Unsafe Injection Practices Plaque U.S. Outpatient Facilities

In a post last year I discussed how an Oral Surgeon Investigated for Reusing Needles and Syringes. In a recent article in JAMA titled “Unsafe Injection Practices Plague US Outpatient Facilities, Harm Patients,” Bridget M. Kuehn discusses many problems with injection practices (December 26, 2012,Vol 308, No. 24, pp. 2551-2552). She describes how hepatitis C virus was contracted by 2 patients who received an epidural injection from a pain management clinic. “During the visit, they observed the physician who treated both patients withdrawing medication from a multiple-dose vial with a previously used syringe topped with a new needle, a breach of safe injection practices that may have contaminated the vial and exposed subsequent patients to potential blood-borne infections.” This led to 8,000 patients who were treated at the clinic to be tested and 8 additional cases of hepatis C to … Read more

The Immune System in Critically Ill Children with Influenza

An interesting article discussed the results of a study looking at the immune system in critically ill children. The article describes a study published in early 2013 in the January issue of Critical Care Medicine. Recent evidence indicates that the suppression of innate immune system function can occur in critically ill patients. In this study patients with innate immune suppression produced reduced amounts of tumor necrosis factor (TNF)-α  when their blood is stimulated with lipopolysaccharide (LPS). The article states “Results indicated that despite high levels of circulating pro-inflammatory cytokines, critically ill children with influenza demonstrated lower TNFα production capacity compared with healthy control subjects. Further, children who died from influenza had markedly lower TNFα production capacity compared with survivors.” Hence this study suggests that the reduction of immune function in these children who are critically ill may make them more prone … Read more

Systematic Review of Prophylactic Extraction of Third Molars: From Brazil

Many reviews have been conducted in recent years to determine if healthy third molars (known as wisdom teeth) should be prophylacticly extracted as in removed before causing problems. A new study by Moacir Guilherme da Costa and four other researchers titled “Is there justification for prophylactic extraction of third molars? A systematic review,” appears in Braz Oral Res., (São Paulo) 2013 Mar-Apr;27(2):183-8. The article discusses how in the United States roughly 10 million wisdom teeth are extracted from around 5 million individuals each year. The article discuss how several reasons are usually given for extracting wisdom teeth pericoronitis periodontal defects in the distal region of the second molar caries in the third or second molars different types of odontogenic cysts and tumors crowding of the lower incisors indications for orthodontic, prosthetic or restorative purposes The authors state how the majority … Read more

Dental Patients Warned of Possible HIV and Hepatitis Exposure Due to Oral Surgeon’s Practices

Previously in this post Oral Surgeon Investigated for Reusing Needles and Syringes it was discussed how last summer in 2012 an oral surgeon in Colorado was investigated for re-using syringes and needles while performing various oral and facial surgery procedures. Around 8,000 patients were told to be tested for potential HIV, hepatitis B, and hepatitis C. Recently, in Oklahoma around 7,000 patients were told to be tested for potential HIV, hepatitis B, and hepatitis C who were treated by an oral surgeon due to his potentially rusty instruments and lax sterilization procedures. A complaint by the Oklahoma  Board of  Dentistry was filed against the oral surgeon on March 26, 2013. It is located over at http://ftpcontent.worldnow.com/ktul/documents/Harrington_Complaint_OBD.pdf (link dead as of 11/09/2019). The complaint says that an unidentified patient who was treated by the oral surgeon tested positive for HIV and … Read more

Unnecessary Medical Care and Over Used Tests: The Choosing Wisely Campaign

The Choosing Wisely Campaign is an initiative which I believe I first heard about in late 2010 launched by the ACR (American College of Radiation as the Imaging Wisely Campaign) The Imagely Wisely Campaign was designed to have people aware of the fact that certain medical imaging tests such as CT exams were sometimes over used and did not always have to be used in some instances. It seems that the Choosing Wisely Campaign was launched by the ABIM Foundation which is an organization designed to advance medical professionalism to improve patient care. In April 2012 the Choosing Wisely Campaign released some lists of tests and procedures commonly done in 9 medical professions that should be questioned.  In February 2013 an additional 18 lists of tests or procedures were released. The press release is located at http://www.choosingwisely.org/wp-content/uploads/2013/02/021513_CW-Phase-II-Press-Release-FINAL.pdf On the website … Read more