March 10, 2014
The ‘cursed’ women living in shame
(BBC) – In a rural central Ugandan village, 17-year-old Sulaina sits on the mud floor of the tiny home she shares with her mother and younger brother and sister. She wants to help provide for her family. But she can’t. She can barely leave her house. Wherever she goes, a sickly smell follows her. That’s because she is constantly leaking urine. The rags she has stuffed in her underwear are drenched quickly, and then the urine starts running down her legs. She has sores all over her thighs where the urine has burned her. Sulaina has a condition called obstetric fistula. She developed it after giving birth to a baby girl last year.
March 6, 2014
Chemotherapy in last months of life associated with increased risk of dying away from home
(Eurekalert) – The use of chemotherapy in terminally-ill cancer patients in the last months of life is associated with increased risk of undergoing resuscitation and dying in an intensive care unit, suggests a paper published on bmj.com today. The researchers suggest that end-of-life discussions may be particularly important for patients receiving chemotherapy and suggest that caregivers should ensure that patients are aware of their prognosis, likely outcomes of treatment and that their choices are aligned with their end-of-life values.
March 5, 2014
Parents’ fight against sepsis reaches C.D.C.
(New York Times) – Sepsis is what happens when the body’s own responses to an infection spin out of control, destroying cells and blood vessels. This leads to shock, organ failure and death. The sooner treatment begins, the better the chances of survival. That and many other aspects of sepsis remain poorly understood. After a campaign by the Stauntons, the New York State Department of Health issued new regulations, which went into effect at the end of 2013, requiring hospitals to adopt techniques for early identification and treatment of sepsis. They are among the most rigorous regulations in the country.
Hospital antibiotics use can put patients at risk, study says
(Washington Post) – Doctors in some hospitals prescribe up to three times as many antibiotics as doctors at other hospitals, putting patients at greater risk for deadly superbug infections, according to a federal study released Tuesday. In addition, about one-third of the time, prescriptions to treat urinary tract infections and prescriptions for the drug vancomycin were given without proper testing or evaluation, or prescribed for too long, according to the Centers for Disease Control and Prevention.
March 4, 2014
Doctors call for healthcare reforms in prisons
(UPI) – In a new study, public health experts say more should be done to protect and improve the health of prison populations. The paper, published in the most recent edition of the journal Health Affairs, argues that too many prisoners return to their communities with debilitating diseases — diseases that burden the economy and exacerbate public healthcare resources.
Differences in care at for-profit hospices
(New York Times) – People who pay attention to hospice care, so often a godsend for the dying and their families, have noticed and wondered about two trends in recent years: 1) What began as a grass-roots movement to improve end-of-life care is becoming a business. In 1990, only 5 percent of hospices were for-profit operations; by last year, they dominated the industry, representing 63 percent of hospices. 2) We’ve also seen that hospice patients are increasingly likely to be “disenrolled” before they die.
Women’s health harmed as medical studies miss gender differences
(Chicago Tribune) – Scientists continue to neglect gender in medical research, endangering women’s health by focusing on males in studies that shape the treatment of disease, according to a report released Monday. The lack of attention to gender differences occurs at all stages of research, from lab to doctor’s office, according to the report released by the Connors Center for Women’s Health at Brigham and Women’s Hospital in Boston, and the Jacobs Institute of Women’s Health at George Washington University in Washington.
Lifesaving implants complicate end-of-life care
(The Boston Globe) – More than a decade has passed, but Nathan Goldstein, then a medical resident at Mount Sinai Hospital in New York City, still remembers it clearly. A man with terminal lung cancer had planned to die at home with hospice care. Instead, the man was lying on a stretcher in the busy emergency room. Every few minutes, his heart received a shock from his internal defibrillator, preventing his heart from stopping.
How can we reduce end-of-life health-care costs?
(The Wall Street Journal) – Balancing cost, care and quality of life near death remains a puzzle for policy makers, practitioners, and of course, patients and their families. With this difficult calculus in mind, we asked The Experts: How can we reduce end-of-life health-care costs? This discussion relates to the latest Health Care Report and formed the basis of a discussion on The Experts blog on Feb. 26 and 27.
March 3, 2014
Brain zap can ‘wake’ nearly-comatose patients
(ABC News) – Researchers in Belgium have found that mild electrical stimulation can temporarily rouse nearly-comatose patients, according to a study from the April issue of Neurology. During the study the patients, all of whom were either minimally conscious or in vegetative state, underwent mild electrical stimulation for 20 minutes at a time. Researchers found that 15 of the minimally conscious patients responded to the stimulation by becoming more responsive and two were even able to communicate nonverbally with researchers. Those in a vegetative state did not show any reaction.
Whose genome is it anyway? Doctors face dilemmas over risk knowledge
(U.S. News and World Report) – When you break your arm and get an X-ray, those results are mostly only significant to you – they don’t affect your brother, your sister, your parents or that distant cousin of yours in Alaska. But genetic testing is different, explains Dr. Mark Robson, clinic director of the Clinical Genetics Service at Memorial Sloan-Kettering Cancer Center in New York City. Targeted genetic tests – such as tests for Alzheimer’s disease, Huntington’s disease and certain types of cancer – yield results that can have dramatic and unpredictable consequences for family members. For doctors, deciding whom to test, when to return results and whom those results might impact is perhaps even more complex.
February 28, 2014
Many countries lack capacity to prevent and treat hearing loss
(World Health Organization) – Many of the countries who responded to a new WHO survey lack the capacity to prevent and care for hearing loss, according to a report published on International Ear Care Day, 3 March. WHO estimates that over 5% of the world’s population – 360 million people – has disabling hearing loss. The highest prevalence is found in the Asia Pacific, South Asia and sub-Saharan Africa. About half of all cases of hearing loss worldwide are easily prevented or treated.
China sees wave of violence against hospital staff
(BBC) – A nurse left paralysed in Nanjing, a doctor with his throat slashed in Hebei and another beaten to death with a pipe in Heilongjiang. Three separate incidents all of which took place in China over the past two weeks. They are, of course, savage and shocking in their own right. Even more troubling though is the fact that they are not isolated cases but the latest in a growing crisis of violence at the heart of China’s healthcare system. It is leaving a trail of bereavement in its wake.
February 27, 2014
South Sudan: Violence ‘jeopardizing MSF work’
(BBC) – Medical charity MSF has warned its work in South Sudan is being jeopardised as a result of “brutal” attacks on medical facilities in which patients and its hospital staff have also been targeted. Hundreds of thousands of people have been effectively denied lifesaving assistance, MSF says in a new report. Fighting between the government and rebels since mid-December has displaced about 860,000 people, the UN says.
‘Stop medicating elderly and let them die naturally’
(The Telegraph) – Doctors should stop prescribing statins and blood pressure drugs to over 80s because they have little effect and many older people would rather be allowed to die naturally, a health expert has warned. More than two million people over 80 in Britain are currently prescribed pills to prevent strokes and heart attacks with many drugs causing debilitating side-effects. Dr Kit Byatt, a specialist in geriatric medicine at The County Hospital, Hereford, claims many older people ‘see death as the next natural event’ and do not want the burden of medication.
U.S. and Eurpoean regulators call popular diabetes drugs safe
(New York Times) – In an unusual joint paper being published in The New England Journal of Medicine on Thursday, officials from the Food and Drug Administration and the European Medicines Agency said that assertions by some researchers that the drugs could cause pancreatic inflammation and pancreatic cancer were “inconsistent with the current data.” The drugs in question have billions of dollars in collective sales. They include Januvia, sold by Merck; Victoza, sold by Novo Nordisk; and AstraZeneca’s drugs Onglyza, Byetta and Bydureon.
Herion overdose antidote promises fewer deaths but raises questions over who should carry it
(Associated Press) – As deaths from heroin and powerful painkillers skyrocket nationwide, governments and clinics are working to put a drug that can reverse an opiate overdose into the hands of more paramedics, police officers and the people advocates say are the most critical group – people who abuse drugs, and their friends and families.
February 26, 2014
New pain pill’s approval: ‘Genuinely frightening’
(CNN) – A potent little painkiller is causing a big stir. A coalition of more than 40 health care, consumer and addiction treatment groups is urging the Food and Drug Administration to revoke approval of the prescription drug Zohydro. The hydrocodone-based drug is the latest in a long line of painkillers called opioid analgesics. The FDA approved the medication last fall to treat chronic pain, and it is set to become available to patients in March.
Aid group sees daunting obstacles to health care for Afghans
(New York Times) – The patients in the four hospitals run by Doctors Without Borders in Afghanistan are the lucky ones, by all accounts, having arrived at well-stocked facilities that maintain international standards with high-quality free care. But when Doctors Without Borders, a French medical aid organization also known as Médecins Sans Frontières, surveyed 800 of those patients last year, the results showed a dismaying picture of unmet health care needs.
Landmark Hispanic study may offer longevity clues
(Boston.com) – The government’s largest-ever study of Hispanics’ health may help answer why they live longer than other Americans but the first results suggest that for some, the trend might be in jeopardy. Overall, high rates of high blood pressure, obesity, diabetes and pre-diabetes were found, especially among older adults. But troubling signs were seen among younger Hispanic adults. They were the least likely to have diabetes under control, and the least likely to eat recommended amounts of fruits and vegetables.
February 25, 2014
Child mortality levels ‘still too high’
(BBC) – Despite progress against child mortality, every day more than 18,000 children under five still die from preventable causes, according to a report from Save the Children. Every year the lives of two million newborn children could be saved by provision of better basic healthcare, the charity says. Globally in 2012, an estimated 40 million women gave birth without the presence of midwives or qualified health workers.