Alarming combo: Bedbugs with 'superbug' germ found (AP)

ATLANTA � Hate insects? Afraid of germs? Researchers are reporting an alarming combination: bedbugs carrying a staph "superbug." Canadian scientists detected drug-resistant staph bacteria in bedbugs from three hospital patients from a downtrodden Vancouver neighborhood.

Bedbugs have not been known to spread disease, and there's no clear evidence that the five bedbugs found on the patients or their belongings had spread the MRSA germ they were carrying or a second less dangerous drug-resistant bacteria.

However, bedbugs can cause itching that can lead to excessive scratching. That can cause breaks in the skin that make people more susceptible to these germs, noted Dr. Marc Romney, one of the study's authors.

The study is small and very preliminary. "But it's an intriguing finding" that needs to be further researched, said Romney, medical microbiologist at St. Paul's Hospital in Vancouver.

The hospital is the closest one to the poor Downtown Eastside neighborhood near the city's waterfront. Romney said he and his colleagues did the research after seeing a simultaneous boom in bedbugs and MRSA cases from the neighborhood.

Five bedbugs were crushed and analyzed. MRSA, or methicillin-resistant Staphylococcus aureus, was found on three bugs. MRSA is resistant to several types of common antibiotics and can become deadly if it gets through the skin and into the bloodstream.

Two bugs had VRE, or vancomycin-resistant Enterococcus faecium, a less dangerous form of antibiotic-resistant bacteria.

Both germs are often seen in hospitals, and experts have been far more worried about nurses and other health care workers spreading the bacteria than insects.

It's not clear if the bacteria originated with the bedbugs or if the bugs picked it up from already infected people, Romney added.

The study was released Wednesday by Emerging Infectious Diseases, a publication of the U.S. Centers for Disease Control and Prevention.

Powered By WizardRSS.com | Full Text RSS Feed | Amazon Plugin | Hud Settlement Statement

Worldwide interest as Canada drug program in court (AP)

VANCOUVER, British Columbia � The woman stands close to a mirror fingering her throat. Then, sweeping back a mane of red hair, she injects heroin into her jugular vein. A nurse keeps an eye on her from behind.

The scene unfolds in North America's first and only legal injection site, promoted by its founders as a safe, humane facility for drug abusers, now facing a court challenge from a government that sees it as a facilitator of drug abuse.

Defenders of the taxpayer-funded site, in a seedy, drug-infested district of Vancouver, British Columbia, say it is a providing a form of health care, and that health care is a provincial matter under Canada's constitution. The federal government counters that its writ trumps provincial rights because heroin is a federally banned substance.

The case opens before the Supreme Court of Canada in Ottawa on Thursday, and has drawn international attention. Insite, as the Vancouver center is called, is the only facility of its kind in Canada. More could open if the top court agrees Insite is legal.

As of 2009, there were 65 injection facilities in 27 cities in Canada, Australia, and western Europe, according to the Canadian Medical Association Journal. The World Health Organization has called them a "priority intervention" in slowing the spread of AIDS via infected needles.

Insite receives more than 800 visitors a day on average and has supervised more than a million injections since it opened in 2003, and none has caused a death, according to Insite supervisor Russ Maynard.

Addicts are given clean needles and sterilized water in which to mix their drug. They bring their own drugs and inject at 12 stainless steel alcoves with mirrors on the walls so nurses on a raised platform can see them.

The storefront facility sits in Downtown Eastside, 15 blocks of cheap rooming houses where addiction and street prostitution are rampant and an estimated 5,000 of the area's 12,000 population are believed to be addicts.

When Insite opened, the Bush administration's drug czar, John Walters, called it "state-sponsored suicide," and after a Conservative government was elected in Canada in 2006, it moved to close the site.

Arguing for the government before the British Columbia Court of Appeal in 2009, Robert Frater rejected the notion that Insite was a form of health care, because it was not the ban on drugs that harms addicts.

"There is no constitutional obligation on the state to provide safe-injection rooms," he said.

The provincial court ruled 2-1 against the federal government.

Supporters of Insite point to studies showing sharp drops in deaths from drug overdoses in the district since the drug-injection program was launched.

"I think it's saying we're effective. We're meeting our mandate," Maynard said. He said Vancouver also needs a safe-inhalation facility for crack users, while Ontario and Quebec need safe-injection sites like Vancouver's.

Julio Montaner, president of the International AIDS Society, an association of professionals in the AIDS field, has said the area's AIDS rate is the worst in the developed world, and can be designated an epidemic. Montaner, a Canadian, accuses his government of ignoring scientific research and sabotaging a health initiative for society's weakest citizens.

In 2008 the then federal health minister, Tony Clement, told the Canadian Medical Association that the Conservative government opposed Insite because "injections are not medicine and they do not heal."

Dr. Bonnie Cham, then head of the CMA's ethics committee, responded that addicts who inject drugs "have the right to compassion and access to care that has proven to be beneficial."

Last week the Conservative Party was elected to another term.

Powered By WizardRSS.com | Full Text RSS Feed | Amazon Plugin | Hud Settlement Statement

Study: Many elderly get colon screening too often (AP)

CHICAGO � Many older Americans get repeat colon cancer tests they don't need and Medicare is paying for it, suggests a study that spotlights unnecessary risks to the elderly and a waste of money.

Almost half of the Medicare patients in the study had had a colonoscopy less than seven years after getting normal results from an earlier test. The test is recommended just every 10 years, starting at age 50, for people at average risk whose initial test is normal.

The study showed that among those 80 and older, one-third had a repeat exam within seven years of the previous colonoscopy. That's an age group that can skip the test altogether if no problems have been spotted before.

The U.S. Preventive Services Task Force recommends against routine colon cancer screening for most people 76 to 85 � and says for those older than 85, screening risks outweigh the benefits.

The older you are, the more likely you are to die from other causes before cancer becomes deadly, which means the screening procedure's risks may outweigh its benefits in many aged patients, the study authors said.

"I was surprised by the magnitude of the issue," said lead author Dr. James Goodwin, a geriatrician and researcher at University of Texas Medical Branch in Galveston.

In the study, researchers chose a random national sample of Medicare claims and enrollment data from more than 200,000 patients over 65 who received colonoscopies between 2001 and 2008. The number of patients in the sample totaled 24,071 � all people considered at normal risk for colon cancer.

The results suggest most of the repeat exams were unnecessary; only 27 percent of all study patients with frequent exams had symptoms that might have raised suspicion of cancer, including abdominal pain, change in bowel habits, and weight loss. The study appears in Monday's Archives of Internal Medicine.

The colonoscopy is considered one of the most effective screening tests available, and it's credited with saving thousands of lives by catching cancer early. The doctor uses a thin flexible tube to examine the intestines. It can snip off suspicious-looking growths.

The exam is generally pretty safe, but does have risks that occur more often with older patients, including complications from sedation, accidental perforation of the colon and bleeding.

Medicare covers colonoscopies every 10 years � more frequently for high-risk patients, including those with a family history of colon cancer. But in this study, the authors excluded high-risk patients.

Colonoscopy costs vary widely but typically exceed $1,000. While Medicare rules say the government won't pay for too-frequent colonoscopies, only 2 percent of the study claims were denied for repeat exams in people without symptoms.

The results suggest the Medicare regulation "is not working," Goodwin said.

Excessive colonoscopies are not just economically costly, he said, noting they can pose a real harm to patients, especially older ones.

Robert Smith, director of cancer screening at the American Cancer Society, said some doctors may recommend more frequent colonoscopies because they think 10-year intervals are too risky. Some may think, incorrectly, that finding any growths, even non-suspicious polyps, means a repeat exam should be done within less than 10 years, Smith said.

Some doctors also order repeat tests "because they want to bring in income," he said.

Besides being risky and costly, too-frequent screenings make colonoscopy resources less available for people who really need them, Smith said.

But, he pointed out, while colonoscopies may be overused in the elderly, the exams and other colon cancer screening methods are underused among some groups, including the uninsured, blacks and Hispanics.

The government's Centers for Medicare & Medicaid Services issued a statement in response to the study, saying the agency recognizes the importance of effective screening as well as "the importance of ensuring Medicare beneficiaries only get screened at appropriate intervals."

Medicare covers the exams every two years for high-risk patients, but if the study results are true, "then we need to further validate the accuracy of our payments," said agency spokeswoman Ellen Griffith.

___

Online: Archives: http://www.archinternmed.com

Powered By WizardRSS.com | Full Text RSS Feed | Amazon Plugin | Hud Settlement Statement

Hospitals 'still lack basic care'

2 December 2010 Last updated at 00:02 ET By Jane Hughes Health correspondent, BBC News

Nursing care must be strengthened and the complaints system overhauled because of continued poor care of older people in hospital, says the Patients Association.

The patient lobby group has highlighted 17 cases in England and Wales where patients were left lying in faeces, or desperately hungry and thirsty.

It said it had been inundated with similar stories.

The government said it was committed to tackling shortfalls in patient care.

The Patients Association acknowledged that most patients do get good treatment, but said some were still being denied the essentials of nursing care, even though it highlighted serious problems last year.

A national survey of hospital experiences in England suggests that nearly half of all patients rate their care as excellent, and just 2% said it was "poor".

Family complaints

Liz Pryor said her elderly mother Anne Robson went to hospital following a fall in January and became badly dehydrated and lost weight. She says her mother was left lying in a nightdress that was wet up to her armpits with urine.

Continue reading the main story

"Start Quote

It's a scandal, and it's outrageous that it has been persisting for years"

End Quote Katherine Murphy Patients Association

She died within hours of being discharged.

"Mum was admitted with a suspected fractured hip and she was discharged a week later about to die," said Liz Pryor. "I think that's unacceptable.

"I don't think anyone did anything on purpose, but it's a systemic, viral attitude."

The hospital does not accept that she deteriorated during her hospital stay, according to the report compiled by the Patients Association.

Louise Jacob's daughters Deborah and Rebecca said she went to hospital in January following a stroke. They said staff often failed to give her the medication she needed, and she was left propped on a bed pan for long periods of time.

<!-- Embedding the video player --> <!-- This is the embedded player component -->

<!-- embedding script -->

<!-- companion banner --> <!-- END - companion banner --><!-- caption -->

Liz Pryor said her mother's hospital care was "unacceptable"

<!-- END - caption -->

<!-- end of the embedded player component --> <!-- Player embedded -->

They were then prevented from visiting her because of an outbreak of the winter vomiting bug, norovirus, on the ward. Mrs Jacob died a few days later.

"The indescribable heartache and anguish caused through us not being allowed to visit our mother will be with us for ever," her daughters told the Patients Association. "We can never forgive the hospital for the way Mum was badly let down during the last few weeks of her life."

According to the report, the hospital apologised to the family and said it was not their intention to stop visits to seriously ill patients.

Wider failings

The Patients Association said the 17 cases highlighted wider failings in NHS nursing care.

It is calling for the introduction of independent "patient safeguarding champions" at every hospital to check that nursing standards are maintained.

It also wants the NHS complaints process to be overhauled.

"Surely the essentials of nursing care are what every patient deserves and should get?" said Chief Executive, Katherine Murphy.

"It's a scandal, and it's outrageous that it has been persisting for years."

The family of former Patients Association president, Claire Rayner, who died in October, is backing the calls for change.

"If she were here today she would have been hollering from the roof tops about it," said Claire Rayner's son Jay.

"Any health system is only as good as its failings, and those detailed in these pages are truly dismal."

'No excuse'

The Royal College of Nursing said there was no excuse for poor care.

General Secretary Peter Carter said: "Neither the RCN nor the overwhelming majority of committed and caring nurses can possibly condone the neglect, rudeness and in some cases outright cruelty outlined in this report."

However, he said problems often arise when staffing levels are cut.

Care Services Minister, Paul Burstow said the report painted a disturbing picture.

"It is an unacceptable legacy that this government is committed to tackling."

He said that was why the government would soon start publishing details about complaints.

"The NHS must become much more tuned into patient views and experience."

Powered by WizardRSS | Best Membership Site Software

Miscarriage &#39;raises heart risk&#39;

2 December 2010 Last updated at 04:04 ET

Having multiple miscarriages increases the risk of a heart attack later in life, according to researchers.

The German study, published in the journal Heart, found that women who had more than three miscarriages had a five-fold increase in risk.

The relatively young age of the women meant overall risk remained low, but miscarriages could alert doctors to future problems, the researchers said.

UK specialists said that the reason for the link was still unclear.

The study looked at more than 11,500 women aged between their mid-30s and mid-60s.

They looked at the pregnancy history of those who had suffered heart attacks, and compared this to the rate of miscarriages in the other women.

They found that one in four of the women in the study reported having a miscarriage - although this number could be higher because some women become pregnant then miscarry without realising what has happened.

Continue reading the main story

"Start Quote

It is possible that there is some common predisposing risk factor for both miscarriage and heart disease"

End Quote Professor Gordon Smith Cambridge University

When other factors linked to heart problems - such as weight, alcohol consumption and smoking - were accounted for, having three or more miscarriages increased the risk of heart attacks by more than 500%.

A smaller increase in risk was recorded in women who had miscarried fewer than three times.

The researchers, from the German Cancer Research Centre in Heidelberg, said that the results suggested a "substantially higher" risk later in life.

They suggested that a history of miscarriage should be recorded by doctors as an "important indicator" when trying to work out whether a woman was likely to suffer heart problems in middle-age and beyond.

The age of the women involved in the study meant that the overall risk of heart attack could not be tested.

The five-fold increase refers to a much smaller risk - that a woman would have a heart attack at a younger age.

This means that even a five-fold increase does not mean that a woman who suffers multiple miscarriages is very likely to have a heart attack.

Indeed, among a sample of 2,876 women who reported miscarriages, there were 82 heart attacks over a ten-year period.

No firm conclusions

However, other specialists said that the link between miscarriage and heart attacks remained a concern.

Professor Gordon Smith, from Cambridge University, said that other studies had pointed to an increase in heart disease risk among women who had pregnancy complications, which included pre-eclampsia, and premature birth alongside miscarriage.

However, he said that the reasons why were still not fully understood, with some evidence suggesting that it was not an effect of having miscarriages.

He said: "It is possible that there is some common predisposing risk factor for both miscarriage and heart disease. During pregnancy, it is manifested by increased risk of miscarriage, and later in life, it manifests itself as an increase in heart disease risk.

"Perhaps this involves an increased propensity to blood clotting - but the honest answer is that we don't yet know."

A spokeswoman for the British Heart Foundation said that it was hard to draw firm conclusions from the study.

She said: "While this is certainly an interesting observation it gives no proven explanation for an increase in heart attack risk.

"It's not simply a case of saying multiple miscarriages increase your risk of a heart attack - lots of other factors come into play.

"It's known in some cases of multiple miscarriages that the women have previously undiagnosed heart and circulatory disease, or significant risk factors for the disease, so they may have an increased heart attack risk which is unrelated to the pregnancy."

Powered by WizardRSS | Best Membership Site Software

Prostate cancer clue in fingers

30 November 2010 Last updated at 19:01 ET By Fergus Walsh Medical correspondent, BBC News

The length of a man's fingers can provide clues to his risk of prostate cancer, according to new research.

A British Journal of Cancer study found men whose index finger was longer than their ring finger were significantly less likely to develop the disease.

Researchers made the discovery after comparing the hands of 1,500 prostate cancer patients with 3,000 healthy men.

The length of the fingers is fixed before birth and is thought to relate to sex hormone levels in the womb.

Being exposed to less testosterone before birth results in a longer index finger and may protect against prostate cancer later in life, say researchers at the University of Warwick and the Institute of Cancer Research.

One of the report authors, Professor Ros Eeles, said more studies would be needed, but if these confirmed the findings it could be used a simple test for prostate cancer risk.

She said: "This exciting finding means that finger pattern could potentially be used to select at-risk men for ongoing screening, perhaps in combination with other factors such as family history or genetic testing."

The study was funded by the charities Prostate Action and Cancer Research UK.

Emma Halls, chief executive of Prostate Action, said: "This research brings us another step closer to helping determine risk factors for prostate cancer, which is possibly the biggest issue in current thinking about preventing and treating the disease.

"However, we are still a long way from reducing the number of men who die of prostate cancer every year and need more research and education in all areas to achieve this."

Dr Helen Rippon, head of research at The prostate Cancer Charity, said the research added to growing evidence that the balance of hormones we are exposed to before birth influences our health for the rest of our lives.

But she said men with shorter index fingers should not be "unduly worried".

"They share this trait with more than half of all men and it does not mean they will definitely develop prostate cancer in later life."

Powered by WizardRSS | Best Membership Site Software