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Clostridium difficile lengthens hospital stays by six days on average
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.
http://tinyurl.com/c5ynk5eNew technology used by Mayo Clinic treats evaporative dry eye symptoms
Mayo Clinic in Arizona is the first medical centre in Arizona and the Southwest to provide a new technology that treats dry eye by targeting blocked eyelid glands. Blocked glands can inhibit production of oil that is necessary for healthy tears needed to lubricate the eyes.
People with chronic dry eye, from this evaporative sub-type , often experience pain and irritation caused by an inadequate protective layer of oils in their tears, which creates a cycle where they resort to excessive use of eye drops that can exacerbate the condition, according to Joanne Shen, M.D., Ophthalmology, Mayo Clinic in Arizona. ‘Patients are frustrated in their attempts to find relief, frequently trying warm compresses, ointment, eye drops or even vitamins,’ says Dr. Shen.
The new treatment, called the LipiFlow thermal pulsation system, represents a significant shift from the traditional management of dry eye, in that the system is able to diagnose and address the root cause of the condition
Additional high blood pressure screening in developing countries would reduce cardiovascular disease
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
Injectable gel could repair tissue damaged by heart attack
University of California, San Diego researchers have developed a new injectable hydrogel that could be an effective and safe treatment for tissue damage caused by heart attacks.
The study was done by Karen Christman and colleagues Christman is a professor in the Department of Bioengineering at the UC San Diego Jacobs School of Engineering and has co-founded a company, Ventrix, Inc., to bring the gel to clinical trials within the next year.
Therapies like the hydrogel would be a welcome development, Christman explained, since there are an estimated 785,000 new heart attack cases in the United States each year, with no established treatment for repairing the resulting damage to cardiac tissue.
The hydrogel is made from cardiac connective tissue that is stripped of heart muscle cells through a cleansing process, freeze-dried and milled into powder form, and then liquefied into a fluid that can be easily injected into the heart. Once it hits body temperature, the liquid turns into a semi-solid, porous gel that encourages cells to repopulate areas of damaged cardiac tissue and to preserve heart function, according to Christman. The hydrogel forms a scaffold to repair the tissue and possibly provides biochemical signals that prevent further deterioration in the surrounding tissues.
‘It helps to promote a positive remodelling-type response, not a pro-inflammatory one in the damaged heart,’ Christman said.
What
New device to diagnose irregular heart beat
A study conducted at Scripps Health has found that a novel new heart monitoring device helped emergency room patients avoid unnecessary follow-up care. Scripps Health electrophysiologist Steven Higgins, MD, presented findings of the study, titled ‘Prevalence of Arrhythmias in Emergency Department Patients Discharged Using a Novel Ambulatory Cardiac Monitor,’ at the Heart Rhythm Society
Metal-on-metal hip replacement patients at no more risk of developing cancer in seven years following surgery
Patients who have had metal-on-metal hip replacements are no more likely to develop cancer in the first seven years after surgery than the general population, although a longer-term study is required, a study led by the University of Bristol claims.
A recent BMJ and BBC Newsnight investigation looked into the potentially high level of toxic metals from failing hip implants which may, in future, affect thousands of people around the world. The investigation also looked at why these hip replacements were allowed despite the risks being known and documented for decades. The BMJ has a large collection of articles about the safety of medical devices which can be found here.
This study, commissioned by the National joint Registry of England and Wales and carried out by authors from the Universities of Bristol and Exeter, looks at whether these concerns are valid. The registry contains records of over one million procedures from at least 97 per cent of orthopaedic units. Every year registry data and hospital episode statistics are linked up to check how patients who have had joint replacements are faring.
Ashley Blom, Professor of Orthopaedic Surgery in the School of Clinical Sciences at the University of Bristol, who led the team that undertook the study, said: ‘This research shows that there is no increased risk of cancer with metal-on-metal hip replacements in the first seven years after surgery. Although this is very reassuring, we do not know what are the long-term risks and thus further studies will be necessary in the future.’
In this study cancer rates in patients with metal-on-metal hip replacements were compared with both a group of patients who had other hip bearing surfaces implanted and the general population. Overall, 14 per cent (40,576) of registered patients had some type of metal-on-metal bearing surface: seven per cent (21,264) had a stemmed metal-on-metal prosthesis and seven per cent (19,312) had a resurfacing procedure. The researchers compared patients’ outcomes using mathematical modelling. The models included the age and sex of the patient as well as three measures of general health at the time of hip surgery (the American Society of Anaesthesiologists grade that scores the patient’s other serious illnesses, the number of distinct diagnostic codes recorded at time of surgery, and the number of NHS funded admissions to hospital in the previous five years). The authors do say, however, that comparison with the general population is not straightforward as hip replacement patients ‘tend to be healthier than others of the same gender and age group’.
Results show that the chance of a 60-year-old man with moderate health and a metal-on-metal stemmed hip replacement being diagnosed with cancer in the five years following surgery is 6.2 per cent, compared to 6.7 per cent chance with hip replacement using other bearing surfaces. For women, these figures were 4.0 per cent for metal-on-metal stemmed hip replacement and 4.4 per cent for other bearing surfaces. Further results show that the incidence of cancer diagnosis is low after hip replacement and lower than that predicted for the age and sex matched general population.
The authors hope that this study will help clinicians reassure patients that the ‘risk of cancer for hip replacement patients is relatively low’ with no evidence of an increase in cancer associated with metal-on-metal hips. They add though that this only shows results for up to seven years following surgery and the analysis of long-term data is required over the next few decades as some cancers take many years to develop.
University of Bristol
New Meningitis B vaccine findings welcomed
Teenagers could be given full protection against Meningitis B, a new vaccine trial suggests. The study, conducted in Chile, is the first large-scale trial of 4CMenB amongst adolescents.
Tests showed that two doses of pharmaceutical company Novartis
New method generates cardiac muscle patches from stem cells
Heart cells bio-engineered at University of Michigan Center for Arrhythmia Research display activity similar to most people’s resting heart rate
A cutting-edge method developed at the University of Michigan Center for Arrhythmia Research successfully uses stem cells to create heart cells capable of mimicking the heart
Aspirin and Warfarin equally effective for most heart failure patients
Neither aspirin nor Warfarin is superior for preventing a combined risk of death, stroke, and cerebral haemorrhage in heart failure patients with normal heart rhythm, according to a landmark clinical trial.
The 10-year Warfarin and Aspirin for Reduced Cardiac Ejection Fraction (WARCEF) trial is the largest double-blind comparison of these medications for heart failure, following 2,305 patients at 168 study sites in 11 countries on three continents. The research was led by clinical principal investigator Shunichi Homma, MD, of Columbia University Medical Center/NewYork-Presbyterian Hospital, and statistical principal investigator John L.P. (Seamus) Thompson, PhD, of Columbia University