If Computer Security Experts are Getting Hacked, Why are Hospitals/Doctors Expected to be Better?

As anyone knows from reading the newspaper recently, major computer security firms like RSA and Verisign have been hacked. Even the pentagon!

If companies that specialize in computer security get hacked, why are hospitals and doctors who do NOT specialize in computer security held to an even higher standard?

Criminal penalties against healthcare professionals and organizations are steep for computer data breaches at $100 per record with criminal penalties that can include fines of $250,000 and 10 years in prison.

Given such steep penalties, the assumption is that hospitals and physicians must be experts in computer and network security... even better than companies that specialize in this subject area... or can purchase one.

So who should healthcare organizations hire to secure their computers to avoid getting hacked as I can certainly tell you, they are most certainly not security experts?

Google? Symantec? RSA? Verisign? The pentagon?

They've all been hacked successfully... As such, how can we trust their security products?

The answer is simple... There is no company that can be contracted to provide bulletproof security.

The only way is to NOT use a computer at all!

So here's the interesting quandary...

The government is mandating hospital and physicians to transition to electronic medical records or start facing penalties for not doing so.

BUT, the electronic medical records must have bulletproof security or else criminal penalties and even jail-time can be had for any breaches.

With these mandates, the only thing doctors and hospitals can hope for is to not get noticed by hackers. Either get punished for not using a computer or get punished for not having a security system even better than the pentagon.

Source:
Why the security industry never actually makes us secure. CNET 3/3/12
HIPAA Violations and Enforcement. AMA

Pill Rather than Allergy Shots for Ragweed

If all goes well, in 2013 there will be a pill a patient can take rather than allergy shots to tone down the immune response to not only grasses (Grazax), but also ragweed.

The active ingredient in this ragweed pill is Ambrosia artemisifolia, the chemical found within ragweed that causes allergy symptoms.

Phase III trials with this pill taken once/day for 52 weeks conducted by Merck show a significant improvement in allergy symptoms by nearly 25%. Use of allergy medications like anti-histamines and steroid nasal sprays decreased by about 40%.

Just as in allergy shots, it is felt that repeated exposure to the actual allergen will induce immune tolerance. As such, rather than treating the symptoms as with anti-histamines, this medication will theoretically prevent the allergy from appearing in the first place.

Of course, side effects were present and akin to allergies it is supposed to prevent.

There is no published data yet, but results were presented at the 2012 AAAAI meeting.

Source:
New allergy pill may tame ragweed symptoms. MSNBC 3/4/12

Rush Limbaugh Has a Cochlear Implant

Infamous conservative talk show host, Rush Limbaugh, suffered from a rare hearing disorder called Autoimmune Inner Ear Disease.

This rare inner ear disease is principally characterized by progressive bilateral fluctuating hearing loss and occurs when the body's own immune system starts to attack the hearing mechanism of the ear... much like rheumatoid arthritis is when the body's immune system attacks the joints. Just as with any other auto-immune disorder, it is mainly treated with repeated courses of prednisone.

However, if the hearing gets poor enough, the patient may become essentially deaf for which even hearing aids are ineffective which is what happened to Mr. Limbaugh.

To restore his hearing, he underwent surgical placement of a cochlear implant at the House Ear Institute in Los Angeles. It is truly a "bionic" ear in that a computer hears the world around him and directly stimulates the hearing nerve bypassing the cochlea.

Here's a transcript of him describing what it's like.

Source:
Questions on the Host's Hearing. March 18, 2011
Rush Limbaugh's Cochlear Implant Surgery A Success. Audiology Online. 1/3/2002.

Celine Dion Cancels Shows Due to Laryngitis

In late Feb 2012, Celine Dion who was to have performed in Las Vegas Feb 22, 2012, cancelled her show at the last minute at the Caesar's Palace due to laryngitis on the advice of her doctors. According to media reports, her doctors instructed her to rest for 7 days to ensure full recovery due to vocal cord inflammation caused by a virus.

What does that mean exactly?

When a virus infects the mucosa of the upper airway, it causes inflammation of the mucosa lining including the vocal cords. With inflammation, the vocal cords swell.

That's why with laryngitis, the pitch of the voice decreases and it becomes more effortful to talk. To use an analogy, think of a violin string where the thicker string has a deeper pitch than a thin string. It also takes more power to play the thicker string. Watch the video below of normal vocal cord functioning:



In order for voice production to occur, the lining of the vocal cords vibrates very quickly when they come together. If the vocal cords are swollen, they don't vibrate as easily.

Here's what inflamed vocal cords might have looked like for Celine Dion. Note the slight bend to the vocal cords and overall dull appearance.

Below is what her vocal cords might look like when they are at peak health!

Voice rest is absolutely important for vocal recovery as quickly as possible. With talking/singing during active laryngitis, further trauma may occur to the vocal cord lining promoting even more inflammation and swelling. It may also lead to another vocal disorder known as muscle tension dysphonia.


Source:
Celine Dion cancels act: laryngitis. UPI 2/26/12

Unnecessary Sinus Surgery

A well-respected ENT surgeon, Dr. Salah Salman, recently wrote a book, "Scrubbed Out," critical of the American health system with its links to corporation, powerful lobbies, administrators, and bureaucrats resulting in care driven by money rather than by medical necessity.

In particular, he focuses in one part of his book on endoscopic sinus surgery in the treatment of chronic sinusitis. The excerpt from the book is quite lengthy and I encourage anybody interested to read a lightly edited version here.

In essence, there are a few unscrupulous sinus surgeons who perform sinus surgery for every patient with facial pain and pressure even though there's no evidence for any chronic sinus infection whether on CT, endoscopic exam, and other objective testing.

Indeed, in my practice, perhaps only 10% (if not less) of patients with chronic "sinus" complaints actually have pathology related directly to the sinuses that merits consideration of sinus surgery. More commonly, symptoms suggestive of a chronic sinus infection are more commonly related to allergies and atypical facial pain syndromes (ie, migraines, sluder's neuralgia, contact point headaches, etc).

Unfortunately, in many physicians' minds including patients, if multiple courses of antibiotics do not resolve pan-facial pain/pressure, the sinuses must be horrible and something more aggressive geared towards the sinuses must happen.

And there's a few ENT surgeons willing to do just that... and mistakenly so.

It's not just ENTs, but allergists and infectious disease specialists who also may accommodate what the patient wants for treatment, even if it is incorrect.

If such patients see an allergist in the belief that their symptoms are due to allergies, they will get allergy testing and allergy shots.

If they see an infectious disease specialist, they will get antibiotics.

A much neglected specialist for patients with "sinus" problems are the neurologists given so many of these patients are actually suffering from atypical facial pain syndromes... but nobody (physicians, pharmaceutical companies, hospitals, bureaucrats) gets paid much for this particular problem... and so it gets ignored.

Though sinus surgery has been abused in the past into the present, a more recent, highly reimbursed, and "sexy" sinus procedural development is balloon sinuplasty, also ripe for being abused.

Traditional sinus surgery and now balloon sinuplasty certainly have their place in the treatment of true chronic sinus pathology with astounding success, but only in highly selected patients.

As with everything, the right treatment in the right patient is the right way of doing things.



Source:
Book Excerpt: A Saga Of ‘Fishy’ Surgery For Chronic Sinus Trouble. WBUR.ORG March 2, 2012