|
hpnonline Daily Update |
||||||||
|
|
March 2006
CDC: Milder than normal flu
season ending
ASHES launches Phoenix
Business Directory
The Council of Supply Chain
Executives
announces new supply chain member
Masimo Corporation
announces that Dolphin Medical
will discontinue product line
Isolating sick people, rapidly treating family members with antiviral drugs, and closing schools and businesses will sharply reduce new infections in a future flu pandemic, according to a new mathematical model described in the British scientific journal Nature. An influenza pandemic in the United States would crop up first in population centers like Houston and be largely over within four months, according to the researchers who created a complex computer simulation of a flu pandemic in the U.S. and Great Britain. The strategies suggested are not new. But when plugged into the computer model and layered over travel patterns, population densities and data about flu transmission, what emerges is one of the most richly detailed glimpses to date of a much-feared pandemic, and the potential payoffs for various measures for survival. Lead author Neil Ferguson teaches in the department of infectious disease epidemiology at Imperial College London. He said his model, and another by the Los Alamos National Laboratory published earlier this month, are “unrivaled in their detail.” Ferguson and his colleagues at Johns Hopkins Bloomberg School of Public Health made their calculations using a number of assumptions. For instance, they estimated that 30 percent of transmission occurs within the household, 33 percent in the general community and 37 percent in schools and workplaces. The Los Alamos model showed how a particularly infectious pandemic strain might sicken 151 million Americans, or about half the population, if unimpeded by antivirals or vaccinations. A mortality rate similar to that of the 1918 flu, estimated at about 2.5 percent, would kill nearly 4 million in the U.S. The H5N1 strain circulating in birds and occasionally infecting people has a mortality rate of 50 percent, though most scientists believe the virus would be less virulent if it mutated into a human-to-human form. For now, the U.S. stockpile of antiviral drugs is too small to mount a successful defense, according to the model, Ferguson said. Halting the spread of the epidemic would require treatment for 150 million people. Even treatment for 75 million people could significantly reduce the impact. But the U.S. government is planning to stockpile treatment for only 51 million people by late 2008. Employing “social distancing”, keeping people away from each other, can have a dramatic impact on reducing infection rates, as it did during the 1918 flu pandemic. “But we're talking about 12 weeks to six months,” Ferguson said. “My own view is we wouldn't achieve a 50 percent reduction in contact rates” over such a prolonged period. The best hope would be blunting the pace of new infections, he said, and reducing demand for hospital services. (Houston Chronicle)
Face masks analyzed as aid in flu pandemic
How useful would face masks actually be in the event of a flu pandemic? A 12-person panel of experts, convened by the government, answered part of that question. It said that form-fitting molded “respirators” would be better than clothlike surgical masks, and surgical masks would be better than handkerchiefs and scarves. But how much protection any would provide is largely unknown, as is the question whether they could be safely washed and reused if there were not enough new ones in a pandemic. “I would not recommend face masks alone. I would not recommend that anyone using a mask think that is adequate protection,” said John C. Bailar, a physician and epidemiologist who chaired the committee at the Institute of Medicine that examined the question. Masks are “part of a package that includes vaccination if it is available, isolation of patients and quarantining, closing of public meetings and schools, 'social distancing' and the washing of hands,” he said. The 97-page report was requested by the U.S. Department of Health and Human Services. Another member of the committee went further in warning people against relying on masks, whose effectiveness in protecting against flu is virtually unstudied. “Mask and respirator use is considered to be the very last in a series of activities that may be more effective in reducing the spread of flu,” said E. John Gallagher, chairman of emergency medicine at Albert Einstein College of Medicine in New York. What little is known about masks and respiratory infections comes from research on tuberculosis and severe acute respiratory syndrome (SARS), two infections that influenza may not mimic. Many companies are now stockpiling masks and gloves. The current growth of consumer demand is unknown, however. The Centers for Disease Control and Prevention has about 1 million masks in a national stockpile, with orders placed for 99 million more. Their delivery date, however, is also unknown. 3M and Kimberly-Clark Corp. are the two largest U.S. producers of medical masks. 3M's plants “have been working 24-7 for some time now,” said Jacqueline Berry, a company spokeswoman. Demand for masks in Asia began to rise in January 2005 and in Europe last summer. Since the start of this year, U.S. customers have been ordering more masks, Berry said. Among the many murky aspects of the subject are the names of the devices. “Surgical masks” or “medical masks” are pleated, soft, clothlike objects that cover the nose and mouth and tie behind the head. They cost about 15 cents apiece. “N95 filtering facepiece respirators” are fitted to the face by molding a cuplike mask that covers the nose and mouth. Like surgical masks, they are also made out of spun plastic fibers, but fit much more tightly. They do not work well with beards. N95 respirators, which cost $1 to $3 apiece, are designed to filter out 95 percent of particles that measure about 0.3 micrometers, or thousandths of a meter, in diameter. Influenza viruses range in size from 0.08 to 0.12 micrometers, though they are often clumped together or stuck to other airborne debris. Bulkier rubber respirators with replaceable filters, priced at $25 and up, are used in some non-healthcare settings. They were not evaluated by the committee. Masks and respirators stop particles three ways. Large particles and droplets can be stopped by the outer surface; smaller particles can be stopped by the mesh; and even smaller particles can be stuck to mask fibers by electrostatic charge. During an epidemic, surgical masks would be most useful for preventing infected people from coughing virus-laden droplets of saliva and mucus into the environment. The N95 respirators are the most useful in preventing healthy people from becoming infected by “respiratory aerosols”, microscopic clumps of material left floating in the air when the water in very small droplets evaporates. How often flu is transmitted by aerosols is unknown, but it does occur. A study found that in a commercial airplane carrying a person ill with a new strain of seasonal flu in 1979, 72 percent of passengers came down with flu. However, the circumstances were unusual; people were kept on the plane for three hours while a broken ventilation system was repaired. The Institute of Medicine committee said there were no data suggesting that surgical masks or N95 respirators could be cleaned and reused, and advised against doing so. In a shortage, however, a person could get more time out of a N95 device by wearing it covered with a surgical mask, the panel found. The surgical mask would be thrown away after a day's use, and the respirator stored in a clean bag for use later. This strategy was used in Asia during the SARS outbreak of 2003. (The Washington Post)
CDC: Milder than normal flu season ending
This year's flu season draws to a close as one of the mildest in recent years,
partly because the vaccine was a good match for this winter's most common virus.
Overall flu and pneumonia deaths were below those of a typical flu season, and
health officials say fewer than two dozen children's deaths were reported. The
one exception to the overall good news is a nasty outbreak of a different flu
virus that hospitalized more than 30 children in Houston. In about half of the
states, reports of flu-like illness are sporadic or virtually nonexistent now,
according to the U.S. Centers for Disease Control and Prevention. “Flu season is
pretty much over,” said David Engelthaler, Arizona's state epidemiologist. Flu
was widespread in only five states, Connecticut, Delaware, Indiana, New York and
Rhode Island, the week of April 9-15, the most recent data available. The
long-lasting season started in December with a rush of cases in the Southwest
that swamped hospital emergency rooms. It then rotated to other regions, with
widespread activity in some areas as late as this month. But it hasn't been bad.
“It has been a very mild season,” said Dr. Roland Levandowski of the National
Institute of Allergy and Infectious Diseases. This season, the number of deaths
are lower than normal. One possible reason: The vaccine seems to be doing the
job. Last year, health officials, making essentially an educated guess,
formulated the vaccine against three flu viruses. They were Type A New
Caledonia, Type A California, and Type B Shanghai. Test results show 84 percent
of people with confirmed flu this season had a Type A flu and the rest had a
Type B. Of the patients who had Type A viruses, about 80 percent or more had
viruses identical or similar to the A bugs in the vaccine. “The vaccine was a
good match to the circulating viruses,” said Dr. Jeffrey Engel, North Carolina's
state epidemiologist. Good, but not perfect: The B virus was not a good match.
Nearly 70 percent of the people testing positive for a B virus had Type B
Victoria, a version not found in the vaccine. For adults, that wasn't a big
deal, because they've been exposed to both lineages of B flu through the years
and could muster an immune response. But for some children never exposed to Type
B Victoria, the result was more serious. Since mid-January, 31 children have
been sent to Texas Children's Hospital in Houston for treatment of Type B
Victoria flu. Some have suffered a rare complication called myositis, a painful
inflammation of the calf muscles that hurts their ability to walk. Next year's
flu vaccine will include Type B Victoria, health officials said. Some experts
say there was additional bad news in the current flu season: The discovery that
one Type A flu virus circulating this season is largely resistant to rimantadine
and amantadine, two drugs commonly used to fight influenza. The resistance of
such a common flu bug to the drugs could require significant changes in how
doctors treat flu patients in the future, said Dr. Bruce Ribner, epidemiologist
for Atlanta's Emory University Hospital. Some health officials also worry that
the mild nature of this flu season will lull the public into forgetting the
potential dangers of the common flu bug. (The Associated Press)
ASHES launches Phoenix Business Directory
The American Society for Healthcare Environmental Services (ASHES) has launched an online business directory as a resource for its membership to easily find needed suppliers, products and services. The Phoenix Business Directory is an online database ASHES members can quickly browse to find suppliers, products and health care environmental services information. The directory is searchable by category or by geographical area and is available 24 hours a day, 7 days a week. Visit www.ashes.org and click on the Phoenix Business Directory logo to view the directory. With a click of the mouse, users are taken directly to the website listing. New listings will be added frequently and ASHES members are encouraged to check the directory often. Manufacturers, consultants, distributors and other health care service providers are encouraged to list their business in the Phoenix Business Directory. Interested companies may visit www.ashes.org and click on the directory's image at the bottom of the home page, or contact ASHES at 312-422-3860 to obtain an application. Applications are being accepted by mail, fax or online.
The Council of Supply Chain Executives
announces new supply chain member
The Council of Supply Chain Executives (The Council), a division of the Institute of Healthcare Executives and Suppliers (IHES), announces the addition of Michael T. Langlois, Senior Vice President and Chief Supply Chain Officer of Ascension Health, to its roster of nationally acclaimed supply chain executives. Langlois is responsible for all aspects of Supply Chain Management including Logistics, Performance Measurement and Information Technology at Ascension Health, the largest nonprofit health system in the United States, with 67 acute care hospitals and dozens of related health facilities in 20 states and the District of Columbia. The Council is an organization that allows supply chain executives from across the country to assemble together to offer their best practices and experiences to their peers and to healthcare suppliers in focus group panels. The Council offers healthcare suppliers a collaborative forum to ask for feedback and advice from the country’s leading supply chain executives in a neutral and constructive environment. The Council of Supply Chain Executives will next convene on November 9-10, 2006 in Franklin, TN. The Council will provide their service to a limited number of healthcare suppliers. www.Councilhome.com.
Masimo Corporation announces that Dolphin Medical
will discontinue product line
Masimo Corporation announced that Dolphin Medical Inc. has agreed that it will discontinue its Dolphin ONE product line. The discontinuation is part of an agreement between Dolphin and Masimo Corporation, in which Masimo has agreed to release Dolphin and its affiliates from certain patent infringement claims.
Doctors urge safety panels for
devices
California Blue Cross employee
testifies company cancels policies
with inconsistencies, even inadvertent errors
Earnings improvements reflect
momentum in Cardinal Health's
core businesses during third quarter
At its annual meeting in Las Vegas, April 19-20, MedAssets announced its initiative to drive innovation and support transparency in the healthcare industry by helping providers reengineer business processes and incorporate technology. In his address to the more than 2,500 healthcare professionals attending the MedAssets Healthcare Business Summit, MedAssets’ Chairman, President and CEO John Bardis emphasized the importance of transparency in sustaining our nation’s healthcare system. “We are all partners in the healthcare system, and we all have a responsibility to develop business strategies to improve the delivery and cost effectiveness of care,” Bardis said. “Normalizing the inequities between stakeholders within the healthcare environment is crucial to the future of the entire system and will ensure that America’s hospitals can continue to fulfill their mission of providing high quality patient care for years to come. There is currently a call for increased transparency in the healthcare industry that will help facilitate an improved financial balance between stakeholders, and MedAssets fully supports any effort to bring about positive change in this area.” MedAssets’ Merge Technology platform includes a suite of solutions to help providers prepare for the industry challenges such as pricing transparency and consumer-managed healthcare. During the event, MedAssets unveiled its strategy to drive process improvement in healthcare provider setting. With decision support as its core competency, MedAssets can access the financial impact of clinical outcomes to help healthcare organizations identify meaningful performance gaps. To address these opportunities, MedAssets then develops a customized program incorporating consulting and/or technology solutions, and monitors and evaluates the results. The combined capabilities of decision support, supply chain and revenue cycle solutions offers providers a single data repository and allows greater transparency for clinical, financial and operational decision-making. The general session of the MedAssets Healthcare Business Summit included the presentation of the 2006 Outstanding Humanitarian Award to Sister Alice Marie Quinn, D.C., Director of the St. Vincent Meals On Wheels program in Los Angeles in addition to other supplier and provider awards. The number of attendees increased approximately 25 percent more than last year’s meeting and was the largest in the company’s history. An addition to the meeting schedule this year was the MedAssets Revenue Cycle Forum in which chief financial officers and revenue cycle personnel learned of the latest trends in revenue cycle improvements. www.medassets.com.
Amerinet introduces new leadership and new business model
The board of directors of health care group purchasing organization (GPO) Amerinet announced the appointments of a new CEO and COO. Victor E. Samolovitch was named as the new CEO replacing the retired Robert P. “Bud” Bowen. Selecting a new CEO represents the first phase of the GPO’s initiative to optimize resources and streamline operations with the implementation of a new business model. With a focus on better serving health care providers, the new model is designed to create a single national business platform among all three shareholders. Samolovitch, who is currently president of Amerinet Central, becomes CEO effective June 1, 2006. The role of CEO has been significantly redefined to expand responsibility from what was primarily St. Louis operation to all Amerinet operations, including shareholder companies. Samolovitch will oversee the implementation of a new business model, which will integrate operations nationally and unite the employees of all Amerinet companies under one strategic plan. This continues a process that began in 2003 when Amerinet united its network of companies under a new national image and strategic direction. The Amerinet board of directors also announced that Todd Ebert, who was formerly president of Amerinet, was named president and chief operating officer (COO), expanding his responsibilities to encompass all of the GPO’s customer-facing operations including contracting, sales, and marketing. The COO role is a newly created position for Amerinet. http://www.amerinet-gpo.com/
Doctors urge safety panels for devices
A medical group has called for sweeping changes in
how the medical device industry and the government oversee implanted heart
devices, and urged companies to use outside experts to help them decide when to
issue alerts about potential safety problems in products. The Heart Rhythm
Society believed that “single adverse events that could cause death or serious
injuries in patients merit notification” if the problem was likely to recur. It
also recommended ways of collecting more data about a device's performance and
proposed methods to standardize how doctors and patients were made aware of
problems. The organization's proposal that device producers appoint outside
experts to help oversee product safety is particularly striking because it
signals that doctors, who are effectively the customers of heart device makers,
want independent information about product safety. The recommendation, which the
group called central, may also have financial implications for makers of
defibrillators because it means that units suspected of problems may be removed
more quickly from hospital shelves. The high-profit devices sell for $20,000 to
$35,000 each. “Manufacturers are in the best position to evaluate their own
devices,” the medical group wrote in its report. “However, a concern with this
system is that the evaluation of the devices and the recommendations for actions
by those within the company involves an inherent conflict of interest that could
affect the outcome.” The medical group's report, which is in draft form, follows
a controversy last year in which the
Guidant Corporation did not alert doctors
to life-threatening flaws in some units and allowed more than 4,000 suspect
defibrillators to be implanted in patients when safer ones were available. The
recommendation that companies create outside safety panels mirrors a similar one
made last month by a group of medical experts appointed by Guidant to review its
handling of safety issues. Recently, device makers and the F.D.A. have adopted
some of the group's recommendations. Producers have started issuing reports with
far more detailed data on device performance. And earlier this month, the F.D.A.
said it would appoint outside medical experts to help it review the safety of
heart devices on the market. Dr. Anne B. Curtis, the president of the Heart
Rhythm Society, said that manufacturers were receptive to the recommendation
that individual companies, or the industry as a group, set up an independent
panel of doctors and other experts to monitor product safety data and advise
companies about how to respond. Boston Scientific said that it supported the
creation of an industrywide, independent safety board. James R. Tobin, chief
executive of Boston Scientific, based in
Natick, MA,
also said the company was adopting all the medical group's recommendations. The
other two major heart device producers,
Medtronic and St. Jude Medical, said
separately that they were reviewing the safety board proposal. The group of
heart specialists also recommended that added data about heart devices be
collected by having physicians return more units after removal to manufacturers
for review, and called on doctors to test a heart unit at the time of a
patient's death to see if it played any role. The organization is also asking
the F.D.A. to create specialized reporting forms to track reports of heart
device problems, and urged the F.D.A. to drop use of the term “recall” when
issuing an alert about a unit. Dr. Curtis, the chief of the division of
cardiology at the University of South Florida, said that some experts were
concerned that the term created a feeling among doctors and patients that a
device had to be removed, when it might be safer to leave it in many patients. A
spokeswoman for the F.D.A., said the agency was considering making such changes.
(The
New York Times)
Earnings improvements reflect momentum in Cardinal Health's
core businesses during third quarter
Cardinal Health has reported that third-quarter earnings continued to strengthen sequentially as revenue reached a record level and operating margins improved in all segments from the first half of the fiscal year. During the quarter ended March 31, revenue increased 9 percent to $20.6 billion from $19 billion last year. Operating earnings of $559 million declined 5 percent from $591 million, primarily due to greater seasonality associated with its former ‘buy-and-hold’ business model during the third quarter of fiscal 2005. Today, Cardinal Health and OTN are announcing the sale of the majority of Cardinal Health's specialty distribution business to OTN, a wholly owned subsidiary of Oncology Holdings, Inc. OTN, the second largest distributor to the community oncology market, will primarily acquire Cardinal Health's oncology distribution capabilities and Cardinal Health will become a minority owner in the firm. Also, Cardinal Health sold its pharmacy staffing business during the quarter to Soliant Health, the health-care staffing unit of MPS Group. Cardinal Health also acquired Parmed Pharmaceuticals Inc. and signed a definitive agreement to acquire Denver Biomedical to extend its product and service offerings for key customers. In medical products manufacturing, sales growth was led by demand for Cardinal Health's glove and respiratory products. Revenue for the Clinical Technologies and Services segment rose 15 percent from the prior year to $603 million, led by 23 percent growth for Alaris and Pyxis products. Revenue for clinical services and consulting grew 8 percent. Operating earnings for the segment increased 73 percent from the prior year to $101 million. The sharp increase in operating earnings resulted from strong demand, combined with expense controls, manufacturing efficiency and ongoing improvements to customer service and the Pyxis installation process. Committed contracts were again strong for both Alaris and Pyxis products, with the Pyxis backlog ending the quarter at $243 million. Customers continued to transition to Cardinal Health's Pyxis MedStation 3000, which accounted for nearly 75 percent of new Pyxis orders during the quarter. In addition, approximately 40 percent of Alaris product sales during the quarter were from competitive displacements. For a copy of the complete report visit: http://www.cardinalhealth.com.
FDA: Antihistamine linked to
deaths of young children
AANA publishes position
statement on unintended
awareness under general anesthesia
Amerinet, Amerinet Choice
announce new agreements
Implantable defibrillators had a roller-coaster record of reliability, as the rate of malfunctions fell in the early years, rose in the late 1990s and recently declined again. Compared with pacemakers, implantable defibrillators are five to 20 times more likely to malfunction and need replacement. At the same time, people who learn that the device implanted in their chest may have a defect should think hard before having it replaced. Switching it out may be more risky than leaving it in. Those are among the conclusions of three studies being published in the Journal of the American Medical Association that shed light on the hazards of implantable cardioverter-defibrillators (ICDs). The number of ICDs implanted in Americans has more than tripled from about 54,000 in 1999 to 168,000 last year. Sales are increasing 15 to 18 percent a year and are expected to continue rising as the population ages and the number of medical conditions shown to benefit from ICD use grows. The devices, which are made by five highly competitive companies, cost about $20,000. The implantation procedure costs about $10,000 in physician and hospital charges. Two of the studies were headed by William H. Maisel, a cardiologist at Beth Israel Deaconess Medical Center in Boston. After a study he did suggested that malfunction rates for ICDs were rising, the Food and Drug Administration, which licenses the devices, asked him to study the issue further. Maisel and his collaborators examined device-makers’ reports of ICD and pacemaker malfunctions for the years 1990 through 2002. They calculated the number of ICDs and pacemakers that malfunctioned and were replaced per 1,000 of the devices implanted each year. (This does not represent an individual's chances of getting a defective device.) For pacemakers, the malfunction rate declined from 9 per 1,000 implantations in 1993 to 1.4 per 1,000 in 2002. For ICDs, it fell from 39 per 1,000 implantations in 1993 to 8 in 1996, but then rose to 36 per 1,000 in 2002. A study of three registries of ICD and pacemaker implantations, in North America, Denmark and Britain, found the same trend but extended it longer and found a marked decline in malfunctions from 2002 through 2004. A trade organization for device-makers, the Advanced Medical Technology Association, said its records show the malfunction rate for ICDs last year was about 1 per 1,000 implanted, and that about half the problems would simply delay a shock by several seconds. The rise in the malfunction rate in the late 1990s came as device-makers were adding new features and power to ICDs while trying to make them smaller. In the third study, Andrew D. Krahn, a cardiologist at the University of Western Ontario, examined the rate of complications in people who were told their ICD might have a chance of failing. In 17 Canadian hospitals over a one-year period, about 3,000 patients received such a notice, and 533 (18 percent) decided to get the devices replaced. Of them, 31 (6 percent) had complications and two died. During that year, only three malfunctions occurred in the devices for which “advisories” had been issued. None of those resulted in death or serious illness. Guidant Corp. of Indianapolis issued recalls last year of both pacemakers and ICDs. A leaky seal in some pacemaker models caused failure of 69 devices and one death. There were 18,000 potentially affected models in the United States and 10,000 in other countries. The company recalled three ICD models after deteriorating insulation contributed to two deaths in 42,000 devices worldwide. (The Washington Post)
Pennsylvania Hospital is now able to offer so-called “bloodless surgery” to 90 percent of its patients who want it, joining a small but growing number of bloodless medicine programs around the country. Advocates put the number at about 120. Many states have bloodless surgery centers or hospitals that perform no-transfusion surgery for Jehovah's Witnesses, who believe the Bible forbids transfusions, but not for the general public. Some hospitals are now providing no-transfusion surgery to more patients because of advances in equipment and changes in protocols. Bloodless surgery techniques vary depending on the type of operation, but can include heart-lung bypass machines; using high-tech scalpels that clot the blood as they cut tissue; or freezing tissue before it’s excised. There is also pre-surgery planning. Doctors start seeing patients weeks before surgery to prepare. Among the benefits are reductions in recovery time, hospital stay, cost and complications, as well as an estimated $20,000 in savings per patient, said Dr. Charles Bridges, a Pennsylvania Hospital cardiologist. The general consensus in the medical community is that it is best to avoid donor blood transfusions whenever possible, but that transfusions remain an important lifesaving strategy. The American Medical Association endorses “autologous” blood transfusion, giving a patient his own blood, but takes no specific stance on no-transfusion surgery. Pennsylvania Hospital has for at least a decade performed all kinds of no-transfusion surgery on Jehovah's Witnesses, Bridges said. In the year that no-transfusion heart surgery has been offered to patients, Bridges estimated that he has performed between 50 and 75, up from about 10 just a few years earlier. Heart surgery, because it is associated with extensive blood loss, is more difficult to do “bloodless” than other operations. In traditional open-heart surgery, a patient may need up to six units of red blood cells, four units of plasma and 10 units of platelets, according to the American Red Cross. The best no-transfusion candidates typically are those needing only one procedure, repair of a single heart valve or a single bypass, for example. It also can be done in more complex operations, however. From pre- to post-surgery, the goal is conserving the patient's own blood, Bridges said. “There's no downside to it that we can see, and there's certainly no downside that's been documented,” Bridges said. Patients who choose the no-transfusion option eliminate the risk of blood-borne infection and complications from clerical errors. They also get out of the hospital an average of one day earlier and avoid potential transfusion-related complications including immune system suppression, inflammatory response, and renal or respiratory failure, Bridges said. (Associated Press)
AANA
publishes position statement on unintended
awareness under general anesthesia
Aspect Medical Systems announced that the American Association of Nurse Anesthetists (AANA) has published a position statement regarding unintended awareness under general anesthesia on the AANA Web site. Unintended awareness occurs when patients do not receive enough anesthesia to remain unconscious, leaving them at risk for becoming aware of what is happening and remembering this experience after the surgery is over. The document states that awareness occurs in one to two cases per thousand patients receiving general anesthesia. To address this clinical concern, the position statement recommends that every anesthetizing location develop a defined written policy that includes the following practices: Assessing patient risk for awareness prior to surgery and anesthesia; Ensuring proper function of anesthesia equipment; Developing an anesthesia care plan that includes appropriate pharmacologic agents, anesthesia techniques and patient monitoring techniques to reduce risk of awareness; Considering brain function monitoring in situations where awareness risk is increased; Conducting patient assessments post-surgery to identify and manage possible occurrences of awareness. The position statement notes that use of brain function monitors along with other patient monitoring modalities has been shown to reduce patient risk of awareness. Further, the document states that not all brain monitors have been studied for their effectiveness in reducing the incidence of awareness and individual health care facilities and anesthesia departments should consider clinical evidence when selecting brain monitors for use to reduce risk of awareness.
The position
statement can be found on the AANA Web site at:
http://www.aana.com/Resources.aspx
?ucNavMenu_TSMenuTargetID=51&ucNavMenu_TSMenuTargetType=4&ucNavMenu_TSMenuID=6&id=1747
Amerinet, Amerinet Choice announce new agreements
Amerinet Choice announces its agreement with Encompass Group LLC for pillows offered under the Amerinet Choice LLC label. Effective through March 31, 2009, this contract includes disposable, limited-use and reusable pillows. Disposable pillows are designed for personal single use and have a non-woven breathable cover to allow for more comfort and support. Reusable pillows are vinyl-coated for cost effectiveness and easy cleaning. This contract was the result of a competitive bidding process.
Hybrid virus targets cancer
cells
Two Veterans hospitals select
clinical decision support software
to improve patient care, infection control
FDA approves MAMMOMAT Novation
system for mobile use
Goldman Sachs (GS) recently attended the annual World Health Care Congress with health care executives, key government leaders and academics in Washington, D.C. Consumer driven health plans (CDHP) and Pay-for-performance (P4P) were the focus of discussions. Key points included: 1) Treasury Secretary Snow emphasized the administration’s belief that Health Savings Accounts (HSAs) are key to controlling the unsustainable trajectory of health care costs; 2) P4P seen as key to success of CDHPs with numerous panels focused on health outcomes quality measures. While the government prefers private sector agreement on price and quality transparency, Alan Hubbard, Assistant to the President for Economic Policy, indicated it would pass legislation enforcing transparency if necessary; 3) Significant health care legislation is unlikely in the current Congressional term; 4) Abby Block of the Centers for Medicare and Medicaid Services (CMS) provided an update on Part D implementation.
Snow affirmed the Bush administration's commitment to reforming health care through HSAs linked to high deductible health plans. Hubbard addressed the perception that HSAs are favorable for richer segments of the population by indicating that of the 3 million HSA accounts, a third belong to individuals previously lacking insurance. Hubbard contended that HSAs are a viable means of health insurance particularly for individuals and small employers who would otherwise not be able to buy conventional health insurance. However, Hubbard acknowledged that HSAs are not able to address the challenge of providing care for the chronically ill. GS noted that the chronically ill account for a large majority of costs in the health care system.
A key component of consumer directed health plan initiatives is the availability of objective information on care outcomes quality that consumers can base purchasing decisions on. Numerous discussions were devoted to detailing P4P initiatives nationwide such as UnitedHealth's Premium Designation Program for physicians meeting standards of quality and efficiency of care. However, it is evident that considerable work needs to be done before payers, providers and patients can reach consensus on appropriate measures of health care quality outcomes. Hubbard made it clear that while the government prefers the private sector reach agreement on disclosure of price and quality measures, it was determined to pass legislation to enforce transparency if necessary.
In spite of widespread negative press coverage, a survey of Medicare Part D program enrollees shows that a large majority of enrollees are satisfied with the program and would recommend it to others. However, it was acknowledged that low-income seniors, potentially the biggest beneficiaries of the bill, had been enrolling at lower than expected rates. With the May 15th enrollment deadline for Part D approaching, Block emphasized that CMS does not plan to extend the enrollment deadline (although the deadline was extended for roughly 2 million low-income seniors). According to recently released figures 8.1 million seniors are enrolled in Stand-Alone Prescription Drug Plans (as of April 2006).
Earnings expected to decline at HCA; uninsured patients offset revenue
Hospital operator HCA Inc. said Monday that it expects first-quarter earnings to fall from the year-ago period because although revenue is rising, so is the number of uninsured patients. HCA forecast first quarter earnings per share of 89 to 93 cents, down from 95 cents per share a year ago. Nashville-based HCA also expects revenues to rise to about $6.42 billion for the first quarter, up from $6.18 billion a year ago. HCA said facility revenues increased 5 percent, and same facility revenue per equivalent admission increased 5.1 percent in the first quarter. Same-facility uninsured admissions rose by 2,438, or 13.1 percent, from a year ago. Provisions for doubtful accounts also rose to 12.8 percent of revenue, compared with 10.9 percent a year ago, when taking into account discounts for uninsured patients. (The Associated Press)
Hybrid virus targets cancer cells
A hybrid virus may allow researchers to target tumor cells directly and to deliver genes that either treat or locate the malignancy. In principle, the hybrid virus could make it easier to image tumors, make them more accessible to treatment, and allow doctors to monitor how well anticancer agents are working, according to Wadih Arap, M.D., a professor of medicine and cancer biology at the University of Texas M. D. Anderson Cancer Center. But, Dr. Arap cautioned, the value of the hybrid virus, reported in the April 21 issue of Cell, has so far been demonstrated only in mice and will require much more research before it’s available for patients. Viruses whose natural target is animal cells have long been used to carry transgenes into tissue, but their value in targeting cancer cells is limited, because they tend to infect all mammalian cells. On the other hand, the researchers noted, viruses whose target is bacterial cells are not easily made to carry transgenes, but can be aimed directly at specific types of cells. In mice “this hybrid virus can target tumors systemically” and deliver genes that can either be used to image the tumor or perhaps to treat it, said study co-author Renata Pasqualini, Ph.D., also of M.D. Anderson. (MedPage Today)
Two
Veterans hospitals select clinical decision support software
to improve patient care, infection control
VA Pittsburgh Healthcare System in Pennsylvania and VA Greater Los Angeles Healthcare System recently selected clinical decision support software (CDSS) provided by TheraDoc Inc. The software's real-time surveillance, alerting and reporting capabilities will enhance infection control and prevention initiatives at both hospitals. TheraDoc will implement its Expert System Platform (ESP), Antibiotic Assistant and Infection Control Assistant to further enhance the already high quality of patient care provided at both Veterans Hospitals. At VA Pittsburgh Healthcare System, TheraDoc will collaborate with the Pittsburgh Regional Healthcare Initiative (PRHI), a consortium that is working toward improving health care for patients and reducing healthcare costs. PRHI plays a unique role in the transfer of clinical improvement knowledge in Pittsburgh hospitals. CDSS will be integrated with the Veterans Health Information Systems and Technology Architecture (VistA) at the Pittsburgh and Los Angeles hospitals. The system automates and accelerates the surveillance of electronic medical records and the identification of infections while streamlining data collection processes for the clinicians.
FDA approves MAMMOMAT Novation system for mobile use
Siemens Medical Solutions announced that the U.S. Food and Drug Administration (FDA) has approved a PMA supplement to allow marketing of the MAMMOMAT Novation for mobile use. Medical facilities can now “hit the road” with this full field digital mammography system, as it can be hooked up to a mobile coach, offering clinicians improved functionality and flexibility in the mobile environment. Proven in addressing the demands of the modern mammography practice, Siemens' MAMMOMAT Novation provides digital screening, diagnosis and stereotactic biopsy capabilities, all in one system. It enables clinicians to better pinpoint disease and plan treatment. With the mobile configuration, medical facilities can bring digital mammography directly to their patients and offer comprehensive women's health services on the road. Featuring a flat panel detector-based on amorphous Selenium (aSe) technology, MAMMOMAT Novation enables a direct conversion of X-ray to digital information.
Sun Microsystems thanks David
Brailer
Guide for blood cleaning
efficiency developed
by committee on soaps and other detergents
Novation signs new technology
agreement
with Abbott Diagnostics
Obesity a prime agent in the diabetes epidemic
From 1997 to 2003, the incidence of diagnosed diabetes increased 41%, with obesity a major player, researchers at the Centers for Disease Control and Prevention (CDC) reported. During this period, the incidence of diagnosed diabetes among U.S. adults, ages 18 to 79, increased annually from 4.9 to 6.9 per 1,000 population, amounting to a 41% increase over seven years, the researchers reported in the May issue of the American Journal of Preventive Medicine. The data came from the National Health Interview Survey of the CDC's National Center for Health Statistics. All adults who were sampled (approximately 31,000 annually) were asked whether a health professional had ever told them they had diabetes other than during pregnancy. Respondents, about 2,000 annually, were then asked further questions, including age at diabetes diagnosis, health status, ethnicity, education level, and so forth. When the researchers compared the findings for 2002 to 2003 with those for 1997 and 1998, they found an increase in the prevalence of obesity among incident cases, rising to 59.7% in 2002 and 2003, compared with 51.6% in 1997 and 1998, reported Linda Geiss, M.A., Michael Engelgau, M.D., and colleagues at the CDC. Over seven years, the incidence of diabetes increased among men and women, non-Hispanic whites (once low), persons with at least a high school education, nonsmokers, active and inactive persons, and among obese persons, the researchers reported. Multivariate-adjusted incidence increased with age, rising from 2.1 to 2.5 per 1,000 persons among people 18 to 44 years old; from 8.6 to 11.2 per 1,000 among those 45 to 64; and 10.2 to 16.8 per 1,000 among those 65 to 79. Incidence decreased with higher education levels, down from 9.7 per 1,000 among people with less than a high school education to 5.6 per 1,000 for those with more education. Although age-adjusted incidence increased in all ethnic groups, the increase was significant only among non-Hispanic whites. The rates for non-Hispanic blacks were high, 8.2 per 1,000, but due to the small number of cases and limited number of years analyzed, significant differences could not be detected. The rapid increase in diabetes cases was not accompanied by improvements in the health of the incident cases, the CDC researchers wrote. The data suggest that obesity is a major factor, although not the sole factor, in the increasing incidence and that those with newly diagnosed diabetes are becoming more obese, they wrote. “Recent clinical trials have found that lifestyle changes that include moderate weight loss and exercise can prevent or delay the onset of diabetes among high-risk adults.” they concluded. “The development and delivery of lifestyle interventions to people at risk for diabetes are needed to halt the increasing incidence of diabetes.” (MedPage Today)
Sun Microsystems thanks David Brailer
Thursday, Dr. David Brailer announced his resignation as the National Coordinator for Health IT. Brailer was the first person to hold this role in a presidential administration and actively used it as a bully-pulpit to tout the safety and savings benefits of electronic healthcare records and the creation of the National Health Information Network. Following is a statement from Wayne Owens, Sun's SVP & General Manager for Healthcare, regarding Dr. Brailer's departure. “In two years, Dr. Brailer has led the effort to transform Health IT from a desirable, if ethereal, goal to a necessary and critical part of the national agenda for healthcare reform. Brailer united Republicans and Democrats, insurers and technology vendors, consumer groups and health care providers and got them working together to start building a framework for a healthcare system that befits the most innovative nation on the world. Brailer coined the term RHIO. Brailer got the nation thinking and believing that the time is now, the time is right to bring clinical automation and clinical transformation to the healthcare industry. Brailer was the beacon that helped transform President Bush's call to arms for the healthcare industry to automate their old manual systems to state-of-the-art digital information systems that can be shared across the street or across the nation. We owe a large debt to Dr. Brailer, as all journeys begin with a single step, and he has put us on the right path. It will be up to the healthcare industry as a whole to make Brailer's vision a reality. Sun Microsystems thanks Dr. Brailer for his contribution and looks forward to working with his successor on improving the quality and safety of health care through effective implementation of healthcare information networks and electronic health record systems.”
Guide for blood cleaning efficiency developed
by committee on soaps and other detergents
Dried blood represents the greatest challenge to cleaning surgical instruments. To meet this challenge, ASTM International Committee D12 on Soaps and Other Detergents has developed a new standard, D 7225, Guide for Blood Cleaning Efficiency of Detergents and Washer-Disinfectors. The new guide is under the jurisdiction of Subcommittee D12.16 on Hard Surface Cleaning. Water-soluble components of blood are easily rendered insoluble when exposed to heat, chemical solutions, or time at room temperature. The water insoluble components of blood are the coagulating agents. These proteins bind quite readily to the surfaces of surgical instruments, making them difficult to remove even with the aid of chemical-cleaning agents. Instruments contaminated with blood represent a significant threat for contamination to healthcare workers and patients. Healthcare facilities typically employ the use of automated instrument washers. These devices combine mechanical action along with chemical cleaning agents in a staged cycle designed to thoroughly clean surgical instruments, including areas of instruments which are not easy observed (for example, box locks). To function properly, these machines must perform at targeted mechanical efficiency and deliver the correct chemical-cleaning agents at the correct temperature, at the correct dosage for the correct period of time. Failure to meet these parameters will lead to a less than optimal cleaning process. ASTM D 7225 suggests related methods for challenging the removal of standardized test soil as a result of mechanical or chemical action, or both, by the tested detergents or washer-disinfectors, or both. One method involves the use of a stainless steel coupon with dried blood soil held in a plastic holder. When followed, this method provides the user with a qualitative evaluation of cleaning efficiency. Another method utilizes a peroxidase reaction with hemoglobin to test for residual blood soil on presumptively cleaned surfaces. ASTM International standards are available for purchase from Customer Service (phone: 610/832-9585; service@astm.org) or at http://www.astm.org/.
Novation signs new technology agreement with Abbott Diagnostics
Novation, the health care contracting services company of VHA Inc., and the University HealthSystem Consortium (UHC), has signed a single-source, new technology agreement with Abbott Diagnostics for the OraQuick Rapid HIV Test Kit. The agreement began on April 1, 2006 and will run through March 31, 2009. The agreement was not competitively bid, it was awarded through Novation’s new-technology evaluation process, which accelerates the review process so new and improved technologies do not have to wait for a scheduled competitive bid. The process allows VHA and UHC members speedier access to savings on the latest FDA approved medical technology. The OraQuick Rapid HIV Test is a single-use device intended to provide qualitative results for human immunodeficiency virus type 1 (HIV-1) and type 2 (HIV-2) using oral fluid, finger stick, whole blood and plasma specimens. The product is deemed a moderately complex, CLIA waived test, which means it can be used in a physician’s office setting as well as in the clinical laboratory. Other tests on the market do not have CLIA-waived status.
U.S. to kill flocks suspected of having bird flu
NIH researches interregional
spread of influenza
Interdisciplinary team develops guidelines for
treating
severely injured patients
Amerinet
wins the Nielsen Healthcare Group Award,
makes donation to Project Perfect World
Secretary of Health and Human Services Mike Leavitt released the following statement regarding the resignation of David J. Brailer, National Coordinator for Health IT. “It is with regret that I have accepted Dr. Brailer’s resignation as the National Coordinator for Health Information Technology. Over the past two years, David has made significant progress in advancing the President’s health IT agenda and laying the building blocks for future progress. While I will miss him here at HHS, I am pleased that David has agreed to serve as Vice-Chair of the American Health Information Community (The Community), which is charged with making recommendations to the Secretary of HHS to facilitate the development and adoption of standards-based health IT. David has helped the Community identify promising breakthroughs for near-term progress while continuing to move us closer to longer-term health IT goals. David will also continue to serve as a consultant to HHS to help lead the President’s health care transparency initiative. Until a replacement for David’s position is announced, the work of the Office of the National Coordinator will continue under the leadership of the four permanent directors of the office.”
A woman is in stable condition with bubonic plague, the first confirmed human case in Los Angeles County since 1984, health officials said. The woman, who was not identified, was admitted to a hospital April 13 with a fever, swollen lymph nodes and other symptoms. A blood test confirmed the bacterial disease, and she was given antibiotics, officials said. Bubonic plague is not contagious, but if left untreated it can morph into pneumonic plague, which is. Bubonic plague is usually transmitted to humans from the bites of fleas infected by rodents. Health officials said they suspect the woman was exposed by fleas in her home and that there was no cause for alarm. An estimated 10 to 20 Americans contract plague each year, mostly in rural communities. Bubonic plague is believed to have been the “Black Death” that killed 25 million people in Europe between 1346 and 1351. (The Associated Press)
NIH researches interregional spread of influenza
Researchers at the National Institutes of Health (NIH) conclude that the
regional spread of annual influenza epidemics throughout the United States is
more closely connected with rates of movement of people to and from work than
with geographical distance or air travels. They also found that epidemics spread
faster between more populous locations. The research results, published this
week in Science Express, is based on 30 years of weekly data from the National
Center for Health Statistics on influenza-related mortality in different States
since 1972. The investigators reached their conclusions by building a
mathematical model of influenza spread in the
U.S.
based on the historical pattern of epidemics. The results suggest that when
disease is imported into the U.S. in a well-connected state, one with many
inflows and outflows of workers, for example, California, disease spreads much
faster than if disease is imported in a less-connected state, for example,
Wyoming. In observed epidemics, the initial focus of infection varies from year
to year, but epidemics tend to emerge more often from
California
than other less populated states. The model can simulate influenza pandemic
spread, a situation where the greatest majority of the population is susceptible
to a new virus. In this case, transcontinental spread could occur more quickly.
Infection could reach all states within 2-4 weeks, instead of the 5-7 weeks for
annual epidemics, if seeded in a highly connected state. Past research
highlighted the role of children in the local spread of influenza, in
particular, in schools and households. This study, by contrast, suggests that
adults are responsible for the regional spread of influenza because they travel
farther and more frequently. As the speed of influenza spread between states is
affected by work-related population movements and transmissibility,
interventions which limit inter-regional routine travel might slow epidemic
spread. Describing the mechanisms of local spread of influenza within cities or
states is a key area for future work and would provide insight into which
control strategies might be effective to control epidemic and pandemic
influenza, in particular, social distancing measures.
http://www.nih.gov.
Interdisciplinary team develops guidelines
for treating severely injured patients
If someone is injured in an automobile collision or is severely burned,
emergency room physicians across the country would probably take similar steps
to stabilize each condition. But subsequent treatment in the intensive care unit
or operating room is less well established and may vary significantly. That is
likely to change based on the work of an interdisciplinary team of dozens of
scientists and physicians funded by the National Institute of General Medical
Sciences (NIGMS), part of the National Institutes of Health (NIH). Drawing from
the best available evidence, the team is developing a series of standard
procedures for the care of severely injured patients. The guidelines will
describe how to implement the most successful treatment protocols in the clinic
and will include summaries of each procedure ready to print on 3-by-5 index
cards for quick bedside reference. The team’s first article, on mechanical
ventilation, appeared in the September 2005 issue of the
Journal of Trauma: Injury, Infection, and
Critical Care. Planned future topics will cover resuscitation,
prevention and treatment of venous blood clots, diagnosis of
ventilator-associated pneumonia, blood sugar control, nutritional support,
transfusion thresholds, and sedation. The team chose to cover aspects of care
for which practices vary the most and those that have the greatest potential to
influence patient outcomes. The scientific team is part of a collaborative,
NIGMS-supported initiative called the Inflammation and Host Response to Injury
“glue grant” program. Glue grants bring together scientists with diverse
expertise to address major biomedical questions that are beyond the scope of any
one research group, in this case, to uncover why patients who experience
comparable traumatic injuries can have dramatically different outcomes. The
outcomes for trauma and burn patients often depend on the strength of their
inflammatory response to their injury. Inflammation helps the healing process in
many cases, but an excessive response can lead to multiple organ failure, a
common cause of death following a traumatic injury. While the magnitude of the
injury and the quality of care affect the inflammatory response, the patient’s
genetic make-up is also thought to contribute. To pinpoint the relevant genetic
factors, the researchers are looking for gene activity patterns that correlate
with specific outcomes. All nine of the clinical institutions participating in
the project are adopting the standard practices, which will make these genetic
patterns easier to discern. “Establishing standard treatment procedures is an
important first step in improving patient care,” said NIGMS Director Jeremy M.
Berg, Ph.D. “But we expect the real breakthrough to come when genetic data from
the project helps physicians tailor treatments for each critically injured
patient.” While the inflammation glue grant focuses on the care of patients once
at the hospital, a complementary NIH program, the Resuscitation Outcomes
Consortium, aims to improve patient survival before an injured person reaches
the emergency room.
http://www.nih.gov.
Amerinet wins the Nielsen Healthcare Group Award,
makes donation to Project Perfect World
Amerinet was recognized in March as a top partner for the Nielsen Healthcare Group. Amerinet is donating the cash award to the Project Perfect World Foundation. The award recognizes Amerinet members’ high-volume use of Nielsen’s interim managers. Amerinet’s donation will help Project Perfect World achieve its mission of improving the lives of underprivileged children by providing for their health care needs.
CDC report shows life
expectancy at all time high
New study finds lifetime costs
of injuries in billions;
costs associated with a year top $406 billion
While health screenings
proliferate, the number of people
getting the right ones isn't keeping up
The budget of the National Institutes for Health is expected to fall 3.8 percent next year after adjusting for inflation, a top U.S. biomedical researcher said, adding that the budget doubled each year between 1998 and 2003. This “0.1 percent decrease from last year ... will be the first true budgeted reduction in NIH support since 1970 ... this downturn is more severe than we have ever faced previously,” Dr. Joseph Loscalzo, physician-in-chief and chairman of medicine at Brigham and Women's Hospital in Boston, writes in an editorial in this week's issue of the New England Journal of Medicine. That hospital receives about $190 million a year in NIH funding, a spokesman said. “Whereas national defense spending has reached approximately $1,600 per capita, federal spending for biomedical research now amounts to about $97 per capita, a rather modest investment in ‘advancing the health, safety and well-being of our people,’” which is a mission of NIH, Dr. Loscalzo, also professor of medicine at Harvard Medical School, added. The Bush administration has proposed a $28.6 billion budget for NIH in fiscal 2007, a 0.1 percent reduction from last year. NIH is the medical research arm of the U.S. Department of Health and Human Services. “It takes many years for institutions to develop investigators skilled in modern research techniques and to build the costly, complicated infrastructure necessary for biomedical research,” Dr. Loscalzo wrote. Amanda Banks, president of the California Biomedical Research Association, said that “without NIH, no company, institution or individual has the kind of money required to get a drug or medical device from benchtop to bedside. A small decrease in the percentage of funding for NIH represents millions of dollars in grants that won't be there.” Alan Dittrich of the Massachusetts Society for Medical Research said that if Dr. Loscalzo's figures are correct, it will mean an $830 million decrease in funding. “Growth in the NIH budget is essential to keep us in the forefront of medical research,” he said. Mary Woolley of Research America, said: “With inflation factored in, an 0.1 percent budget cut would translate into a decrease of $800-plus million. Medical and health research should be a higher priority, when we are still plagued with a number of diseases and disabilities for which there will be answers in the foreseeable future,” she said. An official of the Bethesda-based Federation of American Societies of Experimental Biology said the U.S. Department of Commerce has estimated NIH's inflation rate at 3.8 percent, which makes the reduction figures provided by Woolley and Dittrich accurate, considering the Bush administration's proposed 2007 budget. (The Washington Times)
Midwest's epidemic of mumps continues;
CDC rushes vaccine to affected states
A Midwest mumps epidemic, already the largest U.S. outbreak of the viral infection in decades, shows no signs of slowing and will probably spread farther before being contained, federal health officials said. The number of cases has more than doubled in the past week, with at least 1,100 reported in Iowa and seven other states, officials said. Investigators in seven more states also are studying possible cases. “This is an unstable situation right now,” said Julie L. Gerberding, director of the federal Centers for Disease Control and Prevention in Atlanta. “We're not reliably able to predict where this will go.” The CDC has dispatched teams to Iowa and Nebraska to help local and state health workers try to contain the outbreak, mainly by urging people to watch for symptoms so they can be diagnosed and isolated quickly, and by inoculating unvaccinated adults. The epidemic has disproportionately affected young, healthy adults, including many college students. Gerberding said she expect expects the outbreak to worsen before it starts to ease. “We expect more cases, definitely,” she said, noting that the virus could spread to other parts of the country as college students who are infected but do not have symptoms leave for the summer and come into contact with other people. Intensifying the campaign to contain the outbreak, the CDC is rushing 25,000 additional doses of vaccine from its stockpile to Iowa, the epicenter of the outbreak, and another 25,000 donated by Merck & Co. to Iowa and other states, Gerberding said. Officials said they would use the vaccine to target high-risk groups, such as college students and health-care workers. But scientists are testing the virus involved in the outbreak to see whether it is unusually infectious or less susceptible to the vaccine, and whether the vaccine is less effective or wears off more quickly than had been thought. Officials suspect the outbreak erupted because the vaccine is not 100 percent effective and the virus took hold in a vulnerable population, mainly college students who did not get both of the recommended shots, triggering a “cascade of transmission that's going to take a while to curtail and stop,” the CDC director said. At least 20 people have been hospitalized, but all have recovered, officials said. The outbreak, which appears to have begun in late December, involves the same strain of the virus that has caused a massive mumps epidemic in Britain over several years. Iowa has been hit hardest, with at least 815 cases. An additional 350 have been reported in Illinois, Kansas, Minnesota, Missouri, Nebraska, Oklahoma and Wisconsin. Officials did not identify the seven other states investigating possible cases. Nationwide, about 200 to 300 mumps cases typically occur annually. (The Washington Post)
CDC report shows life expectancy at all time high
A summary released by the Centers for Disease Control and Prevention, which will be followed by a more comprehensive report to be released in May, is based on approximately 90 percent of death records reported in all 50 states for 2004, and shows an increase in life expectancy and a narrowing of the gender gap. Highlights of the report include: The life expectancy of Americans in 2004, 77.9 years, is the highest it has ever been. The life expectancy for women in the United States is 80.4 years; the life expectancy for U.S. men is 75.2 years. The life expectancy gender gap is narrowing - the 5.2 year difference in 2004 was the smallest difference since 1946. Alzheimer's disease moved into 7th place among leading killers in the United States, passing influenza and pneumonia. Age-adjusted death rates fell to a record low of 801 deaths per 100,000 population in 2004, down from almost 833 deaths per 100,000 in 2003. Total deaths (nearly 2.4 million in 2004) declined almost 50,000 between 2003 and 2004, the biggest one year drop in several decades. The report can be accessed at the CDC/NCHS web site at www.