Sunday, April 19, 2015

Health Care Safety Index April 2015

Here are patient safety issues that have appeared in the news and medical journals throughout the last 30 days or so:

Toni Clarke, for Reuters, reported that AstraZeneca's diabetes drug, Onglyza, may be associated with an increased risk of death due to heart failure.

A study published in Circulation demonstrated that sudden cardiac arrest during sports activity occur most frequently in middle age, but the outcomes following such events are usually better. This is because the events are usually witnessed by others and followed by cardiopulmonary resuscitation.

Research undertaken by the American Orthopaedic Society for Sports Medicine demonstrated that one in three children who undergo ACL surgery experience a re-injury to the same ligament.

An article published in Annals of Internal Medicine discussed the 2015 American Diabetes Associations’ Standards of Medical Care in Diabetes which recommended lowering the floor body mass index of Asian-Americans which should prompt investigation into diabetes from 25 to 23, tailoring plans for blood glucose control to individual patients by considering age, other co-morbid medical conditions, life expectancy and the patient’s motivation and preferences. Finally, statins are now recommended for all diabetes patients older than 40.

Stephen West, for Bloomberg, reported that two hepatitis C drugs, Harvoni and Sovaldi may have caused symptomatic bradycardia in patients who were also taking Amiodarone.

Dr. Sidney Wolfe published a paper in the BMJ advocating that Crestor, the most prescribed brand name drug in the United States, be withdrawn from the market. Dr. Wolfe cited studies that demonstrate that the cholesterol lowering drug contributes to causing diabetes and has been tied to kidney problems and the muscle condition rhabdomyolysis.

A study published in the Lancet demonstrated that following a healthy diet and engaging in (a) strength training, (b) aerobic exercise and (c) mental training decreased cognitive decline in at risk elderly patients. The results were significant, test scores in patients who followed a regimen of lifestyle changes scored 25% better on cognitive function tests.

An article published in JAMA Neurology suggested a causal connection between concussion recovery and decreased blood flow to the brain. This may prove to be a valuable tool in measuring the initial injury and monitoring recovery of these kinds of brain injuries.

A study published in Neurology concluded that NFL football players who played football prior to the age of 12 were likely to suffer from more significant cognitive deficits than players who started later in life, raising the question about whether repeated head impacts during a critical neurodevelopmental period may increase the risk of later-life cognitive impairment.

An article published in the BMJ demonstrated that on weekends there is a 20% increase in the likelihood that a patient will be harmed by a never event in a hospital in the United States. “Never events” are an assembly of egregious and preventable hospital occurrences that should not occur with competent care.

The FDA issued a Safety Alert about powdered pure caffeine that is being marketed directly to consumers. Apparently, this is being sold in bulk over the internet. According to the, FDA teenagers and young adults are being drawn to the use of powdered pure caffeine. A single teaspoon of pure powdered caffeine is roughly the equivalent of 25 cups of coffee. Since it is nearly impossible to accurately measure pure powdered caffeine, it is very easy to consume a lethal dose of the substance.

An article appearing in Injury Prevention analyzed teen deaths in automobile accidents and concluded that teens who were in older vehicles that lacked modern safety equipment were particularly at risk. The authors indicated the absence of side airbags and electronic stability control were important factors.

A Harvard study found that pregnant women, especially those in their third trimester, who were exposed to fine particulate matter air pollution had an increased risk of having a child with autism. The conclusion of the study was that women exposed to fine particulate matter had a 50% greater risk of having a child with autism.

Kendal Gapinski reported on a series of patients injured by unfiltered halogen lamps utilized in an Oregon operating room.

Veronica Hackethal reported on a study appearing in the British Journal of Cancer which concluded that men who use muscle building supplements that contain creatine or androstenedione have up to a 65% increased risk for testicular cancer.

Megan Brooks discussed a study published in JAMA Psychology that concluded that patients who have both diabetes and depression are at an even greater risk for dementia.

A study published by the National Academy of Sciences demonstrated that use of light emitting electronic devices for reading or other entertainment before bed prolongs the time that it takes to fall asleep by suppressing melatonin levels. Further, this delays the timing of REM sleep and perpetuate sleep deficiency and disrupts circadian rhythms, both of which can have adverse impacts on performance, health, and safety.

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