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On May 30, 2008, a construction crane collapsed on Manhattan’s Upper East Side, crashing into a 23-story apartment building before falling onto the street below and killing one person. It was the second deadly crane accident in 2 1/2 months in the city, which is undergoing a building boom. Mayor Michael Bloomberg said the latest collapse was “unacceptable,” and the city would investigate.

“The sound was like a thunder clap. Then, an earthquake,” said Peter Barba, who lives on the seventh floor of the building across the street from the construction site that was hit by the crane.

One body was brought out of the rubble at East 91st Street and First Avenue, placed on a gurney and covered in a white sheet. A construction worker knelt over the stretcher, gently stroking the sheet.

It wasn’t immediately clear whether there were additional fatalities.

Crews pulled others out of the wreckage, the Fire Department said. Their conditions were not immediately known.

Firefighters and rescue workers continued to search through the tangled wreckage.

Barba said it appeared the entire cab came off the crane; its main arm hit the penthouse of his building, then “took out the northeast corner,” he said.

Video from the scene showed the upper-floor balconies of the apartment building were severely damaged and a hole extended several stories down the side of the building.

Chaos enveloped the largely residential neighborhood of town houses and apartment high-rises as dozens of emergency vehicles raced to the scene during the morning rush hour.

Brian Nurenberg, 37, was playing indoor tennis two blocks away when he heard the crash.” It was a couple of loud sort of bangs, high in the air,” he said. “It sounded catastrophic, and that’s from two blocks away.”

In the March 15 accident about 2 miles to the south, contractors building a 46-story condominium near the United Nations were trying to lengthen the crane when a steel support broke, killing seven people.

A four-story town house was demolished and several other buildings were damaged.

A city inspector resigned after his arrest on charges of falsifying business records and offering a false instrument for filing.

In April, the city’s buildings commissioner resigned, under fire over a rising number of deadly construction accidents that have left more than 26 construction workers dead in the past year.

Since then, the city has added extra inspections at building sites and required that its staff be on hand whenever the towering cranes were raised higher, a process known as a jump. Those procedures are still being revised.

Results from a recent study reveal that the use of isotretinoin, the active ingredient of the acne drug Accutane more than doubles the risk of depression. The study is the first controlled investigation to find a statistically significant link between isotretinoin and depression, Dr. Anick Berard, from CHU Sainte-Justine Research Centre in Montreal, and colleagues point out in a report in the Journal of Clinical Psychiatry.

“Depression is likely to be a rare side effect of isotretinoin therapy,” they wrote. Nonetheless, “current guidelines should possibly be modified to include psychiatric assessments of patients prior to and during isotretinoin therapy.”

Berard’s team studied 30,496 people from Quebec, Canada, who received at least one isotretinoin prescription from 1984 through 2003. During the study period, 126 of these individuals had a depression-related diagnosis, hospitalization, or treatment.

Based on previous research, the researchers focused on isotretinoin use in the 5 months prior to depression diagnosis (risk period) compared with a 5-month period a year before the diagnosis (control period).

After accounting for potential factors that might influence the results, exposure to isotretinoin was associated with a greater than 2.6-fold relative risk of depression, the team found.

“Because depression could have serious consequences, close monitoring of isotretinoin users is indicated,” Berard and colleagues conclude.

According to new recently released data, elderly people with dementia who are given antipsychotics, even for a very short period of time, are more likely to end up in the hospital or even die, new research shows.

However, the problems underlying the need for such medications, behavioral problems such as aggression and agitation, are very real, and the alternatives to antipsychotics are limited, the researchers added.

“A misreading of the findings would be we don’t need to do something for these nursing home residents,” said study author Dr. Gary J. Kennedy, head of geriatric psychiatry for Montefiore Medical Center in New York City.

Many experts feel behavioral interventions should be tried first and antipsychotics used as a last resort, “when the behavior or the psychiatric symptoms are really out of control and causing complete distress not only for the person suffering from Alzheimer’s, but for caregivers all around them,” said Maria Carrillo, director of medical and scientific affairs at the Alzheimer’s Association in Chicago.

“It’s important to work these things out with the physician and, of course, do follow-up very closely together, so you can make sure these antipsychotics are having the effect you want and, if not, discontinue them immediately.”

The findings were published in the May 26, 2008 issue of the Archives of Internal Medicine.

Antipsychotic drugs are commonly used to treat some of the behavioral complications of dementia, including delirium. Newer antipsychotic medications such as Zyprexa (olanzapine) and Risperdal (risperidone) have been available for about a decade and have largely replaced their older counterparts.

Researchers from the Institute for Clinical Evaluative Sciences in Ontario, Canada, compared 20,682 older adults with dementia living in the community with 20,559 older adults with dementia living in a nursing home between April 1, 1997, and March 31, 2004.

Each group was divided into three subgroups: those not receiving any antipsychotics, those taking newer antipsychotics, and those taking older antipsychotics such as Haldol (haloperidol).

According to information gleaned from medical records, community-dwelling adults who had recently received a prescription for a newer antipsychotic medication were 3.2 times more likely than individuals who had received no antipsychotic therapy to be hospitalized or to die during 30 days of follow-up.

Those who received older antipsychotic therapy were 3.8 times more likely to have such an event, relative to their peers who had received no antipsychotic therapy.

A similar pattern, albeit less dramatic, emerged in the nursing home group. Individuals taking older antipsychotics were 2.4 times more likely to be hospitalized or die, while those taking newer drugs were 1.9 times more likely to die or be hospitalized during the 30 days of follow-up.

The study does, however, have its limitations. “It’s a carefully done study,” Kennedy said. “One flaw is that the [participants] weren’t randomly administered antipsychotics. There was some reason they were given an antipsychotic, such as aggression or agitation. It may have been done if they were recently admitted to the nursing home as part of the adjustment process.

Indeed, the authors acknowledged that about 17 percent of patients entering nursing homes start taking an antipsychotic within 100 days.

“For any of us, moving is like being sick. It takes a while to recover,” Kennedy said. “We need other sets of interventions besides medications. What that implies is more staffing and better training for staff, and that may not be a whole lot more expensive than medicines.”