Reuters (3/22) reported that the Food and Drug Administration (FDA) has “recommended updating the prescribing instructions for a Baxter International anesthesia drug,” Suprane (desflurane), “after three reports of cardiac arrest in children,” according to agency documents. The drug’s label “already carries warnings about other cardiac problems including heart attacks, irregular heart beats, and unstable blood pressure.”

NY Times, 3/24/08: 

NBC News, 3/22/08:  (3/22, story 12, 2:25, Holt) reported, “Public hospitals like San Francisco General make up two percent of America’s hospitals,” yet they “take care of 25 percent of patients with little or no medical coverage.”  However, they are “disappearing at an alarming rate, down almost 22 percent since 1990.”  According to Larry Gage, of the National Association of general hospitals, these closures are due to “a combination of budget cuts at almost every level of government, increased numbers of uninsured, [and] increased demand on the emergency” department “and the trauma systems.”

San Diego Union Tribune, 3/22/08:  Patients with the most lethal type of heart attack are receiving lifesaving care in half the time as before 2007 under a cardiac-response system launched early last year, county officials said yesterday. 

EDUARDO CONTRERAS / Union-Tribune Dr. David Spiegel explained a procedure yesterday to patient Eleanor Kendall at Tri-City Medical Center in Oceanside. Kendall underwent angioplasty and stent placement.

Now, paramedic ambulances carry special equipment that allows them to diagnose these heart attacks in the field. The paramedics then call any of 13 designated hospitals’ heart attack teams to let them know a patient will soon arrive so they can be prepared, said Dr. Bruce Haynes, medical director of the county’s Emergency Medical Services.In the years before the Cardiac System of Care was…

Chicago Tribune, 3/22/08:  The pursuit of a synthetic version of heparin, free of animal materials and made with stricter quality controls, is gaining more attention as awareness grows that the blood thinner can be sourced from an unregulated supply chain that starts with hog lots in rural China.

The U.S. Food and Drug Administration this week disclosed that low-cost animal cartilage made its way into Baxter International Inc.’s heparin, raising fears conventional quality-control procedures do not adequately protect American consumers. Baxter’s product, recalled in the U.S. last month, has been linked to hundreds of potentially dangerous allergic reactions and at least four deaths. On Friday, the FDA said another American heparin-maker, B. Braun Medical Inc., recalled, as a precaution, more than 20 lots made by the…

AP, 3/11/08:  Two sets of parents in Belgium were recently sentenced to five months in prison for failing to vaccinate their children against polio. Each was also fined $8,000. The polio vaccine is the only vaccination required by Belgian law, unlike the United States, where immunizations against many other diseases are required. And unlike the United States, where many state laws allow children to opt out if their parents have religious or philosophical objections, Belgium allows exemptions only if parents prove their child might have a bad reaction to the vaccine. Reaction from some ethicists and public health experts backs the hard-line stance. “At the end of the day, the law must be respected,” said Dr. Victor Lusayu, head of Belgium’s international vaccine center. John…

Postings # 704, 707, 711, 714, 715.

This abstract from a recent J. Emerg Med cautions us to think about acute diverticulitis when faced with a person under 40 years of age with atypical belly pain.  The incidence of such a disease entity is growing in the younger population.  The ones at most risk are males and those who have a pants size as large as Madagascar.  25% may have their pain localized to the RLQ.  CT should make the diagnosis for you.
http://omniphysicians.com/2008/03/23/diverticulitis-in-the-young/

This article is for Dr. L., a cheese gourmand par excellance!  Reports indicate that some of the mozzarella in the Naples is contaminated with dioxin.  The toxicity first came to light when Italians suddenly began talking like Marlon Brando in The Godfather.
http://omniphysicians.com/2008/03/23/malignant-mozzarella/

The FDA is…

Reversible posterior leukoencephalopathy syndrome is a clinicoradiologic entity characterized by headaches, altered mental status, seizures, and visual loss and is associated with white matter vasogenic edema predominantly affecting the posterior occipital and parietal lobes of the brain.^[1] There has been some controversy about what the proper term should be for this entity because MRI has shown that lesions can occur in both gray and white matter. Therefore, a new name, posterior reversible encephalopathy syndrome (PRES), has been coined.^[2] Most cases of PRES occur with hypertension or immunosuppression, but it can occur with many diverse clinical entities.^[1,3] Since PRES is often unsuspected by clinicians, recognition of the characteristic imaging findings by radiologists is key to diagnosing this syndrome and should prevent deleterious work-ups or therapies.

The pathophysiology of PRES is under debate,…

Intro:  Posterior reversible encephalopathy syndrome (PRES) refers to a clinicoradiological entity characterized by headache, confusion, visual disturbances, seizures and posterior transient changes on neuroimaging.  Here is an abstract of a case report involving an eclamptic patient with PRES.

Journal of Emergency Medicine
Volume 33, Issue 4, November 2007, Pages 377-379

Posterior Reversible Encephalopathy Syndrome (PRES) in a Thirty-Six-Week Gestation Eclamptic

Emilie S. Powell MD, MBA and Mitchell J. Goldman DO

Christopher D. Cole MD and Allan B. Wolfson MD

From the 3/11/08 San Francisco Chronicle:  Legislation to create uniform standards for homeless shelters is expected to be enacted soon by San Francisco’s board of supervisors and mayor. “I think we will definitely see a healthier and more positive environment for people who have to use the shelters,” said City Supervisor Tom Ammiano, who introduced the legislation after years of complaints about the shelters’ sanitary conditions. Under the pending law, shelters must provide soap, toilet paper, clean drinking water, and bath towels to people who stay there, as well as telephone access and a secure place to store belongings and medicine. Staff at the shelters would be required to undergo training on how to interact positively with people who have mental illness or abuse drugs…

CNN, 3/22/08:  Makers of Italy’s prized buffalo mozzarella took out full-page ads in Italian newspapers Friday assuring consumers the cheese was safe after high levels of dioxin were found in some samples of buffalo milk.

The tainted products came from a few buffalo dairies in the southern Campania region, whose reputation as a top agricultural producer already has been tarnished by the months-old garbage crisis that has fueled fears of food contamination.

Dioxin, a chemical environmental pollutant, can be hazardous even in small amounts. When it accumulates in the body, it can be linked to cancer, birth defects and organ failure.

Over the past week, Italian authorities have searched dozens of buffalo dairies and seized milk samples for tests after higher-than-permitted levels of dioxin were discovered in products…

NY Times, 3/23/08:  New government research has found “large and growing” disparities in life expectancy for richer and poorer Americans, paralleling the growth of income inequality in the last two decades.

Life expectancy for the nation as a whole has increased, the researchers said, but affluent people have experienced greater gains, and this, in turn, has caused a widening gap.

One of the researchers, Gopal K. Singh, a demographer at the Department of Health and Human Services, said “the growing inequalities in life expectancy” mirrored trends in infant mortality and in death from heart disease and certain cancers.

The gaps have been increasing despite efforts by the federal government to reduce them. One of the top goals of “Healthy People 2010,” an official statement of national health objectives…

Chicago Tribune, 3/23/08:  J.J. Jamison, a “borderline” diabetic who closely monitors his blood sugar, has been missing his sweets. So after reading about stevia and alternative sweeteners in a recent Q cover story, the 61-year-old DeKalb resident e-mailed asking, “What about agave?”

Agave’s naturally sweet sap, once strictly a famous source of tequila, is growing more popular among diabetics and others seeking natural sugar substitutes. The amber-colored nectar contains about 90 percent fructose, a natural sugar found in plants.

But agave, commercially produced as a sweetener in Mexico since the 1990s, is still something of a wild card. Registered dietitian Dave Grotto touts its low glycemic index and lists agave in his book “101 Foods That Could Save Your Life!” Others charge that agave is toxic, harmful…

MarketWatch, 3/23/08:  The Food and Drug Administration warned that cantaloupes from a Honduran producer may be tainted with salmonella and it detained all shipments of cantaloupes by the company.

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