June 27th, 2011


Circumcision Increasing in Africa, Decreasing in America

I've been hearing a lot about circumcision lately. This morning I hear that the CDC has determined that circumcision reduces a man's chance of contracting HIV by 60%! This is news to me. I even have it in me to doubt it, having not heard it until just now after so much previous noise about the question. I suspect the mechanism of resistance to the virus has to do with the thickening of the skin on the glans when it is exposed all the time, as versus the thin-ness of such skin, more like a mucous membrane, when it is permanently covered. One kind in Africa has issued an edict that all men must be circumcised, and young Zulu men are getting cut as a rite of manhood. Cultural change is in progress in Africa.

Anyway, other mentions include a pack of people in San Francisco who tried to get a law passed BANNING circumcision as male genital mutilation. They didn't get very far, but they did get a lot of attention. And also, in pediatrics class I heard that here on the West Coast 60% of new baby boys are NOT being circumcised, and that number is increasing. The pediatrician's perspective is that we will have a generation of men for whom either circ or non-circ is accepttable, and then the next generation will probably be almost entirely noncircumcised. Cultural change is in progress in America, but in the opposite direction from Africa...

Guess what Medical Equipment is Most Likely to be Recalled?

Cardiac devices. Yep. Most of them are covered by insurance. All those fancy gizmos that they are so eager to install in us, whenever we have a little heart trouble, those gizmos are increasingly suspect. The situation has gotten so bad that the GAO is pushing the FDA to take a more active role in overseeing devices used by the cardiac care medical industry.

During the period covered by the report ('05-'09), medical-device makers initiated 3510 device recalls, which cover everything from "field corrections" to revised labeling to retrieving a device from customers. The agency categorized about 83% of these recalls as class II, indicating the devices may cause temporary adverse health consequences, and 14% as class III, indicating the device is not likely to cause any adverse consequences. Only 4% were class I recalls, deemed by the FDA to have a reasonable risk of causing serious adverse health consequences or death.

During this time, cardiovascular devices were the most commonly recalled products: 532 recalls, making up 15% of all recalls during this period, while the 40 class-I recalls of cardiovascular devices represented 31% of all class-I recalls in the period. The largest number for cardiovascular devices involved automatic external defibrillators.

The next most common category is radiological devices, which accounted for 484 total recalls but only two class I recalls, followed by general hospital and personal-use devices, which accounted for 388 recalls overall, including 31 class I recalls.