The patient was not complaining, by any means. He’d just started a new “natural” sex enhancement supplement, and he reported that it was working terrifically.
But Dr. Pieter Cohen’s astute resident at the Somerville Hospital primary care clinic, Dr. Rachael Bedard, had her suspicions, and she brought the patient to his attention. Dr. Cohen, a general internist at Cambridge Health Alliance and a frequent medical mythbuster, sent the pill out to be tested.
“The lab not only found Viagra in it,” he recalled. “They also found Cialis, another erectile dysfunction drug, as well as a brand new designer drug, as well as caffeine.” So in all, “You’ve got two prescription drugs that we would never prescribe together, a brand new drug, and caffeine, all in one pill. And that’s what our patient was consuming when he thought he was taking a natural sex enhancer.” In fact, the supplement, Sex Plus, was “chock full of pharmaceuticals that had nothing to do with nature.”
Dr. Bedard sent the findings to the FDA, which did its own testing and ended up issuing this alert late last month. And Dr. Cohen has just co-authored a paper in the Journal of the American Medical Association Internal Medicine — “Adulterated Sexual Enhancement Supplements,” subtitled “More Than Mojo” — spreading the word that sex-enhancement supplements advertised as natural may in fact be nothing of the kind. And they may contain brand new designer erectile-dysfunction drugs whose potential dangers are anyone’s guess.
His bottom line: “If you want a natural sex enhancer, talk to your doctor about prescription ‘yohimbe,’ but it may have side effects and it’s not very effective. Still, if you want to avoid Viagra, that’s the way to go. When it comes to any supplement sold for sexual enhancement, it should be avoided because it’s either going to be useless or potentially harmful.”
What might be the danger of, say, the drug that Somerville patient was taking? Continue reading →
They offer more than a dozen recommendations, based on successful strategies used in other public health crises. For example, they suggest a new, substantial national tax on all firearms and ammunition, to more accurately reflect the true societal costs of gun ownership and to provide a stable revenue source to target gun violence prevention. Such a tax would function like the tobacco tax, which provides crucial funding for smoking prevention efforts.
Other “off-the-shelf” approaches to preventing gun violence can be borrowed from efforts used in the 1970s to prevent accidental poisonings, the authors say. In the case of potentially harmful drugs, child safety packaging was introduced. In the case of guns, a similar strategy would be the manufacture of “smart guns” with security codes or locking devices. Also, routine education and counseling by physicians and national networks for education and prevention helped significantly reduce childhood poisoning deaths; similar efforts could help curb gun-related deaths. Continue reading →
On a perfect, sunny winter day, I watched helplessly as my son was slammed to the ground by a girl hurtling down our local sledding hill on a giant inner tube. She was moving at such velocity that she barely slowed even after knocking him down. Remarkably, other than a bruised ankle and a bruised ego, my son was fine.
But the girl, splayed on her back and unable to steer, was spun around by the collision. The impact sent her spinning and bouncing crazily, and then she flew off the tube like a rag doll. She barely missed a tree and landed with an ugly thud, slamming her head on the icy snow. I was the first to reach her and she was initially unresponsive, awake but staring blankly at the sky. Eventually her parents ran over and she stumbled to her feet. Then she began crying hysterically.
If her parents took her for a hospital evaluation (and I hope they did), they’d have found that her collision wasn’t a rare occurrence. There are a limited number of sledding days even in frosty winters like this one, yet an estimated 23,000 people are treated annually in the United States for sledding injuries, with the highest percentage being children between ages 10-14.
‘You literally have no control.’
–Dr. David Mooney
“Sledding injuries are common,” acknowledges Dr. Eric Glissmeyer, a fellow in Pediatric Emergency Medicine at the University of Utah. “They range from inconvenient and painful, like broken arms or collar-bones, to serious and life-threatening, such as skull fractures, and neck and brain injuries. As one would expect, the steeper the hill and the faster the speed and the more crowded the sledding day, the more likely injuries are to occur.”
And those dastardly, unsteerable, oversized inner tubes rank at the top of the sledding danger list. A study in the journal Pediatrics evaluated sledding injuries from 1997-2007, and found: “Traumatic brain injuries were more likely to occur with snow tubes than with other sled types.”
“The inner tubes are bouncy and you literally have no control,” explains Dr. David Mooney, director of the Trauma Program and an assistant professor of surgery at Boston Children’s Hospital. “Most of the real injuries we see are when people hit something. We’ve had horrible head injuries with kids hitting trees. With tubes they spin around and even if a kid is trying to be a good citizen (and travel feet first) it could spin when they’re halfway down the hill.” Continue reading →
Somehow, with all the semi-automatic weapons floating around, it’s hard to work up a big fear of champagne corks.
But for that very reason, I found this warning about the dangers that champagne corks pose to our eyes oddly soothing. I may not be able to protect my children while they’re in school, but I can make darned sure my champagne is served chilled and opened in a way that it doesn’t take out anybody’s eye…
BOSTON, Mass. — Warm bottles of champagne and improper cork-removal techniques cause serious, potentially blinding eye injuries each year, according to the Massachusetts Society of Eye Physicians and Surgeons and the American Academy of Ophthalmology. Champagne bottles contain pressure as high as 90 pounds per square inch – more than the pressure found inside a typical car tire. This pressure can launch a champagne cork at 50 miles per hour as it leaves the bottle, which is fast enough to shatter glass. Unfortunately, this is also fast enough to permanently damage vision.
Advice from the American Academy of Ophthalmology:
• Chill sparkling wine and champagne to 45 degrees Fahrenheit or colder before opening. The cork of a warm bottle is more likely to pop unexpectedly.
• Don’t shake the bottle. Shaking increases the speed at which the cork leaves the bottle thereby increasing your chances of severe eye injury.
• Point the bottle at a 45-degree angle away from yourself and any bystanders and hold down the cork with the palm of your hand while removing the wire hood on the bottle.
• Place a towel over the entire top of the bottle and grasp the cork.
• Twist the bottle while holding the cork at a 45 degree angle to break the seal. Counter the force of the cork using downward pressure as the cork breaks free from the bottle.
Tanya Connolly, 37, crushed under a tractor-trailer in South Boston last Monday. Doan Bui, 63, killed by a speeding pickup truck on a busy Dorchester thoroughfare the Friday before. Alexander Motsenigos, 41, victim of a hit-and-run in surburban Wellesley late last month.
In major metropolitan areas like Boston, it often seems as if every week brings news of another bicycling death — or, as in this past week, more than one — usually in an unequal clash between vehicle and rider. Biking experts say that as more people take to two-wheel travel — surely a good thing — more accidents are also likely. Below, writer David C. Holzman describes his own bike crash, and shares a key safety technique that many riders ignore: Helmets save lives, but they have to be worn right.
By David C. Holzman
The treetops seemed far away, as if through the wrong end of a telescope. They were all green, leafy, and dreamlike — like my memory of Seattle before I moved away at age eight.
The dream quickly soured as it began to dawn on me that I might have had a bicycle crash. But that didn’t make sense. Even in my stupor, I remembered that I was a very experienced cyclist, and very safety-conscious.
I began trying to wake myself up, as I’d done so easily in the lucid dreams of my early childhood. But it wasn’t working, and I couldn’t even shift the scene. Shock was cushioning me, like emotional Novocaine; nonetheless, I could feel the fear growing ominously more perceptible.
“When you are hit by a car, if your helmet can move, it will.’
Now I saw two women standing over me. “Am I dreaming?” I asked, fully expecting I was. (I had to be. Crashes didn’t happen to me.) “No, honey, you not dreaming,” one of them said in a dialect common in northeast Washington, DC.
I took five or ten seconds to grasp that I really was lying on my back in the street, and not in a bad dream. Once I did, I thanked the women “for watching over me,” actually thinking that they had come to protect me, the feelings of gratitude washing over me like an ocean wave on a beach.
Then one of them asked me for two dollars. Heretofore, I hadn’t moved a voluntary muscle outside of those involved in speech, but now, almost as if her voice was a hotline to my motor cortex, I pulled my wallet from my pocket, opened it, found a twenty and two ones, and gave her the latter. Had she asked for the twenty, I probably would have given that to her.
Memorial for a bicycle crash victim in Cambridge (Rachel Zimmerman)
Soon the women had disappeared, and a crowd gathered. I asked someone where I was. I was able to trace the route in my mind from my home, at 1200 Jackson St. North East, two miles to Rhode Island Avenue and First Street North West, but I still didn’t know where I had been going, or even whether I still worked at Insight Magazine, or whether I had been laid off, an event which had occurred four and a half months earlier.
Then someone informed me that my face was “all messed up.” I don’t understand why, but suddenly my head was much clearer, and I knew I would be fine.
I looked at my watch. It was 8:20 a.m. on September 6, 1991. I realized I’d been on my way to the doctor’s office, for an annual checkup. I’d crashed about 10 minutes earlier. I’d have to reschedule the appointment.
The guy who told me my face was messed up was partially correct. As my then-four-year-old niece, Beth, said with obvious bemusement when she first saw me the next day, “Uncle David, you need to wash your face!”
I’d been going around 15 to 18 mph when I hit a large bump in the road that I hadn’t seen, wrenching the handlebars out of my hands. That’s the last thing I remember. Despite the tight chin straps, the force of the crash on my helmet had pushed it so far askew that my cheekbone had kissed the pavement, acquiring an impressive bruise, and a laceration which I think had to be taped shut. Luckily the straps had been tight enough to keep my helmet on my skull, or I probably would not be writing this warning.
So I’ve been appalled to see air between the chin straps of helmets and the chins of about one third of the cyclists on the Minuteman Trail, where I run or ride my bicycle just about every day. Chin straps on helmets should be snug, like one’s shoe laces. Continue reading →
Riders all virtuously wearing their helmets when the Hubway bike-sharing program launched last summer (AP photo)
Whenever I see bikers not wearing helmets, I feel a fierce urge to take them on a tour of the kind of head-injury wards where my mother spent 20 months after a devastating car accident. “See these mute, paralyzed people staring all day long at nothing?” I imagine saying. “This could be you.”
End of rant. It was prompted by a study just out from Beth Israel Deaconess Medical Center finding that bike-sharing programs, laudable as they are for other reasons, seem to prompt riders to travel bare-headed. From the press release:
BOSTON – A national rise in public bike sharing programs could mean less air pollution and more exercise, an environmental and health win-win for people in the cities that host them, but according to researchers at Beth Israel Deaconess Medical Center, more than 80 percent of bike share riders are putting themselves at significant health risk by not wearing helmets.
“Head injury accounts for about a third of all bicycle injuries and about three-quarters of bicycle related deaths, so these are some pretty shocking numbers,” says lead author and emergency medicine physician Christopher Fischer, MD. Continue reading →
Please forgive this preaching, but I think I speak for all my WBUR colleagues when I say: We love our listeners and do not want our podcasts and mobile apps to hurt you. So please pay attention — and that is the point, paying attention! — to a new study that finds that reports of serious injuries in pedestrians wearing headphones have tripled in the last several years.
The victims tended to be in urban areas, under 30 and male, and about half were struck by trains. The authors of the paper in the journal “Injury Prevention” — titled “Headphone use and pedestrian injury and death in the United States: 2004-2011 — mined their data from injury databases and even Google, and came up with a total of 116 vehicle accidents, 70% of them fatal.
My speculation is that, say, an On Point segment on physics might be especially perilous.
They found that in three-quarters of the cases, witnesses reported that the victims were wearing headphones, and in about one-quarter, they said a horn or other warning had sounded before the collision.
From the press release:
“The authors say that distraction and sensory deprivation, whereby the wearer is unable to hear any external sounds, are the most likely causes. Distraction caused by the use of electronic devices has been coined ‘inattentional blindness,’ which essentially lowers the resources the brain devotes to external stimuli, they write. Continue reading →
This is particularly welcome news on a day when my octogenarian father is scheduled to pick up my daughter at camp.
“Pediatrics,” the journal of the American Academy of Pediatrics, reports that though we tend to think of elderly drivers as more dangerous, children are actually safer when being driven by a grandparent than a parent. In fact, they’re only half as likely to be injured in a grandparent’s car crash as a parent’s. And that’s true even though grandparents are not quite as good about seatbelts. From “Pediatrics”:
Researchers in a new study, “Grandparents Driving Grandchildren: An Evaluation of Child Passenger Safety and Injuries,” in the August 2011 issue of Pediatrics (published online July 18), hypothesized that grandparent-driven children would be at higher risk of injury.
What they found is that children are actually safer in a crash when grandma or grandpa is behind the wheel. The study authors examined five years worth of crash data, including 217,976 children. Grandparents comprised 9.5 percent of drivers in crashes (the rest were parents), but resulted in only 6.6 percent of the total injuries.
Nearly all children were reported to be restrained at the time of the crash, however children in grandparent-driven vehicles were less likely to be optimally restrained. Despite this, children in grandparent-driven crashes had half the risk of injuries as those in parent-driven crashes.
Study authors suggest grandparents may drive more cautiously when they have “precious cargo” on board, but they also conclude that children’s safety could be enhanced if grandparents followed current child restraint guidelines.
So, I said crankily this morning as I read about the new car-seat guidelines, our kids are basically supposed to ride in booster seats until they start driving themselves??
But that was just a moment of pique. When the American Academy of Pediatrics tells me definitively that I can keep my child safer, I’m not about to say no. Here’s the AAP release, including:
The AAP advises parents to keep their toddlers in rear-facing car seats until age 2, or until they reach the maximum height and weight for their seat. It also advises that most children will need to ride in a belt-positioning booster seat until they have reached 4 feet 9 inches tall and are between 8 and 12 years of age. The previous policy, from 2002, advised that it is safest for infants and toddlers to ride rear-facing up to the limits of the car seat, but it also cited age 12 months and 20 pounds as a minimum. As a result, many parents turned the seat to face the front of the car when their child celebrated his or her first birthday.
And here’s some wisdom from Dr. Lois Lee, medical director of the pediatric injury prevention program at Children’s Hospital Boston. The new guidelines may cause some logistical challenges, she said. For example, how do you fit three booster seats in the back of a sedan? But “It’s worth it, because there’s no price you can set on protecting your child from a permanent brain or spinal cord injury.”
The new guidelines have two main parts, she said, and each has scientific backing:
-Keeping children in rear-facing seats until age 2, rather than 1: “This comes from some research done in Philadelphia that really showed that children who are sitting in rear-facing seats up to age 2 have a significantly decreased risk of injury in the event of a crash, and particularly for side-impact crashes.”
“The child’s head and neck are supported better in rear-facing seats,” she said, “so it is less likely that the head and neck will be whiplashed back and forth.” In Europe, rear-facing seats for children up to 2 have been standard for years, she added.
- Keeping children in booster seats up until the age of 12: With the old recommendations to use boosters until a child was 8 or 4’9″, the height guideline tended to get lost, and people tended to stop using the seats when children turned 8. “Physically,” Lois said, “that doesn’t make sense, because the whole idea is that you have to be tall enough that the shoulder belt crosses over the shoulder and the lap belt sits low over the hips.”
Here’s something I didn’t know, and I’m glad I didn’t have to find out the hard way: A poorly fitted seat belt can actually worsen injuries. Oftentimes, Lois said, the shoulder belt hits smaller children in the neck, which they don’t like, so they put it behind their back and end up with no upper-body protection. And the lap belt rides across the abdomen, so if there’s a crash, “the lap belt basically acts like a fulcrum, and so then the upper body bends forward, so they’re at risk for internal organ injury — intestines, liver and spleen — as well as spinal fractures.”
The idea of the booster seat is that it raises children up to the height of an adult, so the belts can be positioned correctly.
“You have no control of how people drive,” Lois said. “But you do have control over maximimizing the safety of your own children in your own car, so in the event of an unexpected crash, you know you’ve done everything you can to keep your child safe.”
Now where did I put that old booster seat that I thought my daughter had outgrown?