Archive for the ‘Infectious disease’ Category

We are constantly bombarded with alarming announcements about heart attack risks.  Many hundreds of billions of dollars are spent annually in multiple ways  trying to avoid dying from a heart attack.

It is a bit shocking to actually see what the 10 year heart attack mortality risk looks like.  I don’t know what your reaction will be but my was, “Huh, wow, that’s not such a big deal.  Maybe I should just relax, live as healthily as possible and ignore all the medical screaming and shouting.

I have used the data table found on page 128 in the very readable, and useful book Know Your Chances by Woloshin, Schwartz and Welch.

About the illustration-

There are 100 men icons. The darker icons represent the number of 65 yr old nonsmoking men who will die of heart attack before they become 75 yrs old. (5.2  of this group will die of heart attack in the next 10 yrs.)

 

Now let’s do the same sort of chart for a 100 men who smoke.  In this case, the data claims that 7.4 of these 65 yr old smokers will die of heart attack before the age of 75.

Here is a link to a pdf which has downloadable risk charts:  Health Risks by Age, Sex and Smoking Status

The evidence is mounting daily that as a species, much of the time we don’t know what we are doing. We are just willy nilly introducing powerful chemicals and pharmaceuticals into our world without even considering beforehand what kinds of unintended consequences might occur. We are clever but not very smart.

ScienceDaily (June 16, 2010) — Researchers have found antibiotic-resistant bacteria in seven species of sharks and redfish captured in waters off Belize, Florida, Louisiana and Massachusetts. Most of these wild, free-swimming fish harbored several drug-resistant bacterial strains.

The study, published in the Journal of Zoo and Wildlife Medicine, found antibiotic-resistant bacteria in every fish species sampled.

The researchers also found multidrug-resistant bacteria in fish at nearly all of the study sites, said Mark Mitchell, a professor of veterinary clinical medicine at the University of Illinois and a senior author of the paper.

“Ultimately the idea of this study was to see if there were organisms out there that had exposures or resistance patterns to antibiotics that we might not expect,” Mitchell said. “We found that there was resistance to antibiotics that these fish shouldn’t be exposed to.”

much more via Wild Sharks, Redfish Harbor Antibiotic Resistant Bacteria

Apparently manufacturing larger vials of propofol  is cheaper for the producer so even after the cases of infectious hepatitis starting occurring, the producer, Teva has resisted repackaging into smaller vials.

True, Teva clearly labels the vials as single-use but still the temptation to use vials for one than one patient has been too much for some health workers (“waste not, want not”.)

Oddly, this is similar to what occurred in the tattooing industry years ago. In spite of the fact, that the tattoo artists started using single use needle, the incidence of infectious hepatitis continued to be quite high.  This went on until someone realized that the single use needles were being reloaded from multi-use inkwells.

Once that realization was made, the tattoo artists switched to single use needles and single-use inks.  After that change, the incidence of hepatitis being spread by tattooing rapidly declined.

Surely, Teva, which is the biggest of the pharmaceutical companies can follow the example of the tattoo artists.

from Jim Edwards at BNET Pharma blog

 

….Teva received a warning over dirty manufacturing practices in December 2009 after the drug was recalled in July 2009. A propofol shortage followed that.

As for the hep C infections, the company continued to sell the bigger vials even though it knew the vials were being reused, generating infections:

Teva was aware of the potential danger, having logged 148 previous hepatitis C infections blamed on reuse of single-use vials of propofol, [plaintiffs attorney Robert Eglet] said. “They knew it was a problem. They knew there was multidosing with these vials.”

more via $500M Verdict Against Teva Exposes Drug Industry Secret: Dose Packaging Manipulation | BNET Pharma Blog | BNET.

Practical advice on ear infections in children from the blog Before You Take That Pill by Douglas Bremner.

I wonder how many years it will take for articles like this to change the prescribing of antibiotics for conditions where they do more harm than good.  

…For years doctors in Holland have been using the “wait and see” approach with much success. It turns out that antibiotics have minimal impact on ear infections, and that, unless a child is toxic (very visibly ill and unresponsive), that simple ear infections are best treated with ibuprofen, a local pain killer for the ear, and otherwise left alone. If the child does not show improvement after three days, then it is time to go to the doctor. In years of treating children this way there have been no adverse outcomes. I wish they followed the wait and see approach when my daughter was a child.

Children treated with antibiotics for ear infections have a three-fold increase in re-infection. This is related to the fact that normal bacteria in the ear are killed off by antibiotics, creating an environment where pathogenic bacteria can grab a foothold. In spite of the fact that guidelines state not to treat some types of ear infections with antibiotics, many doctors do it anyway. A type of ear infection where there is fluid discharge from the ear, without evidence of acute infection (bulging ear drum, extreme pain, high fever) is often treated with antibiotics, although it increases the risk of re-infection….

much more via Do I Need to Give Antibiotics for my Child’s Ear Infection? | Before You Take That Pill.

The World Health Organization is enduring intense criticism for the way it handled H1N1.  I would agree that the organization is in a difficult position because likely it is only a matter of time before and dramatic form of pandemic appears.  

Nevertheless, to sound the alarm too many times risks the public ignoring warning when a lethal form of pandemic appears.  I do not envy the position of the officials at WHO.

By the way, does anybody out there want to buy large quantities of H1N1 vaccine?

….WHO repeatedly violated Sherlock Holmes’ warning, “It is a capital mistake to theorize before you have all the evidence.” And the pandemic alert was doubly strange, given that ordinary seasonal flu sweeps the world annually, is invariably far more lethal than the currently circulating low-virulence H1N1, and certainly meets the WHO’s definition of a pandemic: infections over a wide geographic area and affecting a large proportion of the population.

Ironically, the appearance of the H1N1 flu during the past nine months might be thought of as a net public-health benefit, because it appears to have suppressed, or at least supplanted, the far more virulent and lethal seasonal flu strains. During the second week of January, 3.7% of Americans tested positive for the seasonal flu, compared to 11.5% during the same week in 2009. The official death toll worldwide from H1N1 is under 14,000, while seasonal flu kills about 36,000 on average in the United States and hundreds of thousands elsewhere.

Most flu and public-health experts consider the WHO to have been overly alarmist. The decision in April 2009 to raise the pandemic flu threat to the penultimate level, Phase 5 (“Pandemic Imminent”), already raced far ahead of the accumulated data, so the Phase 6 declaration in June revealed the organization’s paradigm to be fundamentally flawed. A warning system based solely on how widely a virus has spread, but that does not consider the nature and severity of the illness it causes, would classify as “pandemics” not only seasonal flu, but also the frequent but largely inconsequential outbreaks of virus-caused colds and gastroenteritis, for example. (The WHO has never explained why these obvious examples do not meet their criteria.)

False alarms make the “pandemic under way” designation almost meaningless and diminish its usefulness. And that, in turn, has important consequences: as Jack Fisher, a professor of surgery at the University of California, San Diego, School of Medicine, observed, “Keep crying ‘wolf,’ and WHO can expect lower than customary compliance with flu vaccine advisories next fall.” Worse, imagine what would happen when we encounter a genuinely dangerous new pathogen, such as a strain of H5N1 avian flu (which in its current form has a mortality rate more than 100 times higher than H1N1) that is easily transmissible between humans….

via The Pandemic That Wasn’t – Project Syndicate.