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August 8-12,
2011
August 12, 2011 Download print version Nurses join other moms to demand protections from toxic chemicals Baptist system, Hardin Memorial to pay nearly $9 million for Medicare claims Parkland's Medicare funding in jeopardy Experts design soft, strong robot for healthcare facilities Pilot study suggests new approach to treat preeclampsia A little exercise may protect the aging brain from memory loss following infection Sleep Apnea tied to worse cognition Baker's yeast protects against fatal infections Charged hospital tech wants to teach Nurses join other moms to demand protections from toxic chemicals Nurses from across the country joined other moms to demand increased protections from toxic chemicals. Local state based-events were held to ask Senate leaders to be “Superheroes” by signing on to co-sponsor and actively support the Safer Chemicals Act of 2011 (S 847). (Events were held in Hartford, CT; Lexington, KY; Portland, ME; Baltimore, MD; Boston, MA; Missoula, MT; New York, NY; Portland, OR; Pittsburgh, PA; and Seattle, WA.) Children participating in the event were dressed in red superhero capes and brought gifts of capes for their Senators. Nurse moms have a greater appreciation for the health impacts of unwanted exposures to toxic chemicals. They have seen the impact of increased health problems such as growing number of people with asthma, cancer, learning disabilities and reproductive issues. Nursing has always been about prevention of illness and disease and nurses believe that better oversight of chemicals and disclosure of the health impacts of chemicals being used in consumer products is essential to improving health. The quest for safer chemicals has gained traction among women of all demographics and political parties. Most recently the issue has captured the attention of celebrity spokespeople like actress and mother, Jessica Alba.
Nurses
expect Congress to step up and protect the American consumers from toxic
chemicals lurking in our homes, schools and workplaces. The Safe Chemicals
Act of 2011 (S847) takes meaningful steps to protect the American public
from toxic chemicals. Introduced by Senator Frank Lautenberg (NJ) the bill
would increase chemical safety, inform consumers and the marketplace on
chemical hazards and protect vulnerable populations like pregnant women and
children. For more information on the events and the work nurses have been
doing to support safer chemicals,
visit here.
Baptist system, Hardin Memorial to pay nearly $9 million for Medicare claims Baptist Healthcare System and Hardin Memorial Hospital have agreed to pay nearly $9 million to resolve claims that they improperly billed Medicare, the U.S. Justice Department and the Department of Health and Human Services announced Thursday. The government’s claims involved alleged overbilling at five hospitals owned by Baptist Healthcare, including Baptist Hospital East in Louisville and Baptist Hospital Northeast in La Grange. Under the settlement, Baptist Healthcare System agreed to pay $5,785,000, and Hardin Memorial, which is managed by Baptist Healthcare, agreed to pay $3,115,000, according to a news release issued by the U.S. attorney’s office. In a prepared statement, Derrick L. Jackson, special agent in charge of HHS’s inspector general’s office in Atlanta, said: “This settlement will return a significant amount of money back to the Medicare Trust Fund that should never have been paid out.” The government claimed that Baptist Healthcare System and the Hardin hospital improperly billed Medicare by submitting claims for a number of inappropriate hospital billing codes for certain serious conditions. The U.S. contended that the billing resulted in higher reimbursement rates than warranted by the actual condition of patients treated. According to the news release, the codes generally related to respiratory infections and inflammations, pulmonary edema, respiratory failure and blood infections. The allegedly improper billing covered by the agreement occurred between 2001 and 2006. Don Riggs, vice president of compliance for Baptist Healthcare System, said in a prepared statement that the company and the Justice Department hired third-party reviewers to examine the disputed claims and each reached different conclusions. “After lengthy negotiations, we agreed to disagree, and Baptist decided it was best to settle,” Riggs said.
The other
hospitals involved were Western Baptist Hospital in Paducah, Central Baptist
Hospital in Lexington and Baptist Regional Medical Center in Corbin. Baptist
Healthcare System and Hardin Memorial Hospital made no admission of
liability, and no issues concerning the quality of patient care were raised
as part of this settlement, according to news release. The money must be
paid by Sept. 1.
Visit the Courier Journal for the article.
Parkland's Medicare funding in jeopardy An unannounced inspection of Parkland Memorial Hospital in Dallas last month found a “serious threat to patient health and safety” that put the hospital in “immediate jeopardy” of losing federal funding. The eight-day review by the agency that administers Medicare and Medicaid found “significant deficiencies” that must be corrected immediately or the hospital could lose its Medicare funding on Sept. 2. Parkland -- the county’s only public hospital -- is operated by the Dallas County Hospital District. The hospital treats about 150,000 people a year in its emergency room and admits more than 40,000. It has 675 beds. In unusually blunt language, the Centers for Medicare and Medicaid Services -- or CMS -- explained the violations in a letter to Parkland’s top executive Dr. Ron Anderson. The violations include issues dealing with infection control, nursing services, medical screening examination and on-call physicians. “The CMS has determined that Parkland Health and Hospital System no longer meets the requirements for participation in the Medicare program because of deficiencies that represent an immediate and serious threat to patient health and safety,” the letter warned. Federal regulators gave Parkland until Aug. 20 to come up with “acceptable plans of correction” and warned the hospital’s Medicare funding could be terminated. “Two Parkland violations relating to infection control and emergency care issues are so serious that they triggered 'immediate jeopardy' status,” CMS spokesman Bob Moos said. “That is the most severe finding we can have in a hospital, and it requires immediate attention.” Such a finding is rare, he said. Each year, only two or three hospitals out of more than 400 statewide face such measures. The Medicare and Medicaid programs provide 35 percent of Parkland's budget. In a statement, Anderson promised action and said safe and quality care is the hospital’s top priority. He said the hospital was in the process of drafting a plan to fix the discrepancies. “Some problems were already known to us,” Anderson said in a letter to hospital employees. “We understand them and have already been working on them. We have a 57-year-old facility that must deliver 21st century medicine.” Another inspection will take place before the Sept. 2 deadline.
A $1.27
billion new Parkland Hospital is under construction across Harry Hines
Boulevard from the old hospital. It will include 38 percent more patient bed
space and modern facilities to improve patient care.
Visit MSNBC for the article.
Experts design soft, strong robot for healthcare facilities Researchers in Japan unveiled a robot that can lift a patient weighing up to 80 kg (176 lbs) off the floor and onto a wheelchair, an innovation they say will free healthcare workers from the back-breaking task. In elderly facilities in Japan, where rapid aging of its society is expected to weigh on the economy, staff are required to lift residents from the floor onto a wheelchair about 40 times a day, a task that is both difficult and energy consuming. Nicknamed RIBA 2, the robot is soft to the touch, moves around on wheels and responds to voice commands. Built with rubber sensors, springs and improved joints at its base and lower back, it can crouch and lift a patient off a Japanese futon, a traditional mat placed on the floor. "It can pick a person up from the floor onto a wheelchair or a bed. The earlier robot could only lift 60 kg," said Shijie Guo, leader of the Robot Implementation Research Team. The team is jointly made up of experts from RIKEN, a natural sciences research institute in Japan, and Tokai Rubber Industries. "It is made of very soft material, of rubber, so it won't hurt a person. Normally, to crouch and lift require a huge motor, which would give us a huge robot. But with this robot, we used a spring," Guo said by telephone.
The project
was funded by the Japanese government and Tokai, and the creators hope to
eventually commercialize the robot, at a time when more resources are needed
to cope with challenges posed by ageing populations around the world.
Visit Reuters for the article.
Pilot study suggests new approach to treat preeclampsia A novel therapy that reduces elevated blood levels of a potentially toxic protein in women with preeclampsia, a dangerous complication of pregnancy, may someday address the therapeutic dilemma posed by the condition – balancing life-threatening risks to the mother with the dangers that early delivery poses to an immature fetus. In a paper receiving online release in the journal Circulation, a team of U.S. and German researchers report promising results from their pilot study of a filtration technology that reduces reduce excess blood levels of soluble Flt-1, a protein that limits the growth of blood vessels, in women with very preterm preeclampsia. "Introducing new therapies in pregnancy is uncommon because of the need to avoid extra risks to both the mother and baby," says Ravi Thadhani, MD, MPH, of the Massachusetts General Hospital (MGH) Division of Nephrology, co-corresponding author of the report. "In this paper we show that a disease that affects thousands of women around the world may one day be able to be managed by the therapy we developed. This was a small, proof-of-concept study to see if the therapy is safe and possibly effective; so larger, randomized trials now need to be done." Affecting 5 to 7 percent of pregnancies, preeclampsia is characterized by high blood pressure, protein in the urine and additional metabolic abnormalities. If symptoms progress, it can lead to kidney or liver failure, brain swelling, seizures and death. Since the only way to halt the process is to deliver the fetus, the earlier in a pregnancy preeclampsia occurs the greater the risk to the baby. Very preterm delivery – before 32 weeks of gestation – has been estimated to increase infant mortality as much as 70 times over full-term delivery at 37 or more weeks. Very preterm babies who do survive may face lifelong complications such as cerebral palsy, so finding an intervention that can safely prolong pregnancy is vitally important. The underlying cause of preeclampsia is still unknown, but one hypothesis is that factors released into the bloodstream by the placenta damage blood vessels throughout the body. In a 2003 study Ananth Karumanchi, MBBS, of the Beth Israel-Deaconess Medical Center, a co-author of the current study, identified soluble Flt-1 (FMS-like tyrosine kinase 1) as a possible factor in preeclampsia. Released by the placenta and other tissues, soluble Flt-1 blocks the vascular growth factor VEGF, which is essential to maintaining healthy blood vessels; and levels of soluble Flt-1 are extremely elevated in women with very preterm preeclampsia. Developing a preeclampsia treatment based on removing a factor like soluble Flt-1 rather than giving a drug that may have side effects of its own presented an attractive strategy. Thadhani and his colleagues adapted the blood-filtering technologies used in apheresis to develop a method of rapidly removing soluble Flt-1 from the bloodstream. Since a blood test to measure soluble Flt-1 levels is available in Germany, Thadhani collaborated with Thomas Benzing, MD, University of Cologne, co-corresponding author of the Circulation paper, and Holger Stepan, MD, of University Hospital Leipzig, on the pilot clinical study. The first phase was designed to confirm the safety of the treatment and determine whether how long it was administered affected how much soluble Flt-1 was reduced. In five patients with very preterm preeclampsia and elevated soluble Flt-1, levels did drop in response to a single treatment, with a greater decrease associated with longer treatment. There were no major side effects, but because the treatment sessions were brief, no extension of pregnancy was expected or seen.
The
researchers then offered three women with very preterm preeclampsia – from
27 to 30 weeks – the opportunity to receive several treatment sessions in an
attempt to extend their pregnancies. Two patients, one of them carrying
twins, received two treatments; and the third received four. After each
treatment session, the patients' soluble Flt-1 levels dropped from 20 to 30
percent for several days and urinary protein levels also dropped. Various
factors, including recurrence of preeclampsia symptoms, eventually required
premature delivery of the babies; but the pregnancies had been maintained
from two to three weeks after hospital admission. A comparison group of
patients that received standard monitoring required delivery an average of
3.6 days after admission. While the babies of women receiving the novel
treatment needed the type of support typically required for premature
infants, they all were discharged from the hospital with few complications.
Visit Mass General for the article.
A little exercise may protect the aging brain from memory loss following infection A small amount of exercise shields older animals from memory loss following a bacterial infection, according to a study in the August 10 issue of The Journal of Neuroscience. The findings suggest moderate exercise may lead to several changes in the brain that boost its ability to protect itself during aging — a period of increased vulnerability. In the new study, researchers led by Ruth Barrientos, PhD, of the University of Colorado at Boulder, found running on an exercise wheel protected older rats from memory loss following an Escherichia coli (E. coli) infection. Wheel-running also blunted changes in the hippocampus — an area of the brain involved in learning and memory — that typically follow bacterial infection in aging animals. In humans, older adults are more likely than the young to suffer memory impairment following severe bacterial infection or injury. "This is the first study to show that exercise reduces susceptibility to the cognitive impairments that follow infection in aging animals, and the changes taking place in the brain thought to underlie these impairments," Barrientos said.
Bacterial
infections kick off a cascade of events that signal the brain that something
is wrong. Barrientos and colleagues previously found older rats experienced
memory loss following E. coli infection, an outcome not seen in young adult
rats. They also found the microglia — immune defense cells in the brain — of
older animals became more reactive to infection, releasing more chemicals
involved in inflammation in the hippocampus, in contrast with younger
animals.
Visit here for the article.
Sleep Apnea tied to worse cognition Older women with sleep-disordered breathing are more likely to develop cognitive impairment than those who don't have sleep problems, researchers found. Through nearly five years of follow-up, women 65 and older who had sleep-disordered breathing at baseline had a higher rate of incident mild cognitive impairment or dementia (44.8% versus 31.1%), according to Kristine Yaffe, MD, of the University of California San Francisco, and colleagues. After adjustment for numerous potential confounders, including baseline cognition, women with sleep-disordered breathing maintained a higher likelihood of cognitive impairment (OR 2.36, 95%), the researchers reported in the Aug. 10 issue of the Journal of the American Medical Association. "Given the high prevalence of both sleep-disordered breathing and cognitive impairment among older adults, the possibility of an association between the two conditions, even a modest one, has the potential for a large public health impact," they wrote. These findings and those from related studies, according to Nicola Canessa, PhD, and Luigi Ferini-Strambi, MD, of Vita-Salute San Raffaele University in Milan, "suggest that large trials with continuous positive airway pressure treatment in elderly participants with sleep-disordered breathing should be performed." "Moreover," they wrote in an accompanying editorial, "in trials evaluating the effects of pharmacological and nonpharmacological ... interventions on cognitive function in patients with mild cognitive impairment or dementia, the possible coexistence of sleep-disordered breathing should be considered." Although previous studies have linked sleep-disordered breathing with poor cognition, it had remained unclear whether the sleep problem preceded cognitive decline in older adults, according to the researchers. To explore the issue, they evaluated data on 298 older women (mean age 82) who were free of dementia at baseline and who participated in the sleep and cognition substudy of the Study of Osteoporotic Fractures. All underwent overnight polysomnography in their homes for one night at baseline, which revealed that about one-third (35.2%) had sleep-disordered breathing, defined as 15 or more apnea or hypopnea events per hour of sleep. Through a median follow-up of 4.7 years, 20.1% of the participants developed mild cognitive impairment and 15.8% developed dementia. Women who had sleep-disordered breathing were significantly more likely to develop cognitive impairment during follow-up, after adjustment for age, race, body mass index, education, smoking status, diabetes, hypertension, medication use, and baseline cognition.
Although
sleep fragmentation and duration were not related to the odds of developing
cognitive impairment, two measures of hypoxia -- an elevated oxygen
desaturation index and a high percentage of sleep time in apnea or hypopnea
-- were associated.
Visit JAMA for the study.
Baker's yeast protects against fatal infections Injecting mice with simple baker's yeast protects against the fatal fungal infection, aspergillosis, according to research published in the Journal of Medical Microbiology. The work could lead to the development of a human vaccine that protects immunocompromised people against a range of life-threatening fungal infections, for which current therapy often fails. Researchers from the California Institute for Medical Research, Santa Clara Valley Medical Center and Stanford University gave mice three injections of killed Saccharomyces (baker's yeast), one week apart. Vaccinated mice were able to survive high doses of Aspergillus – the fungus that causes aspergillosis. Mice that survived also showed a reduced infection load in their organs. Aspergillosis is the leading fungal killer among immunocompromised individuals. It is an invasive infection that attacks the lungs, can disseminate to other organs, such as the brain, and can lead to kidney and liver failure. The disease currently has very high mortality as the current available therapy has a high failure rate. The research team used a simple yeast preparation as a vaccine against Aspergillus in mice. They found that unmodified yeast gave just as much protection against the development of aspergillosis as yeasts that had been engineered to display Aspergillus surface proteins. Dr. David A. Stevens, from Santa Clara Valley Medical Center, in whose laboratory the studies were performed, said, "Our results suggest that the protective component of the yeast is in the cell wall. What's more, the simple preparation we used has been shown by us to also protect against infection due to three other fungi that cause human disease – Candida, Cryptococcus and Coccidioides."
Baker's
yeast is being studied by other groups in human clinical trials for other
purposes and appears to be safe. "Research to date, including our study,
supports the development of a yeast vaccine against all pathogenic fungi
that infect humans. Such a 'panfungal' vaccine would further reduce
mortality in immunocompromised individuals," explained Dr. Stevens. "While
vaccinating all individuals with impaired immune systems would be a
formidable challenge, there are certain patient groups that might be the
initial target of a vaccine effort. These include transplant candidates,
leukemics following induction therapy and also patients diagnosed with solid
tumors."
Visit Science Daily for the article.
Charged hospital tech wants to teach PROVIDENCE, R.I. - An orthopedic technician accused of taking part in an illegal prescription drug ring is asking a judge for permission to travel so he can teach his trade. Gary Menissian, 49 of East Providence, is charged with fraudulently obtaining, distributing and dispersing prescription drugs in a shocking case centered out of Rhode Island Hospital. He’s accused by the Drug Enforcement Agency of acting as a middleman in a drug scheme that also implicates an orthopedic surgeon. In the wake of the charges, Menissian had his license suspended by the state. In a filing made late last week, Menissian's attorney is asking a judge to allow his client to travel to Maine, Massachusetts and New Hampshire "for purposes of his employment." "He has been scheduled to perform services as an independent contractor, teaching classes to orthopedic technicians," the filing states. The court filing does not name the institutions where Menissian is scheduled to teach or say if they have been informed of the pending charges. Menissian was arrested Aug. 3 along with orthopedic surgeon Robert Villarreal, 33 of Providence. Prosecutors said Villarreal performed surgeries under the influence of prescription drugs and confessed to a DEA agent to consuming up to 20 Adderall pills a day. Villarreal was a resident at the hospital from 2005 to 2010. He then worked junior attending physician/trauma fellow until June 2011. A hospital spokeswoman said his surgeries were always supervised. Villarreal is accused of forging prescriptions for several employees at Rhode Island Hospital including Vicodin, Percocet and Adderall. In exchange, investigators say he would get a cut of the drugs for personal use. Prosecutors said Menissian coordinated several of the alleged drug deals. He was released on $10,000 unsecured bond and ordered to stay in Rhode Island.
Villarreal
was released on $50,000 unsecured bond and ordered to undergo drug
treatment. A spokeswoman at Rhode Island Hospital said Villarreal’s
privileges at Rhode Island Hospital were revoked as soon as they learned of
his arrest.
Visit WPRI for the article.
August 11, 2011 Download print version New study finds revenue is growing at slowest rate in two decades, leading to uptick in mergers Test can tell fetal sex at 7 weeks, study says California medical board fails to discipline 710 troubled doctors Patient monitors unsafe from hackers Don't take chances with heat, CDC warns DaVita to launch dialyzer recycling pilot project through collaboration with Waste Management and BD Stress MRI in ER reduces chest pain costs Basis for battery-powered skin patch for wider range of protein-based medicines New study finds revenue is growing at slowest rate in two decades, leading to uptick in mergers Nonprofit hospitals are under increasing financial pressure, with revenue growing at the slowest rate in at least two decades, according to a new report from Moody's Investors Service. The 4% median revenue growth rate, based on a review of 401 hospitals' fiscal 2010 financial results, is the lowest the firm has seen since it started tracking the figure two decades ago, Moody's officials said in a report set to be issued Wednesday. Though the hospitals have been pushing hard to reduce expenses over the past few years, around 20% of those in the study were still running in the red on an operating basis. Even those that were in the black achieved fairly thin margins, with 63% of all the hospitals achieving results between break-even and 5%. Nonprofits, including those owned by state and local governments, represent around 80% of U.S. acute-care hospitals, according to the American Hospital Association. One upshot of the tough times is an uptick in hospital mergers, as smaller hospitals seek to link up with larger systems or sell themselves to for-profit operators. In the first six months of this year, there have been 55 deals, more than double the 26 deals at this time last year, according to Irving Levin Associates in Norwalk, CT, a research firm that tracks healthcare transactions. The full number for 2010, 72, was already the highest since 2001. "It's a way to get to the next level of economies of scale," says Ralph de la Torre, chief executive of Steward Health Care System LLC. Dr. de la Torre has been on both ends of the deal-making. Steward was created when Cerberus Capital Management LP took over the ailing six-hospital Catholic system Caritas Christi in Massachusetts last year, and since then the company has struck deals to acquire seven more hospitals, with two closed and five currently pending. Americans have been cutting back on their use of medical services, particularly inpatient ones, the most lucrative for hospitals. Inpatient admissions rates dropped 0.4% in fiscal 2010 compared with the previous year—the first time the firm has seen such a negative admissions number, said Lisa Goldstein, a senior vice president at Moody's. Much of that reflects a downturn in elective surgeries such as knee and hip replacements, she said. Hospitals have been facing cuts in payments from state Medicaid programs. What's more, the financial picture is likely to get even bleaker. States continue to dig for Medicaid savings, while the federal Medicare program is phasing in cutbacks mandated under the national health-overhaul law, as well as possible future reductions tied to the recent debt-ceiling deal.
"The trends
have become more pressing in 2011, no question," said Paul Mango, a director
at McKinsey & Co. At the same time, hospitals are trying to make new
investments in facilities and technology such as electronic health records.
Visit the Wall Street Journal for the article.
Test can tell fetal sex at 7 weeks, study says A simple blood test that can determine a baby’s sex as early as seven weeks into pregnancy is highly accurate if used correctly, a finding that experts say is likely to lead to more widespread use by parents concerned about gender-linked diseases, those who are merely curious and people considering the more ethically controversial step of selecting the sex of their children. The appeal of the test, which analyzes fetal DNA found in the mother’s blood, is that it can establish sex weeks earlier than other options, like ultrasound, and is noninvasive, unlike amniocentesis and other procedures that carry small risks of miscarriage. The finding came in a study published online Tuesday in The Journal of the American Medical Association. The tests have been available to consumers in drugstore chains and online for a few years, but their use has been limited, partly because their accuracy was unclear. One company, which guaranteed 99.9 percent accuracy as early as five weeks into pregnancy, filed for bankruptcy after a lawsuit by scores of women whose tests showed the opposite sex of the baby they ended up having. European doctors now routinely use the tests to help expectant parents whose offspring are at risk for rare gender-linked disorders determine whether they need invasive and costly genetic testing. For example, Duchenne muscular dystrophy affects boys, but if the fetus is not the at-risk sex, such tests are unnecessary. But doctors in the United States generally have not prescribed the tests because they are unregulated and medical labs are not yet federally certified to use them. That and other aspects of the pregnancy landscape could change as a result of the new study. The journal study analyzed reams of research on fetal DNA tests — 57 studies involving about 6,500 pregnancies — and found that carefully conducted tests could determine sex with accuracy of 95 percent at 7 weeks to 99 percent at 20 weeks. One potential worry is that women might abort fetuses of an undesired sex. Several companies do not sell tests in China or India, where boys are prized over girls and fetuses found to be female have been aborted. While sex selection is not considered a widespread objective in the United States, companies say that occasionally customers expressed that interest, and have been denied the test. A recent study of third pregnancies in the journal Prenatal Diagnosis found that in some Asian-American groups, more boys than girls are born in ratios that are “strongly suggesting prenatal sex selection,” the authors said. At least one company, Consumer Genetics, which sells the Pink or Blue test, requires customers to sign a waiver saying they are not using the test for that purpose. “We don’t want this technology to be used as a method of gender selection,” said the company’s executive vice president, Terry Carmichael. Sex-determination tests are part of a new frontier of fetal DNA testing, which can be used to determine paternity and blood type, and is being used to develop early screening tests for genetic diseases like Down syndrome. The new study found that to be reliable, the sex-determination tests had to be performed after at least seven weeks of gestation. Most tests that were highly accurate were conducted on a mother’s blood, not urine. And certain rigorous laboratory procedures had to be followed. For the blood tests, women prick their fingers and send blood samples to labs. If the Y chromosome is detected, the fetus is male. Absence of a Y chromosome would probably mean the fetus is female, but could mean that fetal DNA was not found in that sample. The tests are not regulated by the Food and Drug Administration because they are not used for medical purposes, a spokeswoman said, but the agency is investigating the explosion of home genetic tests like these and genome-sequencing kits. A typical blood test like Pink or Blue, for example, costs $25 for the kit. Lab fees and shipping costs, which vary, bring the total expense to $265 to $330. Another type of test not studied by the researchers has become popular because it is cheaper and can be done at home. These tests analyze hormones in women’s urine, a method that several experts said has not been studied as rigorously as DNA. Rebecca Griffin, a founder of the biggest seller, Intelligender, said two independent studies found it 90 percent accurate at 10 weeks. Another company, TrovaGene, has developed a DNA test using urine, which, according to Gabriele Cerrone, TrovaGene’s co-founder and director, is 95 percent accurate at predicting boys at seven weeks, and 88 percent accurate at predicting girls. TrovaGene is also developing a test for Down syndrome.
The Pink or
Blue test, which claims 95 percent accuracy at seven weeks and gives refunds
for wrong results, appears to meet the standards described in the new study.
Visit the New York Times for the article.
California medical board fails to discipline 710 troubled doctors California's medical board failed to discipline 710 troubled doctors even as they were disciplined by hospitals, surgical centers and other healthcare organizations in the state, according to a report released Tuesday. The report by Washington, DC-based nonprofit Public Citizen was based on an analysis of doctors' records in the National Practitioner Data Bank from 1990 to 2009. The Department of Health & Human Services uses the data bank to track doctors' discipline, medical malpractice payments and other actions. The data released to Public Citizen did not name the doctors or their workplaces. Of the doctors who escaped state discipline in California, 35% had racked up more than one disciplinary action from another entity, according to the report. "If the hospital or HMO has taken action, why hasn't the board?" asked Dr. Sidney Wolfe, director of Public Citizen's health research group. "That's something that as a physician or a patient I would be worried about. Hospitals rarely discipline doctors. When they do, it's usually for very serious infractions." Jennifer Simoes, a Medical Board spokeswoman, said officials have reviewed the report but more analysis is needed. At least 102 of the doctors who escaped discipline in California had their privileges to practice at a given facility suspended, limited or revoked after peer reviews, according to the report. The report described some California cases without identifying the doctors involved, including:
California's Medical Board has done a less thorough and timely job of
disciplining doctors than other states', according to the report.
California's board ranked 35th in the nation for the rate at which it
disciplined doctors, down from 27th five years ago, according to Public
Citizen. It took board investigators more than 400 days on average to
complete an investigation, according to the board's most recent annual
report. State law mandates that the board take no more than 180 days.
Visit the Los Angeles Times for the article.
Patient monitors unsafe from hackers Even the human bloodstream isn't safe from computer hackers. A security researcher who is diabetic has identified flaws that could allow an attacker to remotely control insulin pumps and alter the readouts of blood-sugar monitors. As a result, diabetics could get too much or too little insulin, a hormone they need for proper metabolism. Jay Radcliffe, a diabetic who experimented on his own equipment, shared his findings with The Associated Press before releasing them Thursday at the Black Hat computer security conference in Las Vegas. "My initial reaction was that this was really cool from a technical perspective," Radcliffe said. "The second reaction was one of maybe sheer terror, to know that there's no security around the devices which are a very active part of keeping me alive." Increasingly, medical devices such as pacemakers, operating room monitors and surgical instruments including deep-brain stimulators are being made with the ability to transmit vital health information from a patient's body to doctors and other professionals. Some devices can be remotely controlled by medical professionals. Although there's no evidence that anyone has used Radcliffe's techniques, his findings raise fears about the safety of medical devices as they're brought into the Internet age. Serious attacks have already been demonstrated against pacemakers and defibrillators. Medical device makers downplay the threat from such attacks. They argue that the demonstrated attacks have been performed by skilled security researchers and are unlikely to occur in the real world. But hacking is like athletics. Showing that a far-fetched attack is possible is like cracking the 4-minute mile. Once someone does it, others often follow. Free or inexpensive programs eventually pop up online to help malicious hackers automate obscure attacks. Though there has been a push to automate medical devices and include wireless chips, the devices are typically too small to house processors powerful enough to perform advanced encryption to scramble their communications. As a result, most devices are vulnerable. Radcliffe wears an insulin pump that can be used with a special remote control to administer insulin. He found that the pump can be reprogrammed to respond to a stranger's remote. All he needed was a USB device that can be easily obtained from eBay or medical supply companies. Radcliffe also applied his skill for eavesdropping on computer traffic. By looking at the data being transmitted from the computer with the USB device to the insulin pump, he could instruct the USB device to tell the pump what to do. Although an attacker would need to be within a couple hundred feet of the patient to pull this off, a stranger wandering a hospital or sitting behind a target on an airplane would be close enough. Radcliffe also found that it was possible to tamper with a second device he wears. He found that he could intercept signals sent wirelessly from a sensor to a machine that displays blood-sugar levels. By broadcasting a signal that is stronger than the real-time, authentic readings, the monitor would be tricked into displaying old information over and over. As a result, a patient who didn't notice wouldn't adjust insulin dosage properly. With a powerful enough antenna, Radcliffe said, an attacker could be up to half a mile away. This attack worked on two different blood-sugar monitors, Radcliffe said. Radcliffe refused to identify any of the three device makers, in part out of concern for his own safety. He is concerned that the devices don't appear to have an easy way to be updated with new software to fix the problems. He said he intends to notify the manufacturers after Thursday's presentation outlining the weaknesses. The hacking fears come on top of human errors and technical glitches tied to medical devices. The U.S. Food and Drug Administration has identified software and design errors as critical concerns in investigating hundreds of deaths potentially linked to drug pumps. FDA officials declined to comment specifically on Radcliffe's findings, saying they hadn't seen the research. But the FDA said that any medical device with wireless communication components can fall victim to eavesdropping. It warns device makers that they are responsible for making sure they can update equipment after it's sold.
Radcliffe
said the point of his research is not to alarm people. He said the issues
he's discovered are important to address publicly as the medical industry
moves aggressively toward more networked devices. (Associated Press)
Visit here for the article.
Don't take chances with heat, CDC warns The lingering high-risk conditions for heat illness mandate special precautions for athletes and fitness enthusiasts, the CDC has warned in a public advisory. Taking steps to prevent heat illness and recognizing and responding quickly to the signs of heat-related illness afford the best protection against potentially fatal exposures to heat and humidity. "Any athlete dying from heat is a tragedy that can be prevented," Robin Ikeda, MD, of the CDC's noncommunicable diseases and environmental health section, said in a statement. "Coaches, parents, teachers, and athletes should educate themselves on how to recognize and prevent heat-related illness." The unprecedented heat wave that has affected much of the United States has led to a mounting toll of heat-related illness and death. Within the past two weeks, at least four heat-related deaths have occurred among football players and coaches engaged in preseason practices. The combination of high heat and humidity and increased body weight make football players especially susceptible to heat-related illness. During a media briefing sponsored by the Union of Concerned Scientists, speakers said the rate of heat-related illness and death among football players has increased since the mid-1990s. A recent study by the CDC documented 118 instances from 2005 to 2009 when football players were withheld from practice or games because of heat illness. According to the public advisory from the CDC, heat illness among participants in sports and recreation resulted in almost 6,000 emergency department visits each year.
The CDC has
published a "toolkit" to educate the public about recognizing and responding
to symptoms of heat illness. The agency also has developed an accredited
Internet-based course about heat illness, which is primarily for athletic
coaches but might also be helpful to school nurses and trainers. (MedPage
Today)
Visit here for the article.
DaVita to launch dialyzer recycling pilot project through collaboration with Waste Management and BD DaVita Inc., a provider of kidney care services for those diagnosed with end stage renal disease (ESRD) and chronic kidney disease (CKD), announced the company is leveraging the expertise of WM Healthcare Solutions, Inc., a subsidiary of Waste Management, Inc., and BD (Becton, Dickinson and Company) to launch a dialyzer recycling pilot in 106 DaVita dialysis clinics in Southern California. This recycling pilot project is expected to be the first of its kind in North America. “We have the potential to offset 350,000 pounds of dialyzer waste in this trial alone, which is incredible because until now, there has not been a ‘green’ way to dispose of dialyzers or other medical waste,” said Kent Thiry, chairman and CEO of DaVita. “This pilot program has the potential to change the landscape of sustainable health care, particularly in the dialysis industry, and we are excited to be at the forefront of it.” This dialyzer recycling pilot builds on business solutions developed by BD and WM through the BD ecoFinity Life Cycle Solution program, which DaVita is also launching in the 106 pilot facilities. With the BD ecoFinity program, single-use medical sharps devices such as needles and syringes are collected on-site, then treated and processed by WM to recover reusable materials. BD then uses the recycled plastic to make new BD container products. The dialyzer recycling pilot follows a similar process: WM will treat and recover recyclable materials from the dialyzers, and then BD plans to use the recycled plastic to make new BD products or other applications, creating a closed-loop waste recovery solution of the recyclable materials.
DaVita was
recently recognized with a Green Leadership Award from BD at a World
Environment Day celebration for its commitment to sustainable health care by
implementing innovative programs to reduce the company’s environmental
impact. DaVita was one of three health care companies to receive this award.
For more information about the BD ecoFinity program, visit
www.bd.com/ecofinity.
Stress MRI in ER reduces chest pain costs For patients with chest pain who have intermediate cardiovascular risk, avoiding hospital admission by remaining in an emergency department observation unit and undergoing stress magnetic resonance imaging reduces costs without worsening outcomes, researchers found. Including the initial visit for chest pain, overall direct medical costs for the patients who underwent imaging in the observation unit were lower through one year of follow-up (mean $3,101 versus $4,742), according to Chadwick Miller, MD, of Wake Forest University in Winston-Salem, NC, and colleagues. That was driven by fewer cardiac-related emergency department visits and hospitalizations and cardiac catheterizations, the researchers reported in the August issue of JACC: Cardiovascular Interventions. Chest pain observation units in the emergency department -- recommended by the American College of Cardiology and American Heart Association -- have been shown to reduce the costs of an initial hospital visit for patients with chest pain. Those with intermediate cardiovascular risk, however, are still often admitted. A previous study by Miller and colleagues in which patients were randomized to observation unit care combined with an order for a stress cardiac MRI scan or standard inpatient care showed that the median cost of the initial visit was reduced by $588. In the current study, the researchers evaluated cost differences up to one year after discharge. They randomized 109 patients -- 52 in the observation unit group and 57 in the inpatient group -- in the emergency department of a tertiary care medical center. All of the patients had intermediate risk, defined as at least intermediate probability that the symptoms were related to an acute coronary syndrome or a TIMI risk score of 2 or higher. Of the 52 patients in the observation unit, only 11 were ultimately admitted to the hospital. Only three of the 57 patients in the inpatient group were not admitted. Only four of the patients in the observation unit did not undergo stress cardiac MRI. The inpatients underwent a mix of evaluations, including stress cardiac MRI, stress echocardiography, cardiac catheterization, or no stress testing or catheterization. The overall first-year costs were significantly lower for those who were treated in the observation unit, even after excluding the costs from the initial visit -- $29 versus $152. Most of the patients in both groups combined (83%) had no more than two cardiac-related outpatient visits in the year after discharge. During follow-up, however, a smaller percentage of patients who were treated in the observation unit had a cardiac-related visit to the emergency department (15% versus 37%), a cardiac-related hospitalization (12% versus 35%), or a cardiac catheterization (15% versus 33%). Those treated in the observation unit were more likely to receive stress testing during the index visit and follow-up (96% versus 79%).
Miller and
colleagues noted that there were several potential reasons for lower costs
in the patients who underwent stress imaging in the observation unit: those
patients may have been more carefully selected for revascularization during
the index visit, they may have felt more reassured and thus were less likely
to return to the emergency department, or a recent cardiac MR test could
have affected physician behavior after discharge.
Visit MedPage Today for the article.
Basis for battery-powered skin patch for wider range of protein-based medicines Scientists have confirmed the feasibility of using a new drug delivery system — the basis for a battery-powered skin patch — to administer medication that shows promise for treating peripheral artery disease (PAD) and healing stubborn skin ulcers and burns. The needle-free delivery of the medication, which cannot be given by mouth and can have side effects when injected, is reported in the ACS journal, Molecular Pharmaceutics. Yogeshvar Kalia and colleagues explain that the medication consists of fibroblast growth factors (FGFs), proteins that have shown promise for treating skin conditions and PAD, which causes pain in the legs, buttocks, and feet due to blocked arteries in the legs. However, FGFs become inactive if given by mouth, and their injection can result in kidney and eye damage. The scientists had previously shown that a drug delivery technology called transdermal iontophoresis can deliver medicines made from small proteins. But would the technique, which involves encouraging medicine through the skin with a small electric current, work for larger proteins like FGFs?
Their
laboratory tests with samples of human skin and pig skin showed that
iontophoresis did work – in contrast, no FGF was delivered without
electricity. Four times more medication remained in the skin than passed
through which was also an advantage. Most importantly, the medicine remained
biologically active in the skin. The results confirm the feasibility of
using iontophoresis to deliver medicines consisting of larger proteins,
including FGFs, the scientists note.
Visit ACS for the article.
August 10, 2011 Download print version Colorado fines closed medical imaging company $3.2 million Contained medication system now keeping hospitals compliant with latest legislation Better mattresses could save hospitals money Charity-care hospital regulations scrutinized TECSYS launches new innovation in healthcare HHS awards Affordable Care Act funds to expand access to healthcare Colorado fines closed medical imaging company $3.2 million Colorado has leveled a $3.2 million fine against a defunct medical imaging company accused of performing X-rays and other scans without doctor supervision or referrals, authorities said on Monday. The penalty imposed on Heart Check America, which operated clinics in several states, is the largest ever imposed by the state's radiation regulators, the Colorado Department of Public Health and Environment said in a written statement. It
cited Heart Check for nine violations of Colorado regulations involving
radiation controls. In addition to the lack of physician oversight and
referrals, the company kept inadequate records and failed to properly train
its employees and monitor their exposure to radiation, the department said.
Contained medication system now keeping hospitals compliant with latest legislation In its efforts to further advance best practices with the continuous improvement of safety, B. Braun Medical Inc. (B. Braun) announced that its OnGuard Contained Medication System can help increase institution and new legislation compliance regarding the protection of healthcare workers from exposure to hazardous drugs. Senate Bill 5594 has recently directed The Washington State Department of Labor & Industries to adopt requirements for the handling of hazardous drugs in protecting healthcare workers from occupational drug exposure. Rules focused on proper ventilation, protective equipment, and safe handling practices have been addressed in detail. Amid many reports nationally on the adverse health effects of occupational hazardous drug exposure, Washington is the first state in the nation to require such protection for its workers. Studies have shown certain drugs, such as chemotherapy agents, can be associated with a variety of both short-term and long-term health effects. OnGuard is a next-generation closed system drug-transfer device. The innovative drug admixture and delivery system meets The American Society of Health-System Pharmacists (ASHP), National Institute for Occupational Safety and Health (NIOSH) and USP <797> safety guidelines and provides a new level of hazard protection for pharmacists and nurses on the frontline of chemotherapy preparation and administration.
Prior to Bill 5594, ASHP, NIOSH and USP <797> had each recommended the use
of protective devices for the preparation of hazardous medications. After
its passing, NIOSH teamed up with OSHA and The Joint Commission, sending a
letter to all U.S.
hospitals reinforcing the need to address safe drug handling at their
facilities. For more information, visit
www.bbraunusa.com.
Better mattresses could save hospitals money Hospitals that invest in pressure-redistribution foam mattresses in the emergency department could save money in the long run by reducing the burden of pressure ulcers among elderly patients. The study published online last week in Annals of Emergency Medicine calculates the average cost of the upgrades at 30 cents per patient ("Early Prevention of Pressure Ulcers Among Elderly Patients Admitted Through Emergency Departments: A Cost-effectiveness Analysis"). "Hospitals could save $32 per patient by preventing pressure ulcers among the elderly," said lead study author Ba' Pham, MSc, PhD of The University of Toronto. "Most pressure ulcers are preventable, which is why they are considered a 'never event' by the Centers for Medicare and Medicaid Service (CMS). Upgrading to better mattresses will not only save money, but it will prevent needless suffering among elderly patients." Researchers studied the cost-effectiveness of pressure-redistribution foam mattresses on emergency department stretchers and beds for early prevention of pressure ulcers in elderly admitted emergency department patients. They found that early prevention was 82 percent likely to be cost-effective.
Every year, approximately 6.2 million hospital admissions through emergency
departments involve elderly patients at risk of developing pressure ulcers.
Earlier studies have found that approximately 6 percent of patients admitted
through the emergency department acquired pressure ulcers within 48 hours of
admission. CMS will not reimburse hospitals for the cost of treating
hospital-acquired pressure ulcers.
Whitepaper examines the proliferation of mobile device alternatives in today’s evolving healthcare landscape Today’s U.S. healthcare providers face a three-pronged deluge of demands from patients, insurance companies, and the government. To successfully address these new and evolving expectations, members of the medical sector must leverage the capabilities of new wireless technologies – or fall behind their more savvy competitors. Frost & Sullivan recently published a whitepaper, Mobile Devices and Healthcare: What’s New, What Fits, and How Do You Decide?, which examines the strengths and drawbacks of four major mobile device types – smartphones, tablets, push-to-talk communication devices, and machine-to-machine (M2M) remote medical monitoring devices. Each device category is evaluated for application in three unique environments – the hospital, physician’s office, and the patient’s home. Criteria for selecting a mobility partner are also discussed. “The healthcare sector has never been known for being an early adopter of information technology. However, now there are innovative, powerful mobile devices that must be recognized as absolutely key to expanding and improving patient care, to controlling costs, and to complying with regulatory mandates,” said Frost & Sullivan Senior Industry Analyst, Jeanine Sterling. Smartphone penetration among U.S. healthcare providers continues to surge, and understandably so. As these devices have become more powerful and convenient, their assortment of medical software applications has grown. Caregivers can now use their smartphones to easily access medical reference libraries, view lab results, monitor patient vitals, and access patient electronic health records (EHR). A second device category – today’s next-generation tablets – is now taking these capabilities and magnifying their usefulness with the aid of larger screens, high-resolution displays, and dual cameras. Even the familiar push-to-talk devices are augmenting their instant voice communications benefit with new form factors and an array of new capabilities, providing needed functionality in multiple scenarios, including the emergency room and in natural disaster situations. And, lastly, M2M remote monitoring devices are starting to bridge the geographic gap between healthcare providers and patients who find it difficult to make in-person office visits. In addition to supporting patients with chronic conditions, M2M technology is being used for personal wellness monitoring and for helping elderly or at-risk individuals to live independently. M2M is improving outcomes and cutting expense – a win-win combination of benefits that few can afford to ignore.
Please visit
here, if you are interested in receiving a copy of the Mobile Devices
and Healthcare: What’s New, What Fits, and How Do You Decide? white paper.
Charity-care hospital regulations scrutinized Georgia’s not-for-profit hospitals receive millions of dollars a year in federal, state and local tax breaks. Residents pay more in taxes because these hospitals are exempt. In exchange, taxpayer-subsidized hospitals are expected to provide charitable services — “a community benefit.” But Georgia, like 35 other states, has no specific requirements hospitals must meet to justify these tax breaks. And an Atlanta Journal-Constitution analysis of hospital data reveals that some not-for-profit hospitals provide less in community benefits — specifically, charity healthcare for the poor — than the tax-paying, for-profit hospitals they compete with. Atlanta’s Piedmont Hospital is an example. It is considered a charity, but this tax-exempt hospital consistently spent a smaller percentage of its adjusted gross revenue on uncompensated care than many of metro Atlanta’s for-profit hospitals from 2007-09. Piedmont is among 18 not-for-profit hospitals in Georgia and four in metro Atlanta that spent less than 3 percent of adjusted gross revenue on uncompensated charity care from 2006-09. Three percent is a meaningful metric. In the only instance where Georgia requires hospitals to provide a minimum level of charity care — when they apply for permission to expand facilities or services — it requires 3 percent. Nina Day, vice president of corporate communications and community affairs for Piedmont, said the hospital provides other charitable benefits to the community: a monthly cardiology clinic, cancer wellness programs and free lab work for two clinics in low income areas. What those services are worth compared to their tax exemption is unclear. Piedmont and other not-for-profit hospitals aren’t required to disclose that. Now, with tax revenues shrinking and the cost of public healthcare rising, policy makers across the country are starting to require not-for-profit hospitals to provide more evidence of tangible community benefits. The Patient Protection and Affordable Care Act, adopted by congressional Democrats last year, requires not-for-profits to assess community healthcare needs and inform patients of their charity care policies. Across the political aisle, Sen. Chuck Grassley, R-Iowa, spearheaded a Senate investigation of the value of not-for-profit hospital community benefits. Exactly how much in taxes not-for-profit hospitals are avoiding is unknown because neither state nor federal officials calculate the total value of the exemptions. But estimates run well into the millions of dollars. By comparison, Tenet Healthcare Corp., a for-profit system of five Georgia hospitals, paid $10.1 million last year in local, state and federal taxes. John Parker, general counsel for the Georgia Alliance of Community Hospitals, an association of not-for-profit hospitals, said tax-exempt hospitals provide community services worth far more than their exemptions, including conducting medical research and operating unprofitable medical services. For decades, being a hospital seemed sufficient justification for nonprofit status, but as medical services took on aspects of big business — aggressive bill collection tactics and six-figure pay for executives — the distinction between not-for-profit hospitals and their for-profit competitors blurred. The only requirement Georgia not-for-profit hospitals must meet to obtain and maintain their tax-exempt status is set by the IRS and not the state. The IRS requires that hospitals, like all not-for-profits, provide a “community benefit.” Georgia House Majority Leader Larry O’Neal, R-Bonaire, said the state needs more information about the community benefits these hospitals provide. The only data available for all hospitals is the amount of uncompensated care they provide, and some critics find the numbers discouraging. Uncompensated care is free or discounted services for low-income patients who do not have public or private insurance or who don’t have enough insurance. Each hospital sets its own standards. From 2006 to 2009, 28 Georgia hospitals spent less than 3 percent of adjusted gross revenue on uncompensated care, according to data collected by the Georgia Department of Community Health. In contrast, Grady Memorial Hospital, a facility that has historically served low-income people, spent 28 percent of adjusted gross revenue on uncompensated care in 2009; Emory-Adventist in Smyrna, 13 percent, and Piedmont Mountainside Hospital in Jasper, 9.5 percent. In the past, hospitals with a requirement that did not spend 3 percent would be assessed the difference for the state’s Indigent Care Trust Fund. The assessment was repealed last year. John
Parker, of the Alliance of Community Hospitals, said requirements in the
Affordable Care Act and
IRS requirements provide enough information about hospitals’
community benefits. But those regulations are optional and patient advocates
believe more detailed reporting requirements would provide policy makers the
information they need to create firm but flexible standards.
Visit The Atlanta Journal-Constitution for the article.
VHA Inc. launches strategic suite of offerings to help members accelerate performance, improve outcomes in transitioning healthcare environment VHA Inc., the national healthcare network, has launched a new, strategic suite of offerings called Performance Management, designed to provide a broader view of performance across today's shifting integrated environment. With a focus on linking clinical, financial, operational and supply data across the care continuum, these new services will provide multiple stakeholders with a more accurate view of performance. These new offerings, designed to help healthcare leaders manage their business more effectively in a clinically integrated environment, center around advisory services designed to clearly and quickly identify the critical next steps for improvement and are paired with a robust knowledge-sharing and data platform. To complement its highly valued networks, deep analytic assets and expert implementation resources, VHA is entering into strategic collaborations with UHC and Thomson Reuters to continue to build the value of Performance Management. Both UHC and Thomson Reuters are recognized leaders at acquiring and synthesizing data and already work with many VHA members. Building upon existing relationships, these new collaborations unite unrivaled information assets with analytic prowess, expert advisory services and industry knowledge to help hospitals improve their operational, clinical and financial performance. Initial offerings include: -Business Intelligence that identifies organization-wide insights and trends at the system or facility level to discover improvement opportunities affecting cost, quality and reimbursement as well as side-by-side comparisons with peers across key indicators including clinical quality, patient safety, value-based purchasing, patient experience, supply chain and operational and work force measures. -Customized advisory services and action plans provided by experienced VHA staff members to synthesize strengths, opportunities and improvements gleaned from business intelligence and develop customized performance improvement-directed action plans. -Links to leading practices from other hospitals that are specific to core measures and other clinical, supply chain or operational processes and incorporate detailed, user-friendly depictions of the clinical practices, tools and cultures recognized in leading performers. Future services will: -Help providers thrive by delivering a comprehensive view of clinical, financial, supply chain and operational data across the continuum of care, offering market-leading business intelligence capabilities and advisory services. -Link supply costs and utilization to present providers with a total picture of quality and reimbursement on a patient-by-patient basis.
-Allow providers to manage the health of the communities they serve through
improved insights on outcomes, reimbursement and cost for specific patient
populations. Visit
www.vha.com.
TECSYS launches new innovation in healthcare TECSYS Inc., a supply chain management software company, announced TECSYS’ Supply Management System (SMS), a clinical staff-friendly solution that addresses the just-in-time needs of the clinical supply chain at point-of-use. It provides clear visibility and accessibility of supplies anywhere in a hospital or an Integrated Delivery Network (IDN), it also automates replenishment based on real consumption, captures item usage for patient billing while significantly reducing cost as well as cash tied-up in inventory. An
industry first, TECSYS’ SMS, brings optimum ease-of-use to a clinical
setting; it uses touchscreen technology to facilitate ease of access to
information with the least amount of intervention. It cuts cost, relieves
clinicians from the drudgery of inventory management chores and enables them
to access supplies quickly and easily from anywhere in a hospital network.
Product and usage information are captured via barcode and stored in the
TECSYS system, enabling purchasing organizations to track usage, re-order to
minimums and plan the demand accordingly, virtually eliminating all stock
outs. For more information about TECSYS’ SMS,
visit here.
HHS awards Affordable Care Act funds to expand access to healthcare HHS Secretary Kathleen Sebelius announced awards of $28.8 million to 67 community health center programs across the country. These funds, made available by the Affordable Care Act, will help to establish new health service delivery sites to care for an additional 286,000 patients. Community health centers work to improve the health of the nation's underserved communities and vulnerable populations by ensuring access to comprehensive, culturally competent, quality primary healthcare services. As community-based and patient-directed organizations, health centers are well positioned to be responsive to the specific healthcare needs of their community. These grants will support new access points which are new full-time service delivery sites that provide comprehensive primary and preventive health care services. By maximizing the availability, access, and continuity of primary care services to the nation's neediest populations, these sites will play a critical role in improving the healthcare status of medically underserved and vulnerable populations and decreasing health disparities throughout the United States. Eligible applicants included public or nonprofit private entities, including tribal, faith-based and community-based organizations who meet health center funding requirements. Current HRSA grantees could apply as well as organizations applying for the first time. “It is fitting that these awards are announced as we celebrate National Health Center Week,” said HRSA Administrator Mary K. Wakefield, Ph.D., R.N. “These awardees join the 1,100 current health center grantees that provide affordable community-based primary care to more than 19 million people across the country.”
Health Center New Access Point grants, listed by organization and state, are
available
here.
August 9, 2011 Download print version Metro introduces advanced monitoring system at AHRMM11 DNA building blocks found in meteorites Soon, a breast cancer gel that shrinks tumors Hospital blood tests tied to anemia in heart-attack patients Iowa hospitals see rise in unpaid, charity care Four patients receive tainted shots at Nashville VA hospital MedAssets technology-enabled innovation and processes turn transparency and behavior change into millions in savings In an environment where every dollar counts, hospitals and health systems can no longer afford to lack transparency in supply chain management and stick to traditional group-purchasing concepts. This is the message that MedAssets customers will present at the 2011 AHRMM conference in Boston, MA, August 7-10, AHRMM Booth #801. As one of the nation’s largest spend management companies, MedAssets combines experts and an evidence-based suite of technology-enabled products and services to deliver a differentiated, long-lasting approach to help its customers tackle the challenges of shrinking margins, regulatory requirements and changing reimbursement. MedAssets customer presenters at AHRMM will review their strategies to gain tangible, sustainable performance improvement. Each engaged the company’s distinct consultative processes and/or proprietary data accurate business intelligence that takes spend and clinical resource management and decision rationale out of its “black box” to yield substantial savings, such as:
MedAssets customers and subject matter experts are providing their valuable insight and journeys to sustainable savings at 2011 AHRMM educational sessions: The Future of Value Analysis: Clinical Resource Management & Breaking Even on Medicare – presented by Nick Sears, M.D., Chief Medical Officer, MedAssets and Andy Knight, RN, Vice President, Clinical Resource Management, MedAssets Using Data to Drive Clinical Change – presented by Brent Petty, CMRP, Director, Supply Chain, Wellmont Health System and Blane Schilling, M.D., Senior Vice President, Pharmacy, Aspen Healthcare Metrics, a MedAssets Company Instrumental Improvement: Using Process Improvements to Streamline Surgical Instrument Management – presented by Diana Fitzpatrick, RN, Surgical Services, Saint Thomas Hospital, Pat Stefanik, BSPA, RN, Patient Care Manager, Saint Thomas Hospital and Richard Tucker, Director, Healthcare Performance Partners, a MedAssets Company
MedAssets
manages approximately $45 billion in total spend for healthcare providers.
Its Spend and Clinical Resource Management Solutions have been proven to
reduce supply expense by five to 15 percent. Visit MedAssets for their
solutions in strategic sourcing, capital equipment and construction
solutions, purchased services, procurement solutions, workforce solutions,
and consulting services for clinical resources and service lines. For more
information, go to
www.medassets.com.
GHX launches new registration center, making it easier, faster for healthcare providers to increase usage of e-commerce, better manage trading community Healthcare providers can now directly manage the registration of trading partners on the GHX exchange using Registration Center, a new browser-based portal that significantly increases efficiency in conducting electronic business and controlling spend. By removing the third-party intervention required in the previous registration process, the new Registration Center allows providers to connect with trading partners at their own pace, while also providing real-time visibility into trading partner information. By maximizing electronic purchasing, hospitals can drive greater cost savings and efficiencies. Registration Center helps facilitate increased usage of the exchange by aiding and maintaining accurate trading partner relationships and initiating requests for new trading partner connections. The portal also provides visibility into trading partner activity, allowing providers to encourage activity in non-active participants. Derek Smith, GHX executive vice president of Marketing and Product Management, said the new Registration Center, which will be included in any customer’s exchange subscription fees, is in line with the company’s strategic goal of reducing the cost of healthcare in North America by $5 billion over five years. GHX is measuring this through a tool co-built with and validated by PRTM. Using the self-serve registration tool, providers can gain several benefits in addition to speed, including: The ability to reach the world’s largest healthcare community more easily than ever; Real-time access to view and validate vendor information; increased trading partner satisfaction as providers make it easier for suppliers to do business with them; and increased usage of EDI to help reduce discrepancies and operating expenses.
During a
three-month long trial conducted by GHX, 24 participating healthcare
providers experienced a 22.4 percent increase in trading partners using the
new registration tool. Miya Gray, ERP e-commerce systems administrator at
Bon Secours Health System, was one of the top users of the tool during the
pilot. For more information, visit
www.ghx.com.
Metro introduces advanced monitoring system at AHRMM11 Metro introduced MetroMonitor Dashboard System version 2.0, an intelligent management and monitoring dashboard system for mobile computing workstations. Metro’s enterprise software enables web-based access of workstation performance, including power system and network connectivity, to streamline fleet management and increase workstation uptime. In addition to the centralized dashboard and base reporting, MetroMonitor 2.0 provides alerts when a workstation or group of workstations requires attention. Advanced reporting features, including usage rates, real-time updates on number and type of alerts and other data to support predictive maintenance & efficient fleet management, are also available as optional features. Metro is showcasing the MetroMonitor Dashboard System along with its supply & medication storage & transport solutions, point-of-care computing workstations and automated dispensing systems at the Association for Healthcare Resource & Materials Management (AHRMM) Conference and Exhibition booth #701. Metro will highlight solutions for nearly every department in healthcare, long-term care and alternative care facilities, from automated medication dispensing to clinical documentation and specialized procedure carts. Metro’s booth will also feature product demonstrations at AHRMM, including:
For more
information on Metro and its diverse breadth of healthcare products, visit
www.metro.com.
DNA building blocks found in meteorites For 50 years, scientists have debated whether the components of DNA — the molecule central to all life on Earth — could spontaneously form in space. A new analysis of a dozen meteorites found in Antarctica and elsewhere presents the strongest evidence yet that the answer is yes. Meteorites are space rocks that have fallen to the ground, and the new report bolsters the notion that heavy meteorite bombardment of the early Earth may have seeded the planet with the stuff of life. While life has not been found beyond Earth, all earthly plants and animals rely on DNA to store genetic information. At the center of the ladder-like DNA molecule lie ring-like structures called nucleobases. It’s these tiny rings that scientists at NASA and the Carnegie Institution for Science in Washington found in 11 of 12 meteorites they scrutinized. Two of the meteorites in particular, called Murchison and Lonewolf Nunataks 94102, contained a trove of nucleobases, including those also found in DNA. But these meteorites and also held an extraterrestrial secret: related but exotic nucleobases never seen before, said Michael Callahan, the NASA scientist who analyzed the space rocks. Analysis of dirt and ice found near the meteorites showed no evidence of these exotic nucleobases. Since the 1960s, other scientists have reported nucleobases in meteorites, but concerns about contamination always hung over those findings, said Max Bernstein, a NASA scientist who has studied organic molecules in meteorites but was not involved in the current study. The detection of the exotic nucleobases, and their absence from surrounding material, helped rule out contamination in this study, said Callahan. Bernstein said the study’s thoroughness gave him confidence in its conclusions. “I don’t think it’s contamination,” he said. In laboratory experiments, Callahan and colleagues showed how the nucleobases could have formed inside meteorites. Simple chemical reactions involving ammonia, water and hydrogen cyanide — all ingredients found in meteorites — produced the wide range of nucleobases the scientists found in the space rocks. Scientists have also found other building blocks of life — most notably amino acids, the links that form proteins — inside meteorites.
While
Bernstein said that it’s impossible to discern whether the first life on
Earth was built on chemicals that fell from the sky, that possibility is now
stronger.
Visit the Washington Post for the article.
Soon, a breast cancer gel that shrinks tumors In a breakthrough that could revolutionize the treatment of cancer, a new gel treatment for breast cancer is being developed and tested in the U.S to shrink tumors. The treatment is rubbed on to the skin daily and has far fewer unpleasant side effects than the tablet tamoxifen - the most commonly used drug in Britain. But it contains the same active ingredient, and concentrates it in the breast rather than dispersing it around the entire body like pills do. "We think it may be a very good solution for women who are reluctant to take tamoxifen," the Daily Mail quoted researcher Professor Seema Khan, of Northwestern University near Chicago who is testing the gel, as saying. "Delivery through the skin means there will be very little drug circulating through the bloodstream and the body. It is a way to minimise exposure to the rest of the body and concentrate the drug where it is needed," she stated.
If the
trials are successful then the treatment - called afimoxifene - could be
available to British patients in the next three to four years.
Visit the Times of India for the article.
Hospital blood tests tied to anemia in heart-attack patients A blood test can provide crucial information that can’t be gotten any other way. But sometimes there may be a downside. A study of heart-attack patients just published online by the Archives of Internal Medicine finds that blood loss from diagnostic tests is associated with acquiring anemia in the hospital. And anemia — a decrease in the red blood cells or in the specific protein that carry oxygen throughout the body– is associated with poorer health and a higher risk of death. The study looked at data from 17,676 heart-attack patients in 57 hospitals between 2000 and 2008. None of them had anemia when they were admitted, but over the course of their hospital stay 20% developed moderate-to-severe anemia. While it’s impossible to prove causation with this type of study, those folks had a lot more blood taken than their counterparts who didn’t acquire anemia in the hospital — 174 milliliters over the course of a stay, compared to 84 mL. (A unit of blood, which is a bit less than a pint, is 450 mL.) For every 50 mL of blood drawn, the risk of moderate to severe anemia rose by 18%, researchers found. Patients who developed moderate to severe anemia also had, on average, more blood drawn on each of the first ten days of hospitalization than those with mild or no anemia, as well as more blood drawn per 24-hour period. It’s impossible to identify which — if any — of the blood work was unnecessary, says study co-author Mikhail Kosiborod, a cardiologist and clinical researcher at St. Luke’s Mid America Heart and Vascular Institute in Kansas City, MO. “By no means does this suggest that we should be afraid of testing patients,” he tells the Health Blog. But there are variations across hospitals in how much blood is taken, even after adjusting for patient characteristics, he says, and some of that variation may be explained by differences in blood-drawing practices. That suggests “an opportunity for reducing the total volume of blood” taken, he says. Pediatric tubes, for example, would be sufficient for most of the blood tests being performed, and they don’t cost more. It may also be possible to rely on stored specimens for certain tests that don’t demand fresh samples, he says. And in stable patients who are waiting to go home, it may not be necessary to draw blood for routine tests every day. The next step is to test possible interventions to see if they help minimize hospital-acquired anemia, Kosiborod says.
A study
published in May showed that simply making physicians aware of the cost of
regular blood tests cut the daily bill for the tests by as much as 27%.
Meantime, research also suggests that too many people are getting
unnecessary blood transfusions.
Visit the Wall Street Journal for the article.
Iowa hospitals see rise in unpaid, charity care The prolonged U.S. economic downturn has led to an increase in "charity care" and unpaid medical costs for Iowa hospitals, officials said. The 118 members of the Iowa Hospital Association provided more than $850 million in care in 2010 that was not fully compensated, The Gazette in Cedar Rapids reported. A member survey showed that is up $54 million, or 6.8 percent, from 2009. Scott McIntyre, the association's spokesman, said the total stood at $252 million in 2000. The rise in the number of people who are unable to pay due to mounting debt problems is a growing concern, McIntyre said. The increase has followed a trend of rising healthcare costs and the number of people who are unemployed or uninsured. Hospitals try to work with patients to set up payment plans with the goal of creating a situation so they don't end up in debt and the hospital doesn't end up with bad debt, McIntyre said. Overall, the organization's 2010 statewide survey showed Iowa hospitals provided "community benefits" that were valued at more than $1.3 billion. McIntyre said community benefits are activities designed to improve health status and provide greater access to health care. Along with uncompensated care, the category includes such services and programs as health screenings, support groups, counseling, immunizations, nutritional services and transportation programs valued at nearly $212 million.
Kirk
Norris, the hospital association's president, said the programs listed in
the survey were implemented in response to the needs of individual
communities as well as entire counties and regions. Norris said the ability
of hospitals to respond to various communities' needs is challenged by the
ongoing economic downturn and by losses in Medicare and Medicaid. Those
programs account for about 60 percent of all Iowa hospital revenue.
(Associated Press)
Visit the Chicago Tribune for the article.
Four patients receive tainted shots at Nashville VA hospital Mason Sylvis of Inglewood can’t play dominoes with his brother, scan the grocery aisles for bargains or watch reruns of The Andy Griffith Show anymore because of a medical error at the VA hospital in Nashville. He is blind, has brain damage and is on a feeding tube. Bacteria-tainted medicine from a shot that Sylvis received in his eye caused an infection that spread to his brain, according to a claim for damages his family filed with the U.S. Department of Veterans Affairs. Three other patients suffered complications from injections at the same time. Avastin, the medicine they received as a treatment for macular degeneration — the most common cause of blindness in older Americans — was prepared for eye injection at the hospital. Chris Alexander, a spokesman for VA Tennessee Valley Healthcare System, said physicians made full disclosure of what happened to all four patients. “Any incident impacting patient safety is taken seriously, acted on quickly and analyzed for possible improvements,” Alexander said. He did not comment on the extent of the complications of the three other patients. The medicine may have become contaminated during a cost-cutting procedure — one that is commonly performed at VA hospitals across the country. Lucentis, the drug approved by the U.S. Food and Drug Administration for macular degeneration, costs about $2,000 for a single-dose vial. A close cousin to that drug, the cancer medicine Avastin, is equally effective, according to a study published this year in The New England Journal of Medicine. It costs about $50 a dose. However, Avastin does not come in single-dose vials for eye injections. The FDA has not approved it for that purpose, so hospital pharmacies have to compound Avastin for eye injections from packaging intended for intravenous use. In October 2006, a medical advisory panel for the Department of Veterans Affairs issued a bulletin about patients suffering eyeball inflammation from Avastin injections. Sterility issues while compounding the intravenous drugs into shot vials were one of the concerns raised in that bulletin. Sylvis got his shot on March 29 of this year. Two days later, he woke up in pain. That was the same day the VA became aware of complications with three other patients who received the shots. Other than those four, “No other patients who received eye injections from the facility were affected,” Alexander said. Although Sylvis went back to the VA hospital on March 31 and received additional follow-up treatment for bacterial inflammation, he was suffering a loss in mental capability by April 6 when he was readmitted to the hospital. After being treated for bacterial encephalitis, he was discharged a month later. The 77-year-old man couldn’t make it in the front door of his home.
The family
had to call someone to help them get Sylvis inside, where they noticed blood
in his catheter bag. The Sylvis family filed a $4 million claim, which is
paperwork preliminary to a lawsuit, on June 8 but remained silent about
their problems. They decided to go public because of what they say are
recurring lapses in care.
Visit the Tennessean for the article.
August 8, 2011 Download print version Hybrid operating rooms pull double duty at hospitals Industry collaboration announces complimentary GLN implementation workshop RTLS tracks location and temperature of perishables during transport and storage Study suggests increase in public health spending results in healthier people Gov. Rick Perry’s controversial surgery sparks debate Botox and other drugs seek off-label approval for other usages Predicting Alzheimer’s blood test almost 100% accurate Hybrid operating rooms pull double duty at hospitals Vascular surgeon Kumara Rama checks a patient's aneurysm on screen in the control room of the hybrid operating room at Detroit's St. John's Hospital on June 27 in Detroit. The patient had a ruptured stomach artery that doctors fixed with a minimally invasive procedure. Had the operation gotten tricky or gone wrong, his doctor could have switched immediately to do the rest of the operation with a large chest incision in a new type of operating room at St. John Hospital and Medical Center in Detroit. Hybrid operating rooms, as they are called, bring together the most modern of surgical innovations with the equipment and staffing for conventional open-heart procedures. The ECRI Institute, a nonprofit Pennsylvania organization that advises hospitals on spending and planning for new technology, estimates that fewer than 100 U.S. hospitals have hybrid rooms. But the number "is expected to climb rapidly" with 15 percent or more yearly increases in hospitals adding them over the next few years, said Robert Bense, a senior healthcare technology executive. Procedures suited to the new hybrid rooms use minimally invasive methods to fix and replace heart valves; correct abnormal heartbeats; and place tiny metal coils, or stents, to fix stiffened, aging heart vessels. At costs of $1.5 million to $9 million, if robots and videoconferencing technology are included, hospitals seek out generous donors to help pay for the new operating suites. A $5 million donation paid for the hybrid operating room, including a robotics system, opened in June at St. John. In theory, the rooms save lives, reduce infections and speed recovery because patients don't have to be unhooked from tubes and machines and transferred to other surgery rooms in the middle of a procedure. For now, the proof is "sort of soft" that the rooms improve care, though most health care experts presume they will, Bense said. More than 40 procedures have been performed in St. John's new hybrid room, which has a robotic surgery system and cutting-edge fluoroscopy machine that allows doctors to immediately view X-ray pictures taken of structures inside the body during an operation. Dr. Michael Deeb, a University of Michigan cardiovascular surgeon, said he believes the rooms will deliver on efficiencies and patient-care improvements. Recovery time is longer and complications greater the longer heart-lung machines have to circulate blood and breathe for patients during open-heart procedures, Deeb said. The university has three hybrid rooms and plans to add another for its new children's and women's hospital, he said.
Most
minimally invasive procedures can be done in standard operating rooms and
catheterization labs, doctors said. Costs also may force larger hospital
systems to invest in the rooms at one facility but not at others.
Visit USA Today for the article.
Industry collaboration announces complimentary GLN implementation workshop To help the healthcare industry with its adoption of GS1 Global Location Numbers (GLNs), the Association for Healthcare Resource and Materials Management (AHRMM), GS1 Healthcare US, and the Strategic Marketplace Initiative (SMI) will co-sponsor a GLN Implementation Workshop. The half-day complimentary session, recommended for healthcare provider, manufacturer, and distributor supply chain professionals, will take place on Monday, September 12, 2011 at the Westin O’Hare Airport, Chicago (Rosemont), Illinois. The workshop is designed specifically for data managers, electronic data interchange (EDI) professionals, and other healthcare supply chain professionals with front-line responsibility for implementing the GLN in their organizations. It will feature a live tutorial on the GLN Registry for Healthcare and instruction from provider and supplier-based faculty. The workshop will provide attendees the information and training needed to begin GLN implementation within their organizations. Space in the workshop is limited – only the first 60 registrants will be enrolled in order to maximize the interaction throughout the all-day session. There is no registration fee for the workshop; however attendees will be responsible for their own travel expenses. The workshop co-sponsors are the leading organizations that have been consistently supportive of supply chain data standards adoption in healthcare. “While many organizations in healthcare have already made great progress in adopting the GLN, there are still other organizations seeking direction on where to start and how to implement,” said Tom Hughes, Executive Director of SMI. AHRMM President Bill Stitt said, “AHRMM is pleased to be a part of this collaboration to help industry professionals adopt and utilize the GLN. Through increased adoption, the benefits of the GLN will begin to be realized.”
“With such
an industry-wide intense focus on using consistent, standardized location
information via the GLN, there is no better time for hospitals and their
supplier partners to work out their GLN implementation strategies so that
all parties can begin to reap the benefits, including assurance that
supplies get to the right place at the right time, every time,” said Ed
Miles, Vice President of GS1 Healthcare US. For registration information and
agenda, visit
http://www.gs1us.org/sectors/healthcare/hcglnworkshop.
RTLS tracks location and temperature of perishables during transport and storage Ekahau Inc., a provider of high performance Wi-Fi-based Real Time Location Systems (RTLS), announced today that a monitoring system for blood, food and pharmacy orders developed at Wake Forest Baptist Medical Center will operate on Ekahau’s RTLS technology. The system, called Time Temp Trac, can be used to track the location, movement and validation time of perishable items such as blood, food and pharmacy orders during transport and storage. Alerts can be sent to staff via mobile phone or pager if Items become compromised due to fluctuating temperatures. Ron Noel of Time Temp Trac, a co-inventor of the system at Wake Forest Baptist, will be in Ekahau’s booth 1139 at AHRMM 2011 in Boston. “Because blood, dietary items, and certain medications all have a very limited time to be administered to the patient, we have devised a method to use real-time location solutions (RTLS) to provide the needed data about these items. By outfitting a cooler with Ekahau’s Wi-Fi tag, we are able to determine how long a unit of blood has been out of the blood bank. We can track the item’s location anywhere in the coverage area. Dietary carts and pharmacy orders are tracked in a similar fashion,” Noel stated. “Ekahau software can automatically alert staff when the validated time or temperature limit is approaching.” The location, movement and validation time for each blood cooler is displayed on a computer monitor at the control desk for the department as well as transmitted to Ekahau’s Wi-Fi Pagers anywhere in the hospital. While developed primarily to track blood bank coolers, the system can be adapted for use by food services to monitor the meal delivery time and to audit the temperature of items served to patients. Also, pharmacies can ensure that time-sensitive medications are delivered in the required time.
For more
information about Ekahau, please visit
www.ekahau.com.
Study suggests increase in public health spending results in healthier people A groundbreaking new study published in the journal, Health Affairs, suggests that increases in public health spending result in healthier people, especially in communities with fewer resources. The study was co-authored by Glen P. Mays, the new F. Douglas Scutchfield Endowed Professor in Health Services and Systems Research at the University of Kentucky College of Public Health. At UK, Mays is affiliated with the National Coordinating Center for Public Health Services and Systems Research, funded by the Robert Wood Johnson Foundation. Sharla A. Smith, a research associate in the Department of Health Policy and Management, University of Arkansas for Medical Sciences, co-authored the study. The study examined whether changes in spending by local public health agencies over a 13-year period contributed to changes in rates of community mortality from preventable causes of death, including infant mortality and deaths due to cardiovascular disease, diabetes and cancer. The researchers found for every 10 percent increase in local public health spending, mortality rates from the four causes of death analyzed dropped anywhere from 1 percent to almost 7 percent. It’s important to examine not only how much was spent, but also how it was spent, Mays said. “Our findings suggest that a connection between spending and health outcomes does exist, although it’s important to note that resources must be successfully aimed at activities that target at-risk population groups to ensure that spending is resulting in positive outcomes.” Previously, little research has been done in the area of the impact of public health spending on population health. Mays and Smith analyzed changes in spending patterns and mortality rates within the service areas of the nation’s nearly 3,000 local public health agencies over a 13-year period. Increases in public health spending were associated most significantly with reductions in deaths for four of the six mortality rates, with the strongest effects for infant mortality and cardiovascular disease mortality. After accounting for differences in demographic and socioeconomic characteristics, medical resources and other factors, communities that made the largest investments in public health spending experienced the most significant reductions in mortality from leading preventable causes of death. Public health spending varies widely around the country. For example, per capita state public health spending ranged from a low of less than $4 in Nevada to a high of more than $171 in Hawaii. Local public health spending varied even more significantly – ranging from less than $1 per capita to more than $200 per capita, with the median spent around $36 per person.
The study
provides a foundation for further research, particularly in light of the ACA
investment of a projected $15 billion in new spending over 10 years in
federal public health spending and the continued reductions in state and
local government spending for public health, Mays said.
Visit here for the complete article.
Gov. Rick Perry’s controversial surgery sparks debate Texas Gov. Rick Perry received an injection of his own stem cells during spinal fusion surgery last month and wants his state to be a leader in the use of adult stem cells in medical treatment. But using a concentrated mixture of adult stem cells to fuse bone hasn't been tested in any major U.S. trials, raising questions of whether a governor (and reportedly a potential Republican presidential candidate) should be advocating an unproven medical procedure. Perry and a state representative who has multiple sclerosis championed a healthcare bill that created an adult stem cell bank in Texas. A month after Perry signed that bill into law, his friend, Stanley Jones, MD, a Houston-based orthopedist, performed spinal fusion surgery on the governor using Perry's own stem cells to treat a recurring spinal injury, according to an article in the Texas Tribune. The Tribune also said that Jones is a major advocate for adult stem cell therapy: Jones says he was cured of his debilitating arthritis after receiving injections of his own stem cells in Japan. Experts contacted by ABC News/MedPage Today, who weren't familiar with the specifics of Perry's surgery, guessed that the governor had mesenchymal stem cells cultured from a biopsy of his own marrow or fat, that those cells were concentrated in a lab, and then were reinjected onto a scaffold-like device implanted in the spine. Following the surgery, according to the Texas Tribune, Perry and Jones reportedly urged the Texas Medical Board to hold a meeting to explore ways to regulate the procedure in Texas. The procedure is similar to spinal fusion surgery using a piece of bone harvested from the patient's own iliac crest to fuse two or more vertebrae. However, mesenchymal stem cells have a higher stem cell concentration than what is found in the iliac crest, and after the cells are spun in a centrifuge, the stem cells become even more concentrated. Mesenchymal stem cells differ from iliac bone cells because they are multipotent, meaning they can turn into bone, fat, cartilage, muscle, and skin.
There have
not been any phase III clinical trials that tested the utility and safety of
stem cell spinal fusion procedures, nor have there been any published trials
of the procedure in the U.S.
This article was developed in collaboration with ABC News.
Botox and other drugs seek off-label approval for other usages Botox, famous for smoothing out wrinkles, could make life a little easier for people with urinary incontinence. By paralyzing the muscular lining of the bladder, the drug decreases the urgency and frequency of urination. Botox maker Allergan has applied for Food and Drug Administration approval in people with multiple sclerosis and spinal cord injury whose conditions result in bladder overactivity. Approval could come by the end of the year, potentially making urinary incontinence the eighth condition treated with Botox. Only one use is cosmetic; the other conditions include chronic migraine and spasticity. "The uses of Botox are increasing," said Van Hove, adding that medical indications currently account for roughly half of the drug's $1.4 billion in worldwide sales, the remainder coming from cosmetic uses. "With the new uses, definitely that 50-50 split will sway more towards therapeutic." There are other drugs that perform multiple roles, including a skin cancer cream used to smooth out your facial wrinkles, a baldness drug to protect against prostate cancer, and a drug for enlarged prostate and possibly prostate cancer that may stop baldness. Once a drug has been approved for one use, doctors can prescribe it "off-label" when it is shown to be useful for something else. And an increasing number of drugs are prescribed in this manner. Off-label use of medicines accounts for about one fifth of all prescriptions, according to a 2008 study in the New England Journal of Medicine. Many of these off-label uses meet with controversy and questions about their value, particularly since the FDA has not yet approved them. (As a result, drug companies cannot advertise off-label uses.) But in other cases, the alternative uses are well-known in the medical community -- though perhaps not among the general public -- and are regularly exploited.Other double-duty drugs include: Prozac, also known as fluoxetine, is approved by the FDA for the treatment of major depression, obsessive-compulsive disorder, panic disorder and a number of other conditions. But a group of French researchers found the drug may have another use. Their study, published in The Lancet, found that giving fluoxetine after a stroke could help sufferers improve their motor skills. Viagra is approved for use as a treatment for erectile dysfunction, and is also marketed under the name Revatio to treat pulmonary hypertension, a buildup of pressure in blood vessels leading to the lungs. Doctors have also used it off-label to increase the blood flow to damaged areas as a way to avoid amputation and the onset of gangrene. And new promising research may also lead to another use of Viagra: as a treatment for prostate cancer in combination with another cancer drug, doxorubicin. Latise has been used by many glaucoma patients using an eye drop known as bimatoprost to improve their vision have enjoyed an unexpected side effect -- thicker, more luxurious eyelashes. The effects of the medication were so pronounced, in fact, that the FDA recently approved the drug for this cosmetic use. Allergan, the company that manufactures the glaucoma drug known as Lumigan, rebranded it under the new name Latisse. When it comes to trying to get pregnant, some women look to a remedy more associated with coughs and colds than conception. That remedy is Robitussin. So far there is no reliable evidence to show that the syrup does much, if anything, to increase the odds of a woman getting pregnant. The theory, however, is that in much the same way the drug can thin the mucus in your nose and throat, it may also thin the cervical mucus. Thinner cervical mucus means that sperm may have an easier time making it into the uterus to fertilize a waiting egg. But because so many factors contribute to a woman's ability to conceive, doctors warn that changing any one variable is not likely to have a huge overall effect on the chances of pregnancy. More often associated with its use as a club drug, ecstasy has captured the attention of researchers who hope that the illicit pill may one day be used to help treat post-traumatic stress disorder, or PTSD. In the late 1970s, a group of psychiatrists found that the drug had an effect on levels of serotonin, a brain chemical that is known to regulate mood. Indeed, before ecstasy was made illegal in 1985, some psychotherapists were giving the drug to patients, citing its usefulness as an effective therapeutic tool. Few drugs have as controversial a reputation as thalidomide. First marketed in 1957 to stave off morning sickness in pregnant women, the drug was soon found to be linked with severe birth defects ranging from cleft palates to missing and abnormal limbs, spinal cord deformities and organ abnormalities. Despite these tragic and high-profile outcomes, a small group of patients did benefit from using the drug -- those with a severe and debilitating leprosy-associated complication known as erythema nodosum leprosum (ENL). Considering the small number of people today who live with leprosy, it may come as little surprise that the silver lining of this devastating drug remains relatively secret. And the World Health Organization still recommends against the use of the drug to treat the ravages of ENL due to birth defects. Among the plethora of drugs used in the cosmetic realm, it's a safe bet that few would recognize the name phosphatidylcholine. But in many clinics around the world, this soybean-based, FDA-approved treatment to break down fat in the blood is also being injected under the more familiar names lipostabil or lipodissolve as a surgery-free fat buster. That's not to say, however, that the treatment is safe. Indeed, cosmetic surgeons and dermatologists agree that these injections should be avoided by consumers shopping around for a slimmer look. Approved for the treatment of enlarged prostate, Avodart, like Propecia, has been tested for prevention of prostate cancer as well. But the drug from GlaxoSmithKline, chemically known as dutasteride, finds a third use: preventing baldness. Smaller studies have shown some encouraging results. Efudex, a skin cream that has been used for years to combat the early stages of skin cancer, may one day have a second use as a wrinkle-buster. So suggests a small study of 21 subjects, commissioned by Valeant Pharmaceuticals, which makes the cream. The study is published in the June issue of the journal Archives of Dermatology. Study participants who applied the cream twice daily for two weeks were able to reduce the number of potentially pre-cancerous spots on their faces. But in addition to this, researchers also found through clinical evaluation that the subjects enjoyed other improvements in aging-related damage, including fewer wrinkles, fewer dark skin spots and less hyperpigmentation. The drug, of course, also had side effects -- primarily in the form of redness and irritation shortly after the application of the cream.
"The
American Society of Clinical Oncology (ASCO) and the American Urological
Association (AUA) -- recommend that millions of men over age 55 who are
regularly screened for prostate cancer speak with their doctor about taking
a drug which might reduce their risk of the disease. The drug is finasteride
-- a drug that has been shown in studies to help ward off prostate cancer,
but is perhaps more well-known as the hair-loss drug Propecia. Indeed, in a
2003 study involving 18,000 men, finasteride was shown to cut the risk of
prostate cancer by around 8 percent. But at the estimated cost of $90 a
month, the drug is expensive. And in the earlier trials there was some
evidence that the drug might cause high-grade cancers. While proponents have
denied such findings, other doctors have voiced their concern over this
potential use of the drug.
Visit ABC News for the article.
Predicting Alzheimer’s blood test almost 100% accurate
A new blood
test for Alzheimer's disease is 96% accurate at identifying the disease and
can perhaps detect it even before symptoms such as memory loss (dementia)
develop. An estimated 5.4 million Americans have Alzheimer's disease, the
most common form of dementia, according to the Alzheimer's Association. ''This is a simple test that has high accuracy and can be run from a single drop of blood. Brain cells die and when they die, they pop; they explode, like a water balloon breaking. Your body makes antibodies against the cell debris. We believe that happens so it can facilitate the cleanup of the cell debris. Many of these are related to the presence of the disease."
Nagele's
team looked at blood samples from 50 people with Alzheimer's disease and 40
without. They also looked at blood samples from 30 breast cancer patients
and 29 with Parkinson's disease; to be sure the test could be specific for
Alzheimer's. Overall, the tests identified 96% of those with Alzheimer's
correctly. It correctly identified 92.5% of those who didn't have
Alzheimer's. Nagele was able to form a list of antibody biomarkers needed to
detect Alzheimer's disease to 10.
Nagle is
hopeful the test could be available within a year. Costs are difficult to
estimate, but it could be about $200, which is quite affordable related to
current test pricing standards.
Visit Medical News Today for the article.
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