Hundreds of patients of an Oklahoma oral surgeon accused of unsanitary practices showed up at a health clinic Saturday, looking to find out whether they were exposed to hepatitis or the virus that causes AIDS.

Letters began going out Friday to 7,000 patients who had seen Dr. W. Scott Harrington during the past six years, warning them that poor hygiene at his clinics created a public health hazard. The one-page letter said how and where to seek treatment but couldn't explain why Harrington's allegedly unsafe practices went on for so long.

Background: Dentist's office a 'menace,' HIV tests urged for thousands

Testing for hepatitis B, hepatitis C and the virus that causes AIDS began at 10 a.m. Saturday, but many arrived early and stood through torrential downpours. The Tulsa Health Department said 420 people were tested Saturday at its North Regional Health and Wellness Center. Screenings resume Monday morning.

Kari Childress, 38, showed up at 8:30 a.m., mainly because she was nervous.

"I just hope I don't have anything," said Childress, who had a tooth extracted at one of Harrington's two clinics five months ago. "You trust and believe in doctors to follow the rules, and that's the scariest part."

Inspectors found a number of problems at the doctor's clinics in Tulsa and suburban Owasso, according to the state Dentistry Board, which filed a 17-count complaint against Harrington pending an April 19 license revocation hearing. According to the complaint, needles were reinserted into drug vials after being used on patients, expired drugs were found in a medicine cabinet and dental assistants, not the doctor, administered sedatives to patients.

One patient, Orville Marshall, said he didn't meet Harrington until after he had two wisdom teeth pulled about five years ago at the Owasso clinic. A nurse inserted the IV for his anesthesia; Harrington was there when Marshall came to.

"It's just really scary. It makes you doubt the whole system, especially with how good his place looked," said Marshall, 37.

An instrument set reserved for use on patients with infectious diseases was rusty, preventing its effective sterilization, and the office autoclave — a pressurized cleaner — was used improperly and hadn't been certified as effective in at least six years, according to the complaint.

Dr. Matt Messina, a Cleveland dentist and a consumer adviser for the American Dental Association, said creating a safe and hygienic environment is "one of the fundamental requirements" before any dental procedure can be performed.

"It's not hard. It just takes effort," he said.

Weekly autoclave testing can be performed for less than $400 annually, according to the website of the Autoclave Testing Services of Pearl River, New York.

Autoclaves typically can be purchased for $1,000 to $8,000, depending on their size and features. And an average dental practice can expect to pay more than $40,000 a year in equipment, tools and supplies alone, according to several dental organizations.

Attempts to reach Harrington have been unsuccessful. No one answered the door Thursday at his Oklahoma home, which property records show is worth more than $1 million. His practice a few miles away, in a tony section of Tulsa where plastic surgeons operate and locals congregate at bistros and stores such as Saks Fifth Avenue, has a fair-market value of around $851,000.

Property and tax records show Harrington owns another residence in Carefree, Ariz., in an area of upscale homes tucked into in the boulder-strewn mountains north of Phoenix.

Nobody was at home Saturday at the low-slung, 1950s-style vacation home, across from the Boulders Resort. Neighbors said they had seen a lot of activity at the home in recent weeks.

Harrington's malpractice lawyer, Jim Secrest II, did not respond to phone messages left Thursday or Friday. A message at Harrington's Tulsa office said it was closed and an answering service referred callers to the Tulsa Health Department.

Suzy Horton, an old friend of Harrington's, said she can't believe the allegations about the man who removed two of her teeth in the early '90s. Horton's ex-husband sold Harrington his home in Carefree — a home where she once lived.

"I've been to dentists my whole life, so I know what a professional office looks like," Horton, who now lives in Phoenix, said in a telephone interview. "His was just as professional as anybody."

Horton hasn't seen Harrington in years, but she said he has sent her a Christmas card and wreath every year since her 1999 divorce.

"It was a long time ago, so I suppose anything can change, but the kind of person they're portraying in the news is not the kind of person who sends you a Christmas" card, she said.

___

Associated Press writers Traci Carl in Carefree, Ariz., and Jeannie Nuss in Little Rock, Ark., contributed to this report.

They’re cheap, easy to make and they not only prevent pregnancy but protect against a range of infections, including the AIDS virus. But men often don’t like to use condoms and women are afraid to ask them to.

So why hasn’t someone figured out how to make one that more people would want to use? The Bill & Melinda Gates Foundation is putting up $100,000 to try to entice someone to try.

“There are few places on earth where condoms are not recognized or not available,” the foundation, headed by Microsoft founder Bill Gates and his wife Melinda Gates, says in a statement.

“The primary drawback from the male perspective is that condoms decrease pleasure as compared to no condom, creating a trade-off that many men find unacceptable, particularly given that the decisions about use must be made just prior to intercourse,” it adds.

“Is it possible to develop a product without this stigma, or better, one that is felt to enhance pleasure?  If so, would such a product lead to substantial benefits for global health, both in terms of reducing the incidence of unplanned pregnancies and in prevention of infection with HIV or other sexually transmitted infections (STIs)?”

The Foundation estimates that 15 billion condoms are made each year, with 750 million users. But the design hasn’t changed much from the day when men used lamb intestines to make them. Now, latex is the preferred material.

“We are looking for a Next Generation Condom that significantly preserves or enhances pleasure, in order to improve uptake and regular use. Additional concepts that might increase uptake include attributes that increase ease-of-use for male and female condoms, for example better packaging or designs that are easier to properly apply,” the Foundation says in an invitation on its Grand Challenges website.

“In addition, attributes that address and overcome cultural barriers are also desired.  Proposals must (i) have a testable hypothesis, (ii) include an associated plan for how the idea would be tested or validated, and (iii) yield interpretable and unambiguous data in Phase I, in order to be considered for Phase II funding.”

That second phase of funding could go up to a million dollars. The Foundation says it will consider applciations for new materials, new shapes or designs, or science-based ways to make condoms more enticing to use.

The Foundation’s Grand Challenges project was set up to kick-start very early-stage endeavors. It’s paid out $450 million to efforts on childhood vaccines, controlling insects that spread disease and other public health challenges.

Related:

• Condom use 101: Errors are common
• Condoms don't ruin good sex, study finds
• In Florida, spring breakers get free condoms
  

States with a heavier dose of firearm laws tend to have the lowest rates of gun deaths, according to a study released Wednesday by Boston-based researchers who argue their findings show "there is a role" in America for more rigid gun-control legislation.

"It seems pretty clear: If you want to know which of the states have the lowest gun-mortality rates just look for those with the greatest number of gun laws," said Dr. Eric W. Fleegler of Boston Children's Hospital who, with colleagues, analyzed firearm-related deaths reported to the Centers for Disease Control and Prevention from 2007 through 2010.

By scoring individual states simply by the sheer volume of gun laws they have on the books, the researchers noted that in states with the highest number of firearms measures, their rate of gun deaths is collectively 42 percent lower when compared to states that have passed the fewest number of gun rules. The study was published online in the journal JAMA Internal Medicine.

As proof, Fleegler pointed to the firearm-fatality rates in law-laden states such as Massachusetts (where there were 3.4 gun deaths per 100,000 individuals), New Jersey (4.9 per 100,000) and Connecticut (5.1 per 100,000). In states with sparser firearms laws, researchers reported that gun-mortality rates were higher: Louisiana (18.0 per 100,000), Alaska (17.5 per 100,000) and Arizona (13.6 per 100,000). 

In Arizona -- just as the new study was released -- former Rep. Gabrielle Giffords returned Wednesday to the grocery store where she was shot and urged Congress to expand background checks for gun purchases. She told the gathered crowd and U.S. lawmakers to: "Be bold. Be courageous. Please support background checks." 

On Thursday, the Senate Judiciary Committee is expected to vote on a bill that would stiffen penalties for people who purchase guns illegally for others, and to make gun trafficking a felony. 

Fleegler and his team openly acknowledged they could not prove a definitive "cause-and-effect" link between tighter laws and a lower risk of gun-caused homicides or gun-related suicides. But ahead of the expected Senate vote, the researchers said they did determine this:

In those states that have the most firearm laws, those states also have the lowest rates of household-firearm ownership.

"And states that have the lowest gun-ownership rates also have the lowest gun-mortality rates," Fleegler said. "So states that try to have gun laws that are meant to be meaningful, they seem to be able to actually have an impact. That’s an important thing to learn from."

The findings were quickly challenged by two critics,  a top gun-rights advocate and a leading expert on the nexus of public health and gun policy, who each questioned the merits of the Boston findings and the rigor of the science behind the study.

It sounds to me like some sort of sleight of hand from a political sense," said Dave Workman, senior editor at Gun Week magazine and director of communications for the Citizens Committee for the Right to Keep and Bear Arms, in Bellevue, Wash.

"If they are dancing around this cause and effect, I'm not sure that the public should warm up to that kind of a conclusion because it really doesn't conclude it, it only suggests or intimates something," said Workman, who served three terms on the National Rifle Association board of directors.

"It's presumably the result they wanted to get in order to have the public believe something. Is that fair? Is that good science? Is that good research? I don't know." 

Workman further argued that in states or jurisdictions where gun laws "make it difficult for law-abiding citizens" to buy firearms through legal channels, "that does not necessarily translate to lower fatalities."

"And, as proof," he added, "I give you the city of Chicago." 

In an accompanying commentary, Dr. Garen J. Wintemute of the University of California, Davis, Sacramento, wrote that the paper's conclusion "would be an important finding — if it were robust and if its meaning were clear."

Ultimately, Wintemute wrote, the new study provides no insights on the key questions facing Congress: "Do the (gun) laws work, or not? If so, which ones?"

"Correlation does not imply causation," Wintemute said in a phone interview. "The plain English way of saying this is: Just because two things exist at the same time, that does not mean one thing caused the other. That's what's being implied here. All they counted in that analysis was the number of laws in each state, not which laws. There's no information in this study on the specifics of the (state) laws and whether they were enforced or not."

"So in a sense, the only conclusion you could draw would be: Pass more more laws but it doesn't matter which ones or what they're intended to do," Wintemute said. "That's just silly." 

Fleegler's study was not related to a recent executive order by President Barack Obama lifting a ban on gun violence research funded by federal agencies such as the CDC. Fleegler said he used public data at no cost to conduct his analysis. 

Wintemute said the study actually underscores the need for well-funded research into the effects of gun violence on public health. 

"Until we revitalize firearm violence research, studies using available data will be the best we have. They are not good enough."

Related stories:

• Guns in America: The weapon of choice for criminals, but also a deterrent?
• Obama plan eases freeze on gun research

The number of seizure patients in a northern Japanese fishing community devastated by the March 11, 2011 tsunami spiked in the weeks following the disaster, according to a Japanese study.

© Toru Hanai / Reuters / REUTERS

Devastation in Miyagi prefecture following the 2011 earthquake and tsunami that killed thousands.

The study, published in the journal Epilepsia, looked at 440 patient records from Kesennuma City Hospital, in a city that was devastated by the massive tsunami touched off by the 9.0 magnitude earthquake.

Thirteen patients were admitted with seizures in the eight weeks after the disaster, but only one had been admitted in the two months before March 11.

Previous research has linked stressful life-threatening disasters with an increased risk of seizures, but most case reports lacked clinical data with multiple patients.

"We suggest that stress associated with life-threatening situations may enhance seizure generation," wrote lead author Ichiyo Shibahara, a staff neurosurgeon at Sendai Medical Center in northern Japan.

But he added that stress itself is not a universal risk factor for seizures.

"Most of the seizure patients had some sort of neurological disease before the earthquake," he said.

His team examined medical records from patients admitted to the neurosurgery ward in the eight weeks before and after the March 11 disaster and compared them to the same time period each year between 2008 and 2010.

In 2008, there were 11 seizure patients admitted between January 14 and May 15. In 2009, there were seven and in 2010, just four.

Of the 13 admitted after the disaster, 11 had preexisting brain disorders that included epilepsy, head injuries or stroke. All the patients lived independently, and eight took anti-convulsive medication.

Shibahara noted that of the five patients admitted just days after the tsunami, it was "not because of a lack of anticonvulsants, but because of the stress."

One later patient, though, was unable to refill his medication weeks after the devastation.

"This is interesting, but I'm not 100 percent convinced," said William Theodore, senior investigator of the clinical epilepsy section at the National Institute for Neurological Disorders and Stroke in Bethesda, Maryland.

Theodore, who was not involved in the study, told Reuters health that because the number of patients was so small, random variation could explain the surge in seizures. Upset patients may also have forgotten to take, or weren't able to find, anticonvulsant drugs.

There are also various ways that natural disasters might cause seizures, including head trauma, infections from polluted water or a lack of sleep, he added.

But the study did have a practical take home message, he said: "If you already have seizures and you're taking medication, always make sure you have a decent supply just in case some natural disaster occurs."

(Reporting from New York by Trevor Stokes at Reuters Health; editing by Elaine Lies)

Could you get 200 wedding guests into the bathroom if a tornado hit?

The CDC team that brought us zombie preparedness tips last year seems to have hit on one good formula for helping Americans get ready for disasters, natural or otherwise, in a blog post on preparedness, experts say. And none too soon, as half of all Americas seem clueless about what they need to do to prepare, according to a new poll.

“You never know when Bridezilla might pop up,” the Centers for Disease Control and Prevention's blog cautions. “Be supportive and have some bottled water from your emergency kit and a box of chocolate on hand.”

But it weaves in some serious pointers. “Make sure all of the guests are aware of who they can call if there is an emergency,” the blog, written by Office of Public Health Preparedness and Response staffer Caitlin Shockey, advises.

“If a tornado warning rips through the area, would you know what to do?  200 guests are not going to be able to crowd into the one windowless bathroom.  Ask the reception venue for their emergency plans and evacuation routes.”

The blog post got more than 50,000 hits the first week, according to the site analytics company Omniture, and generated some lively comments, many of them critical.

“Another waste of taxpayer money. It (is) not our government('s) business to be in the wedding business, get out of our lives and spend the money reducing the debt,” complained one reader who gave the name Judith Sabella.

But risk communications expert Jody Lanard said controversy can be good. “It got people who are completely uninterested and who would never read past the headline of a safety article to read all the way through, even if the only reason they read through was because they thought it was stupid,” Lanard said in a telephone interview. “CDC has seduced them into reading it all the way through so they can hone their snarky remarks.”

The key is balancing humor with serious advice, said Lanard.  “I think they are brilliant for doing this,” she said. “It’s so nice to have something nice to say about CDC.”

A survey released on Friday suggests it’s none too soon. It found 53 percent of the 1,000 adults questioned did not have the recommended three-day supply of nonperishable food and water stored at home, and 55 percent thought the authorities would look after them in case of a disaster – something the Health and Human Services Department and the Department of Homeland Security have repeatedly stressed is not the case.

The survey also found 63 percent did not have a list of their current medications prepared in case of a natural disaster and 52 percent lacked copies of health insurance documents.

“About a third of people weren’t sure they could name the prescription medications that they needed with the doses. That is surprising and alarming,” said Philip Alcabes, director of the Public Health Program at Adelphi University, who led the study. He said 44 percent didn’t have a first aid kit.

 “Our health officials are doing a very good  job --  maybe too good a job -- of warning people about unlikely events, but not a good job of letting people know how to be prepared to take care of themselves,” Alcabes said in a telephone interview.

But he isn’t sure about the Bridezilla blog. “Clearly CDC is trying to take account of the relatively new way that information spreads: put something onto the blogosphere, put it in Twitter. That makes sense,” he said. “But it is hard to know whether this sort of jocular approach makes sense. Do you get information across while you are kind of joking with people, or is it so ridiculous to people that they just stop paying attention?”

The comments were running four to one in favor of the Bridezilla jokes. “These blogs are probably the absolute cheapest, most effective way to get preparedness messages out to a broad audience. This blog right here probably saved CDC a TON of $$$ compared to the alternatives,” said a reader who gave only the name Mark. “Even the haters read it despite themselves. I think it’s a great follow up to the zombie apocolypse bit.”

The CDC Office of Public Health Preparedness and Response team, led by public relations veteran Dave Daigle and his associates Catherine Jamal and Maggie Silver, won an HHSInnovates award in March for the zombie blog post. “When the campaign went viral, its messages reached millions of viewers, and personal knowledge about preparing for disasters was enormously increased – for an initial investment of only $87,” HHS said in awarding the prize.

Erica Ayisi contributed to this story.

Related:

How to prepare for the zombie apocalypse? CDC has you covered

Commentary

Giving clean needles to IV drug addicts saves lives – and money. That’s why the federal government should be spending your tax dollars to keep drug users -– and the people who have sex with them -- from getting AIDS and hepatitis.

But Republicans in Congress have decided that despite a veritable mountain of scientific evidence showing that needle-exchange work, they are not going to pay for this sort of program any more.

They just yanked it out of the end-of-year spending package.

Shouldn’t public health policy be guided by the best evidence we have about what reduces the dangers and costs of AIDS and hepatitis?

Studies done over more than 15 years across the U.S. and in Australia, Hungary, Holland, Ukraine, Canada, Portugal, Switzerland, Brazil, Belgium and Germany show that there is no doubt that needle- exchange programs lower infection rates for HIV and hepatitis C.

Less infection not only means fewer deaths, but lower costs associated with caring for infected people. 

So what reason might Congressional Republicans or anyone else have for deciding to ignore the evidence and let people die, increase the infection rate and add to the cost of your medical insurance?

It’s not about the money. These programs are inexpensive for such a highly effective public health measure.

The reason is a belief that simply won’t go away: Giving out free clean needles sends the message that injecting drugs is OK.  That belief just happens to be completely unsupported by any evidence at all. 

Whatever leads people to decide to ruin their lives by becoming injection drug users, it is certainly not the chance to get free needles. 

Policy involves more than scientific evidence when it comes to touchy subjects like drug addiction. However, morality cannot ignore the facts. 

If needle-exchange programs do reduce risk, suffering, deaths and costs and it is beyond dispute that they do then it is bad ethics to insist on a moral message that is utterly disconnected from the harsh realities of drug abuse.

Art Caplan, Ph.D., is the director for the Center for Bioethics at the University of Pennsylvania.  Follow him on Twitter @ArthurCaplan.