Out with the Old and in with the Older.
Each year about 300 000 people in the United States are hit with cardiac arrest. Of these, 125,000 are found too late for any help. With cardio-pulmonary resuscitation (CPR) and defibrillation many patients get to the emergency department, but fewer than 10% of victims ever leave the hospital. Only a minority have sufficient brain function to return to normal life. A “new” modality is on the scene. Numerous studies over the past decade have shown that cold treatment after sudden cardiac arrest greatly improves survival rate. Perhaps more important, cognitive damage is much less in surviving patients when core body temperature is kept at 91° F. for 24 hours after the arrest, then slowly brought back to normal. The Minneapolis Heart Institute reported that of 140 unresponsive heart-attack patients treated with hypothermia, 56% survived and left the hospital, and 92% of them retained normal brain function. Therapeutic hypothermia has been used since days of antiquity. Hippocrates, arguably the first enlightened physician, wrote that wounded soldiers should be packed in snow and ice. The current evidence for therapeutic hypothermia is so overwhelming it should be part of the standard package of emergency therapy for cardiac arrest.
Here's a Good Rule of Thumb: Being Too Clever is Dumb.
Dr. Lazar Greenfield, Professor Emeritus of the University of Michigan School of Medicine, was the president-elect of the American College of Surgeons (ACS). With 77 000 surgeon members, the ACS is the largest organization of surgeons in the world. Dr Greenfield wrote a Valentine's Day editorial for the ACS newspaper in which he referred to a scientific study that described semen as a “mood enhancer” for college women. The study described college women who had unprotected sex as less depressed than those with partners who used condoms. Dr. Greenfield wrote, “So there's a deeper bond between men and women than St. Valentine would have suspected, and now we know there is a better gift for that day than chocolates.” A firestorm ensued with the membership divided, and the backlash forced the doctor to resign his leadership role. He claimed he was merely making a joke, and deeply apologized to the ACS board of directors. They rejected his attempt to make amends. What a sad final chapter for the distinguished, highly respected 76-year-old professor.
If at First You Don't Succeed, Turn the Evidence into Plastic.
Associate Professor David Bressler at the University of Alberta, Department of Agricultural Food and Nutritional Science, led a team of researchers to forge waste-cattle proteins into heavy-duty plastics. The raw materials are discarded parts of carcasses that were sidelined from beef production because of bovine spongiform encephalopathy (mad-cow disease). Using high temperatures, the bovine proteins are broken into small molecular components then cross-linked to other protein molecules to create a rigid structure. Dr. Bressler believes that these bio-friendly plastics are poised to become an innovative resource for the plastics industry. The project offers the opportunity to make use of renewable material and help send value back to rural Alberta's devastated beef sector.
Sometimes the Doctor is the Disease.
Dr George Reardon, was the chief of endocrinology at St. Francis in Hartford, Connecticut, from 1963 to 1993. In 1970 a parent issued a complaint stating that Dr Reardon had sexually abused her child at the St. Francis Medical Center. The matter was referred to the local medical society. Dr Joseph Sadowski, a neuro-surgeon and colleague of Dr Reardon's on the staff at St. Francis, was chairman of the medical society committee on medical ethics and deportment. He handled the complaint, but disposition was not recorded and both Drs Sadowski and Reardon are now deceased. In 1993 the Connecticut medical board revoked Dr Reardon's license after investigating four complaints of child abuse. The medical center claimed that they had no knowledge of the alleged child abuse before the license revocation. In November 2007, a home-owner renovating Dr Reardon's former house, found a cache of sexually-explicit pornographic material of children under his care. The doctor had collected a monstrous file of 50 000 thirty-five mm. slides and 100 eight mm movie reels. When news of the police investigation hit the media, a storm of complaints rained in on St. Francis from adults who remembered being abused, but were too ashamed or frightened at the time to tell anyone. Now at least 135 law suits are in the hopper with multi-millions of dollars at risk for the hospital and insurance carriers. Does the leadership at St. Francis truly expect that anyone would believe no doctors, nurses, office staff or board members ever questioned the grotesque “research” this pervert was carrying on for over thirty years in their hospital?
If Seat Cushions are Great for Flotation, Why Don't People Take Them to the Beach?
On every airplane flight the Federal Aviation Administration (FAA) requires that carriers hit the basic points of passenger air safety. Seat belts, oxygen masks, water landings, exit doors and more, must be presented to an audience of bored frequent flyers or novice travelers ready to freak out. The creative challenge is how to get the message across. Southwest Airlines uses a wise-guy approach with one-liners like, “If you haven't been in a car since 1957, this is a seat belt…” Virgin America features an animated buck-toothed nun struggling to put away her electronic gear and a matador seated next to a bull. Turkish Airlines has a video of soccer stars goofing around by inflating life jackets while the announcer is saying, “Hey, that's not a toy.” The hands-down winner for grabbing the passengers attention is Air New Zealand. This airline produced a video called “The Bare Essentials” starring bare-ass, stark-naked employees. They are all dressed in precisely and carefully painted-on complete uniforms, including kerchief ruffles. Let's all take a trip to Auckland.
Beer is Much Cheaper Than Gasoline. Drink, Don't Drive.
Two economists writing in the Journal of Economic Perspectives, published a study on “The Minimum Legal Drinking Age and Public Health.” Collecting data from the National Vital Statistics System from 1997–2003, they found an eight percent jump in deaths from the age of 20 to 21. The two important categories in which deaths jumped were motor vehicle collisions and suicides. They also studied mortality from 1975– 1993 in states (eg, Hawai‘i) that lowered their drinking age to eighteen during the 70s and 80s. When compared to neighboring states that kept drinking age to twenty one, the 18 to 20 year-olds displayed a 17% increase in nighttime driving deaths in that category. While many flout the 21 years drinking age law, their data show that alcohol laws do have a positive influence on behavior.
Can the Institute of Medicine Wake Up Medicare?
Writing letters to politicians (read Hawai‘i's dynamic Dans) about Medicare's meager coefficient for Hawai‘i physician reimbursement has proven to be useless. Now the Institute of Medicine (IOM) has taken notice of these unfair medical costs and reimbursements. The IOM stated bluntly that Medicare's methods of calculating regional costs are inaccurate and must be redone. Medicare needs to “make a significant change” regarding real estate costs and salaries of health care workers. Add in the premium price of groceries, petroleum and utilities, plus the income tax, property tax, gasoline tax, and the super-ugly, all-inclusive gross excise tax, and it equates to a physician recruiting challenge without hope of relief.
Tastes a Lot Like Chicken, but a Trifle Scaly.
A clumsy smuggler lost control of his cache of king cobra snakes that he was transporting by train from Ho Chi Minh City (nee Saigon) to restaurants in Hanoi. After panic broke out on the train the snakes were collected and placed in a sanctuary, much to the smuggler's chagrin. Upscale restaurants charge up to $500 for cobra dinners, including selection of the snake, having it killed at the table-side and using the snake's blood as an appetizer. About 85% of restaurants in Hanoi serve illegal wild animals of some kind, including weasel, monitor lizard and porcupine. Hey, you could pick your teeth with a quill.
Addenda
According to a recent commentary in JAMA, only 8.3% of Americans over age 65 are still smoking.
The 8th month of the modern day calendar was originally known as sextilis until it was renamed in honor of the emperor Augustus.
In Los Angeles, California, the police conducted a line-up for possible criminal identification. When the suspect was told to say the words, “Give me all your money or I'll shoot,” he responded, “That's not what I said.”
All politicians should be limited to two terms; one in office, one in prison. Illinois already does this.
ALOHA AND KEEP THE FAITH rts
(Editorial comment is strictly that of the writer.)