Public Health

Cases of Necrotizing Fasciitis, Serious Genital Infection with certain Diabetic Medications, FDA warns

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The US Food and Drug Administration has put out a warning about certain Type II Diabetes medications causing cases of genital infection and necrotizing fasciitis in the perineum.

According to Medscape

“The new warning will be added to the prescribing information and the patient medication guides for all single and combination agents in the glucose-lowering SGLT2 inhibitor class of drugs approved to treat type 2 diabetes. Those drugs include the following:

  • Canagliflozin (Invokana, Invokamet, Invokamet XR; Janssen)
  • Dapagliflozin (Farxiga, Xigduo XR, Qtern, AstraZeneca)
  • Empagliflozin (Jardiance, Glyxambi, Synjardy, Synjardy XR; Boehringer Ingelheim/Eli Lilly)
  • Ertugliflozin (Steglatro, Segluromet, Stelujan; Merck)

Necrotizing fasciitis of the perineum, also called Fournier’s gangrene, is an extremely rare but life-threatening bacterial infection of the tissues underlying the skin surrounding the perineal muscles, nerves, fat, and blood vessels. It is estimated to occur in about 1.6 of 100,000 males annually in the United States, most often among those aged 50 to 79 years (3.3/100,000).

However, from March 2013 to May 2018, the FDA received reports of 12 cases of Fournier’s gangrene among patients taking SGLT2 inhibitors, of whom five were women and seven were men. The condition has rarely been reported among women. The patients ranged in age from 38 to 78 years.”

Read on at Medscape to find out about treatment options and what patients and healthcare professionals should do.

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A Loneliness Epidemic

By | Blog, Kathleen Bartholomew, Public Health | No Comments

Kathleen Bartholomew is back with another excellent blog post. Kathleen is a well known Nurse speaker and the author of “The Dauntless Nurse”. She can be found at her website Kathleen Bartholomew as well I Am Dauntless.  You don’t want to miss her other posts on the SMYS Blog How Much Weed is Too Much Weed for NursesIt all comes back to staffing, and Late to the game:What can China and South Korea teach America?


Just this week a survey of 20,000 adults conducted for the health insurer Cigna found that 50% of adults said they sometimes or always felt alone or left out. That’s a big leap from 1985 when only 10% of our population had no one to confide in about serious matters.

Can you guess which age group was the worst affected? Ages 18-22. Alarming!

In our Instagram world where we are constantly texting friends and family, the Great Nothing of loneliness has taken up residence in our souls. What gives? It turns out that a “like” is not the same as real human connection where we feel truly seen.

Most nurses know that loneliness is a predictor of functional decline and mortality and is associated with depression, poverty, arthritis, and heart and lung disease. A 2010 study found that being lonely has the same effect on mortality as smoking 15 cigarettes a day!

Let’s recognize outliers and do something about strengthening community before Loneliness turns into yet another billing code and treatable commodity where big pharma can make big money by creating new drugs like “Forlorn-azol”, or immunize us from loneliness with “Dejectacillan”.

Look around. A good place to start is your own unit. Engage in conversation with someone new, initiate genuine conversation instead of always diverting into our own smartphones at breaks, and discover something unique and good to say about a co-worker every day.

We are over 3.6 million nurses. We can reverse this trend.

Tell us what you think in the comments section and over on the SMYS Facebook Page and join us in the SMYS Facebook Group

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When A Mystery Outbreak Strikes, Who You Gonna Call?

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NPR’s Morning Edition did a fantastic report on a mysterious disease outbreak in Liberia that was spreading rapidly and was potentially deadly.  Read the excerpt below:

In April 2017 about 150 people had gathered for the funeral of a Christian minister in the small port city of Greenville, Liberia, in West Africa. The memorial spanned April 21 and 22 and included a wake that extended late into the night of the first day.
Just one day after the minister was buried, ten people arrived at the local hospital violently sick. Most of them were vomiting and had severe stomach cramps. Some had diarrhea as well. A few ran a fever, but most did not.
The symptoms came on rapidly.
But it was unclear what the patients were suffering from.
What was clear was that it could be lethal.

Head on over to the NPR Morning Edition website to read the rest, and see how they figured out what the disease is and how they figured it out, but before you do comment below with what you think it could be!

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Late to the game:What can China and South Korea teach America?

By | Blog, Healthcare Policy, Kathleen Bartholomew, Public Health | No Comments


This is the third in a series of guest posts by Kathleen Bartholemew, author of The Dauntless Nurse.  Don’t miss her first two blog posts, “It all comes back to staffing” and “How much weed is to much for Nurses“.  Check out all of Kathleen’s posts and leave comments below!

In 2008 both South Korea and China declared that gaming addiction was their number one public health problem. Today, these countries have sixteen treatment centers, a school internet screening tool, two week detox program and over 5000 counselors trained in internet addiction. In contrast, the CDC does not list internet addiction as even one of its top ten public health concerns – despite the fact that the screen time for America’s youth is over 7 hours a day, and that our children today only spend 4 to 7 minutes a day outdoors.

As a country we have failed to adequately acknowledge this crises as well as the impact it will ultimately have on our society. Most people do not even know that gaming in excess causes physical changes to the brain’s very structure at a time when it is still evolving. According to Dr. Hillarie Cash, founding member of ReStart Life, the signs and symptoms of addiction are:

  • Attention, learning and self-control problems
  • Impaired social skills
  • Emotional problems, anxiety, low self-esteem and depression
  • Aggression and indifference to human pain
  • Physical problems – eye strain, weakness, carpal tunnel
  • Strong correlation with sex and porn

Concerned, I paid a visit to the first digital addiction treatment center in the nation. Dr. Hillarie Cash  gave me a tour of the group treatment center at ReStART, but most enlightening were the personal conversations with the residents themselves who could barely make eye contact with me. Emphatically, these young men relayed what parents should NOT do:

  • Don’t tell kids its bad – tell them and show them the impact gaming has on their lives
  • Don’t get help until children admit there is a problem (it’s usually an event)
  • Don’t act like being on the internet is a reward
  • Don’t say “as long as you do what you are supposed to do (like good grades) then I don’t care

What should parents do? Unanimously these men wished that their parents had put parental controls on with explanations about the power of digital addiction – and they also wanted their parents to sit down and eat dinner with them. Real human connection appears to be a good antidote.

Pass this information along. Educate yourself on the powerful pull of digital media. Bring up the subject in PTA meetings, churches and social gatherings to help raise awareness in our society of the insidious damage of digital media addiction and inform your loved ones- in person! Or maybe download the APP “Moment” to monitor your own screen time (a reality check for my husband and I). As adults, set a good example. Over 60% of adults sleep with their cell phones at night, and half of adults read their emails during the night.

There has been a two year waiting list for ReStart Life for quite a while now – which clearly demonstrates the need. We may be late to the game, but there is still time for us to rally together to preserve the personal connections that make us human, and to protect our children from danger that they cannot see.

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