Hannah Otepka remembers when people in a rural village in the state of Tamil Nadu, India, would line up outside the mobile health clinic. It was 2006, and Otepka, a third-year medical student at Creighton University, and her colleagues did the only thing they could — they handed four ibuprofen pills to each patient and sent them on their way. "I knew we'd relieve their pain for the day but that was it," Otepka said. "There was no work-up or treatment to fix what was really happening. I remember thinking we weren't really making a huge impact on healthcare, that there had to be a better way." Fast-forward five years to a recent afternoon. Otepka, now a resident in internal medicine at Washington University, stands beside an ambulance outside a warehouse in Fenton. One day soon, maybe in December, she says, she or other members of the university's Global Health Scholars in Internal Medicine will head to Guatemala — with the ambulance — to treat patients.
Hannah Otepka remembers when people in a rural village in the state of Tamil Nadu, India, would line up outside the mobile health clinic. It was 2006, and Otepka, a third-year medical student at Creighton University, and her colleagues did the only thing they could — they handed four ibuprofen pills to each patient and sent them on their way. "I knew we'd relieve their pain for the day but that was it," Otepka said. "There was no work-up or treatment to fix what was really happening. I remember thinking we weren't really making a huge impact on healthcare, that there had to be a better way." Fast-forward five years to a recent afternoon. Otepka, now a resident in internal medicine at Washington University, stands beside an ambulance outside a warehouse in Fenton. One day soon, maybe in December, she says, she or other members of the university's Global Health Scholars in Internal Medicine will head to Guatemala — with the ambulance — to treat patients.
Federal disease investigators have looked into more than 200 cases of unexpected, suspected transmission of HIV, hepatitis B and hepatitis C through transplanted organs between 2007 and 2010, including some cases that led to the recipient's death.
Now, the Centers for Disease Control and Prevention has issued a draft of stricter guidelines of what hospitals and others involved in the transplant process should do to prevent these tragic results. The proposed recommendations were last issued in 1994.
"Our first priority must be patient safety," said Matthew J. Kuehnert, MD, director of the CDC's Office of Blood, Organ and Other Tissue Safety Office. "The guideline will help patients and their doctors have information they need to fully weigh risks and benefits of transplanting a particular organ."
The agency's major draft recommendations include the following:
In addition to screening for HIV, the agency suggests that donors be screened for hepatitis B and hepatitis C viruses.
The agency suggests that labs conducting the testing use more updated and sensitive methods to test organs destined for transplant.
The agency recommends that procurement organizations and others involved in the process use a revised set of donor risk factors that can give clinicians a more thorough picture about possible risks associated with donors' organs.
Since the U.S. Food and Drug Administration has implemented more comprehensive regulations for tissue and semen donors, the agency suggests that centers focus on solid organs and vessel conduits and not other tissues.
The guidelines should apply to organ procurement organizations, transplant centers, clinical coordinators, lab personnel responsible for testing and storing donor and recipient specimens and those responsible for developing and evaluating infection control programs.
"We recognize that organ demand is much greater than availability," Kuehnert said in a statement. "This guideline will assist the transplant community in ensuring that each patient is protected against unexpected diseases from the organ they so desperately need."
President Obama and some members of Congress assert that, in cutting Medicare and Medicaid, they can whack healthcare providers while protecting beneficiaries. But experts say it is not so simple. Experience, they say, shows that some cuts in payments to providers hurt beneficiaries, as more doctors refuse to take Medicaid patients or limit the number of new Medicare patients they will accept. Hospitals curtail services. Beneficiaries may have more difficulty getting therapy services after a stroke, traumatic brain injury or hip fracture.
A Greene County couple involved in a botched kidney transplant that led to a two-month shutdown of UPMC's living donor kidney and liver transplant programs -- and to state and federal investigations -- filed two malpractice lawsuits this week in Allegheny County Common Pleas Court. Christina Mecannic and Michael Yocabet sued UPMC, University of Pittsburgh Physicians, four doctors and one nurse after federal investigators determined that an entire transplant team missed a test result that showed Mecannic was infected with hepatitis C when her kidney was transplanted into Yocabet on April 6. The 12-count lawsuits allege acts of professional negligence, corporate negligence, intentional and negligent misrepresentation, and intentional and negligent infliction of emotional distress. They ask for compensatory and punitive damages but do not ask for a specific amount. The lawsuits ask for a jury trial.
Major health insurers are pooling more than $1 trillion in claims data and creating an institute to cull the statistics and identify the drivers of higher health spending. More than 5 billion medical claims from Aetna Inc., Humana Inc., Kaiser Permanente and UnitedHealth Group Inc. will be collected and combined with government health claims data by the newly formed Health Care Cost Institute. The nonprofit group, which will likely be housed in Washington, will begin publishing semi-annual scorecards beginning next year on spending and consumption of health-care services and products. Policy makers and researchers have been frustrated by the limited availability of information from commercial insurers, who provide coverage for about two-thirds of Americans with insurance, said Martin Gaynor, a professor of economics and public policy at Carnegie Mellon University in Pittsburgh who will lead the institute. Much of the available data now comes from Medicare, the U.S. health program for the elderly and disabled.
Texas State Sen. Kirk Watson outlined an ambitious plan to establish a medical school, a teaching hospital, a series of neighborhood clinics and a health-related research institute in Austin. "I'm going to lay out 10 goals for the next 10 years and, in addition, lay out an initial organizing committee ? a group of people in a position to help make sure that this happens," Watson, D-Austin, told the American-Statesman on Monday. "Every 't' hasn't been crossed, and every 'i' hasn't been dotted, but it's time to go from incremental to transformational." His proposal comes at a time of a growing consensus among civic leaders that Austin should have a medical school, the centerpiece of his plan. Austin is the second-largest city in the nation without a medical school, the largest being San Jose, CA. City leaders, the Greater Austin Chamber of Commerce, the Seton Healthcare Family and St. David's HealthCare expressed support for a medical school more than three years ago. In the past couple of years, the University of Texas Southwestern Medical Center in Dallas and Seton have collaborated here to expand medical research and training, a partnership seen as a possible precursor to a medical school.