team should select from the many tests and procedures available to look for diseases and abnormalities before signs (remember, your complaints) or signs (observable physical phenomena) occur. We call this process of using studies to search for hidden problems &#8220;screening.&#8221;</p><p>Pretty cool how I got that from window screens to screening tests, huh? Bet you thought I couldn&#8217;t do it, right?</p><p>The ability to choose the right tests, at the right interval, for the right person, to maximize the benefit of early detection of problems that warrant attention, while minimizing the risks of both the test causing complications itself, or having misleading or imperfect results lead to &#8220;a wild goose chase&#8221; is a core skill of a great medical professional.</p><p>We&#8217;re also fortunate that today many guidelines have been published to guide these choices.</p><p>So let&#8217;s get to it.</p><p>Newborns get screened routinely for some important problems. Their first physical exam within minutes of birth establishes an &#8220;Apgar&#8221; score that helps determine what, if any, special care needs should be attended to right away. A comprehensive exam before a baby goes home is important in identifying any number of issues, from minor skin blemishes to congenital heart defects and deafness.Tiny blood samples screen for a variety of enzyme deficiencies that could cause problems like phenylketonuria, cystic fibrosis, maple syrup urine disease (yes, it&#8217;s a real thing) as well as blood cell issues like sickle cell anemia. New moms should be screened for postpartum depression several times in the first months after delivering.</p><p>Throughout infancy and childhood screening for sensory, physical, cognitive and physiological issues are the focus of &#8220;well child&#8221; visits and school evaluations &#8212; all forms of screening.</p><p>Some may remember when states required screening for sexually transmitted diseases like syphillis and gonnorhea before marriage licenses would be issued. Now, however only Montana screens with blood tests before issuing marriage licenses.</p><p>Health care organizations still require screening for tuberculosis before hiring staff.</p><p>Blood testing screening for infection with the viruses that cause various types of the liver disease, hepatitis, is appropriate for Americans in the Baby Boomer generation.</p><p>Women should talk to their medical advisors about when and how often to be screened for gynecological cancer and other problems by having pelvic exams and Pap smears. If you can&#8217;t remember when your last one was, or if you&#8217;re reading this and have never had one (not you, wise guy) talk to someone today!</p><p>Same thing for mammograms and professional breast physical exams, ladies. Learn the right way to do breast self-exams while you&#8217;re at it.</p><p>Women should also determine with their advisors when to get screened for osteoporosis, a problem with &#8220;thin&#8221; somewhat fragile bones, that can develop after menopause related to calcium metabolism and hormone changes. This abnormality can be treated and thus lessen the risk of fractures if a &#8220;Dexa Scan&#8221; (a special X-ray test) shows bones are weak.</p><p>Guys, blood testing for prostate trouble may be right for you. Have that conversation with your doctor NOW. A rectal exam allows your doctor to feel the prostate and is critical for men &#8230; no joking about it.</p><p>For those of us who have smoked, screening for lung cancer with a low-dose CAT scan of the chests has been shown to be potentially life-saving. Talk to your team and be HONEST about your smoking history, please.</p><p>We&#8217;ve talked a lot about colonoscopy to screen for colon problems, Have you arranged for yours? Really? Come on &#8230; I promise it&#8217;s not bad at all &#8230; and once it&#8217;s done, I&#8217;ll stop bugging you for at least five years.</p><p>That&#8217;s about how long the window screen repair lasted too.</p><p>Let me know if you need a lightly used screen piping roller</p><p>Next week we&#8217;ll talk about screening for heart disease. </p><style>
.neFileBlock {
	margin-bottom: 20px;
}
.neFileBlock p {
	margin: 0px 0px 0px 0px;
}
.neFileBlock .neFile {
	border-bottom: 1px dotted #aaa;
	padding-bottom: 5px;
	padding-top: 10px;
}
.neFileBlock .neCaption {
	font-size: 85%;
}
</style>
<div class='neFileBlock'>
<div class="neFile"><img class="neImage" src="https://www.timesleader.com/wp-content/uploads/2019/03/web1_casale_edit-3.jpg">
<div class="neCaption"></div></div><div class="metaInfo"><photo0>https://www.timesleader.com/wp-content/uploads/2019/03/web1_casale_edit-3.jpg</photo0><caption0></caption0><photoCredit0></photoCredit0></div></div>
<div class="metaInfo"><bylineMeta><p>By Alfred Casale</p><p>To Your Health</p></bylineMeta></div><div class="metaInfo"><shirttailMeta><p>Dr. Alfred Casale, a cardiothoracic surgeon, is associate chief medical officer for Geisinger and chair of the Geisinger Heart Institute. Readers may write to him via ae@www.timesleader.com.</p></shirttailMeta></div>

Colonoscopy: Which tests appropriate, and when?