Diagnostic Tests

Darren James saw the news flash on his TV screen last week: A porn actress had tested positive for HIV. James, 45, felt a moment of shock, then sadness. "I feel really bad for this girl," he said. "One thing I can say, I just wish her well. It's the worst thing to get that call." It's the call James got in 2004 when the well-liked porn star known for his courteous nature on set found himself at the center of an HIV outbreak in the San Fernando Valley's multibillion-dollar porn industry.

With soothing walls of turquoise tile and a vase of orchids on the front desk, the Colon Health Center of Delaware has been selling an alternative to one of medicine's most unloved procedures -- the colonoscopy. Rather than insert several feet of tubing into patients' lower intestines, clinicians slide patients into a computed tomography, or CT, imaging machine that can quickly scan the abdomen for signs of cancer.

Researchers have identified a chemical in urine that is closely associated with appendicitis in children and are working to develop a simple test that could be used to diagnose the condition -- a test that would both increase the likelihood of performing surgery before the appendix bursts and prevent unnecessary surgery.

The abrupt shutdown of two aging nuclear reactors that produce a radioisotope widely used in medical imaging has forced physicians in the U.S. and abroad into a crisis, requiring them to postpone or cancel necessary scans for heart disease and cancer, or turn to alternative tests that are not as accurate, take longer and expose patients to higher doses of radiation. Because of limits on testing produced by the shortage, some patients will undergo heart or cancer surgeries that could have been prevented by imaging, and others will miss needed surgeries because of the lack of testing, said Dr. Michael Graham of the University of Iowa, president of SNM, formerly the Society of Nuclear Medicine.

For busy people, time is money. And when you've got more money than time, the cost of an executive physical examination is kind of like the price of a yacht. If you have to ask, you can't afford it. Tom Gilmore arrived at L.A.'s Good Samaritan Hospital on a bright Friday morning, sporting a dark blue Nike warmup suit the hospital had sent.

Any good physical examination is highly individual, whether it's with the family doctor who's known you since childhood or with a team at a hospital-based executive physical program. Patients going for an executive physical can expect a packet of information to precede their visit. They'll fill out head-to-toe medical information and answer questions about lifestyle and family medical history so that a team of physicians can design a physical for their unique needs.

When it comes to medical care, my husband and I generally call the shots in our family. Most people would agree that this is an appropriate role for us to play, but certain medical decisions aren't normally the purview of parents. Nor should they be. Foremost among them is the decision to screen children for some genetic diseases. During the last 25 years, the number of genetic tests has increased rapidly.

Medical experts recommended Wednesday that a less-invasive procedure known as a virtual colonoscopy and a stool DNA test join the arsenal of screenings for colon cancer in the hopes that more people would get checked out. The recommendations bring to six the number of screening tests suggested for spotting signs of colon cancer, said Dr. Otis Brawley, national chief medical officer of the American Cancer Society, one of the groups that made the recommendations.

Coronary artery calcium scanning -- a method that takes images of the coronaries and uses them to predict heart attack risk -- has soared in popularity over the last decade. But controversy has dogged the test for two reasons: a lack of scientific evidence that it can predict risk in people of all ethnicities and doubts about its cost-effectiveness. One of those issues appears to be resolved.

The VA Greater Los Angeles Healthcare System began offering 20-minute HIV tests at its downtown ambulatory care center Tuesday -- part of a campaign to encourage more veterans to get tested and treated for the virus. "HIV testing is the gateway to life-saving therapy," said Dr. Earl Tso, a primary care physician who is leading the downtown center's outreach effort. In the past, veterans wanting to be tested for HIV had to have blood drawn and sent to a laboratory for analysis.