Cardiac Screening
October 31, 2014
Sudden death among 12 to 25-year-olds is “a low event rate occurrence.”
“There is insufficient information to support the view that ECGs in asymptomatic young people for cardiac disease is appropriate or possible on a national basis for the United States, in competitive athletics or in the general population.”
“At present, there is no mechanism available in the United States to effectively create national programs of such magnitude, whether limited to athletics or including the wider population of all young people.”
“There is insufficient evidence that particularly large-scale/mass screening initiatives are feasible or cost effective within the current US healthcare infrastructure . . .”
“The ECG . . . cannot be regarded as an ideal or effective test when applied to large healthy populations.”
“An additional, but unresolved, ethical issue concerns whether students who voluntarily engage in competitive athletic programs should have advantage of cardiovascular screening, while others who choose not to be involved in such activities (but may be at the same or similar risk) are in effect excluded from the same opportunity.”
The AHA’s Sept. 14 AHA writing group “does not believe the available data support significant public health benefit from using the 12-lead ECG as a universal screening tool. The writing group, however, does endorse the widespread dissemination of automated external defibrillators which are effective in saving young lives on the athletic field and elsewhere.”
Swimming Lessons
January 19, 2016
I found a place between Christmas and New Year’s Day that was out of Internet reach. For four days and three nights I spent most of the days in the water looking downward into an ocean of coral canyons surrounded by swarms of colorful fish, and much of the nights on the open deck of a catamaran looking up at a nearly full moon moving between stars and swirling clouds. Here is some of what I learned from experiences, rather than from Google, on those days.
First, flying fish really do fly, on average, about the length of a football field.
Second, sea urchins have an edible element, if the spiny critters are smoked in a fire of coconuts and palm fronds and then soaked in saltwater, and if you are either desperately marooned on some remote island or just trying to be nice to the local residents you just met who believe the urchin's slimy, salty core is a delicacy that hospitality requires be shared and graciousness demands be appreciated.
And, more relevant to the work we share that I tried unsuccessfully to tune out for these four days, I learned ...
What you see in the ocean is distorted until you put on your goggles and get beneath the surface of the water. Getting beneath the surface of things is necessary for clear vision.
What you see first is likely to be the flashy fish, while the greater significance is observed more slowly in what appears to be their inanimate habitats, which turn out to be alive with movement if you wait and watch for it. Patience is necessary for clear vision.
The wavy six-inch line of purple coral was really the lips of a large clam that actually separate a fraction of an inch every minute or so to take in the nourishment of the sea. The brown stump below it was really a sea cucumber that actually moves an inch or two a day to vacuum the ocean floor. I saw none of this until I got beneath the surface, and waited.