Zika images show 'worst brain infections that doctors will ever see'
series of medical images published Tuesday offer the most complete picture,
so far, of how the Zika virus can damage the brain of a fetus.
"The images show the worst brain infections that doctors will ever see,"
says Dr. Deborah Levine, at Beth Israel Deaconess Medical Center in Boston,
who contributed to the study. "Zika is such a severe infection [in fetuses].
Most doctors will have never seen brains like this before."
The images â€” published in the journal Radiology â€” are part of a
special report put together by neurologists in Boston and doctors in
northeastern Brazil who care for babies with Zika infections.
"Our goal is to illustrate for heathcare professionals around the world what
they could expect to see with a Zika infection during pregnancy," Levine
Many research studies and news stories have focused on microcephaly â€” a
condition in which babies are born with very small heads, Levine says. But
that defect is just the tip of iceberg of what Zika does to a fetus's brain.
For example, one baby in the study was born with a normal-size head. "But
when you look inside the brain," Levine says, "there's very little brain
MRI scans at 36 weeks of pregnancy showed the fetus's brain was filled with
fluid, which had puffed up the size of the skull. And the baby was missing
parts of the nervous system, including sections of the brain stem, the
spinal cord and the midbrain, which controls eye movements and processes
information from the eyes and ears.
The baby also had a flattened skull and extra skin around the head â€” which
is likely caused by the skull collapsing in on itself after the brain
stopped growing early in development, the researchers write.
For the study, Levine and colleagues analyzed medical images of 46 fetuses
and babies born to mothers who had Zika during pregnancy. In almost all
cases, the babies had damage in the cortex, the outer layer of the brain
that controls a huge number of high-level functions like problem-solving,
emotion and language. The cortex contains many folds and gives our brains
its characteristic shape. But in these babies, oftentimes, the cortex was
smooth, Levine says.
All the babies had scars in their brains, called calcifications. These are a
telltale sign of an infection, Levine says, and show where the virus has
injured the brain â€” or stopped its development.
The babies also had damage in the brain stem, which controls involuntary
actions, like breathing and heartbeat, as well as injuries in the
cerebellum, which coordinates muscle activity and voluntary movements.
Visit NPR for the report.
Intalere inflationary update for healthcare supplies released
Intalere recently released its updated Inflationary Indices to members. The
update contains company and industry projections for inflation rates across
contract portfolio categories for the coming year.
The Intalere Inflationary Indices is published biannually with updates to
reflect any market trends or changes. The projections represent industry
inflationary performance, actual pricing through Intalere contracts and
programs, and the expected impact of upcoming contract bids.
The report offers estimates in categories including diagnostic imaging,
environmental services, executive resources, foodservice, laboratory,
medical supplies, office solutions, pharmacy, plant engineering and surgical
Some particular items of note:
The price of gases, especially helium, should see some reductions over time,
with the discovery of a major helium field in Tanzania Africa. While there
will probably not be an immediate impact, it should provide relief over time
in helium prices.
In the area of diagnostic imaging, barium will be volatile with an industry
projection of nearly 40 percent, but Intalere members should be protected
based on a previously negotiated long-term contract.
In the information services portfolio, telecommunications (voice and data)
and wireless communication should see slight declines based on increased
market competition. For computer hardware, changes may occur due to extreme
volatility in the memory market for RAM and solid-state drives coming from
Pharmacy will see significant increases in Albumin (approx. 20 percent) due
to increased Asian demand, which has impacted U.S. supply through
disruptions with two manufacturers. Biotech products should also see a
double-digit rise. Although availability of biosimilars is growing,
manufacturers appear to be increasing prices up to the time of competitor
launches to maximize return.
Intalereâ€™s members benefit from price protection controls and pricing being
locked in for a majority of their contracts.
Visit Intalere for the report.
continues to support Florida in response to Zika outbreak
CDC has and will continue to provide support to Florida to address the Zika
outbreak. CDC experts in epidemiology, surveillance, and vector control have
been on the ground for weeks supporting the state of Floridaâ€™s response.
CDC has provided $35 million in federal funds for Zika and emergency
response, including public health and emergency preparedness funds for both
FY 2015 and 2016 that can be used to purchase items for Zika prevention
kits. CDC also has provided 10,000 bottles of DEET for the kits.
CDC is also providing support for Zika lab testing. To date, CDC has shipped
enough material for about 2,000 Zika lab tests, the number of tests Florida
said would allow them to be at full capacity for Zika testing.
After learning this week that Florida needed more materials, CDC is sending
another shipment expected to arrive on Thursday, August 25. This gives
Florida the ability to conduct 6,300 Zika antibody tests.
CDCâ€™s Fort Collins laboratory is also testing specimens from pregnant women
for the Florida Department of Health and is working with Florida on other
possible support for Zika lab testing.
Visit CDC for the announcement.
SmartUVC to exhibit at annual HealthTrust University Conference
Tru-D SmartUVC will join members of HealthTrust at the organizationâ€™s
upcoming University Conference & Vendor Fair in San Antonio, TX, August
29-31 in booth 613. They will showcase the companyâ€™s automated UV
disinfection robot and discuss how it implements seamlessly into healthcare
facilitiesâ€™ comprehensive infection prevention programs.
Tru-D has been a contracted HealthTrust supplier since January 1, 2015,
working with supply chain management professionals to help save hospitals
precious dollars and lives. HealthTrust, which serves more than 1,400 acute
care facilities and members in more than 15,000 locations offers one of the
industryâ€™s committed and aligned group purchasing models.
Once an EVS worker cleans a hospital room with traditional methods, Tru-D is
brought in to complete the disinfection process. Operating from a single
position and administering a single cycle of UV light, Tru-D provides total
room disinfection, killing up to 99.9 percent of harmful pathogens that can
remain behind such as C. diff, MRSA, MERS, VRE, Ebola and many more. Tru-D
takes whatever time is necessary to disinfect the entire room including in
direct and shadowed areas, leaving EVS staff free to complete other tasks
while Tru-D is in use. Once the cycle is complete, Tru-D alerts the operator
with an audio and/or text message that the room has been thoroughly
Tru-D invites attendees to their booth number 613 to learn more about the
gold standard in UV disinfection.
For more information, visit
HSCA statement on new pharmaceutical pricing report from JAMA/Harvard
Medical School researchers
Healthcare Supply Chain Association (HSCA) President and CEO Todd Ebert,
R.Ph., released the following statement on â€śThe
High Cost of Prescription Drugs in the United States: Origins and Prospects
for Reform,â€ť a new study on the drivers of drug costs from Harvard
Medical School researchers published in the Journal of the American
Medical Association (JAMA):
â€śSignificant pharmaceutical price spikes are jeopardizing patient access to
affordable and effective healthcare, and robust competition and timely
availability of generic drugs are part of the solution. The new report from
Harvard Medical School researchers about the drivers of high drug costs
underscores the need for Congressional and FDA action to expand priority
review of new generic drug applications, particularly in the sterile
â€śAs the report notes, the FDAâ€™s backlog of abbreviated new drug applications
(ANDAs) has, in some instances, led to delays of up to three or four years
for product review and approval, which discourages manufacturers from trying
to bring competitive products to market.
â€śHSCA and its member group purchasing organizations (GPOs) are committed to
reducing costs and increasing competition and innovation in healthcare. HSCA
supports the Increasing Competition in Pharmaceuticals Act (S.2615),
bipartisan legislation that would mandate priority review of generic drug
applications for drugs made by just one manufacturer. As future
opportunities to consider enhancements or additions to S.2615 arise, HSCA
urges Congress to mandate priority review for generic injectable drugs with
two or fewer manufacturers.â€ť
Visit HSCA for the letter.
FDA, medical device industry strike deal over user fees
The FDA and the medical device industry hammered out the principles for the
user fees medtech companies pay to have the federal safety watchdog review
The 4th iteration of the Medical Device User Fee & Modernization Act would
allow the FDA to collect nearly $1 billion in user fees over 5 years,
beginning in October 2017. The last MDUFMA bill, enacted in
2012, doubled user fees from $295 million over 5 years to $595 million, in
exchange for performance goals set for the FDA.
â€śMDUFA IV is the result of more than a year of public input and
negotiations with industry, laboratory, patient, and consumer
representatives,â€ť Dr. Jeffrey Shuren, director of the FDAâ€™s Center for
Devices & Radiological Health, said in prepared remarks. â€śThis funding will
also improve the collection of real-world evidence from different sources
across the medical device lifecycle, such as registries, electronic health
records, and other digital sources.â€ť
Lobbying groups for the medical device industry said the new agreement is
the 1st to include metrics aimed at reducing review times, increased
interaction with FDA staff before and during reviews and a pair of
independent analyses of how the FDA manages the medical device approval
The MDUFMA IV agreement also includes a quality system management
approach and enhanced quarterly and annual reporting requirements, the
groups said. If it goes through, it would also require FDA reviewers to give
feedback 5 days before the pre-submission meeting and document the thinking
behind rejected applications, among other provisions.
â€śThis tentative agreement is good news for FDA and industry, and most
importantly for patients worldwide,â€ť added AdvaMed president & CEO Scott
Whitaker. â€śThis agreement will allow for continued progress in improving the
efficiency and predictability of the agencyâ€™s review process, and that means
doctors and patients will have more timely access to the innovative tests,
treatments and cures they are depending on.â€ť
Visit Mass Device for the story.
Obamacare subsidies preserve access as premiums climb, U.S. says
Most buyers of Obamacare plans wonâ€™t see their costs jump, even if premiums
increase next year, because of government subsidies, the U.S. said in a
study that pushes back on reports of challenges facing the health-coverage
Government contributions to premiums will mask the rise in costs for most
buyers on the programâ€™s exchanges, according to the report from the U.S.
Health and Human Services Department.
â€śHeadline rate increases do not reflect what consumers actually pay,â€ť
Kathryn Martin, HHSâ€™s acting assistant secretary for planning and
evaluation, said in a statement. â€śEven in a scenario where all plans saw
double-digit rate increases, the vast majority of consumers would continue
to have affordable options.â€ť
The U.S. report highlights a bright spot for the Affordable Care Act, where
signs of trouble are mounting. Insurers including UnitedHealth Group Inc.
and Aetna Inc. are halting their sales in some states, citing financial
losses, while many remaining insurers are boosting premiums. The subsidies
may help ensure that buyers stick with the markets even as insurers boost
premiums, helping avoid a situation where the markets become unstable
because too few buy coverage.
Even if premiums rise by 25 percent, about 78 percent of shoppers will be
able to buy health plans for $100 or less a month in 2017, compared to 76
percent this year, according to the report. The ACA offers subsidies to
individuals with incomes of as much as 400 percent of the poverty level. As
of March 31, about 9.4 million of the 11.1 million people in Obamacare plans
on the exchanges were getting subsidies.
Individuals who donâ€™t get the government subsidies, as well as people who
buy individual health insurance through Obamacare exchanges, will bear the
full cost of rate increases, though they may have the option of switching to
cheaper plans. About 9 million people buy individual plans outside the
exchanges, the Congressional Budget Office has estimated.
The U.S. report simulates the effect of increasing all health insurance
premiums by 25 percent in the 38 states the use the federal Healthcare.gov
website. It doesnâ€™t analyze actual 2017 premiums, which are still being
evaluated by regulators in some states. The sign-up season for 2017 coverage
begins Nov. 1.
Visit Bloomberg for the report.
Doctors, hospitals prepare for difficult talks surrounding medical mistakes
Hospitals have traditionally been reticent to disclose to patients or their
family members the specifics of how a medical procedure didnâ€™t go as planned
for fear of malpractice lawsuits. In recent years, though, many are
beginning to consider a change. Instead of the usual â€śdeny-and-defendâ€ť
approach, they are revamping their policies to be more open.
To help them move in this direction, the federal Agency for Healthcare
Research and Quality released in May an online toolkit designed to expand
the use of the agencyâ€™s â€śCommunication
and Optimal Resolutionâ€ť process, which establishes guidelines for
adopting more transparency in communicating adverse events.
Hospitalsâ€™ interest in this approach has been fueled by studies showing
that patients want to know when an adverse event has occurred and
doctors suffer from anxiety when there are restrictions and concerns about
what they are allowed to discuss. Some studies have found that patients are
more likely to sue when they perceive that there is a lack of honesty.
MedStar Health, which is among the largest health providers in Maryland and
the Washington, DC region, has been one of the pioneers in setting up such
programs at all of its 10 hospitals. In 2012, it launched standardized
program based on AHRQâ€™s guidelines across the system that drew on similar
initiatives that were already in place at its various facilities.
The initiative established a standardized approach for physicians when they
have to communicate with patients and family members about adverse events. A
team of physicians â€” called the â€śGo Teamâ€ť â€” complete a four-hour initial
training program and then annual booster courses every six to eight months
to prepare them for these conversations and also to help other staff
physicians who confront the problem. After that, Go Team members are on call
24/7 to provide guidance. Another program, â€śCare for the Caregiver,â€ť
provides psychological support to other physicians as needed.
One of central elements of the training program for the Go Team involves
role-playing exercises with professional actors who simulated patient
MedStar is not the only hospital system implementing the system. Since 2012,
second-year medical students at Johns Hopkins University are required to
learn how to disclose adverse events in their patient safety classes by
participating role-playing exercises. Several Harvard teaching hospitals
also have coaching models similar to MedStarâ€™s.
Part of the motivation for David Mayer, vice president of quality and safety
for MedStar Health, to establish open communication programs came from his
personal experience about a decade ago when he was the co-executive director
at the University of Illinois Institute for Patient Safety Excellence. Back
then, he and his colleagues were frustrated with the tension between
doctors, patients and the amount of lawsuits the hospital had to field from
patients who wanted to know more.
Mayer said by emphasizing transparency and creating an open environment, the
doctors have been able to learn from past events and improve their
performance. At MedStar Health, he has seen a 60 percent reduction in
serious safety events in the past four years.
But the openness also has a cost. The hospital might have to pay for
remedies, such as waiving medical bills, if a patient believes the hospital
was at fault.
Visit Kaiser Health for the article.