Articles Posted in Clinical guidelines

ascension-st-vincent-riverside-hospital-300x200The nurses complained, and so did a handful of doctors. The patients howled. Yet, for years, administrators at a Florida hospital ignored the repeated alarms, critics say.

Now, 350 lawsuits have been filed and 100 more are expected, all asserting that Dr. Richard David Heekin, a seasoned orthopedist, suffered from a progressively debilitating, rare, neurologic condition that significantly impaired his capacity to perform what should have been common, uncomplicated knee and hip replacements, putting patients in harm’s way, NBC News reported.

Instead, during his flawed procedures, bones fractured, tendons ruptured, and nerves were severed. Patients required costly, painful, and unnecessary revision surgeries.

unoslogo-300x190UNOS, the independent medical network responsible for procuring and distributing human organs for transplants in this country, needs big changes because it is failing desperate patients, making screening errors, among other missteps, that have killed dozens of them and caused hundreds to develop procedure-related diseases.

The U.S. Senate Finance Committee reviewed hundreds of thousands of pages of subpoenaed documents and other material and investigated the nation’s transplant network for 2½ years, assailing UNOS  for its operational and oversight laxity, the Washington Post reported:

“Testing errors and overlooked communications [in organ procurement] allowed the transmission of cancer, a rare bacterial infection, and other diseases …The errors included failures to identify disease in donor kidneys, hearts and livers, as well as mix-ups in matching blood types and delays in blood and urine tests that were not completed before transplant surgeries occurred, the investigators concluded in a report obtained by The Washington Post. The Senate committee partly blamed lax oversight of organ procurement organizations (OPOs), the regional nonprofits responsible for collecting donated organs, by the United Network for Organ Sharing (UNOS), the Richmond-based contractor that oversees the system. It listed as problems careless treatment of donated organs, organs lost in transit, and technological issues.”

cdcoverdosedeaths-300x175The opioid drug abuse and overdose crisis is not only smashing fatality records, it also is slamming poorer people and communities of color and taking a savage toll on younger black Americans.

The federal Centers for Disease Control and Prevention has analyzed data from Washington, D.C., and 25 states, finding in its study published online, as the New York Times reported:

“Overall, overdose deaths jumped 30% from 2019 to 2020 … Deaths among black people rose 44%, about twice the increase in deaths among white people (22%) or Hispanic people (21%). Deaths among American Indians and Alaska Natives increased 39%. Measured as a portion of the population, in 2020, deaths among black people were higher than in any other racial or ethnic group — 39 per 100,000, compared with 31 for white people, 36 for American Indian and Alaska Native people and 21 for Hispanic people. ‘The disproportionate increase in overdose death rates among blacks and American Indian and Alaska Native people may partly be due to health inequities, like unequal access to substance use treatment and treatment biases,’ said Dr. Debra Houry, acting principal deputy director of the CDC.”

monkeypoxNIAID-300x259The worldwide struggle to contain a fast-spreading outbreak of monkeypox took on new urgency, with the World Health Organization declaring a global emergency and U.S. experts discussing whether the  viral infection is becoming yet another significant sexually transmitted disease that this country is ill-prepared to quell.

The WHO declaration, by WHO Director-General Tedros Adhanom Ghebreyesus, divided experts, some of whom were critical about the already pokey response to monkeypox or by others who said it was misguided.

Dr. Tedros conceded that the committee that advises him on global health emergencies had met twice, declining once to issue its alarm about the current monkeypox spread and then deadlocking on the issue. The WHO director used his authority to issue the emergency declaration, citing data showing that more than 16,500 cases have been reported in 75 countries.

ahaessential8-300x267 Get some sleep!

That’s not just a late-night nudge for the kids from their parents.  It is strong new advice patients will hear from their cardiologists and other doctors, as the American Heart Association has added sleep to its list of important ways for folks to avoid cardiovascular conditions, stay healthier, and live longer, the Washington Post reported.

The association has focused on behavioral and other factors for a time now to battle the leading cause of death in this country: heart disease. The federal Centers for Disease Control and Prevention has reported that almost 700,000 Americans died of heart disease in 2020. The ailment costs the country $230 billion annually. The heart association experts added sleep to the “Life’s Essential 8” list of safeguards, reporting this in an article published in a medical journal:

candidanew-300x150With the coronavirus pandemic surging anew due to the highly infectious Omicron BA.5 variant, federal authorities reported recent data that should give Americans plenty of reason to heed public health warnings and avoid hospitalization if they possibly can.

That’s in part because institutions, overwhelmed by the pandemic, have taken giant steps backward in preventing patients in their care from acquiring nasty bacterial and fungal infections in addition to the coronavirus, and from overusing and misusing lifesaving antibiotics, further fueling the rise of virulent super bugs, the federal Centers for Disease Control and Prevention says. As the New York Times reported:

“The spread of drug-resistant infections surged during the coronavirus pandemic, killing nearly 30,000 people in 2020 and upending much of the recent progress made in containing the spread of so-called superbugs, according to an analysis by the Centers for Disease Control and Prevention. Deaths caused by infections impervious to antibiotics and antifungal medications rose 15% during the first year of the pandemic compared to 2019, federal health officials found. Much of the increase was tied to the chaos wrought by the coronavirus as doctors and nurses struggled to treat waves of grievously sick patients whose illness they did not fully understand before vaccines and treatments were widely available. About 40% of the deaths were among hospitalized patients, with the remainder occurring in nursing homes and other health care settings, the CDC report found. Early on, many frontline hospital workers mistakenly administered antibiotics for viral lung infections that did not respond to such drugs, according to the study. Many of the sickest patients spent weeks or months in intensive care units, increasing the chances for drug-resistant bugs to enter their bodies through intravenous lines, catheters, and ventilator tubes.”

agingwell-150x150Although Americans dread the possibility of experiencing dementia and other debilitating cognitive decline as they age, they can do more than let fear rule their lives — or twiddle their thumbs waiting for Big Pharma to drop billions of dollars more to develop magical and, so far, unworkable pills.

Instead, doctors, epidemiologists, and public health officials argue that non-pharmaceutical approaches can be beneficial to patients’ overall health and play a significant role in decreasing the likelihood of individuals suffering severe memory loss and more crucially dementia, notably in its most common condition Alzheimer’s, the New York Times reported.

Dr. Gill Livingston, a psychiatrist at University College London and chair of the Lancet Commission on Dementia Prevention, Intervention and Care, told New York Times columnist Paula Span this:

kneeinjectionSince the 1970s, some doctors have treated arthritic knees by injecting them with hyaluronic acid, a substance originally derived from the combs of roosters. Specialists have zealously promoted this therapy, costing patients a few hundred dollars a pop and repeated so widely that Medicare alone pays $300 million annually for it. Doctors argue it reduces pain and increases joint mobility.

It hardly lives up to this billing, though, offering patients scant more relief than a placebo (saline, or salt water), researchers found after scrutinizing a half century’s worth of data from 169 clinical trials involving more than 20,000 patients.

The highly popular viscosupplementation procedure, as reported by Stat, a medical and scientific news site, showed an average effect “about 2 points beyond placebo effect on a pain scale that runs from 1 to 100.” The researchers from Canada, Britain, and China concluded this from their study, as published in BMJ, a respected medical journal of the British Medical Association:

MLSlogo-150x150In 2015, public attention galvanized around the significant risks of head trauma and the sport of football with the disclosure that Andre Waters, 44, a hard-hitting, onetime Philadelphia Eagles player, had been diagnosed after his suicide with chronic traumatic encephalopathy, or CTE.

Has soccer — one of the most popular pastimes on the planet and a dominant game of U.S. suburban life — also hit its day of reckoning for head injuries? The issue has been brought to the fore with the revelations that Scott Vermillion, 44, a onetime soccer pro, has been posthumously diagnosed with CTE, the degenerative brain disease “linked to symptoms like memory loss, depression and aggressive or impulsive behavior,” the New York Times reported, adding:

“The diagnosis gave Vermillion the grave distinction of being the first American professional soccer player with a public case of CTE. It was a solemn milestone, too, for MLS, a league that has, even in its young history, seen the consequences of the type of brain injuries more commonly associated with collision sports like football, boxing and hockey. For soccer as a whole, the finding will add another note to a small but growing chorus of concern about the health risks of playing the world’s most popular game. ‘Soccer is clearly a risk for CTE — not as much as football, but clearly a risk,’ said Dr. Ann McKee, the director of the CTE Center at Boston University.”

facepox-150x150In the 21st century, in the wealthiest and supposedly most advanced nation on the planet, infectious diseases and vaccines continue to be major part of the news headlines.

Experts and regular folks are paying attention to the persistent coronavirus pandemic, a stubborn and apparently widening outbreak of monkeypox, and a startling spike of meningitis and listeria cases in or tied to Florida.

The coronavirus pandemic

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