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Some doctors caution against full-body MRIs as celebrity endorsements drive up demand – CBC.ca

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The Current24:35Are full-body MRIs worth the money?

After a bout of prostate cancer, Don Garnier wanted to take a more proactive approach to his health. That’s why he went out of his way to pay $2,500 for a full-body MRI scan at a private Vancouver clinic called Prenuvo. 

“We live in a world now where getting medical care can be a bit of a challenge. So the more you are on top of your health, the better,” he told The Current.

Garnier said the scan results took five days to come in and were unremarkable — which was good news. He said the nurse clinicians there went through the results with him in detail.

He feels it was worth the money for his peace of mind — and many people share that view.

Although full-body MRI scans — using Magnetic Resonance Imaging technology to scan your body for anything abnormal — are not new, they’ve recently soared in popularity due to celebrity endorsements from the likes of Kim Kardashian.

But as more private clinics start offering them, some doctors are telling patients to think twice before they slide into the machine.

“I think the general view of the medical establishment is that, you know, these things don’t have a lot of evidence and we should be very cautious before we advise people to get something like this,” Dr. Dhruv Khullar, a physician and a New Yorker writer, told The Current‘s Matt Galloway.

A nurse walks towards a patient in the emergency department of Humber River Hospital, in Toronto, on Jan. 25. (Evan Mitsui/CBC)

Peace of mind or anxiety-inducing?

Khullar says companies offering full-body MRIs “promise a sense that you’re in charge of your health care” and a peace of mind.

But he claims the narrative is only partially true, and that the scans can be a hassle for patients too.

“People may experience anxiety,” he said. “They may receive false positive test results. They may be diagnosed with conditions that might never end up hurting them.”

Khullar understands these anxieties first-hand because he got a full-body MRI — and he said his own experience speaks to some of the challenges with them.

Everything in his results looked OK, he said. But, there was a one-centimetre lesion in his prostate, and it wasn’t clear whether it was cancerous.

A full-body MRI machine operated by Prenuvo.
A full-body MRI machine operated by Prenuvo. According to Dr. Dhruv Khullar, it’s important for screening tests to be targeted for certain people at certain ages “because the likelihood of finding something that you can actually intervene on and change the trajectory of someone’s life in a positive way is relatively high.” (Ben Gancsos)

“These are sometimes called incidentalomas,” he said. “These are kind of asymptomatic abnormalities that are found incidentally and they generate more questions than answers.”

Khullar needs a follow-up blood test, and he’ll have to get a follow-up, dedicated prostate MRI to get a clearer answer.

“I’m still going to have to get a follow-up, dedicated prostate MRI to really figure out what’s going on there,” he added.

Khullar said his sense is that the lesion won’t hurt him. But now that he knows about it, he feels like he’s had to change his identity from someone who was healthy to someone who is a patient.

“Now, instead of assuming that I’m healthy … I know that there’s something inside me and I need continued tests to kind of prove to myself and to my loved ones that I am, in fact, healthy,” he said.

Turtles, birds and rabbits

According to Khullar, it’s important for screening tests to be targeted for certain people at certain ages at certain points in life “because the likelihood of finding something that you can actually intervene on and change the trajectory of someone’s life in a positive way is relatively high.”

But looking for everything in the body, or trying to, can be a “a recipe for having a tremendous number of false positives and potentially overdiagnosis,” he said. 

You do the screening, you find the problem and you can intervene on it in a way that would be helpful-Dr. Dhruv Khullar, physician and New Yorker writer

Take cancers, which full-body MRIs can reveal. Khullar says cancers can be described as turtles, birds and rabbits in a barnyard, with screening and testing acting as the fence that keeps them from escaping.

The turtles, like some prostate and thyroid cancers, move so slowly that they’re never going to make it out of the barn, “so the screening doesn’t really help you,” Khullar said. “In fact, you find it and you may end up with unnecessary biopsies or other tests.”

An example of a scan provided by an full-body MRI.
An example of a scan provided by an full-body MRI. (Submiteed by Prenuvo)

The birds, on the other hand, are very aggressive cancers that may pick up at some stage, but there are no current interventions that will help patients, so the fence won’t keep them from flying away.

Then there are the rabbits, which are some breast and colon cancers. According to Khullar, these are the cancers that can be fenced in with targeted screening.

“You do the screening, you find the problem and you can intervene on it in a way that would be helpful,” he said.

“So thinking about tumours in terms of turtles, birds and rabbits illustrates why screening tests may not be helpful in every type of cancer and why we need to be judicious about their use.”

Pressure on public health

Some doctors are also concerned about the additional pressure false positives or benign issues could put on Canada’s health-care system.

Dr. Ania Kielar, president of Canadian Association of Radiologists, says radiology is the keyhole into chemotherapy and surgery. Without a diagnosis from radiology, people can’t get the treatment they need.

Yet, Canada is currently experiencing a huge shortage of CT and MRI technologists — in the thousands, according to Kielar. That, as well as a shortage of modern equipment, is leading to long wait times for public health patients who need imaging, she said.

“On average in Canada, people are waiting up to 100 days for an MRI, whereas most of the guidelines say that a non-urgent MRI should be less than 28 days,” she told Galloway. “So we’re waiting three times longer than we should.”

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According to Kielar, if the companies offering full-body MRIs do find something incidental, “the majority of times these people who are healthy people and are now patients, end up coming into our publicly funded health care system in Canada,” she said.

“And because we have such scarce resources, we don’t have the capacity right now to take on a bolus of people who have non-clinically significant incidental findings, but kind of need them worked out because they’ve now been found.”

In a statement to The Current, Prenuvo CEO Andrew Lacy pushed back on the claim that private clinics take away resources from public health care and contribute to a burned-out system.

“We believe that our health-care system is burnt out because treating cancer and disease late is horribly inefficient and leads to much worse patient outcomes,” he said.

“We hope that the approach that Prenuvo is championing will one day be part of standard of care in a transformed health system based around preventative precision medicine.”

Lacking data

Khullar doesn’t deny that some patients, like Garnier, have positive experiences with full-body MRIs. The overarching question is how many people need to be scanned for a case such as Garnier’s to be found.

It’s a question that doesn’t have an answer at the moment, according to Khullar. That may be why no professional medical society currently recommends full-body MRIs as as a preventative screening tool, nor are the scans covered by insurance.

“The reason for that is that there’s no real evidence that they’re going to help you,” he said. “So insurers, government payers, they’re not going to cover these things.”

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At the moment, CEO Lacy says Prenuvo is collecting data about the efficacy of full-body MRIs — “and, as this is ‘long-term data,’ it takes time.” 

However, the company currently is relying on “14 years of clinical practice performing these examinations” and making many early diagnoses to stand by their efficacy, he said.


Produced by Amanda Grant and Emma Posca. This story is the first instalment of The Current’s new series Well Founded, which digs into the wellness industry and how to make sense of all the pitches on how to be a better you.

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What’s the greatest holiday gift: lips, hair, skin? Give the gift of great skin this holiday season

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Give the gift of great skin this holiday season

Skinstitut Holiday Gift Kits take the stress out of gifting

Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.

In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.

“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.

There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.

Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.

Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.

In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.

 

Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

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Here is how to prepare your online accounts for when you die

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LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?

It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.

Here’s how you can prepare your digital life for your survivors:

Apple

The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.

For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.

You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.

Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.

Google

Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.

When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.

You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.

There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.

Facebook and Instagram

Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.

When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.

The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.

You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.

TikTok

The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.

Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.

X

It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.

Passwords

Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?

Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.

But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.

___

Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.

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Pediatric group says doctors should regularly screen kids for reading difficulties

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The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.

New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.

The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.

Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.

Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.

“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.

“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”

McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.

But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.

The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.

He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.

“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.

“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.

McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”

McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.

He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.

“Early identification of reading difficulty can truly change the trajectory of a child’s life.”

This report by The Canadian Press was first published Oct. 23, 2024.

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