Scores of California hospitals, under pressure to reduce infections that kill an estimated 12,000 patients every year, say they have managed to cut costs and save lives through an initiative that has nurses and doctors redoubling efforts to prevent deadly germs from taking root. The three-year campaign is bringing together 160 hospitals across the state with the aim of reducing an estimated 200,000 hospital-related infections in California that add $600 million to healthcare costs every year. Since its launch 19 months ago, the initiative is credited with cutting ventilator-associated pneumonia 41%. Urinary tract infections related to catheters fell 24% last year, and cases of blood poisoning dropped 11%. The lower rates have saved an estimated $11 million in healthcare costs. "We're definitely making progress," said Philip Robinson, MD, who oversees infection prevention at Hoag Memorial Hospital Presbyterian in Newport Beach. "Each one of these infections is a burden to patients, hospitals and the whole healthcare system."
The federal government has received a surge in complaints in recent months about failed hip replacements, suggesting that serious problems persist with some types of artificial hips even as researchers scramble to evaluate the health dangers. An analysis of federal data by The New York Times indicates that the Food and Drug Administration has received more than 5,000 reports since January about several widely used devices known as metal-on-metal hips, more than the agency had received about those devices in the previous four years combined. The vast majority of filings appear to reflect patients who have had an all-metal hip removed, or will soon undergo such a procedure because a device failed after only a few years; typically, replacement hips last 15 years or more. The mounting complaints confirm what many experts have feared -- that all-metal replacement hips are on a trajectory to become the biggest and most costly medical implant problem since Medtronic recalled a widely used heart device component in 2007. About 7,700 complaints have been filed in connection with that recall.
By the time they graduate, every doctor coming out of the University at Buffalo will have gotten a lesson from Mary Brennan-Taylor. It will come from the instructor's experience of losing her mother to medical errors. As an adjunct research instructor of family medicine, Brennan-Taylor will try to open medical students' eyes to the human cost of medical errors by telling them about the death of her 88-year-old mother, who was hospitalized for a non-life-threatening leg ailment in 2009 and died six weeks later from hospital-acquired infections and the use of numerous medications. "Every doctor that graduates from UB will hear Mary's story," said David Holmes, associate vice chair of medical student education at the university's Department of Family Medicine. "Her story adds a very human dimension to our discussion about medical errors. It helps the students realize that it's not just statistics that we are talking about. It's somebody's mom."
More heart-attack patients now than five years ago are getting a potentially life-saving procedure to open blocked arteries within the recommended time frame, a new study shows. The so-called "door-to-balloon" time refers to how long it takes for heart attack patients who need an angioplasty -- an opening of the blocked artery using a catheter -- to receive one once they've gotten to the hospital. The recommendation is to get the procedure within 90 minutes. Every minute is precious, because the longer patients go without the procedure, which restore blood flow to the heart, the lower their odds of survival. In 2005, only 44% of patients were getting treated within the recommended 90 minutes. But by 2010, that had increased to 91%, with 70% treated in less than 75 minutes, according to the study, published in Circulation. The median D2B time fell to 64 minutes from 96 minutes.
For women seeking an abortion, finding a doctor willing to offer one is easier said than done. Ninety-seven percent of OB-GYNs have encountered patients wanting an abortion, but only 14% of the doctors perform them, according to a study published in the journal Obstetrics and Gynecology. That finding suggests a smaller percentage of OB-GYNs may be offering abortion services than previous studies have estimated. Access to abortion has become more limited over the past few decades, the researchers write. Another recent study found that in 2008, 87% of U.S. counties (where 35% of reproductive-aged women live) didn't have any abortion providers. Since 1996, however, all OB-GYN residents have been required to learn how to perform the procedure. This year, states have passed at least 80 new abortion restrictions -- double the previous annual record of 34 seen in 2005, and more than triple 2010's 23 changes. Religious affiliation turns out to be a fairly significant indicator of whether a doctor will or won't provide abortions. Forty percent of Jewish doctors say yes, compared with 1% of evangelicals. Nine percent of Roman Catholics or members of Eastern Orthodox churches were likely to perform abortions. Among OB-BYNs, 10% of non-evangelical Protestants, 20% of Hindus and 27% of doctors who said they had no religious affiliation said they offer abortion services.
Researchers at Case Western Reserve University have uncovered a natural defense mechanism that could be key to fighting the stubborn and sometimes deadly "superbug" Clostridium difficile, know as "C. diff," without using conventional antibiotics. The new findings were published Sunday in the online issue of the journal Nature Medicine. C. diff, a bacterium resistant to many drugs, has become a major problem for hospital and nursing home patients in Ohio and nationwide killing more than 28,000 people each year, according to the Centers for Disease Control and Prevention. Researcher Jonathan Stamler, MD, said that he and his colleagues have uncovered a natural defense produced in a person's body to fight C. diff. C. diff often invades the colon after antibiotics have destroyed the healthy flora. The bacterium releases toxins in the gut that can cause diarrhea, more serious conditions such as colitis and sometimes death. In the study Stamler describes the mechanism that is capable of inactivating the toxins spread in the colon by C. diff. Stamler explained that the newly discovered mechanism involves a nitric oxide-based molecule called S-nitrosoglutathione or GSNO. This molecule binds to the toxins secreted by C. diff, deactivates them and prevents them from penetrating and damaging cells.