Story first appeared on WoodTV10 Grand Rapids -
Hospital did first West Michigan heart transplant
Spectrum Health announced today that it has hired Reda Girgis, MD, to serve as medical director for its lung transplant program.
Girgis comes from the Johns Hopkins School of Medicine and started last week as a member of the Spectrum Health Medical Group.
Girgis will head a multidisciplinary team that will evaluate recipients for lung transplantation, and provide preoperative and follow-up care.
The hiring comes as Spectrum Health begins to establish its lung transplant program.
Currently there are only two hospitals in Michigan that conduct lung transplants.
Both Henry Ford Hospital and the University of Michigan Medical Center are on the east side of the state.
Spectrum will be the first hospital in West Michigan to join as a lung transplant center.
"We are fortunate to have a physician of Dr. Girgis' ability and stature to head our latest transplant endeavor," said Matthew Van Vranken, executive vice president, Spectrum Health Delivery System. "He will build another critical service we can provide to the people of West Michigan. His arrival is an important step as we build a regional transplantation program."
According to the U.S. Department of Health and Human Services there are currently more than 1,600 people waiting for lung transplants, 80 here in Michigan.
One of Girgis' primary tasks this summer will be completing applications for both a lung and combined heart-lung transplant program to the United Network for Organ Sharing (UNOS), a private, non-profit organization that manages the U.S. organ transplant system. Once the programs receive UNOS approval, Spectrum Health can begin listing patients for these transplants.
Girgis grew up in Grand Blanc, Michigan, and earned his medical degree at the University of Cairo in his native Egypt.
Girgis completed both his internal medicine residency and pulmonary and critical care fellowship at Henry Ford Hospital in Detroit.
In addition, he obtained advanced fellowship training in heart-lung and lung transplantation at Stanford University Medical Center in California.
He is board certified in internal medicine, pulmonary medicine and critical care medicine.
"I am extremely excited to return to my home state and help build a new lung transplant program for the residents of Western Michigan and beyond," said Girgis. "Spectrum Health is a state-of-the-art health care institution with all the necessary elements for a successful program."
Girgis has been at Johns Hopkins since 2000, where he served as associate medical director of lung transplantation and co-director of the pulmonary hypertension program.
Back in 2010 Spectrum Health preformed the first heart transplant in West Michigan.
18 February 2013
14 February 2013
Lady Gaga Needs Surgery, Cancels Remaining Tour Dates
Story first appeared on USA Today -
Mother Monster tore the muscle that helps hold the hip joint, forcing her to cancel shows.
Get well soon, Mother Monster!
Tests revealed Wednesday that Lady Gaga tore her labrum -- a layer of muscle that helps hold the hip joint in place -- requiring her to undergo surgery and cancel the rest of her tour dates.
Little Monsters who had tickets for the 21 dates remaining in the Born This Way Ball tour will get a refund beginning Thursday.
Earlier, when the tour was merely postponed, Gaga revealed her injury to fans via a tweet.
"I've been hiding a show injury and chronic pain for sometime now, over the past month it has worsened," Gaga shared Tuesday afternoon. "I've been praying it would heal."
The injury is a synovitis, a severe inflammation of joints, she said, adding, "I hid it from my staff, I didn't want to disappoint my amazing fans. However after last night's performance I could not walk and still can't."
She went on to say, "To the fans in Chicago Detroit & Hamilton I hope you can forgive me, as it is nearly impossible for me to forgive myself. I'm devastated & sad."
Mother Monster tore the muscle that helps hold the hip joint, forcing her to cancel shows.
Get well soon, Mother Monster!
Tests revealed Wednesday that Lady Gaga tore her labrum -- a layer of muscle that helps hold the hip joint in place -- requiring her to undergo surgery and cancel the rest of her tour dates.
Little Monsters who had tickets for the 21 dates remaining in the Born This Way Ball tour will get a refund beginning Thursday.
Earlier, when the tour was merely postponed, Gaga revealed her injury to fans via a tweet.
"I've been hiding a show injury and chronic pain for sometime now, over the past month it has worsened," Gaga shared Tuesday afternoon. "I've been praying it would heal."
The injury is a synovitis, a severe inflammation of joints, she said, adding, "I hid it from my staff, I didn't want to disappoint my amazing fans. However after last night's performance I could not walk and still can't."
She went on to say, "To the fans in Chicago Detroit & Hamilton I hope you can forgive me, as it is nearly impossible for me to forgive myself. I'm devastated & sad."
Heart Attack's Emotional Toll Higher for Women
Story first appeared on USA Today -
A new Gallup poll is based on interviews with heart attack survivors about their well-being.
Women who survive heart attacks may suffer even greater emotional fallout than men who do, a new Gallup Poll suggests.
Heart attack survivors of both genders report more sadness, worry and stress and less enjoyment in life than people who have not had heart attacks, but the gaps are bigger for women, according to results from 353,492 interviews conducted in 2012. The interviews were part of an ongoing, daily poll, the Gallup-Healthways Well-Being Index, which tracks the nation's emotional temperature.
More than 11,000 male heart attack survivors and 6,000 female survivors answered questions about how they felt and what they experienced the day before they were polled, says Lauren Besal, a Gallup research analyst.
Those survivors scored significantly lower than other adults on a 100-point scale of emotional well-being — with male survivors scoring 77 and female survivors scoring 73, compared with 81 for other men and women. The gaps were bigger for women than for men when it came to sadness, worry, stress, pain and diagnosed depression (with 35% of female survivors and 24% of male survivors reporting a diagnosis). These happiness gaps existed for women at every income level, but not for men making more than $90,000 a year.
The poll had a margin of error of about 1 percentage point.
The results do not prove that heart attacks cause more emotional upheaval in women. It's possible that women who have heart attacks and survive them are even more likely than men to have had emotional problems before their heart problems began, Besal says. "Whether one came before the other we cannot tell."
But the findings might mean that "social support as a part of treatment may be especially important for women," she says.
Suzanne Steinbaum, a cardiologist at Lenox Hill Hospital in New York, agrees: "This could be a crucial wake-up call."
The relationship between emotional and heart health is complex, she says, but research shows that "when people have heart disease, and they have depression on top of this, they don't do as well."
Women who survive heart attacks may be more despondent because "a lot of times, women are sicker after they have a heart attack," she says, possibly because they wait longer than men to get medical help for warning signs such as chest pain and shortness of breath.
Women may also face extra stresses "because we are the caretakers of our families," says Amy Heinl a 43-year-old banking executive from Pittsburgh who had a heart attack in June 2010. Heinl, who is a divorced mother of three boys ages 12 to 17, says she "was scared for a year" after her attack, which was especially dangerous because it was caused by a torn artery. "Any pain or tweak I felt, I thought was my heart," she says.
Today, she's optimistic and doing well, but, she says, "I still think about it every day."
Steinbaum and Heinl are spokeswomen for the American Heart Association's Go Red for Women campaign, which raises awareness about heart disease as the No. 1 killer of women.
While women are less likely than men to have heart attacks, they are more likely to die from them, the association says. About 370,000 women and 565,000 men in the United States have heart attacks each year; 26% of women and 19% of men having a first heart attack die within a year. About 4.8 million men and 3.1 million women in the United State are heart attack survivors.
A new Gallup poll is based on interviews with heart attack survivors about their well-being.
Women who survive heart attacks may suffer even greater emotional fallout than men who do, a new Gallup Poll suggests.
Heart attack survivors of both genders report more sadness, worry and stress and less enjoyment in life than people who have not had heart attacks, but the gaps are bigger for women, according to results from 353,492 interviews conducted in 2012. The interviews were part of an ongoing, daily poll, the Gallup-Healthways Well-Being Index, which tracks the nation's emotional temperature.
More than 11,000 male heart attack survivors and 6,000 female survivors answered questions about how they felt and what they experienced the day before they were polled, says Lauren Besal, a Gallup research analyst.
Those survivors scored significantly lower than other adults on a 100-point scale of emotional well-being — with male survivors scoring 77 and female survivors scoring 73, compared with 81 for other men and women. The gaps were bigger for women than for men when it came to sadness, worry, stress, pain and diagnosed depression (with 35% of female survivors and 24% of male survivors reporting a diagnosis). These happiness gaps existed for women at every income level, but not for men making more than $90,000 a year.
The poll had a margin of error of about 1 percentage point.
The results do not prove that heart attacks cause more emotional upheaval in women. It's possible that women who have heart attacks and survive them are even more likely than men to have had emotional problems before their heart problems began, Besal says. "Whether one came before the other we cannot tell."
But the findings might mean that "social support as a part of treatment may be especially important for women," she says.
Suzanne Steinbaum, a cardiologist at Lenox Hill Hospital in New York, agrees: "This could be a crucial wake-up call."
The relationship between emotional and heart health is complex, she says, but research shows that "when people have heart disease, and they have depression on top of this, they don't do as well."
Women who survive heart attacks may be more despondent because "a lot of times, women are sicker after they have a heart attack," she says, possibly because they wait longer than men to get medical help for warning signs such as chest pain and shortness of breath.
Women may also face extra stresses "because we are the caretakers of our families," says Amy Heinl a 43-year-old banking executive from Pittsburgh who had a heart attack in June 2010. Heinl, who is a divorced mother of three boys ages 12 to 17, says she "was scared for a year" after her attack, which was especially dangerous because it was caused by a torn artery. "Any pain or tweak I felt, I thought was my heart," she says.
Today, she's optimistic and doing well, but, she says, "I still think about it every day."
Steinbaum and Heinl are spokeswomen for the American Heart Association's Go Red for Women campaign, which raises awareness about heart disease as the No. 1 killer of women.
While women are less likely than men to have heart attacks, they are more likely to die from them, the association says. About 370,000 women and 565,000 men in the United States have heart attacks each year; 26% of women and 19% of men having a first heart attack die within a year. About 4.8 million men and 3.1 million women in the United State are heart attack survivors.
12 February 2013
Need a Surgery Cost Quote? Good Luck!
Story first appeared on MPR News -
Want to know how much a hip replacement will cost? Many hospitals won't be able to tell you, at least not right away — if at all. And if you shop around and find centers that can quote a price, the amounts could vary astronomically, a study found.
Routine hip replacement surgery on a healthy patient without insurance may cost as little as $11,000 — or up to nearly $126,000.
That's what researchers found after calling hospitals in every state, 122 in all, asking what a healthy 62-year-old woman would have to pay to get an artificial hip. Hospitals were told the made-up patient was the caller's grandmother, had no insurance but could afford to pay out of pocket — that's why knowing the cost information ahead of time was so important.
About 15 percent of hospitals did not provide any price estimate, even after a researcher called back as many as five times.
The researchers were able to obtain a complete price estimate including physician fees from close to half the hospitals. But in most cases, that took contacting the hospital and doctor separately.
"Our calls to hospitals were often greeted by uncertainty and confusion," the researchers wrote. "We were frequently transferred between departments, asked to leave messages that were rarely returned, and told that prices could not be estimated without an office visit."
Many hospitals "are just completely unprepared" for cost questions, said Jaime Rosenthal, a Washington University student who co-authored the report.
Most hospitals aren't intentionally hiding costs, they're just not used to patients asking. That's particularly true for patients with health insurance who "don't bother to ask because they know insurance will cover it," said co-author Dr. Peter Cram, a researcher at the University of Iowa's medical school.
But he said that's likely to change as employers increasingly force workers to share more health care costs by paying higher co-payments and deductibles, making patients more motivated to ask about costs.
The study was published online Monday in JAMA Internal Medicine. A California study published last year about surgery to remove an appendix found similar cost disparities.
Commenting on the study, American Hospital Association spokeswoman Marie Watteau said hospitals "have a uniform set of charges. Sharing meaningful information, however, is challenging because hospital care is unique and based on each individual patient's needs."
She said states and local hospital associations are the best source for pricing data, and that many states already require or encourage hospitals to report pricing information and make that data available to the public.
U.S. insurance companies typically negotiate to pay less than the billing price. Insured patients' health plans determine what they pay, while uninsured patients may end up paying the full amount.
The study authors noted that Medicare and other large insurers frequently pay between $10,000 and $25,000 for hip replacement surgery.
Sean Toohey, a grains broker at the Chicago Board of Trade, had hip replacement surgery last summer at Loyola University Medical Center in Maywood, Ill. An old sports injury had worn out his left hip, causing "horrendous" pain on the job, where he's on his feet all day filling orders.
Toohey, 54, said his health insurance covered most of the costs, and it didn't occur to him to ask about price beforehand. He was back at work two weeks later and is pain free. That's what matters most to him.
"I never really looked or paid attention" to the cost, he said.
He paid about $7,900, but wasn't sure what the total bill amounted to.
The average charge for hip replacement surgery at Loyola is about $42,000, before the negotiated insurance rates. The most expensive items on a typical hip replacement bill include about $11,000 for the hip implant, said Richard Kudia, Loyola's vice president of patient financial services
Kudia said some patients do ask in advance about costs of surgery and other medical procedures, and those questions require "a little bit of research" to come up with an average estimate. Costs vary from center to center because "there is no standard pricing among hospitals across the country. Each hospital develops its own pricing depending on its market," he said.
An editorial accompanying the hip replacement study said "there is no justification" for the huge cost variation the researchers found.
A few online sites provide price comparisons for common medical procedures, but the editorial said that kind of information "is of almost no value" without information on hospital quality.
A proposed federal measure that would have required states to force hospitals to make their charges public failed to advance in Congress last year but could be revived this year, the editorial says.
"It is time we stopped forcing people to buy health care services blindfolded," the editorial said.
Want to know how much a hip replacement will cost? Many hospitals won't be able to tell you, at least not right away — if at all. And if you shop around and find centers that can quote a price, the amounts could vary astronomically, a study found.
Routine hip replacement surgery on a healthy patient without insurance may cost as little as $11,000 — or up to nearly $126,000.
That's what researchers found after calling hospitals in every state, 122 in all, asking what a healthy 62-year-old woman would have to pay to get an artificial hip. Hospitals were told the made-up patient was the caller's grandmother, had no insurance but could afford to pay out of pocket — that's why knowing the cost information ahead of time was so important.
About 15 percent of hospitals did not provide any price estimate, even after a researcher called back as many as five times.
The researchers were able to obtain a complete price estimate including physician fees from close to half the hospitals. But in most cases, that took contacting the hospital and doctor separately.
"Our calls to hospitals were often greeted by uncertainty and confusion," the researchers wrote. "We were frequently transferred between departments, asked to leave messages that were rarely returned, and told that prices could not be estimated without an office visit."
Many hospitals "are just completely unprepared" for cost questions, said Jaime Rosenthal, a Washington University student who co-authored the report.
Most hospitals aren't intentionally hiding costs, they're just not used to patients asking. That's particularly true for patients with health insurance who "don't bother to ask because they know insurance will cover it," said co-author Dr. Peter Cram, a researcher at the University of Iowa's medical school.
But he said that's likely to change as employers increasingly force workers to share more health care costs by paying higher co-payments and deductibles, making patients more motivated to ask about costs.
The study was published online Monday in JAMA Internal Medicine. A California study published last year about surgery to remove an appendix found similar cost disparities.
Commenting on the study, American Hospital Association spokeswoman Marie Watteau said hospitals "have a uniform set of charges. Sharing meaningful information, however, is challenging because hospital care is unique and based on each individual patient's needs."
She said states and local hospital associations are the best source for pricing data, and that many states already require or encourage hospitals to report pricing information and make that data available to the public.
U.S. insurance companies typically negotiate to pay less than the billing price. Insured patients' health plans determine what they pay, while uninsured patients may end up paying the full amount.
The study authors noted that Medicare and other large insurers frequently pay between $10,000 and $25,000 for hip replacement surgery.
Sean Toohey, a grains broker at the Chicago Board of Trade, had hip replacement surgery last summer at Loyola University Medical Center in Maywood, Ill. An old sports injury had worn out his left hip, causing "horrendous" pain on the job, where he's on his feet all day filling orders.
Toohey, 54, said his health insurance covered most of the costs, and it didn't occur to him to ask about price beforehand. He was back at work two weeks later and is pain free. That's what matters most to him.
"I never really looked or paid attention" to the cost, he said.
He paid about $7,900, but wasn't sure what the total bill amounted to.
The average charge for hip replacement surgery at Loyola is about $42,000, before the negotiated insurance rates. The most expensive items on a typical hip replacement bill include about $11,000 for the hip implant, said Richard Kudia, Loyola's vice president of patient financial services
Kudia said some patients do ask in advance about costs of surgery and other medical procedures, and those questions require "a little bit of research" to come up with an average estimate. Costs vary from center to center because "there is no standard pricing among hospitals across the country. Each hospital develops its own pricing depending on its market," he said.
An editorial accompanying the hip replacement study said "there is no justification" for the huge cost variation the researchers found.
A few online sites provide price comparisons for common medical procedures, but the editorial said that kind of information "is of almost no value" without information on hospital quality.
A proposed federal measure that would have required states to force hospitals to make their charges public failed to advance in Congress last year but could be revived this year, the editorial says.
"It is time we stopped forcing people to buy health care services blindfolded," the editorial said.
11 February 2013
Watson Supercomputer Now Available to Doctors for Advice
Story first appeared on USA Today -
The Watson supercomputer is graduating from its medical residency and is being offered commercially to doctors and health insurance companies, IBM said Friday.
IBM, the health insurer WellPoint and Memorial Sloan-Kettering Cancer Center announced two Watson-based applications — one to help diagnose and treat lung cancer and one to help manage health insurance decisions and claims.
Both applications take advantage of the speed, huge database and language skill the computer demonstrated in defeating the best human "Jeopardy!" players on television two years ago.
Armonk-based IBM said Watson has improved its performance by 240 percent since the "Jeopardy!" win.
In both applications, doctors or insurance company workers will access Watson through a tablet or computer. Watson will quickly compare a patient's medical records to what it has learned and make several recommendations in decreasing order of confidence.
In the cancer program, the computer will be considering what treatment is most likely to succeed. In the insurance program, it will consider what treatment should be authorized for payment.
Watson (actually named for IBM founder and not the Sherlock Holmes' friend, Dr. Watson) has been trained in medicine through pilot programs at Indianapolis-based WellPoint and at Sloan-Kettering in New York.
Manoj Saxena, an IBM general manager, said the supercomputer has ingested 1,500 lung cancer cases from Sloan-Kettering records, plus 2 million pages of text from journals, textbooks and treatment guidelines.
It also learned "like a medical student," by being corrected when it was questioned by doctors and came up with wrong answers, Saxena said in an interview.
"Watson is not making the decisions" on treatment or authorization, Saxena said. "It is essentially reducing the effort for doctors and nurses by going through thousands of pages of information for each case."
The lung cancer program is being adopted by two medical groups, the Maine Center for Cancer Medicine and WestMed in New York's Westchester County. Saxena said it should be running at both groups by next month.
WellPoint itself is already using the insurance application in Indiana, Kentucky, Ohio and Wisconsin. It will be selling both applications — at prices still to be negotiated — and will compensate IBM under a contract between the two companies, an IBM spokeswoman said.
WellPoint said using Watson should not increase insurance premiums because of savings from waste and errors.
The Watson supercomputer is graduating from its medical residency and is being offered commercially to doctors and health insurance companies, IBM said Friday.
IBM, the health insurer WellPoint and Memorial Sloan-Kettering Cancer Center announced two Watson-based applications — one to help diagnose and treat lung cancer and one to help manage health insurance decisions and claims.
Both applications take advantage of the speed, huge database and language skill the computer demonstrated in defeating the best human "Jeopardy!" players on television two years ago.
Armonk-based IBM said Watson has improved its performance by 240 percent since the "Jeopardy!" win.
In both applications, doctors or insurance company workers will access Watson through a tablet or computer. Watson will quickly compare a patient's medical records to what it has learned and make several recommendations in decreasing order of confidence.
In the cancer program, the computer will be considering what treatment is most likely to succeed. In the insurance program, it will consider what treatment should be authorized for payment.
Watson (actually named for IBM founder and not the Sherlock Holmes' friend, Dr. Watson) has been trained in medicine through pilot programs at Indianapolis-based WellPoint and at Sloan-Kettering in New York.
Manoj Saxena, an IBM general manager, said the supercomputer has ingested 1,500 lung cancer cases from Sloan-Kettering records, plus 2 million pages of text from journals, textbooks and treatment guidelines.
It also learned "like a medical student," by being corrected when it was questioned by doctors and came up with wrong answers, Saxena said in an interview.
"Watson is not making the decisions" on treatment or authorization, Saxena said. "It is essentially reducing the effort for doctors and nurses by going through thousands of pages of information for each case."
The lung cancer program is being adopted by two medical groups, the Maine Center for Cancer Medicine and WestMed in New York's Westchester County. Saxena said it should be running at both groups by next month.
WellPoint itself is already using the insurance application in Indiana, Kentucky, Ohio and Wisconsin. It will be selling both applications — at prices still to be negotiated — and will compensate IBM under a contract between the two companies, an IBM spokeswoman said.
WellPoint said using Watson should not increase insurance premiums because of savings from waste and errors.
07 February 2013
Daily Antiseptic Baths In Hospitals Reduce Infections
Story first appeared on US News -
Simple swab-based cleansing cut rates of some drug-resistant bacteria by 23 percent, study found
A daily swabbing with a simple antiseptic greatly decreases the number of life-threatening bloodstream infections and drug-resistant bacteria lurking among patients in acute-care hospital units, a new study suggests.
Researchers found that bathing patients with washcloths soaked with chlorhexidine -- a cheap, broad-spectrum antiseptic -- lowered the rate of hospital-acquired bloodstream infections by 28 percent.
Highly feared multidrug-resistant organisms such as MRSA (methicillin-resistant staphylococcus aureus) and VRE (vancomycin-resistant enterococcus) were reduced by 23 percent.
"We're talking about an intervention that's very simple to implement and minimal in cost," said study author Dr. Edward Wong, chief of infectious disease at Hunter Holmes McGuire Veterans Affairs Medical Center in Richmond, Va. "This can be laid on top of all the other things [experts recommend] to decrease the spread of these organisms."
The study is published in the Feb. 7 issue of the New England Journal of Medicine.
About 5 percent of hospitalized patients acquire healthcare-associated infections, often from bacteria entering the bloodstream through surgical incisions or catheters, according to the U.S. Centers for Disease Control and Prevention (CDC). The per-patient cost of treating such infections is enormous -- approximately $40,000, Wong said.
Wong and his colleagues analyzed more than 7,700 patients in nine intensive-care and bone-marrow-transplantation units in six hospitals. Health providers were randomly assigned to bathe patients with either no-rinse chlorhexidine-soaked washcloths or non-antimicrobial washcloths for six months, then alternate with the other product for an additional six months. Chlorhexidine wipes, when sold in bulk, cost less than 20 cents apiece on Internet sites.
The dramatically lowered rates of bloodstream infections and MRSA and VRE acquisition -- which can mean a patient is either a carrier or infected with the bacteria -- didn't surprise Wong, whose previous research yielded similar results.
"At least based on preliminary studies we've done, we knew we'd have some benefit but we wanted to make sure we could generalize," he said. Chlorhexidine wipes "are clearly going to cost much less than the cost of antibiotics or the cost of health care."
Dr. Philip Tierno, director of clinical microbiology and immunology at NYU Langone Medical Center in New York City, said his institution has been using chlorhexidine for years on patients about to have surgery.
"It's very good because it has residual effectiveness on the skin for a day or two," he said. "So when the surgeon cuts through flesh, it's less likely to impregnate the skin with organisms."
"If you get a very serious infection ... it may lead to significant problems," Tierno added. "This has a very good benefit and it's worthwhile to pursue."
Simple swab-based cleansing cut rates of some drug-resistant bacteria by 23 percent, study found
A daily swabbing with a simple antiseptic greatly decreases the number of life-threatening bloodstream infections and drug-resistant bacteria lurking among patients in acute-care hospital units, a new study suggests.
Researchers found that bathing patients with washcloths soaked with chlorhexidine -- a cheap, broad-spectrum antiseptic -- lowered the rate of hospital-acquired bloodstream infections by 28 percent.
Highly feared multidrug-resistant organisms such as MRSA (methicillin-resistant staphylococcus aureus) and VRE (vancomycin-resistant enterococcus) were reduced by 23 percent.
"We're talking about an intervention that's very simple to implement and minimal in cost," said study author Dr. Edward Wong, chief of infectious disease at Hunter Holmes McGuire Veterans Affairs Medical Center in Richmond, Va. "This can be laid on top of all the other things [experts recommend] to decrease the spread of these organisms."
The study is published in the Feb. 7 issue of the New England Journal of Medicine.
About 5 percent of hospitalized patients acquire healthcare-associated infections, often from bacteria entering the bloodstream through surgical incisions or catheters, according to the U.S. Centers for Disease Control and Prevention (CDC). The per-patient cost of treating such infections is enormous -- approximately $40,000, Wong said.
Wong and his colleagues analyzed more than 7,700 patients in nine intensive-care and bone-marrow-transplantation units in six hospitals. Health providers were randomly assigned to bathe patients with either no-rinse chlorhexidine-soaked washcloths or non-antimicrobial washcloths for six months, then alternate with the other product for an additional six months. Chlorhexidine wipes, when sold in bulk, cost less than 20 cents apiece on Internet sites.
The dramatically lowered rates of bloodstream infections and MRSA and VRE acquisition -- which can mean a patient is either a carrier or infected with the bacteria -- didn't surprise Wong, whose previous research yielded similar results.
"At least based on preliminary studies we've done, we knew we'd have some benefit but we wanted to make sure we could generalize," he said. Chlorhexidine wipes "are clearly going to cost much less than the cost of antibiotics or the cost of health care."
Dr. Philip Tierno, director of clinical microbiology and immunology at NYU Langone Medical Center in New York City, said his institution has been using chlorhexidine for years on patients about to have surgery.
"It's very good because it has residual effectiveness on the skin for a day or two," he said. "So when the surgeon cuts through flesh, it's less likely to impregnate the skin with organisms."
"If you get a very serious infection ... it may lead to significant problems," Tierno added. "This has a very good benefit and it's worthwhile to pursue."
04 February 2013
Heart Health ABC's
Story first appeared on ABC News -
With more than 2 million heart attacks and strokes each year, and 800,000 deaths, according to the Centers for Disease Control and Prevention, cardiovascular disease is the leading cause of death for both men and women in the United States. One out of every three deaths is from heart disease and stroke.
These conditions are also the leading causes of disability, and they're costing this country a fortune -- together, heart disease and stroke hospitalizations in 2010 rang up $444 billion in health care expenses and lost productivity, according to the CDC.
It's the rare American who hasn't been touched by heart disease in some way. Just about all of us have known someone who has had cardiovascular illness, a heart attack or stroke. Heart problems can strike older folks, middle-agers, high schoolers, children -- even babies. No ethnicity is immune. And heart disease strikes people from all walks of life, famous or not.
But we can fight back against this scourge. Awareness is key.
With more than 2 million heart attacks and strokes each year, and 800,000 deaths, according to the Centers for Disease Control and Prevention, cardiovascular disease is the leading cause of death for both men and women in the United States. One out of every three deaths is from heart disease and stroke.
These conditions are also the leading causes of disability, and they're costing this country a fortune -- together, heart disease and stroke hospitalizations in 2010 rang up $444 billion in health care expenses and lost productivity, according to the CDC.
It's the rare American who hasn't been touched by heart disease in some way. Just about all of us have known someone who has had cardiovascular illness, a heart attack or stroke. Heart problems can strike older folks, middle-agers, high schoolers, children -- even babies. No ethnicity is immune. And heart disease strikes people from all walks of life, famous or not.
But we can fight back against this scourge. Awareness is key.
Doctor Perks from Pharmaceutical Companies
Story first appeared on the Los Angeles Times -
Though few patients realize it, many doctors receive thousands of dollars from pharmaceutical companies for each patient enrolled in an experimental drug trial. The medication might be the best thing for the patient's condition. The doctor's motives might be pure. But patients should be able to find out about such payments so they can discuss them with their doctors and decide for themselves whether the doctor's participation in an experiment might compromise his medical advice.
A provision of the 2010 healthcare reform law should bring new transparency about these and other corporate payments to physicians — including lavish dinners, gifts and industry-sponsored conventions that are more luxury vacations than medical conferences — by publishing the information in an online database. But the final regulations to implement the Physician Payment Sunshine Act were supposed to be published in October 2011; the database was supposed to go live later this year. Instead, the regulations are 15 months overdue.
As with the new food-safety act regulations — most of which were finally released in January, a full year past deadline — the sunshine rules have been drawn up by the appropriate agency but have been held up by the Office of Management and Budget. One theory for the delay, advanced by critics of the administration, is that President Obama wanted to avoid issuing regulations during election season, when the extent of government's reach was a contentious issue. That would be a poor excuse, if true. In any case, the election is over; at this point the delay smacks more of bureaucratic inefficiency than political expediency.
Most physicians put their patients' well-being first, but a study showed that doctors who receive food from a company are more likely to prescribe that company's products, even though they might not be doing it consciously.
The sunshine act isn't as strong as it should have been. Ideally, doctors would be the ones doing the divulging, making information about payments and gifts they have received readily available in their examining rooms. Not all patients will know about the online database or possess the savvy to use it. But the rules nonetheless are expected to influence behavior; public disclosure will make both physicians and drug companies more circumspect.
One question in the minds of consumer advocates is how much disclosure will reveal. For instance, if a company gives a doctor a large sum to lead a drug trial and that doctor spreads the money among other physicians who enroll patients, it's unclear whether those payments would be reported as coming from the drug company. The administration should release rules that fully reflect the spirit of the law, and it should do so soon.
Though few patients realize it, many doctors receive thousands of dollars from pharmaceutical companies for each patient enrolled in an experimental drug trial. The medication might be the best thing for the patient's condition. The doctor's motives might be pure. But patients should be able to find out about such payments so they can discuss them with their doctors and decide for themselves whether the doctor's participation in an experiment might compromise his medical advice.
A provision of the 2010 healthcare reform law should bring new transparency about these and other corporate payments to physicians — including lavish dinners, gifts and industry-sponsored conventions that are more luxury vacations than medical conferences — by publishing the information in an online database. But the final regulations to implement the Physician Payment Sunshine Act were supposed to be published in October 2011; the database was supposed to go live later this year. Instead, the regulations are 15 months overdue.
As with the new food-safety act regulations — most of which were finally released in January, a full year past deadline — the sunshine rules have been drawn up by the appropriate agency but have been held up by the Office of Management and Budget. One theory for the delay, advanced by critics of the administration, is that President Obama wanted to avoid issuing regulations during election season, when the extent of government's reach was a contentious issue. That would be a poor excuse, if true. In any case, the election is over; at this point the delay smacks more of bureaucratic inefficiency than political expediency.
Most physicians put their patients' well-being first, but a study showed that doctors who receive food from a company are more likely to prescribe that company's products, even though they might not be doing it consciously.
The sunshine act isn't as strong as it should have been. Ideally, doctors would be the ones doing the divulging, making information about payments and gifts they have received readily available in their examining rooms. Not all patients will know about the online database or possess the savvy to use it. But the rules nonetheless are expected to influence behavior; public disclosure will make both physicians and drug companies more circumspect.
One question in the minds of consumer advocates is how much disclosure will reveal. For instance, if a company gives a doctor a large sum to lead a drug trial and that doctor spreads the money among other physicians who enroll patients, it's unclear whether those payments would be reported as coming from the drug company. The administration should release rules that fully reflect the spirit of the law, and it should do so soon.
28 January 2013
Breast Cancer Patients: Lumpectomy is Less Risky than Mastectomy
Story first appeared on Counsel & Heal News
For women who are diagnosed with breast cancer in its early stages, lumpectomy followed by radiation offers more survival chances than mastectomy, a recent study reveals.
The research was led by E. Shelley Hwang, M.D., MPH, chief of breast surgery at Duke Cancer Institute, and the analysis was published in the journal Cancer.
Lumpectomy is a preferred surgical procedure where the lump in the breast is removed; this lump is usually a benign tumor or breast cancer. The procedure is non-invasive as it involves the removal of minimal tissues. Mastectomy, on the other hand, involves the partial or complete removal of one or both the breasts surgically. This research also justified the decision of certain patients to undergo lumpectomy to preserve their breasts.
In the research, data spanning 14 years was collected from the California Cancer Registry, which has detailed information on the result of the cancer. The researchers found that people opting for the less-invasive technique like lumpectomy have a higher survival rate than those opting for a mastectomy. This held true for patients from different age groups and also for those who were either hormone-resistant or sensitive.
For women who were 50 years or above and had been diagnosed with hormone-sensitive breast cancer, lumpectomy gave them 13 percent more survival chances from breast cancer and 19 percent more survival chances from any disease as compared to mastectomy.
"Our findings support the notion that less invasive treatment can provide superior survival to mastectomy in stage I or stage II breast cancer. Given the recent interest in mastectomy to treat early stage breast cancers, despite the research supporting lumpectomy, our study sought to further explore outcomes of breast-conserving treatments in the general population comparing outcomes between younger and older women," Hwang was quoted as saying in Medicalxpress.
"We found that lumpectomy plus radiation was an effective alternative to mastectomy for early stage disease, regardless of age or tumor type. Even patients we thought might benefit less from localized treatment, like younger patients with hormone-resistant disease, can remain confident in lumpectomy as an equivalent and possibly better treatment option," Hwang added
New Norovirus Strain and other Clinical Notes
Story first appeared on MedPage Today -
Most norovirus outbreaks seen recently in the U.S. were caused by a novel strain known as GII.4 Sydney, the CDC reported. Also this week: a name change is urged for polycystic ovary syndrome.
New Norovirus Strain Causing Most Outbreaks -
Most norovirus outbreaks seen late last year in the U.S. were caused by a novel strain known as GII.4 Sydney that appears to have largely replaced the previous dominant strain, the CDC reported.
The clinical importance remains uncertain, however, as there is no vaccine to prevent infections nor any ways to treat them other than supportive care.
According to a report in Morbidity and Mortality Weekly Report, 141 of 266 norovirus outbreaks tracked from September to December 2012 were caused by the novel strain.
"Right now, it's too soon to tell whether the new strain of norovirus will lead to more outbreaks than in previous years. However, CDC continues to work with state partners to watch this closely and see if the strain is associated with more severe illness," said CDC epidemiologist Aron Hall, DVM, MSPH, in an agency press release.
Name Change Urged for PCOS -
"Polycystic ovary syndrome" (PCOS) needs a new name, a panel assembled by the National Institutes of Health has recommended.
The four-member committee found that "the name 'PCOS' is a distraction and impediment to progress" because the presence of ovarian cysts "is neither necessary nor sufficient to diagnose the syndrome."
"It is time to expeditiously assign a name that reflects the complex metabolic, hypothalamic, pituitary, ovarian,
and adrenal interactions that characterize the syndrome -- and their reproductive implications," they added. "The right name will enhance recognition of this major public health issue for women, educational outreach, 'branding,' and public relations and will assist in expanding research support."
But their report, stemming from a 2-day workshop held in December 2012 in which panel members heard from more than two dozen speakers, was missing one thing -- a suggested new name for the condition.
It did, however, recommend keeping the Rotterdam criteria for diagnosing the condition as well as more research on the condition's etiology, diagnosis, and management.
Bird Flu Experts End Research Moratorium -
Prominent virologists who agreed last January to a voluntary moratorium on research involving virulence factors in the H5N1 avian influenza virus have now ended it.
In a letter published online in Science and Nature, Ron Fouchier and 39 colleagues around the world indicated that "the aims of this voluntary moratorium have been met in some countries and are close to being met in others."
The concern had been that the work could lead to development in the laboratory of new H5N1 variants that would make it highly infectious in humans (wild-type strains are not) and highly lethal. Such a supervirus might emerge by accident or, in the hands of terrorists, on purpose.
Fouchier and colleagues indicated that during the past year, the World Health Organization and national regulators have set safety standards for such research. The issues are now well understood by governments and the research community.
As a result, "we declare an end to the voluntary moratorium on avian flu transmission studies," they wrote.
Eye Surgery Devices Recalled -
More than 100 lots of Bausch and Lomb's 27G sterile disposable cannulas packed with the company's Amvisc 1.2% and Amvisc Plus 1.6% sodium hyaluronate ophthalmic surgical device kits have been recalled, the FDA said.
The cannulas are prone to leakage or detachment from the syringe to which they are supposed to be attached. They are used in delivery of the gel-like material in front of, or behind the iris, during cataract surgery and other ocular procedures.
"In rare [instances], detachment has resulted in serious patient injury," the FDA said.
Lot numbers covered by the recall were included in the FDA's announcement posted on its website.
Dengue Vaccine Passes Early Test -
A vaccine against the four major strains of dengue virus induced strong antibody responses and appeared to be well tolerated in a phase I clinical trial, according to the National Institute of Allergy and Infectious Diseases, which had developed the vaccine.
Several versions of the tetravalent vaccine were tested in the trial. All were found to be safe, but only one was strongly immunogenic after a single dose.
NIAID said that formulation produced antibody responses to all four virus strains in 45% of participants, with another 45% showing responses to three strains.
The agency added that the vaccine would be relatively cheap to produce, at less than $1 per dose, making it
potentially affordable in less developed tropical nations where the disease is most rampant.
Dengue fever also appears to have gained a foothold in the Florida Keys and there are concerns that, with climate change, its range may extend further into the U.S.
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