NEVER LET YOUR DAILY CALORIC INTAKE EXCEED YOUR WHITE BLOOD COUNT.

Hannah Gardener, epidemiologist at the University of Miami Miller School of Medicine, studied consumption of diet sodas by 2500 New Yorkers over a nine year period.. Findings showed that those who consumed one or more diet drinks each day increased their risk of a severe vascular event, including stroke and heart attack, by 61% compared with a similar population that eschewed such useless stuff. Researchers admit that one study is not sufficient to condemn diet drinks and Dr. Gardener said, "Stay tuned. I don’t think anyone should change their behavior based on one study." Still, the summary line is: develop fat thighs and a big belly with associated risks by imbibing sugary daily sodas, or drink diet colas and up the chance of heart attack or stroke. Of course, there is the radical idea of merely drinking tap water.

GEORGIE PORGIE KISSED THE GIRLS AND MADE THEM CRY.

Human papillomavirus is a highly prevalent infection in men. Frequently the infected person has no signs nor symptoms, but can spread the disease to a sexual partner. A research team at H. Lee Moffitt Cancer Center and Research Institute in Tampa, Florida, reporting in Lancet, studied a volunteer group of 4,000 men living in Brazil, Mexico and Florida, beginning in 2005. Upon enrollment swabs were taken of the penis and genital area of each man which revealed that 50% were infected with at least one HPV type upon enrollment. Over the succeeding 28 months, the group acquired 1,572 new HPV infections. Male circumcision and use of condoms showed little protection against the disease. The virus is notorious for causing cervical cancer in women, and can hang on unnoticed for months or even years. The study is highly important for strengthening the case for vaccinating men and boys. It’s especially important for the gay population with the threat of rectal cancer as well as venereal warts. At $130 per shot (three for efficacy) no line is forming.

SPILL A ROACH ASH ON YOUR SHIRT AND YOU HAVE A POT HOLE.

In the 2010 fall election California voters rejected Proposition 19, which would have legalized small amounts of marijuana for recreational use. The measure would have allowed local governments to regulate and tax the commercial production and sale of marijuana to adults. California has had a medical marijuana law in place for fourteen years, and a pre-election poll by Survey USA found that 48% of likely voters were in support of Proposition 19 and 41% were opposed. On election day the vote count was 54% against and 46 % in favor. The Obama administration drug policy very nearly echoes the previous administration. White House spokesman Gil Kerlikowske stated that Californians recognize that legalizing marijuana will not make citizens healthier, will not solve the budget crisis and will not alter the drug wars in Mexico. The legalization issue is dead in California for the present, but it is sure to arise in another state in the near future.

THE FOOD WAS OKAY, BUT THE PLACE LACKED ATMOSPHERE.

Researchers at NASA’s Johnson Space Center are in the midst of a multi-years study of how the human heart reacts to weightlessness in prolonged space flight. Data presented at the annual meeting of the American College of Cardiology included findings that on trips lasting less than 30 days, 25 to 30% of astronauts have trouble maintaining blood pressure. When voyages last longer than one month, 80% have low blood pressure, develop symptoms like tunnel vision and may have cold sweats. Astronauts are likely to lose heart mass and develop what is called "Grinch Syndrome" (named after the Dr. Seuss character whose heart was two sizes too small). Blood volume decreases, arrhythmias are common, blood pressure becomes abnormally low and fainting and dizziness are frequent. While on the space station, astronauts are advised to work out for two hours each day, usually on a treadmill or strapped on a bicycle, but exercise with a stationary rowing machine was ergonomically superior. Thirty minutes of rowing was equal to 90 minutes of cycling.

MEDICINE IS AN HONORABLE PROFESSION EXCEPT WHEN IT ISN’T. PART I

In Chicago, Mark Weinberger, an otolaryngologist awaiting sentencing for health care fraud was ordered to pay $13 million in a malpractice lawsuit. The award includes $10 million in punitive damages to the estate of a deceased woman. He negligently failed to diagnose a nasal cancer and performed unnecessary and damaging sinus surgery. She died despite vigorous therapy by a second surgeon who immediately recognized the cancer. The case was the first of 350 malpractice lawsuits against Weinberger. He is scheduled to be sentenced for his admitted guilt in 22 counts of healthcare fraud. He billed insurance companies for up to $400,000 for surgeries which he did not perform. He had fled to northern Italy and was living in a tent when he was apprehended.

MEDICINE IS AN HONORABLE PROFESSION EXCEPT WHEN IT ISN’T. PART II

In Portland, Oregon, neurosurgeon James Makker lost his surgical privileges at Providence Medical Center when it was discovered that he had the highest rate of spinal-fusion surgeries among 3,407 spinal surgeons who performed similar operations. Dr. Makker’s rate was ten times the national average, and some of his patients had multiple fusions – one patient had seven spinal procedures! Another a malpractice complaint against the doctor was recently filed, the ninth in the last seven years. Ugly enough, but there is more. Dr. Makker got his spinal implants through Omega Solutions of Fresno, California, a Physician Owned Distributorship (POD). This limited liability company (LLC) acts as a middleman between medical device makers and hospitals. Surgeons dictate to hospitals which devices to buy, so by offering physicians partnership in the POD they lock up the hospital’s business allowing the surgeon to profit. The Office of the Inspector General of the Department of Health warned that PODs may violate anti-kickback laws, and the FBI is asking questions about Dr. Makker. The Oregon Board of Medical Examiners has opened their own investigation.

BLACK DEATH IN A LAB COAT.

A type two diabetic, sixty year-old man who worked in a research lab went to an outpatient clinic with a three day history of fever, body aches and cough. The clinic physician suspected an acute respiratory infection and referred the man to an emergency department (ED) for evaluation, but the patient chose to return home. Three days later he was brought by ambulance to a Chicago hospital ED with fever of 100.9 F, pulse of 106, respirations at 42 per minute and blood pressure of 106/75. He was alert and responsive. Examination showed distant breath tones, abdominal distention, peripheral cyanosis, but no rash, jaundice nor lymphadenopathy. Bacteria were noted in a peripheral blood smear. Chest x-ray revealed normal lung fields. Believing he was in congestive heart failure with infection, the physician prescribed diuretics and IV antibiotics. Twelve hours after admission the respiratory distress became critical, and he was intubated. He died within an hour. Resuscitation efforts failed. Culture revealed Yersinia pestis (Pasteurella pestis to us geezers) believed to be lab-generated plague. The last known laboratory-acquired plague infection was in 1959.

IT MIGHT PRODUCE A FROZEN COCKTAIL

A central Pennsylvania man was spotted stealing frozen shrimp in a super market. While he was stuffing his loot into his shorts he was apprehended by a security officer who suffered minor injuries. The icy-pants thief ran to the parking lot where he was caught by the security guard and a helpful bystander. No report was given about the fate of the frozen shrimp.
IT WIGGLED AND RIGGLED AND TICKLED INSIDE HER
At Albert Einstein Medical Center in Philadelphia, a physician reported finding a cockroach in the transverse colon of a 52 year-old woman during a routine colonoscopy. Previously other tiny creatures e.g. ants, wasps, bees, had been reported, but this is the first reported cockroach. Still, as the physician noted, cockroaches are considered a delicacy in some countries. If it had been a standard humungus Maui cockroach it would have obstructed the bowel.

ADDENDA –

------ An Article in Archives of Internal Medicine found that one of every 100 patients goes to the emergency room following colonoscopy, most commonly for abdominal pain believed to be from trapped air.
----- When you try bungee jumping take the change out of your pockets.
----- Grown men do cry, but only when assembling furniture kits.
----- Immortality is a long shot, I know, but hey, somebody has to be first.

Aloha, and keep the faith. ----------rts
 

Contents of this Newsletter do not necessarily reflect the opinion, policy or position of the Hawaii Ophthalmology Society or the Hawaii Medical Association. Editorial comment is strictly that of the writer