stay linked to increased risk of death following hip fracture
Hip fractures in the elderly are a major cause of disability and associated
with an increased risk of death. The growth of the elderly population along
with rising healthcare costs has placed considerable strain on hospitals.
Consequently hospital bed shortages are now commonplace across Europe and
length of stay in hospitals has generally decreased. Previous research has
shown mixed results on patient outcomes of shorter length of hospital stay.
A team of researchers, led by Peter NordstrĂ¶m at UmeĂĄ University, examined
the effect of the length of stay in hospital on the risk of death following
a hip fracture among older persons. Results showed that average length of
stay in hospital decreased from 14.2 days in 2006 to 11.6 days in 2012.
Patients had an average age of 82.2 years. Patients who stayed in hospital
for up to 5 days had twice the risk of death compared with patients staying
15 days or more.
High risk groups included men, patients with specific fractures along the
femur connecting to the hip bone and certain conditions such as, chronic
obstructive pulmonary disease, renal failure and cardiovascular disease.
The effect of hospital stays according to number of days was also analyzed.
Hospital stays of less than 10 days were linked to a higher risk of death.
And each one day reduction in hospital stay increased the risk of death by
8% in 2006 and this rose to 16% in 2012. This effect disappeared with
hospital stays of 11 days or more. Age was found to be the strongest
predictor of risk of death within one year of admission.
Shorter hospital stay may reduce proper rehabilitation that enables patients
to regain mobility, for example, and limits access to medical staff, further
assessment and appropriate care, explain the authors.
Visit UMU for the report.
flourishes often fail to impress patients
When Johns Hopkins Medicine opened gleaming new clinical buildings, it
created a natural experiment to gauge patient satisfaction.
The sleek hospital tower that Johns Hopkins Medicine built in 2012 has
the frills of a luxury hotel, including a meditation garden, 500 works of
art, free wi-fi and a library of books, games and audio.
As Dr. Zishan Siddiqui watched patients and some fellow physicians in
Baltimore move from their decades-old building into the Sheikh Zayed Tower,
the internist saw a rare opportunity to test a widespread assumption in the
hospital industry: that patients rate their care more highly when it is
given in a nicer place.
For decades, hospital executives across the country have justified expensive
renovation and expansion projects by saying they will lead to better patient
reviews and recommendations. One study estimated $200 billion might have
been spent over a decade on new building. Hopkins' construction of the tower
and a new children's hospital cost $1.1 billion. Patient judgments have
become even more important to hospitals since Medicare started publishing
ratings and basing some of its pay on surveys patients fill out after they
have left the hospital.
Siddiqui's study, published this month by the Journal of Hospital
Medicine, contradicts the presumption that better facilities translate
into better patient reviews. Siddiqui examined how patient satisfaction
scores changed when doctors started practicing in the new tower, which has
355 beds and units for neurology, cardiology, radiology, labor and delivery
and other specialties.
Siddiqui discovered that for the most part, patients' assessments of the
quality of the clinical care they received did not improve any more than
they did for patients treated in the older Hopkins building, which had
remained open. Units there were constructed as early as 1913 and as late as
1980, Hopkins officials said. They functioned as the control group in the
study, since a hospital's satisfaction scores often change over time even
when a hospital's physical environment remains constant.
The study used the responses both to Medicare-mandated surveys and private
ones from Press Ganey, a consulting company that administers surveys. In the
study, Hopkins patient ratings about the cleanliness and quiet in new
tower's roomsâ€”elements Medicare uses in setting payâ€”soared, as did views on
the pleasantness of the dĂ©cor and comfort of the accommodations. But patient
opinions about their actual care â€“ such as the communication skills of
doctors, nurses and staff â€” didn't rise any higher than they did in the
The study's results were startling because previous studies have found that
patients in older hospital buildings give lower scores on the quality of
their care. Hospital executives have noticed it anecdotally as well. For
instance, when NYU Langone Medical Center relocated its cardiology unit to a
renovated floor, its patient experience scores rose.
Newer buildings allow for some medical benefits, such as better organized
nursing stations and private rooms that protect against the spread of
infectious bacteria and diseases. But some hospital leaders excuse low
patient ratings by blaming the physical environment. The Hopkins researchers
said their study showed that "hospitals should not use outdated facilities
as an excuse for achievement of suboptimal satisfaction scores."
Visit NPR for the study.
seeks FDA ban of antifungal tablets
A consumer safety group is calling on the Food and Drug Administration to
pull certain antifungal tablets off the market, saying there are safer
medicines that do not carry risks of liver damage. Public Citizen filed a
petition Tuesday asking the FDA to ban ketoconazole tablets, which are used
against hard-to-treat fungal infections.
First approved in 1981, the drug has long carried a boxed warning about
potentially fatal liver damage. In July 2013 the FDA restricted
ketoconazole's use to infections that do not respond to other drugs. The
agency also required that all patients filling a prescription receive a
medication guide detailing the drug's risks.
But Public Citizen notes that European regulators went further, recommending
that all oral versions of the drug be removed from the market. Additionally,
the consumer watchdog group points to an internal FDA memo in which 14
scientists from the agency's surveillance unit conclude that ketoconazole's
risks outweigh its benefits.
Those findings were delivered at an agency workshop in January 2013, six
months before the FDA decided to restrict the drug's use, but keep it on the
Last year U.S. patients filled 462,000 prescriptions for the drug, according
to data cited by Public Citizen. Ketoconazole is also available in topical
formulations, though Public Citizen says those versions do not carry the
risks cited in the petition. Tablets of the drug are sold by generic
drugmakers Teva Pharmaceuticals and Mylan Inc. (Associated Press)
Visit ABC News for the story.
Dr. Google may
not be the best way to get information for picking a hospital
Searching for health information online has become almost a reflex for
anyone with access to a computer. Worried about that pain in your left side?
Concerned about drug interactions? Need a dentist or a dermatologist? You
probably consult Dr. Google.
But JAMA Internal Medicine has a new commentary article that
questions the accuracy of online information about one of the biggest
decisions you might have to make: picking a hospital.
Researchers Alex John London of Carnegie Mellon University and Yael Schenker
of the University of Pittsburgh took a look at a study by Mariah Kincaid and
other researchers about online ads for transaortic valve replacement, or
TAVR, a minimally invasive procedure for treating the narrowing of the
aortic valve that is common in older adults, particularly men. The study
reviewed the online advertisements of all 317 U.S. hospitals that offer TAVR
and found that all of them cited the benefits of the procedure â€” but only
one-fourth acknowledged that it had any risk. And fewer than 5 percent of
the hospitals quantified the risks in a way that would be useful to
Many of the ads, the researchers noted, are very informational â€” with
â€śgraphs, diagrams, statistics and physician testimonialsâ€ť â€” and therefore
not identifiable to patients as promotional material. This kind of
â€śincomplete and imbalanced informationâ€ť is particularly dangerous, they
note, because of its deceptively professional appearance: â€śAlthough
consumers who are bombarded by television commercials may be aware that they
are viewing an advertisement, hospital websites often have the appearance of
an education portal.â€ť
The authors acknowledge that many clinicians encourage patients to look for
information online as a way of participating in their own healthcare. But
they say the â€ścrowded landscape of biased informationâ€ť may actually mislead
consumers â€” and they say that closer scrutiny of hospital Web sites might
give reason to support stricter advertising regulations.
Visit the Washington Post for the story.
FTC cracks down
on marketers of â€śMelanoma Detectionâ€ť Apps
The Federal Trade Commission has challenged marketers for deceptively
claiming their mobile apps could detect symptoms of melanoma, even in its
early stages. In two separate cases, marketers of MelApp and Mole Detective
have agreed to settlements that bar them from continuing to make such
unsupported claims. The agency is pursuing charges against two additional
marketers of Mole Detective who did not agree to settle.
According to the FTCâ€™s complaints, each of the apps instructed users to
photograph a mole with a smartphone camera and input other information about
the mole. The apps then purported to calculate the moleâ€™s melanoma risk as
low, medium, or high. The FTC alleged that the marketers deceptively claimed
the apps accurately analyzed melanoma risk and could assess such risk in
early stages. The marketers lacked adequate evidence to support such claims,
the FTC charged.
MelApp Settlement. Health Discovery Corporation began marketing MelApp
online in 2011 for $1.99. The proposed settlement will bar the company from
claiming that any device detects or diagnoses melanoma or its risk factors,
or increases usersâ€™ chances of early detection, unless the representation is
not misleading and supported by competent and reliable scientific evidence
in the form of human clinical testing of the device. The settlement also
prohibits the company from making any other misleading or unsubstantiated
claims about a deviceâ€™s health benefits or efficacy. Finally, the company
must disgorge $17,963.
Visit FTC for the ruling.
hydrogel offers replacement to invasive surgical implants for drug delivery
A team of chemical engineers at MIT have developed a new self-healing
hydrogel that is poised to replace current surgical implants used for drug
The findings have been published in a recent issue of Nature
Communications. They show the success of a two-component system for
getting patients drugs designed to treat certain cancers, macular
degeneration, and a range of other diseases. Researchers involved with the
project say the gel is an improvement on existing drug-delivery methods,
which are either quickly dispersed away from the target site or require
â€śNow you have a gel that can change shape when you apply stress to it, and
then, importantly, it can re-heal when you relax those forces,â€ť said Mark
Tibbitt, a postdoctoral researcher at MITâ€™s Koch Institute for Integrative
Cancer Research and one of the lead authors, in a university release. â€śThat
allows you to squeeze it through a syringe or a needle and get it into the
body without surgery.â€ť
In changing the delivery method, the team is changing the drugsâ€™ efficacy,
too. Typical drug deliveries use a liquid solution, which disperse
throughout the body after injection. But since the hydrogel quickly hardens
near the desired tissue, drugs stay localized. This not only reduces the
necessary amount of the drug a patient needs, but allows doctors to control
the timing of multiple drugs that get delivered together.
For cancer patients, the hydrogel would attack tumors that get left behind
after surgery. If left unabated, residual cancer cells can multiply and
reappear in the body with greater force. â€śRemoving the tumor leaves behind a
cavity that you could fill with our material, which would provide some
therapeutic benefit over the long term in recruiting and killing those
cells,â€ť said Eric Appel, co-lead author on the paper. â€śWe can tailor the
materials to provide us with the drug-release profile that makes it the most
effective at actually recruiting the cells.â€ť
Visit Medical Daily for the release.
reason why you should stop drinking soda
As a public health threat, soda is less the suspect than the messenger.
Thanks to countless infographics, PSAs, and news stories revealing the
astonishing number of teaspoons of sugar contained in a can of soda, itâ€™s
clear that the sweetener is the real culprit. High levels of consumption are
linked not only with obesity but with the development of other chronic
diseases, such as diabetes.
Thereâ€™s more to worry about when it comes to sodaâ€”namely, cancer. According
to a study by Consumer Reports and the Center for a Livable Future at the
John Hopkins Bloomberg School of Public Health, sodas routinely have high
levels of the chemical 4-methylimidazole, or 4-Mel, a common component of
the caramel coloring that gives cola drinks their signature brown hue. The
U.S. Food and Drug Administration does not regulate the amount of 4-Mel used
in soda formulations, but in California products that contain more than 29
micrograms of the coloring agent must bear a label noting that it can cause
According to the analysis, based on current levels of consumption and the
levels of 4-Mel found in retails samples, â€śwe would expect to see between 76
and 5,000 cases of cancer in the U.S. over the next 70 years from 4-MeI
The researchers looked at 110 sodas bought at retail locations in New York
and California. According to the study, the highest concentration of 4-Mel
was found in Malta Goya, while Coca-Cola had the lowest.
The study comes a day after NestlĂ© announced that it plans to drop
artificial ingredients, including food dyes, from its candy products by the
end of the year. In addition to switching Red 40 and Yellow 5 for
plant-based coloring agents, which are used more broadly, the candy company
is looking to remove caramel coloring from nine products. Similarly, brewer
Newcastle recently announced that it will remove caramel coloring from its
signature brown ale.
Visit Yahoo for the story.
Chips under the
skin: Biohacking, the connected body is 'here to stay'
If you could replace your car keys, website login data, credit cards and bus
passes with a chip embedded under your skin, would you? This is a question
addressed recently at the Kaspersky Labs Security Analyst Summit by
biohacker Hannes Sjoblad from BioNyfiken. A pioneer in what has been deemed
'biohacking," Sjoblad is the leader of a group of biohackers in Sweden who
took the first step in experimenting with embedded NFC chips -- by having
them implanted into their own hands.
BioNyfiken, a grassroots open network based in Sweden, is a breeding ground
for advancement in the field of biohacking. While it began with a small
group of people willing to experiment with everything from "biology to cells
to plants to Homo sapiens," in the last few months, over 300 people in the
country have now volunteered to have NFC chips embedded in the skin between
thumb and forefinger in their hands.
The first step was a successful crowdfunded Indiegogo campaign. The xNT NFC
chip implant captured the attention not only of the media but the interest
of the general public, and now the network is in full swing. Sjoblad himself
has the implant, which he says he has developed in the last few months to
replace not only his house keys, but also a bike lock, shop memberships
around Sweden and his business card. However, the biohacker says chips under
the skin have the potential to do much more -- and we can expect use to
become commonplace in the future.
While the idea of chips embedded under the skin brings to mind the idea of
cyborgs, Sjoblad was quick to point out at the conference that they are
"already among us" -- thanks to pacemakers, medical implants, insulin pumps
and neurally controlled prosthetics. Over time, the development and cost of
materials to produce such technology becomes cheaper -- only 10 years ago
mapping the human genome costed over $100,000, now it is closer to $10,000
-- and in the same way, rapid miniaturization of technology, lower
production costs and demand for increased connectivity will propel
under-the-skin smart technology forward.
For those concerned with privacy, the biohacker noted how wearable devices
and mobile technology are already collecting and sharing our personal data.
Where embedded NFC chips come in, however, is that we can achieve the same
results but with "less clutter."
Sjoblad told attendees that by giving his body "the same language" as a
computer system via the embedded NFC chip, life can be made more seamless
and efficient. This may then open the way for a variety of uses and
potentially an ecosystem around the platform -- especially as the Internet
of Things (IoT) emerges.
Sjoblad also believes health monitoring will eventually move under the skin
-- which will result in better data capture and intrusion, insofar that
wearable devices designed for health will no longer be necessary.
Visit ZD Net for the story.