Botox is a neurotoxin used to relax muscles. People take it to relieve pain as well as for cosmetic purposes.
However, the consumer advocacy group Public Citizen is arguing that it should come with a much stronger warning label because of 16 deaths and many serious injuries that the drug has been associated with.
For more information:
Botox, also known as Botulinum toxin type A
Oral contraceptives significantly reduce risks of ovarian cancer in women, says a new large-scale study. The pill has been linked to reduction in breast cancer rates as well, but not so large as the reduction in ovarian cancer rates.
The risk reduction persists up to thirty years after a woman stops taking the pill, although it declines with time. The risk reduction is also stronger in women who take it for long periods of time.
Furthermore, as the linked article says:
The proportional risk reduction for every 5 years of use was 29 per cent up to 10 years of stopping use, 19 per cent for 10 - 19 years after stopping, and 15 per cent for 20 - 29 years after stopping.
Doctors are unwilling to report colleagues for making medical mistakes, as we have discussed before. A new study from the University of Iowa shows that a significant number do not report their own, either, even though they believe they should.
Lauris Kaldijan, lead researcher for the study, had this to say about it:
Kaldjian said in an interview that he was encouraged that most of the doctors believed reporting errors was an important way to improve health care quality. But he said he was troubled by the fact that fewer than half of them would have reported the hypothetical error if it didn't cause problems. He said doctors and other medical workers should take their cue from the airline industry, which encourages pilots to report every error so it can be analyzed for possible systemic flaws.
As the linked article notes, there are several positive aspects to this study. For instance, awareness of the problems caused by medical error has increased, and belief that errors should be reported is strong.
MRSA or methicillin-resistant staphylococcus aureus, a "superbug" infection usually contracted in hospitals, is now being transmitted during male-male sexual encounters. This news comes just a few months after MRSA was discovered in some Virginia schools. As the linked pages note, MRSA is highly drug resistant and can be deadly. It comes in many strains and is often difficult to treat, requiring expensive antibiotic regimes. The discovery of MRSA in schools and among sexually active gay men is disturbing because it indicates that this "superbug" is no longer an exclusively hospital-based phenomenon and may start becoming more common in the general population, where researcher Binh Diep says it would be "unstoppable."
In San Francisco, researchers found that sexually active gay men were 13 times more likely to have MRSA than sexually active heterosexuals. It is passed on in the same way as other sexually transmitted diseases: unprotected and skin-abrading sex.
The best way to avoid getting MRSA in any fashion is through simply practicing good hygiene and washing with soap and water. This is why, as this blog has discussed before, it is vitally important for healthcare professionals to wash their hands before examining or treating patients.
If the number of emergency rooms go down and the number of medical emergencies rise, it stands to reason that the average waiting time in emergency rooms would get longer, resulting in more problems and even deaths. That is exactly what is happening right now in the U.S, as a new study from Harvard Medical School demonstrates.
In 1997, half of all patients waited for 22 minutes or more in the emergency room. Today, they wait for 30 minutes or more.
Most disturbing is the fact that even patients with the most dire and urgent problems are subjected to greatly increased waits. From the linked article:
Even those experiencing a heart attack are not assured speedy treatment, with half waiting 20 minutes or more to be examined in 2004, up from eight minutes in 1997, the study found. The same was true for those with other serious health problems: By 2004, patients whose conditions warranted treatment within 15 minutes were waiting 14 minutes or more to see a doctor, up from 10 minutes in 1997, the study found.
These longer waits are due to a number of factors: shortage of doctors and nurses, an aging population, and the fact that for uninsured Americans the emergency room is the only method of accessing healthcare. So not only do more people go to the emergency room for non-urgent problems, but many Americans also do not have access to the preventative care that would reduce the risk of serious emergencies that need to be dealt with right away.
Out of nineteen industrialized nations, the U.S. has the most deaths that could have been prevented by access to timely, effective medical care.
Ellen Nolte and Martin McKee of the London School of Hygiene and Tropical Medicine performed the study, looking at deaths before the age of seventy-five caused by numerous diseases and complications. They found that France performed the best by this measure--though France, and other countries that ranked higher than the U.S., spends less money on health care than the U.S. does.
Not only was the U.S. the worst in these rankings, but we Americans are also ranked four places lower than we were in the last study (which covered 1997 and 1998). We are getting worse and spending more money.
By January 1st of this year, Illinois was to have established a system for reporting and reviewing egregious hospital errors--e.g. sponges left inside patients after surgery. But it has not done so. Illinois has also failed to fulfill other elements of the hospital safety legislation the state passed four years ago. For instance, the Illinois Hospital Report Card was supposed to have been published, but is nowhere to be seen. Illinois officials are now predicting that it will be released in October.
Officials blame this failure on everything from poor leadership to lack of funding to unrealistic expectations. Whatever the cause, the failure is disappointing because--as the Consumers Union health-care expert Lisa McGiffert points out--Illinois was regarded as a role model for other states in this area.
It is safer to have a heart attack in an airport or casino than in a hospital.
Why? One reason is that many hospitals still rely on old-fashioned defibrillators rather than the newer ones found in public places. The new ones are fully automated, faster and easy to use.
Chances of surviving a heart attack are nearly 40 percent if you are defibrillated within two minutes of the attack--but fall to 22 percent if it takes longer. Hospital staffs in the study took longer than two minutes in nearly one third of all cases.
Anti-psychotic drugs such as Haldol and Risperdal were developed to treat schizophrenia, but have recently been used for much broader purposes. They have been used to treat aggression in people suffering from everything from attention-deficit disorder to depression to the intellectually handicapped.
A new study finds, however, that these drugs are no more effective than placebos in treating aggression in the mentally disabled. This suggests that the drugs are being abused, and should be prescribed less often.
Why guilt? Because families feel like they should have kept a closer watch on their loved one, and regret the trust they placed in the health care institution or its workers. This guilt persists even if the family took reasonable precautions--for instance, the authors of the article discuss a case where a patient was given morphine and died of kidney failure despite the fact that his family repeatedly told doctors and nurses that he had sickle cell anemia. The family often feels inadequate for being unable to watch the patient twenty-four hours a day.
They also feel fear: fear of retribution, fear that health care workers will neglect or compromise their loved one's care if they make some sort of formal complaint. This is particularly true of people in disadvantaged and disempowered sections of society.
Their emotional turmoil is often compounded by the reactions of the health care workers, who will often isolate the patient's family after realizing their error. This leads to further pain and may even lead to further medical mistakes:
Guilt persists in the daughter of a woman who died after a series of errors culminating in a missed case of pneumonia. Although the daughter is a nurse, she could not gain entry into her mother's circle of clinicians, who closed ranks after the errors occurred. "The nurses were ruder to me than you can ever imagine, and the doctors wouldn't tell me anything," she said. "They looked at me like I was a dumb little girl. I became so addled that I couldn't act decisively and get her out of there to another hospital. I'll never get over my guilt."
This isolation comes at a time when, as the authors point out, patients most need someone to communicate with them on a personal and human level. They suggest that honest, direct communication--without condescension, buck-passing or hedging around to avoid lawsuits--is the best way to keep the patient safe as well as feeling satisfied with the care he or she has received.
