Shaw's Eco-Logic

This HND piece describes the apparent wholesale increase in myopia, observed around the world. Long though to be brought on by too much close work, and these days by addiction to personal electronic devices, research over the last few years points to another etiology.

Would you believe it may result from too little time spent outdoors? Yes, that's kind of related, but the real factor here seems to be exposure to sufficient lux—which is tied into retinal development. See, kids? You should be spending more time outside!

Read the complete article.

This HND piece spotlights the serious issue of overdiagnosis—first introduced in a best seller from 2011.

Overdiagnosis matters because the health care system has no mechanism in place for distinguishing between a legitimate diagnosis and an overdiagnosis. As such, an overdiagnosed patient will likely get treated, but by definition can derive no benefit from the treatment. Since nearly all medical therapies carry some potential of harm, this patient can only be harmed.

How many overdiagnosed conditions come to mind? Hypertension, ADHD, type 2 diabetes, any number of quasi-psychiatric maladies. But, don't worry. There are plenty of drugs available, for whatever ails you—real or imagined.

Overdiagnosis has become such a big deal that an annual conference is devoted to this problem, and we reveal some of the findings from that conference.

Read the complete article.

This HND article is a follow-up to last week's entry.

Yet another prestigious hospital joins the ranks of those reporting Carbapenem resistant enterobacteriaceae (CRE) infections, linked to endoscopic retrograde cholangiopancreatography (ERCP) endoscopes. On March 4th, Cedars-Sinai Medical Center in Los Angeles discovered that four patients were infected with CRE, and 67 others may have been exposed. On the same day, Hartford (CT) Hospital announced that as many as 281 patients may have come into contact with a "tough strain" of E. coli over the past year, but denied that it was CRE.

Two matters keep coming up: The non-use of proven ethylene oxide sterilization, and the detached attitude of the GI-docs. Then there's the dumb idea of blaming the scopes and going back to older models, as if the earlier design did not also have contamination problems. More than that, just about everyone thinks that many more similar cases will emerge—and not just with ERCP scopes.

One wonders when the rest of the medical community will put pressure on the GI-docs to show some leadership. Read the complete article.

The title of this HND piece is taken from a mordant lyric in Richard Fariña's 1966 folkie love song "Children of Darkness." In this case, our "foul command" is officialdom, and its pathetic reaction to serious outbreaks of the dreaded superbug Carbapenem resistant enterobacteriaceae (CRE), related to endoscopic retrograde cholangiopancreatography (ERCP).

High profile cases include Seattle's Virginia Mason Medical Center, and UCLA"s Ronald Reagan Medical Center.

The FDA has been asleep at the switch—to be kind about it, while the rest of the players are blaming each other. Cover-ups have surely occurred. Associated deaths have attracted plaintiff's attorneys, but the burden of proof will be on the plaintiffs, to show that the CRE was indeed caught during the hospital stay. Fortunately, this can now be done with DNA analysis.

Lax procedures in disinfecting the endoscopes are likely at fault, but the hospitals insist that they have always followed the manufacturer's instructions. This is subject to some debate, of course. It is expected that many more such cases will emerge in the coming months.

Read the complete article.