Category: Health care news

Health Care Safety Index – January 2016

Here are healthcare safety issues that have appeared in the news and medical journals throughout the last 30 days or so:

The Centers for Disease Control and Prevention issued a recommendation that men with a pregnant partner should abstain from sex or use a condom if they live in or visited an area where mosquitos are spreading the Zika virus. Additionally, the CDC also recommended that pregnant women who have visited countries and territories plagued by the virus, mostly in Latin America, should be tested even if they do not exhibit symptoms of infection.

The Centers for Disease Control and Prevention recommended that hospitalized patients, patients with severe, complicated or progressive illness and patients at high risk for complications due to influenza be treated with antiviral medication irrespective of the outcome of rapid influenza diagnostic test results. The reasons for this are that (a) there have been reports of severe influenza with some deaths and (b) RIDT results have a high potential for false negatives.

A study published in Pediatrics found that exposure to beta-2 adrenergic agonists during pregnancy (used in asthma drugs) may increase the risk for autism spectrum disorders in children.

The American College of Physicians and the Centers for Disease Control and Prevention released a new clinical guideline on antibiotic use in adults with acute respiratory tract infections.Except for confirmed bacterial infections like streptococcal pharyngitis or acute bacterial sinusitis, antibiotics should not routinely be used.

A study published in Emerging Infectious Diseases revealed red flags about the effectiveness of a vaccine for whooping cough after an outbreak in a Florida preschool.

A study published in Pediatrics demonstrated that children with allergic rhinitis and allergic persistent wheezing at age 4 years may have increased risk for anxiety and depression.

A study published in the Journal of Allergy and Clinical Immunology found that adults with asthma have a 70% increased risk for developing shingles. The authors suggested that clinicians should consider vaccinating asthmatics at 50 years old.

The American College of Surgeons and American Geriatrics Society issued joint best practice recommendations for geriatric perioperative care.

In a study published in Neurology, researchers discovered that the distribution of amyloid plaque in traumatic brain injury (TBI) survivors overlaps the distribution that exists in Alzheimer patients, but in TBI survivors the distribution also involves the cerebellum which is not typically involved in Alzheimer’s.The study also concluded that in TBI patients the amyloid burden appears to increase over time, suggesting a progressive neurodegenerative process following TBI.

A study published in Gut suggested that patients with alcohol-induced liver lesions had more Bifidobacteria and Streptococci and less Atopobium than patients with no liver problems. Accordingly, differences between alcoholics who develop severe liver damage and those who do not might be partly due to differences in their gut microbes.

An updated analysis of the NAPOLI-1 trial confirmed the survival benefit of liposomal irinotecan in combination with fluorouracil and leucovorin in patients metastatic pancreatic cancer.

A study published in JAMA Pediatrics indicated that teens diagnosed with depression are not getting the appropriate follow-up care that they need.

An article published in the Annals of Internal Medicine concluded that 51 percent of the people who suffer from Sudden Cardiac Arrest experience warning symptoms within four weeks before the attack. Eighty percent of patients experienced symptoms at least one hour before SCA, and 34 percent had symptoms more than 24 hours before SCA. Chest pain and dyspnea were the most common symptoms.

A study published in the American Heart Journal concluded that use of morphine increased the risk of death in acute coronary syndromes.

Health Care Safety Index – February through March 2015

The editors at medGadget discussed a study appearing in the journal Inorganic Chemistry regarding research at Bielefeld University in Germany which demonstrated a new method of disrupting the spread of cancer using molecules that bind to DNA.

Sarah Knapton, with The Telegraph,discussed research published in JAMA about a new stem cell treatment which is reversing the symptoms of multiple sclerosis.

Robert Preidt, for Health Day, discussed a study performed by Cancer Research UK, which demonstrated that obesity raises the risk of cancer in women 40%.

Jane Brody, for the NYT, reported on a study appearing in The Lancet which described a constellation of symptoms which appear to foretell a diagnosis of Parkinson’s disease, including tremors, balance problems, constipation, low blood pressure, dizziness, erectile and urinary dysfunction, fatigue, depression and anxiety.

Beth Greenwood, for Daily RX, discussed a presentation at the March 12, 2015 American College of Cardiology’s 64th Annual Scientific Session in San Diego, which demonstrated that excessive sitting can increased risk for coronary calcification.

Kathleen Doheny, for Health Day,reported on a study in Neurology that indicated that people who sleep more than 8 hours a day were 46% more likely to have a stroke than people who slept 6-8 hours. The article’s authors, however, did report that there was uncertainty about whether long sleep was a cause, consequence or early warning sign of declining health.

Robert Preidt, for Health Day,reported on an article appearing in Couple and Family Psychology Research and Practice which concluded that depression in fathers may be linked to anxiety and bad behavior in toddlers.

Robert Preidt, for Health Day,discussed an article in Maternal & Child Nutrition which concluded that too much weight gain during pregnancy can put a child at risk for obesity in childhood and later years.

Michelle Roberts, for the BBC,discussed an article appearing in JAMA Psychiatry which indicated that autism is much more likely to be caused by genetics than environmental factors.

Janis C. Kelly, for Medscape Medical News,reported on an article in Arthritis Research & Therapy, which indicated that gout is prevalent, yet undertreated.

Sue Hughes, for Medscape Medical News,reported on an article published in Stroke that indicated that individuals consuming more than 2 alcoholic beverages a day in middle age have an increased risk of stroke.

An article appearing in the Diagnosisdiscussed characteristics of missed myocardial infarction diagnoses. Characteristics of patients increasing the risk of missed diagnoses included being younger, or African American. Characteristics of the hospital increasing the risk of a missed diagnosis included the teaching status of the hospital, the availability of cardiac catheterization, high ED admission rates, high inpatient occupancy rates, and urban location.

An article published in Intensive Care Medicine concluded that the use of liaison nurses and handover forms helps improve the quality of care provided between patients who were being handed off between the ICU and general ward.

An article published in JAMA Pediatrics discussed how simulation training compliments clinical training for health care professionals that is based traditionally on learning from actual patients.

The Joint Commission and National Quality Forumannounced the 2014 Eisenberg Awards for key contributions to patient safety and quality improvement. This year’s honorees include Mark L. Graber, MD, the American College of Surgeons National Surgical Quality Improvement Program, and North Shore-LIJ Health System in New York.

An article in Lancet Infectious Diseasediscussed how to reduce health-care-associated infections and improve patient safety.

Dr. Darshak Sanghaviwrote an editorial in the Boston Globe arguing for disclosure of medical errors to patients.

An article published in Pediatric Critical Care Medicinediscussed the rate and characteristics of diagnostic errors in pediatric and neonatal units that result in morbidity and mortality.

Health Care Safety Index – February 2014

In this story, NPR highlighted Senator Joe Manchin’s attempts to introduce legislation to force the FDA to ban a new painkiller, Zohydro, which was placed on the market this week. Zohydro is one of the most powerful prescription pain medications created and it is crushable, so that it can be abused by snorting it. The drug is so potent that swallowing one tablet could kill a child. 42 different public health organizations have called for the FDA to ban the drug, as well as attorneys general from 28 states. The FDA’s own advisory panel voted 11-2 against approving the drug, but top FDA officials over-ruled this decision, taking the position that the drug was needed. Emails later became public that showed that FDA officials participated in private meetings with pain drug companies that paid organizers thousands of dollars to attend, including Zohydro’s manufacturer. Matthew Perrone wrote a similar story for ABC.Huffington Post Live discussed this storyin the context of the nation’s current hydrocodone abuse epidemic.

Yolanda Kennedy, for Medical Xpress, discussed a study appearing in the British Medical Journal Quality & Safety which demonstrated that by requiring hospital pharmacists to collaborate with health care providers during key points of a hospital admission, overall prescription errors were reduced 79% and severely harmful medication errors were entirely eliminated.

Errors due to the failure of junior physicians and nurses to speak up about concerns of patient safety were discussed in this article appearing on BMC Health Services Research.

Vineet Chopra, MD and Laurence F. McMahon Jr., MD, argued in JAMA that the rudimentary alarm systems in hospitals need to be updated with new technology that analyzes information and sends meaningful warnings to health practitioners.

Pauline W. Chen, MD discussed in the New York Times how an emergency room’s goals of speed and efficiency conflict with caring for the elderly, how the aging population may exacerbate this problem in the coming years and how a “small but dedicated group of emergency medicine and geriatrics specialists have been working to improve this situation.”

Philip Levitt, M.D., a retired neurosurgeon argued in the L.A. Times that a systems approach to patient safety has inadequately reduced medical errors because most errors are not due to faulty systems, but the acts of individual practitioners. Meanwhile, in an interview appearing in Forbes magazine, Ashish K. Jha, M.D., a professor at the Harvard School of Public Health, indicated that the focus of the patient safety movement on systems failures rather than individual physician mistakes was one of two areas of advancement in patient safety since 2000. Nevertheless, Dr. Jha also characterized improvement in patient safety as “excruciatingly slow.”

Peter Orszag, former director of the Office of Management and Budget in the Obama administration, argued in this article appearing in the Insurance Journalthat the appropriate route to malpractice reform is not to cap damages, but to protect doctors from liability when they follow national clinical decision guidelines.

The Florida Supreme Court held that legislation capping noneconomic damages against physicians who commit medical malpractice is unconstitutional because it violates the equal protection clause of the state constitution.

Nancy Chute with NPR reported that a recent study demonstrated that statins do not actually cause muscle aches, despite the fact that this is listed as a potential side-effect on most packages.

A second article by Ms. Chutediscussed the increasing use of ADHD medications revealed in a study performed by Express Scripts, a pharmacy benefits management company. Between 2008 through 2012, the use of these medications rose 35.5 percent overall. Interestingly, while children’s use of ADHD medication rose 19 percent, the use of these medications by adults rose 53 percent during the same time period.

Arundhati Parmar wrote an article on MDDI Onlinethat spotlighted how the Consumers Union through its Safe Patient Project is asking members of the American Academy of Orthopaedic Surgeons to demand warranties for joint replacement prosthetics.

Paula Span, writing for the New York Times addressed an article appearing in JAMA which the discussed the consequences of for-profit corporations taking over the provision of hospice care. The article suggests that one of the consequences of this evolution is that for-profit hospitals are actually discharging patients from hospice care for economic reasons rather than consideration of patients’ well-being.

Inna Jaffe, writing for NRPdiscussedthe February 2014 report of the Department of Health and Human Services which indicated that approximately one-third of patients admitted to skilled nursing homes are actually harmed by the medical care that they receive.

Geoffrey Mohan pointed out in an article in the LA Times that one of the consequences of global warming is that drilling activities in previously dormant frozen areas may revive ancient viruses. Finally, the Huffington Post featured an article by Jenn Savedgediscussing a recent article appearing in the Journal of Medical Entomology about a new strain of super lice, resistant to traditional forms of treatment.

Health Care Safety Index October 2015

Here are noteworthy healthcare issues that have appeared in the news and medical journals throughout the last 30 days or so:

Issac Itzkoff, of the New York Times, reported that comedian Robin Williams was battling Lewy body dementia at the time of his suicide. Lewy body dementia causes an Alzheimer’s-like slippage in memory and thinking as well as stiffness and movement problems such as the kind seen in Parkinson’s disease. It can also cause hallucinations which often involve seeing animals, children or miniature people. The condition results in steady decline, an average of 10% or more a year and there is no cure.

A study appearing in the American Journal of Psychiatry demonstrated that schizophrenia may be caused by inflammation in the brain which can be discovered through PET scans which measure the levels of activity of immune cells in the brain.The authors suggest that the next step is to determine whether anti-inflammatory treatment in patients who are predisposed to the disease can prevent the disorder.

An article published in Trends in Pharmacological Sciences surveyed advances in “exercise pills” which seek to mimic the effects produced by physical exercise.

An article published in Science discussed the development of artificial skin that acts as a mechanoreceptor in conjunction with an organic transistor circuit that can simulate the sensation of touch.The hope is that this technology will aid in the design of large area organic electronic skin with neural integrated touch feedback for replacement limbs.

A study published in the Journal of Antimicrobial Chemotherapy demonstrated that washing hands with antibiotic soap proved no more effective than regular soap at killing bacteria.

A study published in the Lancet discussed the development of (PrEP) that contains tenofovir-emtricitabine and acts as a prophylactic against the development of HIV.

An article appearing in JAMA discussed a new drug, marketed under the name Nuedexta, containing dextromethorphan hydrobromide and quinidine sulfate, which has been proven effective in quelling agitation and aggression in patients with Alzheimer’s disease.

A study published by the American Academy of Pediatrics found that injuries from airsoft and paintball guns can sometimes be severe. 83% of the injuries were related to the eye and 10% of children injured by these kinds of devices sustained injuries that resulted in lasting functional deficits.

Researchers at the University of Liverpool reported that treatment with a metabolic hormone called GLP-1 helped obese people lose weight.

Sanofi US is voluntarily recalling all Auvi-Q epinephrine injectors because of inaccurate dosage deliveries.

Idarucizumab (Praxbind) was approved as a reversal agent for the thrombin inhibitor dabigatran by the FDA for patients requiring emergency surgery.

The American Heart Association recommended the same hand positioning that is normally used for chest compressions in pregnant women during resuscitation after cardiac arrest.Previous guidelines suggested a more cephalad hand position in pregnancy to adjust for elevation of the diaphragm by the gravid uterus.

An article published in JAMA demonstrated that pediatric trauma patients treated at pediatric trauma centers have a much lower mortality rate than pediatric trauma patients treated in other hospitals. Children treated in adult or mixed trauma centers had an estimated 57 and 45 percent increased risk of dying.

The American Cancer Society has developed new revised recommendations for breast cancer screening.The ACS now recommends that screening begin at age 45, that women aged 45 to 54 years be screened annually and that women age 55 years and older be screened biennially if they have a life expectancy of at least 10 years. The guidelines indicate that a clinical breast examination is not necessary.

An article published in the Lancet showed that chlorhexidine-alcohol prior to intravascular catheter insertion provides greater protection against short-term catheter-related infection than povidone iodine-alcohol.

An article appearing in the New England Journal of Medicine showed that there was no difference in outcome when open fracture wounds were irrigated with high, or low pressure.The authors recommended the use of low pressure irrigation because it was less likely to cause additional tissue injury.

The American Heart Association provided new recommendations for the treatment of infective endocarditis.

A study appearing in the Journal of the American Academy of Child and Adolescent Psychiatry concluded that children treated with stimulants did not have an increased risk of onset or worsening of tics with the use of psychostimulant treatment.

An article appearing in JAMA concluded that children spending 40 minutes a day engaging in outdoor activity suffered from less myopia than those who did not.