April 27th, 2011 by Michael Kirsch, M.D. in Health Policy, News, Opinion
Tags: Accident, Alabama, Bacteria, CMS, Death, Error, Hospital, Never Events, Nutrition, Sepsis, Total Parenteral Nutrition, TPN
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Recently, nine patients died in Alabama when they received intravenous nutrition that was contaminated with deadly bacteria. This type of nutrition is called total parenteral nutrition, or TPN, and is used to nourish patients by vein when their digestive systems are not functioning properly. It is a milestone achievement in medicine and saves and maintains lives every day.
What went wrong? How did an instrument of healing become death by lethal injection? What is the lesson that can emerge from this unimaginable horror?
This tragedy represents that most feared ‘never event’ that can ever occur – death by friendly fire. No survivors. Contrast this with many other medical ‘never events’ as defined by the Centers for Medicare and Medicaid Services, such as post-operative infections, development of bed sores in the hospital or wrong-site surgery. Under the ‘never events’ program, hospitals will be financially penalized if a listed event occurs. Many physicians and hospitals are concerned that there will be a ‘never events’ mission creep with new outcomes added to the list that don’t belong there. Medical complications, which are unavoidable, may soon be defined as ‘never events’.
Do we need a new category of ‘never ever ever events’ to include those that lead to fatal outcomes? Read more »
*This blog post was originally published at MD Whistleblower*
April 25th, 2011 by PeterWehrwein in News, Research
Tags: Cardiology, Cholesterol, Do Statins Work?, Family Medicine, Heart Disease, Heart Health, Internal Medicine, Medications, Morbidity And Mortality, Statins
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Baseball fans have the Baseball Prospectus annual. Political junkies can get their fix from Nate Silver’s 538 blog.
For those of us with geeky interest in health and medicine statistics, graphs, and charts, the Health, United States, 2010 report from the National Center for Health Statistics is that kind of treat. The 41 charts and graphs and 148 trend tables in the 2010 report (it’s dated 2010 but was released earlier this year) could keep me happily occupied for hours.
One graph that really caught my eye shows the percentage of Americans that take a statin. Statins are prescribed mainly to lower “bad” LDL cholesterol, but they may have other benefits, too. The statins include atorvastatin (sold as Lipitor), rosuvastatin (sold as Crestor), and simvastatin (sold as Zocor but also available as a generic ).
Here is the graph I am talking about:
Many Americans take statins. No surprise there. But half of men, ages to 65 to 74, and 39% of women, ages 75 and older—that’s pretty stunning. Read more »
*This blog post was originally published at Harvard Health Blog*
April 25th, 2011 by David Kroll, Ph.D. in News
Tags: Analgesic Powder, BC Powder, Glaxo Smith Kline, GSK, Pharmaceuticals, Science and Medicine, Southern Tradition
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After spending the first 21 years of life in New Jersey and Philadelphia, I ventured to the University of Florida for graduate school. For those who don’t know, UF is in the north-central Florida city of Gainesville – culturally much more like idyllic south Georgia than flashy south Florida.
It was in Gainesville – “Hogtown” to some – that I first encountered the analgesic powder. I believe it was BC Powder, first manufactured just over 100 years ago within a stone’s throw of the Durham, NC, baseball park made famous by the movie, Bull Durham. I remember sitting with my grad school buddy from Kansas City watching this TV commercial with hardy men possessing strong Southern accents enthusiastically espousing the benefits of BC. I looked at Roger – a registered pharmacist – and asked, “what in the hell is an analgesic powder?”
What I learned is that powders of analgesic compounds were one of the individual trademark products of Southern pharmacies during the early 1900s. Many of these powders became quite popular with mill and textile workers needing to calm headaches induced by long hot days with loud machinery. The original powders contained a precursor to acetaminophen called phenacetin. However, phenacetin was found to cause renal papillary necrosis, such as in this 1964 case report in Annals of Internal Medicine.
Today, most of these powders are comprised of aspirin, acetaminophen, and caffeine. Read more »
*This blog post was originally published at Science-Based Medicine*
April 25th, 2011 by RyanDuBosar in News
Tags: Antibiotics, Chicken, Drug Resistance, Drug Resistant Staph, Epidemiology, Infectious Disease, Meat, MRSA, USDA
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Drug-resistant strains of Staphylococcus aureus were found in nearly half of meat and poultry samples, and were likely from the animal themselves, a study reported.
Researchers collected and analyzed 136 samples of 80 brands of beef, chicken, pork and turkey from 26 retail grocery stores in Los Angeles, Chicago, Washington, D.C., Fort Lauderdale, Fla., and Flagstaff, Ariz. Among the samples, 47% were contaminated with S. aureus, and 52% of the strains were resistant to at least three classes of antibiotics–and some to nine antibiotics.
Translational Genomics Research Institute, a non-profit research organization, conducted the study and published results in Clinical Infectious Diseases.
DNA testing suggested that the food animals themselves were the major source of contamination. Read more »
*This blog post was originally published at ACP Internist*
April 24th, 2011 by ChristopherChangMD in News, Research
Tags: All Natural, Baby, CDC, Cedar, Child, Citrus, FDA, infant, Insecticide, Mosquito, Nootkatone, Repellent, Safe, Tick
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It’s about TIME!!! I read this fascinating story on NPR here.
An all-natural insect repellant called nootkatone found in Alaska yellow cedar trees and citrus fruits (like grapefruit) is being developed by the CDC. It is so safe for humans, it is even an FDA-approved food additive.
Nootkatone is not only safe for humans and the environment, it is a highly effective insect repellant. In fact, it is not only a bug repellant, but an insecticide causing death to biting insects like mosquitoes within 15 seconds.
Application of 2% nootkatone will also control ticks for up to 42 days at greater than 97 percent efficacy.
It is non-greasy, dries very quickly, and it has a very pleasant, citrus-y grapefruit odor to it.
Sounds too good to be true… But it is true! The only downside right now is that it is not available in the market, mainly because it is expensive — $4,000 per kilogram for highly purified food-grade material, which is used in parts-per-million amounts as a flavoring agent.
However, there are two companies that are currently working to make it available as insect control, hopefully in the near future!
Read more about this here.
References:
Susceptibility of four tick species, Amblyomma americanum, Dermacentor variabilis, Ixodes scapularis, and Rhipicephalus sanguineus (Acari: Ixodidae), to nootkatone from essential oil of grapefruit. J Med Entomol. 2011 Mar;48(2):322-6.
Mode of action for natural products isolated from essential oils of two trees is different from available mosquito adulticides. J Med Entomol. 2010 Nov;47(6):1123-6.
Ability of two natural products, nootkatone and carvacrol, to suppress Ixodes scapularis and Amblyomma americanum (Acari: Ixodidae) in a Lyme disease endemic area of New Jersey. J Econ Entomol. 2009 Dec;102(6):2316-24.
Use of novel compounds for pest control: insecticidal and acaricidal activity of essential oil components from heartwood of Alaska yellow cedar. J Med Entomol. 2005 May;42(3):352-8.
*This blog post was originally published at Fauquier ENT Blog*
Recently, nine patients died in Alabama when they received intravenous nutrition that was contaminated with deadly bacteria. This type of nutrition is called total parenteral nutrition, or TPN, and is used to nourish patients by vein when their digestive systems are not functioning properly. It is a milestone achievement in medicine and saves and maintains lives every day.
