A cheap medical device can dramatically reduce the number of premature births in some at-risk women, according to a team of doctors in Spain. Being born before 34 weeks of pregnancy is linked to a host of health problems.
The study showed that using a ‘cervical pessary’ reduced the rate in the at-risk group. Doctors said more studies were needed before the technique was used routinely.
The authors said 13 million babies were born prematurely every year.
In the trial, doctors were looking at women who had a cervix – part of the lower section of the uterus – which was shorter than 25mm. These pregnant women are thought to be at a higher risk of an early delivery.
The cervix was measured between 18 and 22 weeks into the pregnancy by an ultrasound scan. Of the 11,875 women who took part in the trial, 726 had a cervical length less than 25mm. Half of these women had a pessary, a small ring of silicone, inserted into their cervix.
In the group of women without the pessary, 27% of babies were born prematurely. The rate was six per cent among those fitted with a pessary.
Maria Goya, one of the researchers at the Vall d’Hebron Hospital, said: ‘Placement of a pessary is an affordable procedure, non-invasive, and easy to insert and remove as required.’
The study concluded the pessary was a ‘reliable alternative for prevention of preterm birth’ in a group of at-risk women.
Prof Steve Thornton of the University of Exeter, a spokesman for the Royal College of Obstetricians and Gynaecologists, said: ‘The difference in the two groups is pretty amazing.’
He said more research was needed to prove that it worked, and to find out if it could help other women at risk of a premature birth.
‘If this is borne out it could make a big difference,’ he added. BBC

Siemens awarded large-scale service contract in Australia covering 6,000 items of medical technology equipment

In a 1.3 billion Australian Dollar partnership between the Western Australian Department of Health and the services company Serco, Siemens has been subcontracted by Serco to provide a Managed Equipment Service (MES) for the new Fiona Stanley Hospital in Perth, Australia. Consequently, Siemens will be providing services that will manage procurement, installation, maintenance, and regular system replacements of diagnostic and treatment equipment for the next 15 years.

The agreement involves capital investment of 100 Million Australian Dollars (app. 78 million euros) and includes around 6,000 items from CT scanners to monitoring equipment. This is the largest deal that Siemens Healthcare has ever won in Australia.

Fiona Stanley Hospital in Perth, currently under construction, is a two-billion-dollar venture and one of the largest healthcare new build projects in Australia. The Western Australian Department of Health has contracted the international services company Serco as the overall facilities manager of the hospital. Serco in turn has selected Siemens to provide support in the form of a Managed Equipment Service (MES). This is a comprehensive service agreement that manages not only initial procurement, but also replacement, ongoing management, maintenance and disposal of medical equipment, as well as coordination of user trainings.

Siemens will be managing and supporting around 6,000 pieces of medical equipment for almost all departments in the hospital, ranging from diagnostic imaging, laboratory diagnostics, anesthetics, audiology and intensive care. Under the vendor-independent agreement, Siemens will manage differing equipment suppliers, with the aim of integrating them into the hospital workflow to optimize the quality of care and to ensure best technologies are available to the patients. The contract runs for a period of 15 years and includes management of planned replacement of the equipment with updated technology.

In December 2011, Siemens commenced with the first phase of the 100 million AUD capital investment program which will see the first major items being procured. These include advanced computed tomography scanners, magnetic resonance systems, and other imaging equipment.

The Fiona Stanley Hospital is scheduled to open in April 2014 and will be Western Australia

C. difficile is the most common cause of infectious diarrhoea in hospital, and it is estimated that 10% of patients who become infected in hospital will die. Researchers used The Ottawa Hospital Data Warehouse, Canada to analyse data on 136 877 admissions to The Ottawa Hospital between July 1, 2002 and March 31, 2009. A total of 1393 patients acquired C. difficile in hospital during this time, and these patients spent 34 days in hospital compared with eight days for patients who did not have C. difficile. However, the researchers also found that patients who became infected with C. difficile tended to have more serious illnesses and would have been more likely to stay longer in hospital anyway. When the researchers controlled for the level of illness using a mathematical model, they found that hospital-acquired C. difficile increased the length of stay in hospital by six days. The researchers believe that the study provides the most accurate measure yet of the impact of hospital-acquired C. difficile on length of hospital stay. C. difficile is a very serious problem for patients and for healthcare systems, however the good news is that tools such as this can provide more accurate information about C. difficile infection, helping to improve infection prevention efforts and also analyse their cost-effectiveness.

A 25 per cent increase in high blood pressure screening in 19 developing countries would reduce the number of cardiovascular disease (CVD) events and deaths that occur each year by up to 3 per cent in these countries. The preliminary data presented today at the World Congress of Cardiology are the first findings from a new report from Harvard that will be published later this year.
The study found that around 900 million people in developing countries have high blood pressure but that only one-third are aware of their disease. Moreover, only 100 million of these people receive treatment, while only 5 per cent of the total are controlled.
Against this backdrop, this study was designed to assess the cost-effectiveness of an intervention to increase screening by 25 per cent in developing countries using a non-lab screening tool to treat those with a systolic blood pressure of greater than 140 mmHg and CVD risk of greater than 20 per cent.
The study found that screening an additional 25 per cent of the population would lead to an increase of more than 10 per cent in the rate of appropriate treatment of hypertension in high-risk individuals. The intervention would lead to about a 1-3 per cent reduction in CVD events and deaths. Furthermore, the incremental cost-effectiveness ratios of these screening programs were found to be well below one times GDP per capita in the 19 developing countries assessed.
‘Strategies to increase the screening for hypertension could lead to significant reductions in CVD deaths, at costs that are considered to be acceptable according to WHO recommendations,’ said Dr. Thomas Gaziano, assistant professor, Harvard School of Medicine.
CVD is the world