Funtabulously Frivolous Friday Five 268

Medical error.

Over 250,000 deaths per year are due to medical error in the US.

One solution from the bcemergencynetwork is inter-professional simulation.

References

• Medical error – the third leading cause of death in the US. BMJ 2016;353 doi: https://doi.org/10.1136/bmj.i2139

Thalidomide

Thalidomide is a known cardiac teratogen and can cause a number of cardiac malformations including ventricle, atrial septal defects as well as TOF.

Thalidomide was first marketed in 1957 in West Germany to alleviate morning sickness. Despite the side effects the drug was still found in Canada until 1962. It is not known how many victims worldwide there have been but estimates extend to 100,000. Victims in Germany are still being paid by the government since the original foundation by Chemie Grünenthal (the company responsible) ran out of money. Grünenthal paid 50 million euros in 2008 on top of a 100 million DM in 1970.

Currently thalidomide is used to treat multiple myeloma and erythema nodosum leprosum (ENL).

Reference: Jenkins JK. Noninherited Risk Factors and Congential Cardiovascular Defects: Current Knowledge. AHA Scientific statement. Circulation. 2007;115:2995-3014

Just about anything…

In Precolumbian America: Columbus found Native Americans growing and using tobacco for various ills including as a sedative for trepanning, mixed with chalk and lime for toothpaste and ulcerating abscesses. Observation that the tobacco plant could cure multiple ills led to the export of the plant around the world.

Early use in Europe included; catarrh, colds, fevers, malaria, an aid to digestion, prevention of hunger and thirst, as a purgative and as a narcotic. There were even attempts to use tobacco to treat cutaneous diseases such as; scrofula, yaws, lupus, basal cell carcinomas; syphilis, finger amputations and even your piles (recommended up to 1847).

During the London plague of 1665 children were instructed to smoke in their school rooms.

In the nineteenth century nicotine was isolated and the medical world became more mistrustful of the plant due to the dangerous alkaloid present. Even so, a nicotine salicylate was made to treat scabies, and tobacco smoke per rectum was used for strychnine poisoning, constipation, strangulated hernia, tetanus and worms.

Twentieth Century: As the medicinal properties of tobacco was being disproven, doctors were then used for marketing during 1940s to 1950s to claim cigarrets cause Less irritation and soothe the throat, cure a cough and prevent a cold and finally keep you slim

It wasn’t until Sir Richard Doll and Austin Hill helped to determine the link between smoking and lung cancer that changed our thinking. On a preliminary survey of 649 cases of lung cancer patients they discovered only 2 patients didn’t smoke. Doll preceded to give up his 5 a day habit. Some were harder to convince so they surveyed a more reliable cohort, doctors. They got 40,500 replies and monitored smoking habits and their general health, by 1956 the results were unmistakable. More than 200 heavy smokers had died of lung cancer in 4 years with an incidence in the non-smokers was negligible.

• Stewart GG. A history of the medicinal use of tobacco 1492-1860. Med Hist 1967;11: 228-68
• Charlton A. Medicinal uses of tobacco in history. J R Soc Med. 2004;97(6):292-296
• Doll R and Hill AB. The mortality of Doctors in Relation to Their Smoking Habits. BMJ. 1954;1(4877):1451-1455

Compression of the left iliac vein by the right iliac artery which crosses over it.

This is normal anatomical variant, but in some people the artery presses on the vein enough to thicken the vein wall over time and cause proximal DVTs.

• May R, Thurner J. The cause of the Predominatly Sinistral Occurrence of Thrombosis of the pelvic veins. Angiology. 1957 Oct;8(5):419-27.

Otis Campbell is a mnemonic for drugs that cause seizures.

Otis Campbell is also a fictional “town drunk” in Mayberry on the American TV sitcom The Andy Griffith Show. Otis was played by Hal Smith and made frequent appearances on the show from 1960 to 1967. 

• Organophosphates, oral hypoglycaemics
• Tricyclic antidepressants
• Isoniazid, insulin
• Sympathomimetics, strychnine, salicylates
• Camphor, cocaine, carbon monoxide, cyanide, chlorinated hydrocarbons
• Amphetamines, anticholinergics
• Methylxanthines (theophylline, caffeine), methanol
• Phencyclidine (PCP), propranolol
• Benzodiazepine withdrawal, botanicals (water hemlock, nicotine), bupropion, GHB
• Ethanol withdrawal, ethylene glycol
• Lithium, lidocaine
• Lead, lindane