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         Clinical intelligence for supply chain leadership


hpnonline Daily Update


January 5-9, 2015
January 5 January 6 January 7 January 8 January 9

January 9, 2015   Download print version

Pivotal Ebola vaccine trials to start this month or next: WHO

New genetic tests for women who are expecting

Antibiotic resistance will kill 10 million people a year by 2050; Report shows grim future if changes aren't made

Behind the numbers: Are healthcare costs really getting better?

Genetic testing company 23andMe finds new revenue with big pharma

Infections increase death risk by 35% for ICU patients

AMP releases 'A Molecular Diagnostic Perfect Storm' paper

Lavish ‘Cadillac’ health plans dying out as Obamacare tax looms

Pivotal Ebola vaccine trials to start this month or next: WHO

Final-stage trials of experimental Ebola vaccines will begin in January or February in the worst-hit West African countries as scientists and drugmakers race to block the deadly disease, the World Health Organization said on Thursday. If effective, the shots will be available for deployment a few months later.

Nearly 90 experts from vaccine manufacturers, regulatory agencies and health ministries met at WHO headquarters to review data from initial safety trials and finalize plans for pivotal Phase III clinical trials in Liberia, Sierra Leone and Guinea.

The meeting is discussing three different large-scale clinical trial designs using the most advanced vaccines to fight a disease that has killed more than 8,000 people in the past year.

Two vaccines from GlaxoSmithKline and another from a collaboration between NewLink Genetics and Merck started initial clinical testing in the autumn. A third one from Johnson & Johnson and Bavarian Nordic has just reached the first-in-human testing stage. Officials from GSK, Merck and J&J all addressed the closed-door meeting. In addition, officials heard from developers of earlier-stage vaccines, including U.S.-based Novavax and Russia's Influenza Research Institute.

The talks also assessed the funding situation, after the GAVI global vaccines alliance said last month it was committing up to $300 million to buy Ebola shots.

Sierra Leone, the country worst affected by Ebola, plans to start vaccine trials in the second half of January, Samuel Kargbo of its health ministry told Reuters Television on the sidelines of the Geneva talks.

Ebola continues to spread in the Liberian capital of Monrovia, with cases scattered throughout the city, making it hard to identify distinct chains of transmission, WHO director-general Margaret Chan said. Visit Reuters for the story.



New genetic tests for women who are expecting

Women expecting a baby or planning a pregnancy are being pitched a fast-growing array of tests to check if they are carriers for hundreds of mostly rare genetic diseases. Such genetic testing, called carrier screening, has long been targeted mainly at people of certain ethnic groups such as Ashkenazi Jews, who are at higher risk for some conditions such as Tay-Sachs disease.

Now, companies that offer carrier screening are promoting the idea that testing everyone for many diseases is a more effective way to reduce the number of babies born with serious disorders, including cystic fibrosis, a life-limiting lung condition, and Canavan disease, a fatal neurological disorder.

“We have the technology and it’s affordable enough that we don’t need to put people into ethnic categories,” says Shivani Nazareth, director of women’s health for Counsyl Inc., in South San Francisco, CA, one of the largest carrier-screening companies. “If we can offer the same panel to everyone, it’s so much more efficient.”

Scientists keep identifying new gene mutations, or variations, associated with specific diseases. Advances in DNA technology allow companies to quickly screen large numbers of people, using saliva or blood samples, to determine if parents could pass the genetic variations to their children.

Counsyl offers tests that aim to detect heightened genetic risk for at least 98 different diseases, for between $599 and $999. Another company, Gene by Gene Ltd., of Houston, plans in the next few months to introduce First Look, a test billed as the most comprehensive on the market that can screen for more than 300 diseases. The company expects the price could be close to $1,500. Visit the Wall Street Journal for the article.



Antibiotic resistance will kill 10 million people a year by 2050; Report shows grim future if changes aren't made

A recent review on antimicrobial resistance released last month estimated that if bacteria keep evolving at the current rate, by 2050 10 million people will die a year from otherwise curable diseases.

According to the review, these deaths will vary from country to country, with malaria taking the biggest toll on countries in Asia and tuberculosis estimated to greatly affect Russia as well.

Antibiotic resistance is a natural part of evolution. As humans create drugs to combat dangerous illnesses, bacteria evolve a resistance to the drugs. It used to be that by the time bacteria had evolved a resistance man had already created a new form of the drug. The antibiotic resistance crisis, however, is a man-made global threat.

Due to a number of human-influenced factors, bacteria are now evolving at a rate much faster than pharmacists can keep up with, and the result is that more and more people are dying every year from diseases that were once thought to be completely curable.

It’s not just the common illnesses that are thought to be affected by antibiotic resistance; the crisis is believed to have serious secondary health effects as well. For example, without effective antibiotics, cancer treatments, organ transplants, and even cesarean child birth is believed to become far more deadly.  

Essentially, there is no one person to blame for the antibiotic resistance crisis. In fact, one could even say that everyone who ever used a prescription antibiotic at some point in their life played a part in the crisis.

Mother Jones reported that doctors overprescribing antibiotics and farmers feeding daily doses of antibiotics to animals helped bring about the current situation. This isn’t the whole picture, however. Misuse of antibiotics also played a part. Not finishing a course of antibiotics and then using the “leftovers” months later when you feel yourself getting sick helped the bacteria to evolve resistance at an unnatural and unprecedented rate.

Scientists throughout the globe are joining forces to both create new antibiotics as well as devise ways to tackle infection without the need for these drugs in the first place. The fact that more scientists as well as lay people are becoming aware of the current issue of antibiotic resistance is cause for optimism.

We all play a role in ensuring that our planet does not revert back to the “dark ages of medicine,” and in order to ensure the future of our children, it’s time to not only recognize but also act on the issue of antibacterial resistance. Visit Medical Daily for the article.



Behind the numbers: Are healthcare costs really getting better?

A series of news reports over the past weeks have trumpeted the low rate of growth in healthcare costs.

“Health care spending grows at lowest-ever rate,” declared USA Today.

“Growth in health care costs flat, but will it last?” asked the Houston Chronicle.

“Health Spending Rises Only Modestly,” read a slightly more tempered headline in the New York Times.

From a quick glance at the headlines, one could easily be forgiven for assuming that healthcare costs – long painted as the bane of businesses and families alike – are finally starting to come down. On the left, some have been quick to point to the Affordable Care Act as the source of this boon. On the right, others have cited a persistently weak economy.

But lost in all of the chatter are two important points: first, that overall healthcare spending in the United States continues to rise faster than the rate of inflation; and second, that healthcare premium costs for businesses are rising as well.

Some of the confusion comes from using similar terms to describe very different numbers. National healthcare spending refers to the total amount spent every year by all payers: individuals, governments, businesses – everyone – on healthcare. For 2013, this number was $2.9 trillion.

Healthcare cost growth refers to the rate at which the national spending is increasing. In 2013, this was 3.6 percent. That’s the lowest rate of increase since 1960 when the government started keeping track of these things – but it’s still more than double the 1.5 percent rate of inflation that we saw in the broader US economy in 2013.

And for private businesses – who pay for health coverage for more than half of all Americans – the numbers aren’t much better. This is because the rate of increase in health insurance premiums is also continuing to rise. From 2013 to 2014, average premium for employer-sponsored family coverage for large employers (those with more than 200 employees) increased by 3.2 percent. Overall, since 2009, premiums for large firms have increased by 26 percent.

Ultimately, the topline numbers announced earlier this month are generally a positive development. But even as the rate of national healthcare cost growth has slowed in recent years, enterprises are still seeing their costs increase, and they still face a business imperative to take control of their healthcare spending. Visit Forbes for the article.



Genetic testing company 23andMe finds new revenue with big pharma

The past two years have been a rough and transformative time for the controversial DIY genetic testing company 23andMe. At the end of 2013, the Food and Drug Administration requested that the company shut down its main service, an analysis of a person’s genome gleaned from spit samples that anyone who purchased a kit could send in, noting that interpreting human genes—understanding what changes in DNA mean, and how they contribute or don’t contribute to disease—is still too much of a black box.

But things may be looking better for the company in 2015. On Jan. 6, it announced a $10 million partnership with biotech company Genentech, which will sequence the entire genomes of 3,000 23andMe customers with a higher risk for developing Parkinson’s disease.

Genentech is hoping the information will speed development of more effective drugs against the neurodegenerative disorder, in which motor nerves in the brain start to deteriorate.

“What attracted us to 23andMe and this opportunity is the work 23andMe has done together with the Michael J. Fox Foundation in the Parkinson’s space,” says Alex Schuth, head of technology innovation and diagnostics at Genentech. “They have built a community of individuals and their family members who have contributed DNA samples. What is unique about this cohort is that it gives us an opportunity to connect clinical data on how patients feel and how their disease is progressing, with their genomic data. That’s unique.”

The 23andMe customers will be asked to sign new consent forms as part of any Genentech studies. The agreement is one of many that 23andMe CEO and co-founder Anne Wojcicki says are in the works, and hint at the company’s most valuable asset—the genetic information on the 800,000 customers who have sent in their DNA-laden saliva since the company began selling kits in 2006.

But for the past year, the company hasn’t been sending back health information to customers who pay the $99 for an analysis. Instead, customers are getting reports on their genetic ancestry, with the promise that when the FDA permits it again, they will receive health-related information based on their genetic profile. Wojcicki says that since the FDA action, sales of the kits have been cut by about half, and while they are slowly climbing back up, they haven’t yet reached pre-2013 levels.

In the meantime, the genetic information 23andMe has already collected is becoming a potential gold mine for academic researchers and for-profit drug developers. The company has more than 30 agreements with academic researchers for which they receive no monetary compensation, so that scientists can learn more about certain diseases and contribute to basic knowledge about what goes wrong in those conditions.

Wojcicki says she’s balancing opportunities with both non-profit and for-profit companies to optimize the value of 23andMe’s database. Visit Time for the story.



Infections increase death risk by 35% for ICU patients

Elderly patients admitted to intensive care units (ICUs) are about 35 percent more likely to die within five years of leaving the hospital if they develop an infection during their stay, a new study finds.

Preventing two of the most common healthcare-associated infections – bloodstream infections caused by central lines and pneumonia caused by ventilators – can increase the odds that these patients survive and reduce the cost of their care by more than $150,000, according to a study published in the January 2015 issue of the American Journal of Infection Control.

The study looked at outcomes for 17,537 elderly Medicare patients admitted to 31 hospitals in 2002 to assess the cost and effectiveness of infection prevention efforts. Then, the researchers used an additional five years of Medicare claims data to assess the long-term outcomes and health costs attributed to healthcare-associated infections.

While 57 percent of all the elderly ICU patients died within five years, the researchers found that infections made death more likely. For those who developed central line associated bloodstream infections, or CLABSI, 75 percent died within five years, as did 77 percent of those who developed ventilator-associated pneumonia, or VAP.

Effective prevention programs for CLABSI resulted in an estimated gain of 15.55 years of life on average for all patients treated in the ICU, the study found. Central line catheters deliver life-saving medicines and nutrition. Without proper Central line catheter insertion, utilization, and maintenance, catheters can also transmit deadly infections to the bloodstream. Simple infection prevention measures include hand washing before handling the catheter and immediately changing the dressing around the central line if it gets wet or dirty.

Efforts to prevent VAP resulted in an estimated gain of 10.84 years of life on average for all patients treated in the ICU. Ventilators, machines that force air into the lungs when patients can’t breathe on their own, can cause infections when patients lie flat in bed for long periods of time. Keeping patients elevated in bed, with the head higher than the feet, is one simple precaution that can help prevent pneumonia.

On average, the ongoing cost of running an infection prevention program in the ICU is about $145,000, the study found. Prevention efforts reduced ICU costs by $174,713 per patient for each instance of CLABSI, and by $163,090 for VAP.

Healthcare-associated infections kill an estimated 75,000 Americans a year and create approximately $33 billion in excess medical costs. The U.S. Centers for Disease Control and Prevention first linked infection rates to prevention programs in the 1970s. Research since then has shown that checklists and other targeted infection control practices can make a significant dent in infection rates.

The paper is titled: “A decade of investment in infection prevention: A cost-effectiveness analysis,” and it was published in the official journal of the Association for Professionals in Infection Control and Epidemiology (APIC). Visit APIC for the report summary.



AMP releases 'A Molecular Diagnostic Perfect Storm' paper

The Association for Molecular Pathology (AMP), a non-profit organization serving molecular testing professionals, announced the release of an important white paper addressing the consequences of regulatory and reimbursement forces directed against molecular diagnostic testing that threaten patient care.

"The breakthroughs made possible by mapping the human genome - a multi-billion dollar project that took more than a decade to complete - are being threatened by government regulations, which in turn are threatening patient access to truly revolutionary treatments," said Victoria M. Pratt, PhD, Indiana University School of Medicine, active AMP Member, and lead author of the paper. "We hope that this manuscript further enlightens regulatory and reimbursement stakeholders about the storm brewing in Washington that could dismantle the development and coverage of important molecular diagnostic tests."

Medical professionals in universities, cancer centers, clinical laboratories, and pharmaceutical/manufacturing companies across the country have honored the public trust in the Human Genome Project by developing hundreds of innovative diagnostic tests and therapies that are advancing modern medicine in ways that would have been impossible without this breakthrough. By eliminating the barriers outlined in "The Perfect Storm" paper, genome-based research will continue to play a critical role in the development of more powerful tools to treat complex diseases such as cancer, diabetes, and cardiovascular disease.

Threats stemming from efforts by the U.S. Food and Drug Administration (FDA) and the Centers for Medicare and Medicaid Services (CMS), the two federal agencies that oversee molecular diagnostic testing, are the cause of this "Perfect Storm."

The FDA's new policies will effectively reformulate existing medical device regulations and consider medical professionals as manufacturers which will impose substantially new and duplicative requirements on clinical laboratories and hospitals.

Meanwhile, CMS, whose actions are frequently mimicked in the private sector, has taken a heavy handed approach in denying coverage or reducing payment for several medically necessary molecular pathology tests. Unfortunately, healthcare providers - those developing and delivering innovative diagnostic tests - along with patients, who are the ultimate intended beneficiaries, are caught in the middle.

"AMP is addressing the consequences of this gathering perfect storm of regulatory and reimbursement challenges directed against molecular diagnostic testing with recommendations designed to preserve patient access to these essential medical services" said AMP President, Janina Longtine, MD. "We are greatly concerned that these forces are coalescing to bring about consolidation of laboratory testing, to the detriment of local testing. This would have far-reaching negative effects on the healthcare system. As such, AMP is committed to working with the regulatory and reimbursement bodies to find a resolution that optimizes patient safety and offers access to important medical tests."

The paper, titled, “A Molecular Diagnostic Perfect Storm: The Convergence of Regulatory & Reimbursement Forces that Threaten Patient Access to Innovations in Genomic Medicine” is now available online



Lavish ‘Cadillac’ health plans dying out as Obamacare tax looms

Large employers are increasingly putting an end to their most generous healthcare coverage as a tax on “Cadillac” insurance plans looms closer under Obamacare.

Employees including bankers at JPMorgan Chase & Co. (JPM) and college professors at Harvard University are seeing a range of moves to shift more costs to workers. Companies are introducing higher deductibles and co-payments, rising premiums and the imposition of wellness programs that carry penalties for people who don’t comply.

Requiring employees to shoulder more of the cost burden may undermine public support for Obamacare just as Congress, now firmly under Republican control, considers new ways to gut the law.

The tax takes effect in 2018, and employers are already laying the groundwork to make sure they don’t have to pay the 40 percent surcharge on health-insurance spending that exceeds $27,500 for a family or $10,200 for an individual. Once envisioned as a tool to slow the nation’s growing healthcare tab, the tax has in practice meant higher out-of-pocket healthcare costs for workers.

The tax on Cadillac plans named after the luxury vehicle to denote their lavishness, is one reason the growth in healthcare premiums has slowed since the Patient Protection and Affordable Care Act took effect in 2010.

Last year, average family premiums rose 3 percent to $16,834, while single premiums held steady at $6,025, according to the Kaiser Family Foundation. Companies with a large percentage of high-wage workers paid more, with an average of $6,244 for single coverage.

Among employers with 200 or more workers, 51 percent had employees paying one-quarter or more of their premiums for family coverage last year, according to Kaiser’s report in September. That portion has been gradually increasing since 2011, when it was 42 percent.

Employers who have traditionally offered generous benefits to lure top professional talent, or who have conceded to demands from labor unions for better health benefits, are most susceptible to the tax, Wojcik said. Many are responding by imposing new requirements on workers and reducing their health benefits.

The number of employers offering only a high-deductible plan was expected to increase by 50 percent for 2015, according to an August study from the National Business Group on Health. Thirty-two percent planned to offer such “consumer-directed health plans,” up from 22 percent in 2014. Visit Bloomberg for the article.



January 8, 2015   Download print version

The drugs that companies promote to doctors are rarely breakthroughs

How U.S. utilization and price of healthcare compare to other countries

Antibiotic breakthrough may signal the end of drug-resistant superbugs

PTSD may raise risk for diabetes

Stryker acquires assets of Canada-based CHG Hospital Beds

Nine people infected with measles after visits to Disney parks

Inteplast Group advances in healthcare products market

Don't miss these discounts for the 9th Annual World Congress Leadership Summit on Healthcare Supply Chain Management

The drugs that companies promote to doctors are rarely breakthroughs

For more than five decades, the blood thinner Coumadin was the only option for millions of patients at risk for life-threatening blood clots. But now, a furious battle is underway among the makers of three newer competitors for the prescription pads of doctors across the country.

The manufacturers of these drugs — Pradaxa, Xarelto and Eliquis — have been wooing physicians in part by paying for meals, promotional speeches, consulting gigs and educational gifts. In the last five months of 2013, the companies spent nearly $19.4 million on doctors and teaching hospitals, according to ProPublica’s analysis of federal data released last fall.

The information, from a database known as Open Payments, gives the first comprehensive look at how much money drug and device companies have spent working with doctors. What it shows is that the drugs most aggressively promoted to doctors typically aren’t cures or even big medical breakthroughs. Some are top sellers, but most are not.

In almost all cases, older, cheaper products are available to treat the same conditions. Companies typically try to differentiate the new drugs by asserting they are easier to use; carry fewer side effects; work faster than competitors; or have medical advantages.

The makers of Pradaxa, Xarelto and Eliquis, for example, say their drugs are at least as effective as Coumadin for certain conditions but do not require routine blood tests or put limitations on what patients can eat. (Patients taking Coumadin, also known as warfarin, shouldn’t eat grapefruit or cranberries and have to limit green leafy vegetables in their diet.)

Officials at the Centers for Medicare and Medicaid Services, which administers Open Payments, and the Pharmaceutical Research and Manufacturers of America, the drug industry trade group, said they had not analyzed the data in order to rank spending by drug.

When told of ProPublica’s analysis, John Murphy, PhRMA’s assistant general counsel, said drug makers’ spending should be seen not only as a marketing strategy, but also as a way of ensuring the best treatment options for patients. “On paper, a drug may not look like it is monumentally better than another drug, but to an individual patient, it might be,” Murphy said.

According to ProPublica’s analysis, Victoza, a diabetes medication made by Novo Nordisk, was the drug associated with the most payments to doctors, by dollar amount. The company spent more than $9 million on physician interactions related to Victoza in the last five months of 2013, excluding research payments and royalties, which relate more to drug development than marketing.

Eliquis, the anticoagulant jointly marketed by Bristol-Myers Squibb and Pfizer, ranked second in its link to spending on physicians, with nearly $8 million, our analysis showed. In a statement, the companies said their spending helps ensure physicians understand the appropriate use of Eliquis. Because the drug is prescribed by physicians in different specialties, the statement said, “it is critical to have a speaker program that adequately provides robust education to these physicians.”

The drug associated with the third-most payments to doctors was Brilinta, a different type of blood thinner made by AstraZeneca that vies for sales with Plavix, which is now available generically. In an email, AstraZeneca said it had identified Brilinta as one of its “key platforms for growth” and increased speaker and research spending on it. “Physicians are also indispensable partners in our efforts to bring new medicines to patients,” the company said.

The list of most promoted drugs featured many recent arrivals: 14 of the top 20 were approved by the Food and Drug Administration since 2010. Some treat similar conditions, including diabetes, schizophrenia and chronic obstructive pulmonary disease, so the competition among them is fierce.

Largely absent from the top of the list were drugs that cure disease, such as a new class of hepatitis C treatments, or those that significantly extend life, particularly for cancer patients.

According to ProPublica’s analysis, a few of the most heavily promoted drugs, including Samsca, which treats low sodium levels in the blood, have serious side effects that came to light after their approval by the federal government. The manufacturers of several others, including Copaxone, Latuda, Xarelto, Daliresp and Humira, have been faulted by the F.D.A. for improper promotion. The medical device associated with the most payments to doctors was Intuitive Surgical’s da Vinci surgical robot system, which the company has marketed as an effective, less invasive option for an array of procedures. Critics have complained that the device is needlessly expensive and overused, and say it has been linked to patient complications and deaths. Intuitive spent nearly $12.8 million on physician interactions to promote the robot in the last five months of 2013, not including royalties and research. Visit the New York Times for the article



How U.S. utilization and price of healthcare compare to other countries

A new study by Kaiser Healthcare takes a look at how utilization and price of healthcare in the United States compare to similarly wealthy and sizable OECD countries. The analysis looks to 2013 health utilization data from the OECD Health Statistics database, and medical and hospital price variation data from the International Federation of Health Plans (IFHP) 2013 Comparative Price Report.

Generally speaking, people in the U.S. use health services overall less than in other countries, while services in the U.S. are consistently more expensive than in comparably wealthy OECD countries.

Along with Switzerland, the U.S. has the fewest physician consultations per capita among comparable OECD countries. Twenty years ago, the U.S. had roughly half as many physician consultations per capita than comparable OECD countries, and the gap has remained generally consistent over time, even as consultation use has grown in both the U.S. and other countries. 

Although the U.S. has a higher mortality rate than comparable countries, the U.S. and other countries have made dramatic progress in lowering mortality from diseases of the circulatory system. In the U.S., the mortality rate has fallen from 629 deaths per 100,000 population in 1980 to 261 in 2010.

Notably, the U.S. performs fewer coronary angioplasty surgeries and more coronary bypass surgeries than comparable OECD countries, and the number of coronary angioplasties performed in the U.S. is declining. For both procedures, prices are substantially higher than in comparable countries with available data.

One recent study suggests that publicly-available hospital quality reporting may contribute to a moderation in increasing prices for coronary angioplasties and bypass surgeries.

The study also explores availability, use, and price of MRIs, and imaging is one area where use of the health system is higher in the U.S. than in other countries. The U.S. has both the largest number of MRI units available per capita and the highest number of MRI exams performed. The average price per MRI exam in the U.S is 3.6 times higher than the average of comparable countries with data available. Visit Kaiser Family Foundation for the report.



Antibiotic breakthrough may signal the end of drug-resistant superbugs

Scientists have come across a potential game-changer in the fight against drug-resistant superbugs - a new class of antibiotic that is resistant to resistance. Not only does the new compound - which comes from soil bacteria - kill deadly superbugs like MRSA, but also - because of the way it destroys their cell wall - the pathogens will find it very difficult to mutate into resistant strains.

Many of the antibiotics in use today were discovered decades ago, and since then, microbes have evolved into resistant strains that do not succumb to them.

Most of the antibiotics used in human and animal medicine today come from soil microbes - for millions of years they have been producing toxic compounds to fight off other enemy microbes. For example penicillin, the first successful antibiotic, comes from the soil fungus Penicillium.

But there is a major problem with researching soil microbes - they are very difficult to culture in the lab. This means that as many as 99% of the microbes on our planet remain under-researched as sources of new antibiotics because they refuse to grow in lab cultures. That is until now.

Prof. Kim Lewis, a microbiologist and professor at Northeastern University in Boston, MA, and colleagues developed a way to culture bacteria in their natural environment. This uses a device that they call a "diffusion chamber" where the soil microbes they want to grow are separated into individual chambers sandwiched between two semi-permeable membranes. They then bury the device back in the soil. Thus, through the semi-permeable membranes, the bacteria become exposed to the highly complex mix of other microbes and compounds of the soil, and grow readily as if they were in the soil. This way, the researchers produced bacterial colonies large enough to research back in the lab.

They found 25 potential antibiotics, of which one, teixobactin, appeared the most powerful. In the lab, teixobactin, killed a broad range of pathogenic bacteria, including the drug-resistant superbugs MRSA and VRE (vancomycin resistant enterococci). Further tests in mice showed promising results against bacteria that cause septicemia, skin and lung infections.

Teixobactin breaks down the bacterial cell wall - the pathogen's key defense against attack. The researchers believe this means the microbe can mutate all it likes, but its cell walls will always be its Achilles heel.

Prof. Lewis and his colleagues found that repeated exposure to the drug did not produce any resistant mutations in Staphylococcus aureus or Mycobacterium tuberculosis, the bacterium that causes most cases of TB. Visit the Medical News Today for the report.



PTSD may raise risk for diabetes

Women with post-traumatic stress disorder seem more likely than others to develop type 2 diabetes, with severe PTSD almost doubling the risk, a new study suggests.

The research "brings to attention an unrecognized problem," said Dr. Alexander Neumeister, director of the molecular imaging program for anxiety and mood disorders at New York University School of Medicine. It's crucial to treat both PTSD and diabetes when they're interconnected in women, he said. Otherwise, "you can try to treat diabetes as much as you want, but you'll never be fully successful," he added.

PTSD is an anxiety disorder that develops after living through or witnessing a dangerous event. People with the disorder may feel intense stress, suffer from flashbacks or experience a "fight or flight" response when there's no apparent danger.

It's estimated that one in 10 U.S. women will develop PTSD in their lifetime, with potentially severe effects, according to the study.

People with type 2 diabetes have higher than normal blood sugar levels. Untreated, the disease can cause serious problems such as blindness or kidney damage.

Over the course of the study, 6 percent, developed type 2 diabetes, which is linked to being overweight and sedentary. Those with the most PTSD symptoms were almost twice as likely to develop diabetes as those without PTSD, said study co-author Karestan Koenen, professor of epidemiology at Columbia University Mailman School of Public Health in New York City.

The study doesn't prove that PTSD directly causes diabetes, although Koenen said the study's design allows the researchers to "know that PTSD came before type 2 diabetes."

Since PTSD disrupts various systems in the body, such as those that manage stress hormones, "it may be that something about PTSD changes women's biology and increases risk" of diabetes, she said.

The study appears in the Jan. 7 issue of JAMA Psychiatry.

Visit CBS News for the article.



Stryker acquires assets of Canada-based CHG Hospital Beds

Stryker Corporation has purchased the assets of CHG Hospital Beds, Inc., a privately-held low-height hospital bed maker headquartered in London, Ontario, Canada. The acquisition will grow one of Stryker's original product lines – hospital beds.

The purchase of CHG’s low-height beds that are designed to reduce the incidents of patient fall, is in line with Stryker’s commitment to offer products that enhance the quality of care for both patients and healthcare professionals.

Founded in 2003, CHG makes and markets a series of low-height hospital beds and related accessories across Canada, the U.S. and the U.K. Among CHG’s offerings is the recently launched Spirit One bed which is an expandable low-height bariatric bed for the acute care segment.

Recently, there have been rumors hinting that Stryker may bid for U.K.-based Smith & Nephew and offer a significant premium, likely to be about 30%, to the latter’s current share price. According to a latest Bloomberg report, a Stryker move for Smith & Nephew could come in as early as the next few weeks. Visit Zacks for the article.



Nine people infected with measles after visits to Disney parks

At least nine people came down with the measles after visiting Disneyland or the adjoining Disney California Adventure Park last month, probably by contracting it from somebody there, California’s health department said.

The confirmed cases include seven in five different California cities and two in Utah, the agency said today in a statement. California has three other suspected cases, it said. The confirmed California patients range in age from 8 months to 21 years, and all but one hadn’t been vaccinated.

The state is tracing the contacts the patients have had to determine the spread of the disease, a respiratory infection that causes a rash and can lead to pneumonia. While the measles is relatively rare in the U.S. because a vaccine is available, it persists in other countries, making international tourist destinations like Disneyland vulnerable.

The U.S. Centers for Disease Control and Prevention reported 20 measles outbreaks through November of last year, leading to 610 cases, a record since the disease was temporarily eliminated in 2000.

Two of the unvaccinated patients in the California cases were too young to get the vaccine, the health department said. Only one patient in the state had received the recommended two doses of the vaccine, which are more than 99 percent effective in preventing the measles, the agency said. Visit Bloomberg for the story.



Inteplast Group advances in healthcare products market

Integrated plastics manufacturer Inteplast Group has established a new business unit, Inteplast Healthcare, to align the wide range of healthcare industry products and services offered by its Medegen Medical Products, Minigrip, Inteplast/Pitt Plastics and Integrated Bagging Systems businesses.

The integration of Inteplast's healthcare products provides additional value to the healthcare industry through new sourcing and procurement synergies and is a significant progression for the company. Inteplast Healthcare now offers the broadest selection of Patient Bedside Plastics, Measurement and Collection, and Waste Containment Products in the marketplace.

Inteplast acquired Medical Action Industries' substantial Patient Care business earlier this year and rebranded it as Medegen Medical Products. Medegen Medical Products is the largest manufacturer of plastic injection molded patient bedside items such as urinals, pitchers, emesis basins and bedpans in the United States, and manufactures items such as sharps containers and graduated measures as well.

Inteplast is the parent company for Minigrip, inventors and patent holders for zipper and specialty medical bags; and Inteplast's Integrated Bagging Systems division and Inteplast/Pitt Plastics both manufacture can liners, laundry and linen bags, bio hazardous waste bags and more for the healthcare industry.

Charles (Chuck) Kelly, former president of Patient Care Products at Medical Action Industries, was named president of Medegen Medical Products and is now leading initiatives at Inteplast Healthcare. 

The entire family of Inteplast Healthcare products is available now to GPOs, IDNs, Acute and Alternate Care facilities, through Medegen Medical Products' sales force. The company will launch a new website in the first quarter of 2015. Visit here for the full release.



Don't miss these discounts for the 9th Annual World Congress Leadership Summit on Healthcare Supply Chain Management

Don’t miss your chance to join Healthcare Purchasing News and an amazing speaker lineup at the World Congress 9th Annual Leadership Summit on Health Care Supply Chain in New Orleans, January 26–27, 2015.

Hear industry experts address today’s most critical issues facing healthcare supply chain operations. Sessions include thought-provoking panels and case studies by healthcare executives from leading organizations who will share details about how they transformed their supply chain departments into systems with a strategic, collaborative and innovative focus that accomplished the overall business and clinical goals of the organization.

Technology, value analysis, and integration are all new and vital components to consider when developing future healthcare supply chain strategy. The Summit session will feature presentations on how hospitals and health systems are addressing these components and others relating to physician engagement, variation, utilization, distribution, clinical outcomes, transparency, and new issues such as automation, value based contracts, and bundled payments.

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-Innovative breakthroughs in purchasing, distribution, and efficiency

-Out-of-Industry insights that highlight best practices in purchasing and distribution

-Spotlight sessions on rep-less OR programs, pediatric supply chain challenges, bundled payments, and payer relations

-Value-based contracts and creative supplier-provider relations that leverage long-term relationships to improve value and reduce costs

The 2015 Summit will also focus on big-data and evidence-based purchasing, including key insights to supplier-provider relationships that focus on value, improved outcomes, and reduced costs. The Summit will also delve into strategies for payer relations as well as creative approaches to value analysis, clinical engagement, and cost control that will improve supply chain sustainability.

Hospitals and health systems can register for only $695 until December 17, 2014, a $600 savings on your registration fee! Don’t miss this outstanding value.

Visit World Congress for more information and to register.



January 7, 2015   Download print version

CDC: More middle-aged white men than students die from binge drinking

Thumbing around on a smartphone makes your brain more sensitive to touch, study says

Bungling of virus prompts hiring of CDC Safety Chief

Scientists search for new sources of antibiotics in cockroaches and 5 other strange places

People with type 1 diabetes still produce insulin, study says

Your birth year could influence your odds for obesity, study suggests

SPS/Crosstex announce 2015 seminar series: Sterilization Classroom with Chuck Hughes

Gilead Sciences, CVS strike exclusive deal on hepatitis C drugs

CDC: More middle-aged white men than students die from binge drinking

America’s binge drinkers are fueling an average of six alcohol-poisoning deaths per day and the rates are highest among non-Hispanic white, middle-aged men, according to a new government report.

Women who have four or more drinks on an occasion and men who have five or more are considered binge drinkers by the U.S. Centers for Disease Control and Prevention (CDC).

But nearly every week, more than 38 million people report consuming an average of eight drinks during one episode, or binge, the CDC found. That kind of heavy drinking over a short period, such as two to three hours, can prove fatal.

When large amounts of alcohol are consumed in a short period of time, blood-alcohol levels rise sharply, overwhelming the body’s ability to respond. Excessive alcohol intake can shut down parts of the brain that control breathing, body temperature and heart rate.

“If we could eliminate binge drinking, we would dramatically reduce the risk of alcohol poisoning,” said Bob Brewer, who heads the alcohol program of the National Center for Chronic Disease Prevention and Health Promotion at the CDC.

The CDC report is the first in a decade to tally alcohol poisonings for the entire U.S. population. Most previous analyses looked at certain groups, in particular young people.

Most of the estimated 1.5billion binge-drinking episodes each year involve Americans 26 and older, Brewer said. But CDC researchers were surprised to find that people ages 35 to 64 accounted for three-fourths of America’s roughly 2,200 alcohol-poisoning deaths each year from 2010 to 2012.

While binge drinking with hard liquor is more common among younger adults, middle-aged people typically binge on beer.

The CDC analysis, which studied alcohol-poisoning deaths among those 15 and older, found that alcoholism was a factor in 30 percent of the deaths. Almost 70 percent of the deaths from 2010 to 2012 occurred among non-Hispanic whites. American Indians and Alaska Natives, however, had the highest death rates from alcohol. Visit the Seattle Times for the article.



Thumbing around on a smartphone makes your brain more sensitive to touch, study says

A new study suggests that using a smartphone, touching the fingertips against the smooth surface of a screen, can make the brain more sensitive to the thumb, index and middle finger tips being touched.

The study, which was published in the journal Current Biology, found that the differences between people when it comes to how the brain responds to thumb stimulation is partly explained by how often they use their smartphones.

Other research has shown that musicians and expert video gamers show the same type of brain adaptations. Smartphone use isn't something most people would consider an "expertise," but frequent use of the devices might similarly lead to brain adaptations.

Researchers used an electroencephalography (EEG) device to record the activity that occurred in the brain when people touched their thumbs, index and middle fingers to a mechanical object. They compared the brain recordings of smartphone users and regular cellphone users.

Smartphone users showed enhanced brain activity when their thumbs, index and middle fingers were touched. And the more people used their smartphones, the more brain activity researchers observed when the thumb and index fingers were touched. Thumb use in particular resulted in increased or decreased brain activity if there was more or less cellphone use in a single day.

According to the study's author, it suggests that the brain plasticity that is observed among people with "expert" skills, such musicians, can also be observed in people as a result of our day-to-day interactions with technology. Visit the Washington Post for the article.



Bungling of virus prompts hiring of CDC Safety Chief

The U.S. Centers for Disease Control and Prevention will hire a laboratory safety supervisor after an Ebola virus sample was mishandled, the third reported safety lapse with potentially dangerous pathogens at the agency’s labs in the past year.

The new position, posted nationally in November before the Ebola incident, is “under recruitment,” Barbara Reynolds, a CDC spokeswoman, said in an e-mail. The safety chief will be responsible for identifying problems, creating plans to solve them and holding CDC labs “accountable for follow-up,” she said.

Scientists discovered Dec. 23 that a technician in one of the agency’s labs was exposed to what may have been live Ebola virus. In March, the CDC inadvertently shipped a deadly strain of avian flu to a U.S. Department of Agriculture laboratory, and in June more than 80 CDC workers were potentially exposed to anthrax after a sample of the bacteria was mishandled, sparking congressional scrutiny of the agency and its director, Thomas Frieden, who pledged to improve safety measures.

“CDC has made many improvements in laboratory safety, and continues to do so,” Reynolds said in her e-mail. The agency announced in July it would create a single point of accountability for safety in the lab.

In the Ebola incident, a plate with material from an experiment involving the virus was sent from a high-security biosafety laboratory to a less-secure lab at the agency’s Atlanta campus, the CDC said in a Dec. 24 statement. Live Ebola virus requires the highest level of security with special equipment and handling, according to the agency’s rules.

A lab technician who processed the material was the only person believed to be exposed to the virus, the CDC said. The person has no symptoms and will be monitored for 21 days, the maximum incubation period for the virus. Fewer than a dozen people who entered the second, lower-security lab have been contacted “to make them aware” of the mishap, Reynolds said last week.

Other steps the CDC is taking to improve safety in its labs include requiring scientists to use “validated methods” to inactivate dangerous pathogens and to verify the sterility of any materials shipped out of CDC labs, Reynolds said. Visit Bloomberg for the story.



Scientists search for new sources of antibiotics in cockroaches and 5 other strange places

Many of our life-saving medications depend on the discovery of strange medical solutions. Antibiotics were one of the greatest finds and have added 10 years of life on to the average person who would otherwise die from some sort of bacterial infection.

In 1928, when research scientist Alexander Fleming discovered the bacteria in a stack of dirty Petri dishes, one of them caught his attention. “That’s funny,” Fleming was reported as saying when he found a surviving mold on a dish, which he later identified as Penicillium notatum.

His discovery laid the ground for a revolutionary medical approach to drug treatment. Since then, researchers have been searching for a potent antibacterial solution to prevent the drug-resistant infections of two million people in America, according to the CDC. Every year, at least 23,000 of those people die as a result, which is why scientists are searching under every rock — literally — for a solution to the increasingly drug-resistant strains of bacteria. Here's a list of six of the weirdest places they're searching: 

- Cockroach Brains: The cockroach’s nervous system contains nine different antibiotics. Some strains are powerful enough to treat E.coli, which causes serious gastrointestinal problems. They are also effective at fighting MRSA (methicillin-resistant Staphylococcus aureus), a bacterium resistant to many bacteria and can cause life-threatening infections once it hits the bloodstream.

-Alligator Blood: Researchers were curious why alligators could withstand open wounds from territorial fights with other gators without contracting any infections. Their powerful immune systems helped them recover with astonishing speed, and in 2008 researchers extracted white blood cells from the gators and found a wide range of antibacterial compounds. One of the compounds has the ability to kill MRSA, along with 22 different strains of bacteria, including Salmonella, staph, E.coli, strep, and a strain of HIV.

-Old Televisions: In 2010, researchers figured out how to turn the compound that makes up LCD TVs into an antibacterial substance. The liquid crystal display destroys E.coli and certain strains of MRSA by heating, cooling, and dehydrating it with ethanol. It could be used to clean hospital and medical facility tools, which would in turn reduce a hospital patient’s risk for infection.

-Fungi in Pacific Ocean: There are promising new strains of never-before-discovered fungi strains lying at the body of the Pacific Ocean. It’s mixed in with a 100-million-year-old nutrient-starved sediment that was previously thought a dead zone. But somehow eight different fungi strains have been surviving there, and four were collected and survived the journey to a lab.

-Panda DNA: Researchers in China have discovered within a panda’s DNA is a powerful antibiotic compound called cathelicidin-AM. It helps protect them against bacteria and other fungi. In fact, it’s so potent, it can kill bacteria in less than one hour.

-Underground Cave: The Lechuguilla Cave lies 1,600 feet below New Mexico’s Carlsbad Caverns, making it the deepest limestone cave in America. The rock-eating bacteria that thrive off of the sulfur, iron, and manganese deposits found inside the chandelier-like rock formations could be key. Scientists extracted samples and believe it could extend how long a MRSA-fighting drug lasts in the human body.

Visit Medical Daily for the article.



People with type 1 diabetes still produce insulin, study says

Although it's widely accepted that people with type 1 diabetes produce no insulin, a new study suggests otherwise: Roughly one-third produce the hormone long after they are diagnosed.

Residual insulin production can last for more than four decades, researchers reported recently in the journal Diabetes Care. Their findings could help avoid the misdiagnosis of type 1 diabetes as the more common type 2 diabetes and improve treatments for blood sugar control, they suggested.

"Other studies have shown that some type 1 diabetes patients who have lived with the disease for many years continue to secrete insulin, and the assumption has been that these patients are exceptional," said study senior author Dr. Carla Greenbaum, director of T1D Exchange Biobank Operations Center, a repository of type 1 diabetes biological samples, in Seattle.

Worldwide, about 35 million people in the United States have type 1 diabetes, the researchers said. The autoimmune disease causes the destruction of insulin-producing cells in the pancreas, which means patients must take insulin injections or use an insulin pump.

The researchers examined type 1 diabetes samples from more than 900 people ranging in age from 5 to 88, and found that C-peptide, a byproduct of insulin production, was present in patients of all ages.

But C-peptide was found more often and in higher concentrations in those diagnosed as adults. Among those who had type 1 diabetes for three to five years, C-peptide was present in 78 percent of those diagnosed after 18 years of age, and in less than half of those diagnosed before age 18.

Additionally, 16 percent of those diagnosed as an adult and 6 percent of those diagnosed as a child had residual C-peptide more than four decades later, the researchers found. They concluded there are key differences in type 1 diabetes diagnosed during childhood and type 1 diabetes that develops during adulthood.

"These findings lend further credence to research underway on targeted therapies that could prolong insulin production, helping type 1 diabetes patients better manage their disease and reduce complications," study co-author Asa Davis, a T1D Exchange program manager said.

The researchers also said their findings could have major policy implications, noting that many type 1 diabetes may not meet the insulin pump requirements of federal and private insurers, which are based on lack of insulin production. (HealthDay) Visit NIH for the study.



Your birth year could influence your odds for obesity, study suggests

The year in which you're born might affect the activity of a gene that could raise your odds for obesity, a new study finds.

Members of families who share an obesity-prone mutation of the FTO gene are more likely to carry extra weight if they were born after 1942, the researchers found.

"You could have a family where your father might be born in 1920 and you were born after 1942, and you look exactly like him, and only on the basis of the food and environment around you, you will have a higher BMI than your father," said lead author Dr. James Niels Rosenquist, an instructor at Harvard Medical School and psychiatrist with Massachusetts General Hospital in Boston. BMI (body mass index) is a standard measurement of weight and height.

According to the researchers, prior studies have linked variations in the FTO gene to a propensity toward overweight and obesity. For example, federal researchers earlier this year reported that people with mutated FTO genes are more likely to eat high-calorie or fatty foods as they age, compared to people without the mutations.

While the study couldn't prove cause-and-effect, the findings suggest that changes in American culture may be boosting the obesity threat tied to the FTO gene mutation.

To take a multi-generational look at obesity risk, the researchers relied on the Framingham Heart Study, a decades-old study of more than 10,000 parents, children and even grandchildren hailing from the town of Framingham, MA.

About two-thirds of the more than 5,100 children born to the original Framingham participants have had their DNA sequenced. This allowed the research team to determine which families carried the obesity-prone versions of the FTO gene.

The researchers compared people's genes to changes in BMI measurements taken over time, and then compared that to the years participants were born.

Rosenquist's team found no link between the FTO gene and obesity for people born prior to 1942. However, they found a very strong link between the gene and obesity in those born after 1942, a link twice as strong as reported in previous studies.

Dr. Mitchell Roslin is chief of obesity surgery at Lenox Hill Hospital in New York City. He said that science is beginning to show that genes alone may not determine a person's fate. Instead, genes often appear to respond to outside influences, so there's a combination of environment and genetics at play.

The new study could not point to any specific differences in America pre- and post-World War II that might affect the FTO gene and create increased obesity risk. But Rosenquist believes that Americans' increasingly sedentary lifestyles, a shift from a manual labor workforce to a service economy, and increased access to high-calorie foods all might play a role.

"The findings lend credence to the belief that our current obesity epidemic can be linked to major environmental changes that have occurred over the last 50 or so years," added Christine Santori, a registered dietitian and program manager of the Center For Weight Management at North Shore-LIJ's Syosset Hospital in Syosset, NY. Visit HealthDay for the study.



SPS/Crosstex announce 2015 seminar series: Sterilization Classroom with Chuck Hughes

Certified as a Health Education teacher, Chuck Hughes has worked for over 25 years in the manufacturing industry in areas of Regulatory Affairs, R&D, Marketing, Microbiology and Sterilization Training. He is a corporate member of AORN, AST, IAHCSMM, SGNA and numerous other organizations, including AAMI and CSA where he contributes to sterilization standards.

A popular speaker at regional, national and international healthcare conferences, Hughes has visited thousands of healthcare facilities during his career providing sterilization consulting services that include fee-based and complementary audits of instrument reprocessing areas.

Upcoming Topics include:

·         Personal Protection Equipment (PPE) Do's and Don'ts, February 2015

·         Sterile Packaging (Pouches, Wrap & Containers), May 2015

·         High-Level Disinfection (HLD) Record Keeping, August 2015

·         2015 Reprocessing Issues and Solutions, November 2015

In addition to the quarterly seminars, be sure to visit the Sterilization Classroom for: Additional educational opportunities; Industry updates and articles, "Go Green" Ideas for SPD, Sample Polices & Procedures, Learn more about Joint Commission and AAAHC infection control standards, Utilize our "Ask the Experts" link to ask your sterilization/infection control questions.

Visit SPS Medical to register.



Gilead Sciences, CVS strike exclusive deal on hepatitis C drugs

Gilead Sciences Inc. agreed to make its hepatitis C medicines the exclusive treatments for CVS Health Corp. customers, intensifying a drug-industry rivalry to win patients for the $1,000-a-day medicines.

Gilead’s Harvoni and Sovaldi will be the only pills covered on CVS’ main list of drugs, as well as on its list for health plans through the Affordable Care Act, Medicare Part D and Medicaid, the benefits manager said Monday.

The deal blocks AbbVie Inc.’s treatment, called Viekira Pak, which will only be available to patients given approval because of medical exceptions or through a process called prior authorization, according to CVS. Patients already taking Viekira Pak will be allowed to finish their treatment.

“Our goal was to create the lowest net-cost solution for the entire population of patients with all genotypes of hepatitis C,” CVS said. The company didn’t say whether it got a special price for Gilead’s drugs, and a spokeswoman for Foster City’s Gilead wouldn’t comment on details of the agreement.

The agreement with CVS helps Gilead recover after AbbVie struck its own deal with Express Scripts Holding Co., the biggest U.S. drug-benefits manager, which chose last month to favor Viekira Pak for most U.S. patients. AbbVie offered an unspecified discount to Express Scripts, to the dismay of biotech investors who have bet on the industry’s ability to maintain high prices.

The hefty price tags for the hepatitis C drugs have drawn criticism from insurers and lawmakers. Gilead’s Sovaldi costs $84,000 for a 12-week course of treatment, and Harvoni, which combines Sovaldi with another medication, taken as a single pill, costs $94,500 for 12 weeks. Viekira Pak’s 12-week price is $83,319. Visit San Francisco Gate for the article.



January 6, 2015   Download print version

New test measures doctors’ ability to deliver patient-centered care

Ebola Tx poses ethical puzzles

Bloodstream infections correlate with distance from the equator and healthcare spending

Cautious doctors use telemedicine to diagnose flu

Software predicts MRSA'S response to new drug before it's tested on patients

Aethlon Medical announces approval of Ebola treatment protocol

Biological bad luck blamed in two-thirds of cancer cases, researchers say

An anti-aging drug in the works? First steps toward boosting immune system, delaying aging

New test measures doctors’ ability to deliver patient-centered care

When healthcare providers take patients’ perspectives into consideration, patients are more likely to be actively engaged in their treatment and more satisfied with their care. 

This is called patient-centered care, and it has been the central focus of the curriculum at the University of Missouri School of Medicine since 2005. Recently, MU researchers have developed a credible tool to assess whether medical students have learned and are applying specific behaviors that characterize patient-centered care.

The researchers first worked with real patients to identify a list of specific behaviors that demonstrated physicians were providing patient-centered care. By defining these detailed, specific patient-centered behaviors, the researchers have been able to tailor the educational experience at the MU School of Medicine to help students gain these skills.

MU medical students now are assessed on their ability to deliver the care in ways the patients expect; students must perform at a satisfactory level on the patient-centered care exam to graduate from the MU School of Medicine.

The test of patient-centered care behaviors is given to third-year medical students. The exam is given in the third year because it is then the students are immersed in their clinical rotations. Before the third year of medical school, most of the studies are done in a classroom, lab or simulation-center setting. The test is called the Patient-centered Care – Objective Structured Clinical Exam (PCC-OSCE).

The standardized patient (an actor) is trained to take on characteristics of a real patient and portray the roles of patients, family and others. Students are tested on how they interact with standardized patients ranging from adolescents to senior citizens, how to solicit information from the patient, and how to create a management and care plan that reflects the patient’s preferences.

From this authentic assessment, researchers learned students were picking up on many key factors in patient-centered care. Most MU medical students had strong, effective communication skills, didn’t use medical jargon, actively listened to the patient, showed empathy and were in charge of the situation when they needed to lead a critical conversation.

Through these tests, School of Medicine faculty members have also been able to identify other opportunities where students can improve. Many of those include examining barriers a patient could face that would cause problems with compliance with the treatment plan and routinely involving family members and other members of the health care team in the patient’s care. Visit UMW for the study.



Ebola Tx poses ethical puzzles

The treatment of Ebola patients in developed countries poses significant ethical challenges for clinicians, especially when they have to think about urgent life-sustaining care.

Institutions that might have Ebola patients need to develop policies that will guide clinicians faced with delivering such therapies as cardiopulmonary resuscitation and dialysis, according to Scott Halpern, MD, PhD, and Ezekiel Emanuel, MD, PhD, both of the University of Pennsylvania in Philadelphia.

In the absence of Ebola, decisions about such care would usually raise few questions, they argue online in Annals of Internal Medicine. But because of the risk to healthcare workers themselves, the virus raises an "unfamiliar ethical paradigm for clinicians and hospital administrators," Halpern and Emanuel write.

They present four examples to illustrate the issues:

·         An Ebola patient with rapidly progressive hypovolemic shock that leads to cardiac arrest noted from telemetry monitor at the nurses' station. Should CPR be performed?

·         A patient with profound hypokalemia from diarrhea develops ventricular fibrillation. Should nurses and a physician, already in protective equipment at the bedside, attempt electrical defibrillation while using an indwelling intravenous catheter to remedy the low potassium?

·         A patient with shock and multisystem organ failure becomes anuric and develops signs of respiratory failure. Should clinicians initiate mechanical ventilation and hemodialysis?

·         A patient with advanced but stabilized Ebola develops what appears on bedside ultrasonography to be a ruptured appendix. Should clinicians perform an open appendectomy?

All four scenarios would usually be evaluated on the basis of the risks and benefits to the patient alone if, for instance, the underlying condition was bacterial septic shock, Halpern and Emanuel argue.

But when Ebola is the underlying condition, the risks to clinicians must also be taken into account, they argue. In the first two cases, for instance, the risk-benefit profile is different. CPR is likely to release bodily fluids during chest compressions, and the time needed to get into protective gear would limits its effectiveness.

But electrical defibrillation, in the second case, poses a lower risk to the clinicians -- they are already suited up and the procedure is less likely than CPR to cause a release of fluids.

The default policy, Halpern and Emanuel argue, should be against CPR but should leave clinicians the option to perform less risky procedures if they are warranted.

Similar arguments apply to the other cases, where the default policy should be to allow the interventions but to permit physicians to deviate from guidelines in high-risk cases.

Halpern and Emanuel also argue that institutions should "continually measure and report" what the risks are, as well as disclosing their policies both to patients and their families.

Visit MedPage Today for the article.



Bloodstream infections correlate with distance from the equator and healthcare spending

Where you live affects the type of bacteria that cause bloodstream infections, according to researchers at Rhode Island Hospital and an international team of investigators. The closer you live to the equator, the greater the likelihood of a bloodstream infection caused by a group of bacteria called Gram-negative bacteria, which thrive in warm and moist environments, compared to another group of bacteria referred to as Gram-positive bacteria. The study also found that the proportion of a country's GDP spent on healthcare impacted the type of bacteria causing such infections. The study was published in the scientific journal PLOS ONE.

"This study reflects the fascinating interaction of the environment, human health, and economic factors that together help shape the sorts of diseases that become manifest in different parts of the world," said Leonard Mermel, D.O., medical director of the department of epidemiology and infection control at Rhode Island Hospital. "A better understanding of this phenomenon may help us prepare for the effects they have on future human generations around the globe. In addition, such information may assist physicians who need to empirically administer antibiotics to patients with possible bloodstream infections in different areas of the world."

Visit Medical News Today for the study.



Cautious doctors use telemedicine to diagnose flu

Some doctors in Tennessee are asking patients with flu-like symptoms not to come into their offices to avoid spreading the virus to other patients in their waiting room. Instead, these doctors are evaluating patients over the phone or on computers as part of something called "telemedicine."

Although the rapid influenza test is effective at determining whether children have the virus (as opposed to some kind of bacterial infection), it's wrong 25 percent of the time in adults because their bodies don't produce as much of the virus when they're sick. Children, on the other hand, have weaker immune systems and become little flu distributors even before they start to feel sick. As a result, they have very high viral loads.

So Dr. William Schaffner, chair of preventive medicine at Vanderbilt University Medical Center in Nashville, TN, said many doctors will discuss symptoms over the phone and prescribe an antiviral medication. But they ask that sick patients have a family member pick it up at the pharmacy.

He said this approach is cost effective because patients avoid the cost of the test and the doctor’s visit. And they don't spread the virus to other people by coming to the doctor’s office. The influenza virus is highly infectious and can be spread to people within 3 feet of a sick patient when that patient coughs, sneezes or talks, he said.

The Centers for Disease Control and Prevention declared a flu epidemic this week with 22 state reporting high amounts of "influenza-like activity."

Tennessee has seen epidemic levels for two weeks, and three children have already died.

Visit ABC News for the story.



Software predicts MRSA'S response to new drug before it's tested on patients

With drug-resistant bacteria on the rise, even common infections that were easily controlled for decades, such as pneumonia or urinary tract infections, are proving trickier to treat with standard antibiotics.

New drugs are desperately needed, but so are ways to maximize the effective lifespan of these drugs. To accomplish that, Duke University researchers used software they developed to predict a constantly-evolving infectious bacterium's countermoves to one of these new drugs ahead of time, before the drug is even tested on patients.

In a study appearing in the journal Proceedings of the National Academy of Sciences, the team used their program to identify the genetic changes that will allow methicillin-resistant Staphylococcus aureus, or MRSA, to develop resistance to a class of new experimental drugs that show promise against the deadly bug.

When the researchers treated live bacteria with the new drug, two of the genetic changes actually arose, just as their algorithm predicted.

"This gives us a window into the future to see what bacteria will do to evade drugs that we design before a drug is deployed," said co-author Bruce Donald, a professor of computer science and biochemistry at Duke.

Developing pre-emptive strategies while the drugs are still in the design phase will give scientists a head start on the next line of compounds that will be effective despite the germ's resistance mutations.

"If we can somehow predict how bacteria might respond to a particular drug ahead of time, we can change the drug, or plan for the next one, or rule out therapies that are unlikely to remain effective for long," said Duke graduate student Pablo Gainza-Cirauqui, who co-authored the paper.

Because bacteria reproduce so rapidly, growing and dividing from one cell to two in less than an hour, drug-resistant bacteria are constantly evolving, and researchers have to constantly develop new ways to kill them.

Since the first antibacterial drugs were introduced in the 1940s, bacteria have evolved ways to resist every new antibiotic that has been developed, a process that has been accelerated by the use of antibiotics in livestock to help them gain weight, and in humans to treat viral infections that antibiotics are powerless to cure.

The percentage of infections caused by the bacterium Staphylococcus aureus that have proven resistant to treatment has risen steadily from just over 2 percent in 1975 and 29 percent in 1991 to more than 55 percent today -- resulting in more than 11,000 deaths in the U.S. each year, a higher death toll than HIV.

Until now, scientists trying to predict the genetic changes that would enable a bacterium to evade a particular drug have had to look up possible mutations from "libraries" of resistance mutations that have been observed previously. But this approach falls short when it comes to anticipating how bacteria will adapt to new drugs, where the microbes can't be counted on to change in repeatable, predictable ways, Donald said.

"With a new drug, there is always the possibility that the organism will develop different mutations that had never been seen before. This is what really worries physicians."

To overcome this problem, a research team led by Donald at Duke and Amy Anderson at the University of Connecticut used a protein design algorithm they developed, called OSPREY, to identify DNA sequence changes in the bacteria that would enable the resulting protein to block the drug from binding, while still performing its normal work within the cell.

The team focused on a new class of experimental drugs that work by binding and inhibiting a bacterial enzyme called dihydrofolate reductase (DHFR), which plays an essential role in building DNA and other processes. The drugs, called propargyl-linked antifolates, show promise as a treatment for MRSA infections but have yet to be tested in humans.

When the scientists treated MRSA with the new drugs and sequenced the bacteria that survived, more than half of the surviving colonies carried the predicted mutation that conferred the greatest resistance, a tiny change that reduced the drugs' effectiveness by 58-fold.

The researchers are now using their algorithm to predict resistance mutations to other drugs designed to combat pathogens like E. coli and Enterococcus.

The software they developed, called OSPREY, is open-source and freely available for any researcher to use. Visit Eureka for the study.



Aethlon Medical announces approval of Ebola treatment protocol

Aethlon Medical, Inc. (AEMD), announced that the United States Food and Drug Administration (FDA) has approved a clinical protocol to treat Ebola-infected individuals in the U.S. with the Aethlon Hemopurifier. 

In the treatment of viral pathogens, the Hemopurifier is a first-in-class bio-filtration device designed for the single-use removal of viruses and shed glycoproteins from the circulatory system of infected individuals. The device targets antiviral drug resistance and serves as a first-line countermeasure against Ebola and other viruses that are not addressed with proven drug therapies. 

The approved Ebola treatment protocol allows for an investigational study to be conducted at up to 10 U.S. clinical sites, and up to 20 U.S. subjects may be enrolled to receive the treatment protocol. Patients who meet the enrollment criteria will receive a daily six to eight hour administration of Hemopurifier therapy until the point that Ebola viral load drops below 1000 copies/ml. The goal of the study is to standardize and evaluate the use of the Hemopurifier as supportive care in the treatment of Ebola virus disease.  

The Ebola treatment protocol resulted from the submission of a supplement to an Investigation Device Exemption (IDE) previously approved by FDA. The supplement was entitled, "Treatment of Ebola Virus Disease (EVD) in Humans with the Aethlon Hemopurifier Lectin Affinity Plasmapheresis Device."  

Based on the previously approved IDE protocol, Aethlon is conducting a clinical feasibility study of Hemopurifier therapy in individuals infected with Hepatitis C virus (HCV) who are also receiving chronic dialysis therapy. A detailed description of the HCV study, including treatment protocol and patient inclusion/exclusion criteria can be accessed online at www.clinicaltrials.gov.

Time Magazine recently named the Aethlon Hemopurifier to be one of the 25 best inventions of 2014.  The magazine also included the Hemopurifier as one of the 11 most remarkable advances in healthcare in 2014.  

Visit Aethlon for more information.



Biological bad luck blamed in two-thirds of cancer cases, researchers say

Plain old bad luck plays a major role in determining who gets cancer, according to researchers who found that two-thirds of cancer incidence of various types can be blamed on random mutations and not heredity or risky habits such as smoking.

The researchers said that random DNA mutations accumulating in parts of the body during ordinary cell division are the prime culprits behind many cancer types.

The researchers looked at 31 types ofcancer and found that 22types could be explained largely by these random mutations — essentially biological bad luck. The 22 types included leukemia and pancreatic, bone, testicular, ovarian and brain cancer.

The other nine types, including colorectal cancer, skin cancer known as basal cell carcinoma and smoking-related lung cancer, were more heavily influenced by heredity and environmental factors such as risky behavior or exposure to carcinogens. (The study did not cover all cancer types.)

Overall, the researchers attributed 65percent of cancer incidence to random mutations in genes that can drive cancer growth.

“When someone gets cancer, immediately people want to know why,” said oncologist Bert Vogelstein of the Johns Hopkins University School of Medicine in Baltimore. He conducted the study, published in the journal Science, with Johns Hopkins biomathematician Cristian Tomasetti.

“They like to believe there’s a reason. And the real reason, in many cases, is not because you didn’t behave well or were exposed to some bad environmental influence, it’s just because that person was unlucky. It’s losing the lottery.”

Tomasetti said harmful mutations occur for “no particular reason other than randomness” as the body’s master cells, called stem cells, divide in various tissues. Tomasetti said the study indicates that changing one’s lifestyle and habits such as smoking to avoid cancer risks may help prevent certain cancers, but it may not be as effective for others. Visit the Washington Post for the story.



An anti-aging drug in the works? First steps toward boosting immune system, delaying aging

Everyone wants smoother skin, thicker hair, and an absence of wrinkles as they age. In essence, everyone wants to hold onto the virtues of youth. Yet, we haven’t quite been able to find a cure for baldness, let alone a cure for that inevitable decline in health, beauty, and vigor we all must face at some point. We can gather all the anti-aging creams, vitamin supplements, and Botox we want, but these are temporary solutions; what we’ve all been holding out for is some magical elixir that will be some form of a fountain of youth.

According to a new study, researchers may have finally made some steps toward a potential anti-aging drug. The medication, which is a version of the drug known as rapamycin, proved to boost seniors’ immune systems with regard to flu vaccine responses by 20 percent. The study was published in Science Translational Medicine.

Rapamycin belongs to a group of drugs called mTOR inhibitors, which have been shown in previous studies to work as anti-aging agents. As people age, mTOR's genetic pathways seem to have a negative effect, even though they support healthy growth in children (this goes for all mammals). So, using rapamycin to inhibit the mTOR genetic pathway could, in theory, delay aging. In a 2013 study, for example, researchers discovered that rapamycin worked to increase both “mean and maximum life spans” in mice.

However, this is the first time that researchers are studying rapamycin’s effect in humans. While more research is needed to better gauge whether rapamycin can extend a human lifespan like it does in mice, the study shows that it boosts older people’s immune systems, particularly against the flu, which can be especially dangerous to elderly.

For the study, older participants who received the experimental dose of rapamycin had 20 percent more antibodies in response to the flu vaccine than people who didn’t get rapamycin. In addition, rapamycin decreased the amount of white blood cells that are typically linked to aging and immune decline. Visit Medical Daily for the study.



January 5, 2015   Download print version

H3N2 viruses fuel 'epidemic' levels of flu season deaths, CDC says

Proper arrangements for Ebola checks in place, says Prime Minister

1.5 million lives spared by cancer death rate reduction in 20 years, study says

Metformin: A Great Lakes disaster?

FDA clears Olympus’ Narrow Band Imaging for effective targeting of bladder cancer biopsies

40% of cancer victims could have avoided cancer choosing a different lifestyle

Preventing emergency surgeries could save $1 billion

Ebola leaves West African economies ailing heading into 2015

H3N2 viruses fuel 'epidemic' levels of flu season deaths, CDC says

Deaths due to influenza and pneumonia have hit “epidemic” levels in the U.S. as flu activity became widespread in 36 states, according to the Centers for Disease Control and Prevention.

Officials reported 837 flu and pneumonia deaths to the CDC through its 122 Cities Mortality Reporting System during the 51st week of the year. Those deaths accounted for 6.8% of the 12,358 total deaths that week, just meeting the epidemic threshold.

The area that includes cities in Ohio, Michigan, Indiana, Illinois and Wisconsin reported 151 deaths, the most among the nine regions in the system. Another 147 deaths were tallied in the Pacific region, which includes California, Oregon, Washington and Hawaii. (Within California, there were 28 deaths in Los Angeles, 18 in Sacramento, 14 in Fresno, 12 in San Jose, nine in San Diego, eight in San Francisco, seven in Long Beach, three in Santa Cruz and two in Glendale.)

The fewest deaths – 42 – were in the area that includes Minnesota, Iowa, Missouri, Kansas and Nebraska.

Influenza activity was considered “widespread” in 36 states during week 51, according to the CDC’s most recent FluView report. These states included Arkansas, Colorado, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Virginia, Washington, Wisconsin and Wyoming.

Another 10 states (Alabama, Arizona, Idaho, Maine, Nevada, New Mexico, Rhode Island, Utah, Vermont and West Virginia) had “regional” flu activity, two (Alaska and Oregon) and the District of Columbia had “local” activity, and two (California and Hawaii) had “sporadic” flu activity.

At least 2,643 people have been hospitalized with laboratory-confirmed cases of the flu since Oct. 1, the CDC reported. That works out to a hospitalization rate of 9.7 hospitalizations per 100,000 Americans.

But the risk wasn’t the same for all age groups. Senior citizens had the highest hospitalization rate, at 38.3 per 100,000 people. They were followed by children under the age of 5, who were hospitalized at a rate of 13.4 per 100,000.

More than 95% of the hospitalizations this flu season were the result of infection with an H3N2 strain of influenza, according to the CDC. Years that are dominated by H3N2 strains tend to involve more cases of severe illness and death, Dr. Tom Frieden, director of the CDC, has warned.

Complicating matters is the fact that the H3N2 flu strain that’s dominant in the U.S. right now is not the one that was targeted by the flu vaccines distributed in North America. Those vaccines were designed to fight an H3N2 strain known as A/Texas/50/2012, but only about one-third of the H3N2 viruses the CDC has tested since Oct. 1 are of that type. Most of the rest are of the A/Switzerland/9715293/2013 variety, which emerged in the U.S. in March – after the vaccines were already in production.

The CDC’s surveillance continues to show that the other strains picked for the North American vaccines were on target, including the H1N1 virus A/California/7/2009 and the influenza B viruses Yamagata/16/88 and B/Victoria/02/87.

The FluView report also notes that all of the virus samples tested this fall have been susceptible to the main-line medicines Tamiflu (oseltamivir) and Relenza (zanamivir) as well as a new drug called Rapivab (peramivir). Visit the Los Angeles Times for the report.



Proper arrangements for Ebola checks in place, says Prime Minister

Britain has "proper arrangements" in place to screen people who may have contracted Ebola, the David Cameron Prime Minister (PM) has said. Cameron told the BBC current measures ensured people could be taken to a hospital for testing in cases of uncertainty.

It comes after nurse Pauline Cafferkey, who had worked in Sierra Leone, was allowed to fly from London to Glasgow despite raising health concerns. She was later found to have the virus and is now in a critical condition.

Cameron said he had chaired an emergency Cobra meeting on Monday to discuss the case, and was listening to medical experts about whether further screening measures were required.

Cafferkey, a public health nurse, was diagnosed with Ebola in December after volunteering with Save the Children to fight the disease in Sierra Leone. On her return to the UK, she raised concerns about her temperature with officials at Heathrow but after testing, was allowed to continue her journey home to Scotland. She was diagnosed in hospital the next day.

At Heathrow her temperature was taken a six times over a 30-minute period, but each test found her temperature to be normal.

Asked whether airport screening was failing, Cameron said: "What I have said very clearly is that we should have a precautionary principle in place.

On Saturday, the Royal Free Hospital in north London - where Cafferkey is being treated - said she had "deteriorated" and was in a critical condition.

It is the second UK case of Ebola. Another nurse - William Pooley - recovered from Ebola in September after also being treated at the Royal Free Hospital.

Cafferkey has been given an experimental anti-viral drug and blood from disease survivors in a bid to get her immune system to beat the disease. She originally left Freetown in Sierra Leone and made her way to Glasgow after stopping at Casablanca, Morocco, and London's Heathrow.

Officials from Health Protection Scotland have spoken to all 71 people aboard the British Airways flight from Heathrow to Glasgow that Cafferkey took - a Public Health England (PHE) spokeswoman has said.

And all 101 UK-based passengers and crew aboard the Royal Air Maroc flight from Casablanca to Heathrow have been contacted by PHE officials.  Visit BBC for the story.



1.5 million lives spared by cancer death rate reduction in 20 years, study says

More than 1.5 million lives were spared thanks to a nationwide decrease in cancer deaths in the past 20 years, according to a new report by the American Cancer Society.

The report reveals cancer deaths have dropped 22 percent since 1991. If they hadn't and had continued climbing, as they had between 1940 and 1991, an additional 1,071,600 men and 447,700 women would have died, according to the report.

The American Cancer Society attributes the decline in the cancer death rate to a decrease in smoking, as well as "advances in cancer prevention, early detection and treatment."

"We can actually say that one and a half million Americans did not die because of that cumulative effort," said Dr. Otis Brawley, chief medical officer of the American Cancer Society. And the elimination of smoking and issues related to obesity, high caloric intake and too little exercise could decrease cancer rates by an additional 40 percent in the next 20 years, he said.

Brawley said most of the prevented cancer deaths in the past two decades, about 800,000 of them, were prevented because people quit smoking or never started in the first place. One-third of all cancer deaths are the result of tobacco, he said.

And because more men smoked than women to begin with, that smoking has become less common across the board has resulted in more prevented cancer deaths among men.

Some states saw more improvement than others, with those in the Northeast seeing the biggest decline in cancer deaths and those in the South seeing the smallest, according to the report. Washington, DC, saw a 33 percent decline in cancer deaths, and Oklahoma saw a 9 percent drop.

But the battle against cancer is far from over. The American Cancer Society estimates 1,658,370 new cases of cancer and 589,430 deaths from cancer next year. That means about 1,600 people will die each day in 2015. Visit ABC News for the report



Metformin: A Great Lakes disaster?

There is more than one way to measure prescription drug use in modern society. The most direct method is just to count up prescriptions filled by America's pharmacies. That would show, for instance, that more than 180 million prescriptions for diabetes drugs were dispensed in 2013. Or you could test the treated water coming out of sewage facilities such as the South Shore plant in Oak Creek, WI.

That approach reveals that in the Lake Michigan waters outside the plant, the diabetes drug metformin was the most common personal care product found by researchers with the School of Freshwater Sciences at the University of Wisconsin-Milwaukee.

More importantly, according to their latest research, the levels of metformin were so high that the drug could be disrupting the endocrine systems of fish.

Metformin is a first-line treatment for type 2 diabetes and is the most commonly prescribed medicine for the condition. In 2013, about 70 million prescriptions were dispensed, according to IMS Health, a drug market research firm.

It is so ubiquitous it can easily be found in water samples taken two miles off the shore of Lake Michigan. The drugs get into the sewage and eventually the lake because they are not broken down completely after they are consumed and then excreted.

The metformin concentrations are low, compared with the amount taken by people. For instance, coming right out of the treatment plant the levels are about 40 parts per billion. About two miles away, they drop to 120 parts per trillion.

Other commonly found substances include caffeine, sulfamethoxazole, an antibiotic, and triclosan, an antibacterial and antifungal found in soap and other consumer products.

The more recent research suggests that metformin in lake water is not just a curious artifact of everyday life. The study looked at the effect of metformin on fathead minnows in the lab that were exposed to the drug at levels found in the lake for four weeks.

It found gene expression suggesting disruption of the endocrine system of male fish, but not females. In essence, the males were producing biochemicals that are associated with female minnows. The biochemicals are precursors to the production of eggs.

The UWM research confirms what others have found regarding prescription drugs showing up in America's lakes, rivers and streams, said Melissa Lenczewski, PhD, an associate professor of geology and environmental geosciences at Northern Illinois University.

For years, it was assumed that the volume of water in the Great Lakes was so enormous that any drugs that got through treatment facilities would be diluted to the point that they would not pose a problem, said Lenczewski, who was not a part of the UWM study. (Milwaukee Journal Sentinel) Visit MedPage Today for the study.



FDA clears Olympus’ Narrow Band Imaging for effective targeting of bladder cancer biopsies

Olympus announced FDA 510(k) clearance of Narrow Band Imaging (NBI) as enabling effective targeting of biopsies not seen under white light and improved visualization of tumor boundaries in Non-Muscle-Invasive Bladder Cancer (NMIBC) patients.

Based on a weighted average, the aggregated FDA-reviewed studies show NBI has visualized NMIBC lesions in: 17 percent additional patients when compared with white light; 24 percent additional tumors; and 28 percent additional carcinoma in situ (CIS or difficult-to-detect flat lesions).

This finding provides new treatment opportunities for urologists both in-office and in the O.R. Additionally, it offers the potential for improved cost reduction and better patient outcomes resulting from earlier detection.

NBI is the world’s only patented endoscopic light technology that enables effective targeting of biopsies not seen under white light without the use of dyes or drugs. NBI’s potential visualization of bladder cancer symptoms has been acknowledged by the medical community, but in 2013 a meta-analysis reviewed more than 30 disparate studies on the topic, enough to submit to the FDA.

Bladder cancer is the sixth most common cancer in the United States, with the highest lifetime treatment costs per patient of all cancers.

In-office, NBI provides new advantages to physicians because the most effective targeting technologies to-date could only be used in the O.R. and could only be used a single time per patient.

In the O.R., NBI can be used prior to resection to enable effective targeting of biopsies not seen under white light. During resection, NBI can be used to enhance visibility of tumor margins. By enhancing visibility of lesion boundaries, surgeons may be able to perform a more complete resection.

In addition to urology, NBI has clinical applications throughout the anatomy including gastroenterology, pulmonary and rhinolaryngology (ENT). Olympus has received FDA-clearance for the screening and surveillance of Barrett’s esophagus and is currently exploring other claims for NBI both in gynecology and general surgery.

To learn more about NBI, visit Olympus



40% of cancer victims could have avoided cancer choosing a different lifestyle

According to a new research by the Cancer Research UK (CRUK), 40 percent of cancer victims could have avoided cancer by choosing a better lifestyle. Scientists have discovered that at least 600,000 cancer victims could have avoided cancer by choosing better a lifestyle and continuing that life style. In the study around 587,000 people living in UK have developed a different type of cancer within five years period after they began consuming alcohol or tobacco.

The researchers are suggesting that by choosing a poor lifestyle, these victims have developed cancer. One of the researchers and cancer prevention specialists for the Cancer Research UK said, “There are more than 200 types of cancer each caused by a complex set of factors, involving both our lifestyles and our genes.”

By choosing different lifestyle like exercise, eating healthy food, consuming fewer processed meat, keeping their weight checked, eating less fast food, consuming less alcohol or tobacco; many people can avoid having different forms of cancers. Researchers discovered that tobacco is one of the main reasons behind cancer.

A large number of the participants in the study have cancer from consuming tobacco. The researchers also discovered that, among the participants 144,800 people diagnosed with cancer, have poor food habit like eating less green vegetables or red meet regularly. Excessive weight problem was the reason behind 88,100 participants having cancer.

According to Prof. Max Parkin, a Cancer Research UK statistician based at Queen Mary University of London, “There’s now little doubt that certain lifestyle choices can have a big impact on cancer risk, with research around the world all pointing to the same key risk factors”.

Public Health England says a healthy lifestyle can play a vital role in reducing cancer risk. It says campaigns such as Smoke free, Dry January and Change4Life Sugar Swaps all aim to raise public awareness”.  Though the researchers are saying that these are not the only reason people have cancers but there are choices which can avoid this. Visit the Morning Vertical for the study.



Preventing emergency surgeries could save $1 billion

Strategies to reduce the number of emergency surgeries in the United States could save up to $1 billion in healthcare costs over a decade, new research suggests.

The study also found that surgeries planned ahead of time (elective surgery) are less risky for patients and generally have better outcomes.

"The costs of surgical care represent nearly 30 percent of total healthcare expenditures and they are projected to total more than $900 billion by 2025," study author Dr. Adil Haider, director of the Center for Surgery and Public Health at Brigham and Women's Hospital in Boston, said in a hospital news release. Haider was at the Center for Surgical Trials and Outcomes Research at Johns Hopkins University while conducting the study.

"If 10 percent of these emergency surgeries had been performed electively, the cost difference would have been nearly $1 billion over 10 years," Haider said.

"Importantly, elective procedures are better for patients, too, who experience lower rates of mortality and better outcomes. There is a tremendous opportunity to both save lives and decrease costs," he added.

The researchers looked at three common operations for the study. One is a procedure to repair the main artery in the abdomen (aortic aneurysm repair). The second is heart surgery to restore blood supply to the heart (coronary artery bypass graft). The third operation was surgery to remove part of the large intestine (colon resection).

The researchers analyzed data on more than 600,000 patients. All had one of these procedures between 2001 and 2010. The researchers compared the hospital costs and risk of death when surgeries were planned versus when they were performed in an emergency. (HealthDay) Visit NIH for the article.



Ebola leaves West African economies ailing heading into 2015

Liberia, Guinea and Sierra Leone were finally experiencing a turnaround from decades of conflict and political tumult when Ebola interrupted. Now the countries are likely to tip into recession in 2015, the World Bank and government leaders say, the consequence of an epidemic that has killed more than 7,900 people in those three hardest-hit countries.

The number of people threatened by hunger in those countries could double to one million by March if food supplies don’t improve, two United Nations agencies warned in December.

The World Health Organization hopes that work will yield a vaccine in 2015. But no one knows whether the treatment will prove safe and successful, or when it might be ready. Any vaccine would probably be given first to at-risk health workers, pharmaceutical company representatives say, meaning its role ending the broader epidemic would be limited.

Separately, the Bill & Melinda Gates Foundation and other groups are testing whether the antibody-rich blood of people who have survived Ebola can help new patients fight off the virus. Those small, complex tests will also take time to execute and review.

Meanwhile, Ebola is still spreading to new communities, though the rate of new infections is falling. Stamping out Ebola in the far-flung villages where it is appearing now could be more difficult than stopping the wave of cases that overwhelmed weak health systems from July through October. How rapidly the response evolves to tackle that shifting foe will help determine how high the death toll climbs in 2015, health experts say.

At the same time, drawing back investors is also crucial, leaders from the three countries say. So is resuming work on road, water and power projects that could help raise living standards.

Declines in the prices of iron ore and oil also herald a slow recovery for Liberia, Guinea and Sierra Leone, countries looking forward to revenue from promising mining projects and oil reserves off their coasts. Visit the Wall Street Journal for the article.    


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