3 Burning Issues for Hospitals Today

This recession has had quite an impact on hospitals, causing 45% of hospitals to postpone capital projects and 13% to cease any expansion in process, as an American Hospital Association report revealed. But despite the new challenges posed by financial crisis for the medical industry, hospitals have their own health care delivery issues to tackle.

Many hospitals have been purchasing refurbished hospital furniture such as hospital chairs or beds to cut costs. However, in addition, addressing the following issues can lead to long term cost-savings.

1. Hospital Deaths due to Medical Errors

Preventable medical errors caused an average of 195,000 individuals to lose their lives in the USA. This was the finding of a HealthGrades study that assessed 37 million patient records for the years 2000, 2001 and 2002. The associated health care cost of these medical errors is estimated to be over $6 billion per year. Following the study, analysts suggested that just by improving upon four key areas, namely, failure to rescue, bed sores, postoperative sepsis, and postoperative pulmonary embolism. And if their occurrence could be reduced by just 20 percent, 39,000 lives can be saved each year. Whether medical error rates have dropped since the study remains to be seen.

2. Hospitals' Efficiency

The hospitals in the US can significantly improve patient care and also save a minimum of about $4 billion annually, only if they became more efficient. These conclusions follow from an analysis by Thomson Reuters. Key suggestions from the company to save costs include reducing hospital-acquired infections and slashing hospital readmissions. While the minimum savings are to the tune of $4 billion, with some really effective measures in place hospitals could save up to $20 billion over a span of three years. That's about $7 billion a year in savings.

3. Electronic Health Records

The present state of affairs seems pretty dismal as only 1.5 percent of U.S. hospitals have implemented facility-wide comprehensive health care information technology systems. Further, just about 8 – 11 percent hospitals have at least a single unit with installed with basic health care IT systems. (New England Journal of Medicine, NEJM, Mar 2009).

While smaller budgets, maintenance costs, hesitation among health care professional are said to be the primary reasons preventing the widespread use of IT systems, the long-term effects of installing them need to be taken into account. At the same time, it's hardly any use having IT systems in place when their power isn't leveraged via effective use.

Fast Ricin Detection – Is it Now Possible?

Ricin, a poison found in Castor beans is so potent that even if a small quantity, the size of a grain of salt, gets into your system can kill you. Now, if new research is to be believed, then scientists may have developed a new assay system that detects ricin fast and easy.

Perhaps the most popular incident of ricin poisoning is the 1978 assassination of the Bulgarian dissident Georgi Markov in London. He was reportedly stabbed with an umbrella that lodged a small ricin-coated pellet into his leg that later killed him. With no known antidote available, ricin today, is also feared as a potential bio-terrorism agent.

Till now, scientists had a hard time detecting the toxin. Because it involved multi-step procedures that assessed whether certain compounds were stopping ricin from working or not. But now that may not be necessary.

The New Ricin Detection Assay System

The working of the assay is simple. To check the presence of ricin in suspect samples, they need to be put into a few drops of a mixture of reagents. If the mixture emits light, then ricin is present, else it isn't. Further, the brighter the light emitted or the greater is the luminescence, higher is the concentration of the toxin within the sample. This technique has been developed by researchers at the Albert Einstein College of Medicine of Yeshiva University (AECOM).

It may appear that ricin being a poison only has nefarious applications, but no, just like nuclear energy, which can be used to generate electricity or A-bombs. Ricin too can either be used to kill humans or potentially save them. Because it has been used an cancer drug to kill and destroy cancer cells, however, this research is still in its early stages.

Nevertheless, the new ricin detection assay system should be able arm scientists with the tools that can detect ricin in a jiffy and save lives.

Does Bad Economy Equal Low Fertility Rate?

The National Survey of Family Growth (NSFG), 1995, revealed that the number of women using infertility services in the U.S. was 9.3 million, and today if the forecast of some economists is to be believed, the economic crisis could cause the U.S. birth rate to decline.

Aside from the usual infertility problems treated with fertility drugs, the strained economy has its own way of affecting fertility.

Here are some hows and whys?

• According to a story in the LA Times, historical data over the past 75 years suggests that the U.S. fertility rate has declined following economic recessions. Not surprisingly, it was the worst after the Great Depression. Though not as bad as the Great Depression, the recession this time is big enough to be compared head on with its grandpa.

• Further, as a consequence of economic hardships, many couples might decide to either postpone or not have children at all. And it already appears to be happening, as reports from all across the country suggest that the number of men wanting to undergo vasectomy – a medical procedure leading to permanent sterilization, have doubled according to a Web MD article. This seems pretty extreme considering the availability of many other contraceptive methods such as the use of birth control pharma drugs.

• At the same time, some sociologists opine that recession could even lead to more births than less. The reasoning is that job loss will present women with more time and an opportunity to have children and raise them.

• A rather different kind of a baby boom also seems to be occurring and that is of many women opting to donate eggs to fertility clinics, to financially support themselves, an MSNBC report suggests that.

While it will take a couple of months before the actual effect on fertility rate can be assessed, it's seems unmistakable that state of the economy can have some significant repercussions on human fertility.

How to Count Your Calories During Sleep?

Counting your calories is important if your trying lose excess weight, but it's often a pain trying to keep a track of them. However, if scientists are to be believed then they might already have stumbled upon an automatic calorie counting method.

People try many ways to lose weight including dieting, exercise, or weight loss supplements or a combination, but physical exercise seems to be pretty popular. And most of us using treadmills to burn calories know how much we've burned in a session of exercise simply by glancing at the pedometer reading. At the same time it's important to know that we don't just burn calories while we're on the treadmill, but even when we walk, drive, cook, laugh, talk, and even while we sleep. So who'll count all those calories consumed?

The count your calories technology

Apparently, a strap-on device has been invented that allows individuals to continuously track the calories they burn.

Being worked on by a group of Georgia Institute of Technology students and called HappyHR, It's a small, rectangular-shaped instrument, which can be strapped to the wrist or ankle. Once onto the wrist, the instrument begins collecting data pertaining to heart rate and exercise. Next, the information collected is sent to a PC via Bluetooth, where the data is analyzed and calories counted by means of a web-based software.

A subtle device resembling a compact MP3 player more than with an embedded fitness monitoring technology is pretty encouraging. In fact the researchers want to move ahead further and even try to incorporate advanced health applications such as respiratory and glucose monitoring. Which might earn it a place as a valued medical and hospital equipment supply.

According to the National Center for Health Statistics (NCHS) about 133.6 million or 66 percent of Americans are either overweight or obese. And who may want to lose weight for better health. So if technologies such as these keep coming up, maintaining not just a healthy weight, but also fitness, might become a lot easier.

Can Heart Attacks be Predicted to Save Lives?

About one of every five deaths in the United States are attributed to heart diseases. However, scientists may now well be on their way to make heart attack prediction possible so that many lives can be saved.

Heart disease is term used for a range of different diseases affecting the heart. They are often treated by surgery and cardiovascular drugs.

Even though from 1995 to 2005 the death rate from heart disease declined 34 percent, there still is a lot of potential for it to decrease further with the aid of technology. A device is being tested to monitor the heart and raise a red flag in time so that early help can be sought.

The Life Saving Technology

Called the AngelMed Guardian system, the device is about the size of a standard pacemaker is meant to be installed inside the skin close to the collarbone with a wire placed in the right chamber of the heart.

It comprises an external telemetry device and and a programmer meant to help the medics assess the heart signals. The job of the device will be to monitor a person's heart's activity for signs that may indicate an impending heart attack.

As soon as the implanted diagnostic equipment finds that something's gone amiss inside the heart, making use of Bluetooth technology and pagers, it will sound an alert to others so that quick medical attention can be provided to the patient. Also, the more disturbing or acute the symptoms of an upcoming heart attack, stronger the alert this device transmits.

According to experts, the maximum damage to the heart occurs during the first two hours after a coronary gets blocked during a heart attack. And most of the time patients take about three hours to recognize an oncoming heart attack, so help often reaches late to the sufferers. However, the unique ability of this device is that it can recognize the warning signs and sound an alert hours before the attack actually occurs thus helping doctors save lives.

Still undergoing Phase II clinical trials, if all goes well then it may actually be able to predict heart attacks and save lives.

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Now Magnets May Drive Reflux Disease Away

An estimated 20 million Americans suffer from gastroesophageal reflux disease (GERD), which causes a person to experience chronic heartburn. While medical drugs helps manage the condition in the short-term, longer term relief sometimes requires surgery. But could a long term solution to the problem be hidden in modest looking magnets?

A common cause of gastroesophageal reflux disease or (GERD) is a weak or nonfunctional valve at the lower end of the esophagus (the canal that connects the mouth to the stomach), as a result the acids inside the stomach make their way into the esophagus. Since the esophagus or the food pipe isn't designed to withstand acids, the patient experiences chronic heartburn. But medics are now testing a new device which could support the function of the malfunctioning valves to treat the disease.

The New Reflux Control Device

Called the LINX Reflux Management System and introduced by Torax Medical, this device comprises a series of magnetic beads, and is meant to be placed around the bottom of the esophagus through a minimally-invasive surgical procedure, using medical instruments.

Once positioned, the magnetic attraction between the beads work in tandem with the valve and help prevent the acids to reflux, or rush up the esophagus. At the same time, the system is designed to allow food to normally pass through the esophagus to the stomach. Which is exactly what a healthy valve's function is.


According to experts, when medical therapy alone is used to treat GERD, the acids in the stomach are simply suppressed, but the underlying problem of reflux isn't cured. As a result, the most appropriate and lasting treatment for GERD would be to restore the body's own ability to avoid reflux itself.

While the new magnetic device is still being clinically tried, its real success might eventually depend on how effective it will be in comparison to other surgical procedures viz. open and Nissen fundoplications that are sometimes indicated for treating GERD.

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Are Pharma Workers Feeling More Insecure Now?

Pharma staffers, despite working long hours in the wake of the shaky economy are beginning to express insecurity about their careers as a recent survey by the Pharmaceutical Manufacturing magazine found.

The press release reports that of the 400 readers worldwide who participated in the survey, 64% feared job security. While in 2008 this figure was 55.8%, and 42.7% in 2007.

It's a progressive trend that with each passing year the percentage of those expressing insecurity within the pharma drug industry has increased. And that experts think that the dwindling economy isn't the sole reason. In fact, the expression of job insecurity by pharma staffers is a result of dwindling product pipelines, blockbuster drug patent expirations, and the buzz created by the recent culminated & speculated mergers and acquisitions.

Further, pharma companies aren't laying off more now than a few years ago. However, new hiring has certainly taken a hit, and as is the case for most industries, a “wait-and-see attitude” is being adapted by pharma companies too.

Despite the prevailing insecurity, industry employees still find “Improving patients’ lives” as something that motivates and find meaning in their jobs. But they are also turned off by uncertainties about the future, job cuts and the fact that they're maintaining more than they're innovating.

Decreasing salaries too appear to be a concern to the workers from this domain of the medical industry. Because the numbers reveal that in response to this year's study just 40.2% said they were drawing an annual pay package of $100,000 as against 47.3% in 2008. The biotech industry seems to be doing better, as biotech's turning out profits.

Nevertheless, Keeping up the spirits of the workforce has always been essential for running a company well, and it seem even truer during tough times. Perhaps the responsibility to keep staffers in good spirits lies on the shoulders of both the companies and the employees themselves – perhaps by maintaining a positive outlook, enhancing skills, or whatever works.

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Pharma Fighting Hard – But will it win?

Hit by the tsunami of recessionary economy causing sales to dip and growth rates forecasted to fall below historic levels, pharma drug companies have hit the panic button and are trying out different ways in their quest to survive.

Mergers & Acquisitions

Pfizer's acquisition of Wyeth for US$68 Billion is a striking example. The company has acted to safeguard itself, owing to the plummeting revenues from it's popular drug “Lipitor” and several other products, which would soon be faced with expired patent protection.

But this is being seen as just the beginning of a whole wave of mergers to come by. Some other expected acquisitions are being speculated such as Roche buying out the remaining share of Genentech, Merck merging with Schering-Plough, a merger between Sanofi and Bristol-Myers Squibb, and more pharma industry mergers.

In fact the general expectation the big pharma companies are all set to taking over smaller player raised the hopes among small biotechnology companies worrying about their own survival soon a bigger firm would approach them with a buy out offer. However, recently panelists attending the BioPartnering North America conference, warned of harboring such an unrealistic expectation that all biotech companies in distress will be rescued. At present pharma firms have their eyes set on other pharma firms rather than biotech product companies.

Job Cuts

Pharma companies are fast reducing their workforce. The Pfizer-Wyeth deal itself if expected lead to a 15 percent reduction of staff for both the firms combined, which translates in to about 130,000 job cuts.

Other recent layoffs include King Pharmaceuticals (KG), (22%, or 760 jobs), KV Pharmaceutical Co (700 job cuts expected), GlaxoSmithKline (10,000 job cuts predicted), and more.

Skepticism

At the same time analysts are skeptical about some aspects of these deals. For example there's apparently no solution to declining sales outlook, as projections about Pfizer-Wyeth will have a combined 2013 total company sales below the 2008 figure of $70 billion. Some suggest that while large-scale mergers between will create cost savings and give these companies time, that won't be sufficient to reinvent pharma.

Survey: Biotechnology Industry will Bounce Back

The biotechnology industry is expected to rebound and outperform healthcare industry and the rest of the market this year, according to findings from an investor perception study released by Thomson Reuters and the Biotechnology Industry Organization (BIO) at the 11th Annual BIO CEO & Investor Conference in New York.

Findings

• Investors have stated that a company’s cash position is now more important.

• More than two-thirds in the study expect greater M&A volume in 2009, with major pharmaceutical companies buying biotech of all sizes, and large biotechs buying smaller biotech companies.

• The study found that most investors are neutral to positive about the policies likely to be pursued by the Obama administration.

• Investors are particularly hoping for greater consistency and predictability from the FDA where higher safety barriers and insufficient resources are cited as primary reasons for limited drug approvals.

• Most investors pay little attention to activism in the biotech sector

• Meeting with management is the most important factor when researching investments, followed by conferences and sell-side research, which is still considered important.

Investors are optimistic about biotech stock performance

• 70% expect biotech to outperform the rest of the market this year.

• 59% consider biotech undervalued, while only 4% say the sector is overvalued.

• 57% expect biotech to rebound during this year; another 30% expect a rebound in 2010.

Investors are less optimistic about research and development

• 60% state overall productivity in 2009-2011 will be the same as in 2006-2008.

• Investors see the best opportunities in mid-cap companies with late-stage pipelines

• 37% of polled investors see opportunity in micro-and small-cap companies, but only 16% favor early stage pipelines over late stage pipelines.

• 67% of investors state the best investment opportunities lie in oncology while 37% see promise in immunology.

Source: Biotechnology Industry Organization

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Birth Control Pill Adverts - Is Bayer Ethically Challenged?

Recently, the German drugmaker Bayer settled the incident over advertising of its blockbuster birth control pharma drug Yaz with a corrective $20 million national advertising. As the news made waves many opined that the episode only cements the reputation of the drugmaker as being the most ethically challenged pharma company around.

But is a single bad ad campaign enough to brand a manufacturer as ethically challenged?

The drug in question is in fact approved by the FDA as a birth control pill with a side benefit in treating premenstrual dysphoric disorder, and improving moderate acne. The problem lies not with the approved effects but with advertising, which has been considered in the FDAs warning letter as broadening the drugs indication, overstating its efficacy, while minimizing serious risks associated with the use of the drug.

The settlement aside, the question is whether the drugmaker is the only entity to run into problems because of advertising. Many advertisements day in and day out are questioned for making misleading claims for all sorts of products and services.

Also, just because an advertisement has been caught violating laws doesn't mean that those others who've violated but haven't been caught are angels. And this may be quite true within the medical industry, because critics suggest that the F.D.A. division that oversees drug promotion has a staff of only 52 people, who can't be expected to keep a tab on thousands of ad campaigns run by drug makers the year over.

While not being an advocate for any particular drug maker, I'd like to point out a just a few of the “ethical initiatives” by the so termed “ethically challenged” company.

Science and Education

Set up "BayLabs" as they're called at various sites in Germany. These laboratories allow schoolchildren to learn about chemistry and biology with carefully prepared experiments and learning programs.

Environment and Nature

In 2004 Bayer became the first private-sector company start a partnership with the United Nations Environment Programme (UNEP) for involving the youth in caring for the environment. It's run over a dozen projects around the globe since then.

Health and Social Needs

As an aid to Asian tsunami victims the company provided both money and donations in kind with a total value of EUR 13 million (approx US$ 16.8 million).

You can find out more about the company from the Sustainability & Commitment section on their website.

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5 Reasons Why FDA's Furious Over Narcotics Misuse

The US Food and Drug Administration recently announced that it was beefing up efforts to curb unsafe use of 24 narcotics products used as pharmaceutical drugs. In its first such measure the regulator sent 16 companies making these products letters, asking them to have a "Risk Evaluation and Mitigation Strategy (REMS)," in place.

Narcotic products have a chemical composition that simulates the effects of naturally occurring opiates like the opium poppy, and are often prescribed to cancer patients for managing sudden and severe bouts of pain. Though these products have been in use for years now, the question is, why the FDA has come out railing against these prescription drugs?

At least five reasons are the triggers behind the FDA getting tough.

1. Widespread Use: The drugs targeted by the FDA are the most extensively prescribed and used medications. Going by the 2007 figures, pharmacies in the United States doled out about 21 million prescriptions for these 24 narcotic products, and were consumed by approximately 3.7 million Americans.

2. Ineffective Earlier Measures: The FDA was aware of the havoc these chemicals were causing and it did try to reign in on them by means of mandatory label warnings and by working together with other federal agencies. However, the problems seem to have had no effect, and instances of drug misuse, abuse and accidental overdoses have increased over the past decade.

3. Increasing Non-medical Use: The Substance Abuse & Mental Health Services Administration (SAMHSA) data shows that non-medical use of prescription pain relief drugs in Americans 18-25 has increased from 4.1% in 2002 to 4.6% in 2007. And for those aged 26 & Over, the increase has been from 1.6% from 1.3% over the same period.

4. The Products' Addictive Power: The products included in FDA's present hit list are those, which are based on extended-release formulas for long-lasting effects. But despite their efficacy in damping severe pain they carry the risk of being highly addictive. And this makes them perfect candidates for abuse, and they often are abused for their euphoric effects.

5. The FDA is now Empowered to Act!: This isn't quite a reason inherent in unsafe use of drugs, but it still is the necessary condition for the FDA action. It was only in 2007, that the USFDA got the power to require risk-management plans. Otherwise it would still have been negotiating changes to drug labeling and promotion with the drug making companies from the medical industry.

Hopefully, the new measures will harness the beast of prescription drug abuse.

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The Stem Cell Debate - Is It Settled?

The wait for those in support of embryonic-stem-cell research funding seems to be over, as the President Obama is expected to sign an executive order overriding the federal funding limits put on by the former administration. And leading to the rebirth of stem cell research.

Those against stem cell research contend that stem cells research amounts to abortion, because it moves forward at the expense of destroying human embryos, which are fertilized eggs and in early stages of becoming a baby. And abortion is murder, so stem cells research amounts to killing. So when the Bush administration put a cap on funding it was believed that religious convictions had won over science.

But was it really a victory, especially if you consider that stem cells have the potential to be grown into any type of cell the human body has, and thus making them an excellent resource to treat and manage debilitating diseases such as Alzheimer's, Parkinson's, paralysis, diabetes and more.

Who gets to win or lose?

It seems that despite the convincing power of immorality aspect ascribed to stem cell research, many opinion polls have indicated that a majority of Americans think that stem cell research holds a lot of promise to eventually bring down human suffering than cause it. Perhaps, there would have been some breakthroughs in treatments already, if the big biotechnology product companies hadn't shied away from stem-cell research due to the politics involved.

What's more unpleasant is that a political football match is being played with something as noble as scientific research and which has the potential to save so many lives.

The debate probably isn't settled in the minds of those with the opposing views, and it may never be. But if biotechnology isn't given the respect it deserves, it would choose to grow in a place where it gets the freedom to. For instance, The Shandong Stem Cell Engineering Research Center in China reports, via UPI, that they've successfully cloned five human embryos for medical research!

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Economic Recession - Hospitals aren't Spared

In its most recent update published on January 28, the IMF announced that world growth is forecast to fall to its lowest level since World War II. And with the US being one of the worst hit, the hospital business, an integral part of the medical marketplace, and often regarded as recession proof is beginning to feel the heat.

Despite the fact that hospitals aren't hit the way the way the automotive sector or the retail has been, and that people will continue to fall sick irrespective of the economy, it seems that the number of people seeking medical care and the profitability of hospitals don’t walk hand-in-hand.

Growth stunted & patients decreasing

A recent report by the American Hospital Association (AHA) finds that the sputtering economy has already led to 45% of hospitals to postpone forthcoming capital projects, with about 13% being forced to completely stall any expansion projects already underway. The AHA report included 639 hospitals in the study.

Further, experts believe that even though people continue to fall sick they're postponing, most treatments if not all, which can be classified as elective. The credit for the prevailing scenario goes to all the layoffs and the slowing economy. As per the Bureau of Labor Statistics the month of December saw some of the worst layoff figures, as there were 2,275 mass layoff actions, involving 226,117 workers.

What seems worse is that aside from foregoing elective treatments, patients seem to be avoiding essential drugs, with many actually abusing prescription drugs, such as narcotic painkillers , sedatives and tranquilizers and stimulants.

As a consequence, hospitals are reeling under delayed hospital equipment and supply purchases, declining patient visits, reduced staff with no fresh hiring, unpaid medical bills, in addition to ceasing any construction projects. The AHA survey, released in November last year found that patient visits were static or had decreased during the third quarter of 2008, and the cases of unpaid medical bills for hospitals registered a hike of 8%.

The government's role in uplifting the spirit of hospitals is being thought to be instrumental as Medicare and Medicaid account for about half of the hospital business industry.

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Study: Stem Cell Transplant Reverses Multiple Sclerosis

Researchers from Northwestern University's Feinberg School of Medicine appear to have reversed the neurological dysfunction of early-stage multiple sclerosis patients by transplanting their own immune stem cells into their bodies and thereby "resetting" their immune systems.

"This is the first time we have turned the tide on this disease," said principal investigator Richard Burt, M.D. chief of immunotherapy for autoimmune diseases at the Feinberg School. The clinical trial was performed at Northwestern Memorial Hospital where Burt holds the same title.

The patients in the small phase I/II trial continued to improve for up to 24 months after the transplantation procedure and then stabilized. They experienced improvements in areas in which they had been affected by multiple sclerosis including walking, ataxia, limb strength, vision and incontinence. The study will be published online January 30 and in the March issue of The Lancet Neurology.

"We focus on destroying only the immune component of the bone marrow and then regenerate the immune component, which makes the procedure much safer and less toxic than traditional chemotherapy with cancer drugs," Burt said. After the transplantation, the patient's new lymphocytes or immune cells are self-tolerant and do not attack the immune system.

"In MS the immune system is attacking your brain," Burt said. "After the procedure, it doesn't do that anymore."

In previous studies, Burt had transplanted immune stem cells into late-stage MS patients. "It didn't help in the late stages, but when we treat them in the early stage, they get better and continue to get better," he said.

Source: EurekAlert!

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Are Best Hospital Lists Worth their Salt?

Recently, a study found that the top-rated U.S. hospitals had a 27 percent lower death rate than other hospitals. So are the best ranked hospitals within the healthcare market really the best places for patients to seek treatment from.

They probably are to quite an extent and the ratings more credible if it's also known that the health care ratings organization is an independent one, such as is the case with HealthGrades.

So many top-rank lists

But consulting a single organization's ranking lists might not serve to be the final answer in your search for the best place to get medical care from. Perhaps, including the results of other agencies such as the Leapfrog Group, which surveys over 1,300 hospitals nationally, or The Joint Commission, which tracks different kinds of medical care rendered, or even the U.S. News' analysis of more than 5,453 medical centers to produce an Honor Roll based on 16 specialty rankings may also come in handy.

However, referring to several such reports, might at times, turn out to be confusing, because they might not appear to agree on who the best hospitals after all are. And some of the very best on one list simply might not figure on another. For instance, if one study analyzes just high volume and low risk procedures, while the other takes account of difficult and highly specialized treatments, the results would naturally be quite different. Or if one just assessed the hospitals' equipment & supplies, the outcomes would be radically different.

Cheeky Critics

Also, despite these lists being reliable in assessing the factors they rate the health care facilities on, are not without critics. The much debated Federal nursing home rating system is a glaring example, as some think that the assessment doesn't consider a broader view of all that takes place inside nursing homes. Nevertheless, it does consider something, which is better than nothing.

It seems in the end that many of these lists do provide reliable assessments, but search for a perfect hospital should always take into account the patient and her family's needs and limitation. As a result the top rank lists would be truly meaningful when they are used while considering the proximity, the abnormal medical condition, the medical procedure advised, affordability, and a host of such factors for which the patient and her family are perhaps the best judges.

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Atypical Antipsychotic Drugs Increase Risk Of Sudden Cardiac Death In Adults

Patients ages 30 to 74 who took atypical antipsychotic pharmaceutical drugs such as risperidone (sold as Risperdal), quetiapine (Seroquel), olanzapine (Zyprexa) and clozapine (Clozaril) had a significantly higher risk of sudden death from cardiac arrhythmias and other cardiac causes than patients who did not take these medications, according to a new study funded by HHS' Agency for Healthcare Research and Quality. The risk of death increased with higher doses of the drugs taken.

The study, titled "Atypical Antipsychotic Drugs and the Risk of Sudden Cardiac Death," is published in the January 15 issue of the New England Journal of Medicine.

Atypical antipsychotics are commonly used to treat schizophrenia and bipolar disorders. They are also prescribed "off label" for symptoms such as agitation, anxiety, psychotic episodes and obsessive behaviors. Atypical antipsychotics are less likely to cause tremors and other serious movement disorders that affect users of typical antipsychotics.

"This study provides critical information about the safety of atypical antipsychotics that can be used to make important treatment decisions for patients," said AHRQ Director Carolyn M. Clancy, M.D. "These findings will help clinicians and patients weigh the risks versus the benefits of these drugs before prescribing them for treatment of depression or other off label uses for other conditions."

Lead researcher Wayne A. Ray, Ph.D., and his colleagues at AHRQ's Center for Education and Research on Therapeutics at Vanderbilt University in Nashville found that current users of atypical antipsychotic drugs had a rate of sudden cardiac death twice that of people who didn't use the drugs and similar to the death rate for patients taking typical antipsychotics, including haloperidol (Haldol) and thioridazine (Mellaril).

Researchers reviewed medical records from the Tennessee Medicaid program and identified data on patients prescribed atypical antipsychotics, including the number of prescriptions they received, the dose and the number of days supplied. Researchers conclude that atypical antipsychotics are not a safer alternative to typical antipsychotics in preventing death from sudden cardiac causes.

The CERTs program, established in 1999, is a research program administered by AHRQ in consultation with the U.S. Food and Drug Administration. The overarching goal is to serve as a trusted national resource for people seeking to improve health through the best use of medical therapies. The CERTs program includes partnerships of public and private organizations, a national steering committee involving multiple sectors and the CERTs investigators, a coordinating center and 14 research centers.

Source: AHRQ

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Pee on Paper to Treat TB – Here's How?

Effective treatment of tuberculosis entails adhering to lengthy TB pharma drugs regimen. To ensure that people follow through the duration of treatment scientists have found a clever way in which simply peeing on paper can lead you to comply with treatment.

Tuberculosis or TB is an airborne infectious disease that's curable. However it requires strict compliance with TB drugs for months. And many people, especially in poor countries drop out in the middle because the drugs can trigger nausea and other side effects. This in turn is leads to a relapse with drug resistant strains of bacteria, making treatment difficult. The consequences are evident from TB statistics. According to the WHO, TB afflicts millions worldwide – of the 9.2 million cases newly diagnosed in 2006, 1.7 million people succumbed to the disease.

The Pee based approach to TB treatment

Staff from the Innovations in International Health (IIH) project at MIT, recently devised a program which uses paper-based diagnostics called “XoutTB” with text-messaging technology and service to improve tuberculosis (TB) treatment compliance in poor countries.

At the heart of the program lies a rewards schedule, whereby patients complying with to the TB drug regimens consistently for 30 days are rewarded with cell-phone minutes, encouraging them further.

To track compliance, the participants are required to pee on a paper-based diagnostic equipment, which is dispensed once each day. The device is able to detect the metabolites of the TB drug in urine – accurately assessing whether the drugs were consumed or not. Also the reaction between the drug molecules in urine and the chemicals embedded in the paper devices uncover a code that the participants need to text-message to a central database. A consistent record of compliance for 30 days is rewarded with free minuets.

It's simple and hopefully will turn out to be quite effective, as the trials are still on. While the real work is still accomplished by the good old TB drugs, the pee based diagnostics are central to making that happen. Now, that's what I'd call real waste management!

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Vicks VapoRub Misuse May Harm Toddlers

Vicks® VapoRub®, the popular salve used to relieve symptoms of cough and congestion, may be harmful for infants and toddlers. New research appearing in the January issue of CHEST, the peer-reviewed medical industry journal of the American College of Chest Physicians (ACCP), shows that Vicks® VapoRub® (VVR) may stimulate mucus production and airway inflammation, which can have severe effects on breathing in an infant or toddler. Research findings are consistent with current VVR labeling which indicates the product should not be used on children under 2 years of age.

VVR is not indicated for patients under age 2. However, Dr. Rubin realizes that some parents are still choosing to use VVR to relieve their sick young child's symptoms, usually rubbing the salve on the feet or chest.

"I recommend never putting Vicks in, or under, the nose of anybody—adult or child. I also would follow the directions and never use it at all in children under age 2," said Dr. Rubin.

Dr. Rubin also feels that although the study only tested Vick's VapoRub, similar products, including generic brands, could cause the same adverse reaction in infants and toddlers.

"The best treatments for congestion are a bit of saline (salt water) and gentle rubber bulb suction, warm drinks or chicken soup, and, often, just letting the passage of time heal the child." Dr. Rubin also notes that if a child is struggling to breathe, it is a medical emergency and would require the child to be seen by a doctor as quickly as possible.

"Parents should consult with a physician before administering any over-the-counter medicine to infants and young children," said James A. L. Mathers, Jr., MD, FCCP, President of the American College of Chest Physicians. "Furthermore, the American College of Chest Physicians and several other health-care organizations have concluded that over-the-counter cough and cold medicines can be harmful for infants and young children and are, therefore, not recommended."

Source: EurekAlert!

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California's Autism Cases Rising!

A study by researchers at the UC Davis M.I.N.D. Institute has found that the seven- to eight-fold increase in the number children born in California with autism since 1990 cannot be explained by either changes in how the condition is diagnosed or counted — and the trend shows no sign of abating.

Published in the January 2009 issue of the journal Epidemiology, results from the study also suggest that research should shift from genetics to the host of chemicals and infectious microbes in the environment that are likely at the root of changes in the neurodevelopment of California's children.

"It's time to start looking for the environmental culprits responsible for the remarkable increase in the rate of autism in California," said UC Davis M.I.N.D. Institute researcher Irva Hertz-Picciotto, a professor of environmental and occupational health and epidemiology and an internationally respected autism researcher.

Hertz-Picciotto said that many researchers, state officials and advocacy organizations from the medical industry have viewed the rise in autism's incidence in California with skepticism.

The incidence of autism by age six in California has increased from fewer than nine in 10,000 for children born in 1990 to more than 44 in 10,000 for children born in 2000. Some have argued that this change could have been due to migration into California of families with autistic children, inclusion of children with milder forms of autism in the counting and earlier ages of diagnosis as consequences of improved surveillance or greater awareness.

Hertz-Picciotto said that the study is a clarion call to researchers and policy makers who have focused attention and money on understanding the genetic components of autism. She said that the rise in cases of autism in California cannot be attributed to the state's increasingly diverse population because the disorder affects ethnic groups at fairly similar rates.

"We're looking at the possible effects of metals, pesticides and infectious agents on neurodevelopment," Hertz-Picciotto said. "If we're going to stop the rise in autism in California, we need to keep these studies going and expand them to the extent possible."

UC Davis Health System News

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Will Physician Gifting Practices Guidelines Work?

Pens and prescription pads flashing branded pharmaceutical drug names and logos could become less visible in doctor's offices as a result of PhRMA's “Code on Interactions with Healthcare Professionals.” But will it make the practice of medicine any better?

Briefly the new code of interactions instructs pharmaceutical companies not to distribute clothes, office supplies, and other gifts bearing company logos or product brand names to physicians and clinics. In addition, it also asks these companies to refrain from paying for physicians' meals, even during medical education events.

Many feel that these may only have a superficial effect. Why because compliance with the guidelines is purely voluntary. In fact, the guidelines are not even supposed to be a confession that gifts to doctors from the pharma industry influence a doctor's prescription writing skills. So when there's no problem to begin with, what problem will the guidelines solve. Perhaps they will solve just the problem of a perception that free gifts influence prescriptions.

Many from the pharmaceutical industry and doctors, though have shown respect to the guidelines, they scoff at the notion that pens and mugs are meant to influence a medic's practice.

Why Freebies may not be a bane?

Consider free samples of drugs, many physicians look up to these freebies for treating poor and and underinsured patients. Further, the samples also enable both doctors and patients to assess their tolerance of a novel drug before they purchase it. Thus, saving them from undue expenditure.

Often medical models and charts gifted to doctors help them to educate patients better, does it then really matter whether they carry a logo and a brand name? Free pens, flash drives, staplers, calculators paperweights, etc, may simply serve to support doctor's practice. But that a “viagra pen” will influence a prescription for “strep throat” is pretty hard to believe.

Further, some even contend that the guidelines don't at all help to put a stop to give aways other than freebies meant to influence physicians. And some even see it as a clever realization by the industry that rather than spending on freebies, the money could be spent in ways to ensure a better return on investment for them.

Whether or not the freebies influence a doctor's prescription drug advice may not be crystal clear, but what is, is that each practicing doctor has a conscience of her own, and as long as that is intact, no amount of supposed influence should be a cause for worry.

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