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Questioning The Use Of Muscle Rubs
There is not enough evidence to support using gels and creams containing rubefacients for chronic and acute pain, according to a systematic review by Cochrane Researchers. Rubefacients cause irritation and reddening of the skin, due to increased blood flow. The review focused on formulations containing salicylates, which are widely prescribed or sold over the counter as topical treatments for sports injuries and muscle pain.
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'We Want Sex, Not AIDS'
Health workers fail to understand the importance of sex for Tanzanian children
News of the day
Ariz. Gov. Signs Bills Increasing Abortion Restrictions, Updating Existing Statutes
Arizona Gov. Jan Brewer (R) on Monday signed into law a bill (HB 2564) that mandates a 24-hour waiting period and in-person counseling with a doctor before women can receive abortion care, the AP/Yahoo! News reports. The law requires doctors to list risks and alternatives and describe the fetus"s probable characteristics. It also makes an existing parental consent law more restrictive for minors seeking abortion care and allows health care workers to refuse to dispense emergency contraception on moral or religious grounds.Planned Parenthood Arizona said the measure "creates barriers, increases costs and denies access to services and providers to women who seek abortion care." Bryan Howard, the affiliate"s president, said, "Women will be forced to delay their care, in turn increasing their health risks." In signing the measure, Brewer "set a new course" from former Gov. Janet Napolitano (D), who vetoed all bills that restricted abortion rights during her six years as governor, the AP/Yahoo! News reports.Brewer Signs Law Revising "Partial-Birth Abortion" Ban Brewer also signed legislation (HB 2400) that revises an Arizona law banning so-called "partial-birth" abortion except when the procedure is necessary to save the woman"s life. A federal judge in October 1997 ruled that a state law banning the procedure was unconstitutional, but the Supreme Court in 2007 upheld a similar federal law. The new law is intended to align the 1997 state law with the federal statute, according to the AP/Yahoo! News.The new law specifies a punishment of up to two years in prison. It allows a doctor charged under the law to seek a hearing before a state regulatory board to determine if the doctor"s actions were necessary to save the woman. Advocates of the bill say that it will allow local authorities to enforce the ban on the procedure (Davenport, AP/Yahoo! News, 7/13).
Diagnostics

Substance Abuse Appears To Be An Important Factor In Increased Risk Of Violent Crime By Persons With Schizophrenia

The increased risk of persons with schizophrenia committing violent crime may be largely mediated by co-existing substance abuse problems, according to a study in the May 20 issue of JAMA. Many studies have reported on the association between major mental disorder and violence, including some that specifically have examined the relationship with schizophrenia. "These reports typically find that schizophrenia is related to a 4- to 6-fold increased risk of violent behavior, which has led to the view that schizophrenia and other major mental disorders are preventable causes of violence and violent crime," the authors write. They add that considerable uncertainty exists as to what is the cause of this elevated risk. Some studies have indicated that substance abuse may play a role. Seena Fazel, M.D., of the University of Oxford, Warneford Hospital, Oxford, England, and colleagues examined the relationship of schizophrenia with violent crime and the possible role of substance abuse. The study included data from nationwide Swedish registers of hospital admissions and criminal convictions from 1973-2006. Risk of violent crime in patients after diagnosis of schizophrenia (n = 8,003) was compared with that among general population controls (n = 80,025). Potential confounders (factors that can influence outcomes; age, sex, income, and marital and immigrant status) and mediators (intervening factors such as substance abuse) were measured at the beginning of the study. To study familial confounding, the researchers also investigated risk of violence among unaffected siblings (n = 8,123) of patients with schizophrenia. The researchers found that among patients with schizophrenia, 1,504 (13.2 percent) had at least 1 violent offense compared with 4,276 (5.3 percent) of general population controls (adjusted odds ratio, 2.0). The rate of violent crime in individuals diagnosed as having schizophrenia and substance abuse (27.6 percent) was significantly higher than in those without substance abuse (8.5 percent), which resulted in adjusted odds ratios of 4.4 for violent crime in schizophrenia with substance abuse and 1.2 in schizophrenia without substance abuse. The risk increase among those with substance abuse was significantly less pronounced when unaffected siblings were used as controls (28.3 percent of those with schizophrenia had a violent offense compared with 17.9 percent of their unaffected siblings), suggesting significant familial (genetic or early environmental) confounding of the association between schizophrenia and violence. "We demonstrate that the risk of violent crime in schizophrenia in patients without comorbid substance abuse is only slightly increased. In contrast, the risk is substantially increased among patients with comorbidity and suggests that current practice for violence risk assessment and management in schizophrenia may need review," the authors conclude. JAMA 2009;301[19]:2016-2023. JAMA


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