6 Million People will die and $500 Billion Lost

G-20 leaders pledged to provide the International Monetary Fund with $500 billion to help struggling economies, sparking global controversy. Yet startling research shows that the combined costs of tobacco-related death and related productivity losses, healthcare expenditures, employee absenteeism, and widespread environmental harm are responsible for draining the same amount – $500 billion – from the global economy each year and it receives much less attention than it deserves.

In recognition of World No Tobacco Day on 31st May, the World Heart Federation insists on bringing more attention to the impact of tobacco on health and disease. Tobacco use is the leading preventable cause of death and is closely linked to cardiovascular disease, which is the leading cause of death worldwide. In 2010, it is estimated that six million people will die from the effects of tobacco – more than from HIV/AIDS, malaria and tuberculosis combined – and nearly three-quarters (72%) will be in low- and middle-income countries. Using tobacco causes clogging of the arteries, heart disease, stroke, sudden death and heart failure.

Dr. Pekka Puska, President of the World Heart Federation stated: “This year we embrace the WHO theme of tobacco health warnings and demand that the tobacco industry display pictorial warnings on all tobacco packages in order to clearly and effectively communicate tobacco’s deadly consequences.”

Studies show that pictorial warnings work: they effectively motivate users to quit and reduce the appeal of tobacco for those who are not yet addicted. The World Heart Federation supports its members around the world to advocate for pictorial labeling, working with Ministries of Health, the media and businesses. But 9 out of 10 people live in countries that do not require warnings with pictures on tobacco packages.

One successful example is in the Caribbean. Debbie Chen, Executive Director of the Heart Foundation of Jamaica, coordinates a coalition of partners, which includes the Heart and Stroke Foundation of the Barbados and the InterAmerican Heart Foundation, with a Bloomberg Award grant for Global Tobacco Control. She said: “We were convinced that labeling could help us when we read research from other countries. We have accelerated the process in the region and are determining which warnings will have the strongest impact in four Caribbean countries.”

Worldwide, tobacco control is one of the simplest ways to reduce cardiovascular disease; in low-resource settings its feasibility and cost-effectiveness only magnifies its importance.

To know more about the World No Tobacco Day, and download toolkits, please visit: http://www.who.int/tobacco/wntd/2009. To know more about the Framework Convention, please visit: http://www.fctc.org. To know more about countries that are working on ensuring tobacco products have pictorial labels, please visit: http://www.tobaccolabels.ca/labelima

The World Heart Federation, a nongovernmental organization based in Geneva, Switzerland, is committed to helping the global population achieve a longer and better life through prevention and control of heart disease and stroke, with a particular focus on low- and middle-income countries. It is comprised of 198 member societies of cardiology and heart foundations from over 100 countries covering the regions of Asia-Pacific, Europe, the Americas and Africa. For further information on World Heart Federation visit: http://www.worldheart.org

References:

  • The Tobacco Atlas, Third Edition, March 2009, http://www.TobaccoAtlas.org
  • Centers for Disease Control and Prevention. The health consequences of smoking: A report of the Surgeon General, http://www.cdc.gov/tobacco/Data_statistics/sgr/sgr_2004/index.htm
  • Oxford Health Alliance, http://www.oxha.org
  • Tobacco Free Initiative, World Health Organization, http://www.who.int/tobacco/en/index.html

Source: World Heart Federation


Free “Eye Health & Allergies” brochure available from Asthma & Allergy Foundation of America

Many allergy sufferers say symptoms such as itchy, dry, red and watery eyes leave them frustrated and irritable, tired, and distracted, according to a new survey conducted by the Asthma & Allergy Foundation of America (AAFA). About 40 percent of women allergy sufferers surveyed say their red and puffy eyes make them look tired and unattractive.

Among those who wear contact lenses, other problems arise. When their allergies act up, half (50%) say they switch to glasses, while 45 percent report that they wear their contacts less often. For some, not being able to wear their contacts affects how they feel about themselves and impacts their performance at work, school, and when playing sports.

“Having to stop wearing their contacts or wear them less frequently creates a wide range of emotions among allergy sufferers,” says Mike Tringale, Director of External Affairs, AAFA, the leading patient advocacy organization for people with asthma and allergies. “Contact lens wearers say they feel less attractive when wearing their glasses (37%), unhappy (35%), less confident without their contacts (29%), and less able to perform activities as well as when they are wearing their contact lenses (26%).”

More than 800 people responded to the online survey about eyes and allergies, conducted by AAFA, and supported by 1-DAY ACUVUE(R) MOIST(R) Brand Contact Lenses. One-third (33%) identified themselves as contact lens wearers, while 12 percent admit to having dropped out of contacts because of allergies.

The majority of contact lens wearing respondents report that they replace their lenses monthly (45%) or every one to two weeks (38%). Paul Karpecki, O.D., F.A.A.O., Clinical Director, Kofler Vision Group, Lexington, Kentucky says he is not surprised to learn that two out of three (66%) say they find it very uncomfortable to wear their contacts while suffering from eye allergy symptoms.

“Allergy sufferers who wear contact lenses that you use for two weeks or more may experience discomfort and symptoms such as ocular itching, tearing, and redness because allergens and other irritants can build up on contact lenses over time, he says. “This can lead to discomfort and interference with job performance, school, and sports activities.”

For allergy sufferers who want to remain in contacts, Dr. Karpecki recommends single-use contact lenses – daily disposable lenses that you throw away at the end of the day.

“Studies have shown that single use contacts, such as 1-DAY ACUVUE(R) MOIST(R) can be a healthy and more comfortable option for any lens wearer with eye allergies,” he explains. “By putting in a clean, fresh lens every day, one-day contacts minimize the potential for accumulation of allergens and irritants that can often accumulate with repeated use of the same pair of lenses.”

Other major findings from the survey show:

  • Spring was identified by 67% of respondents as the most troublesome time of year for eye-related allergies. Over half (51%) say they experience eye allergy symptoms all year long. One-quarter of all respondents (26%) report Fall as the worst time for eye allergies
  • Half of women surveyed (52%) report that their eyes are so itchy as a result of their allergies that it causes them to rub their eyes and rub off makeup
  • About four in ten (39%) of allergy sufferers say they have consulted with an allergy specialist about their eye-related allergy symptoms. They also report consulting with their Family Practitioner (28%), Optometrist (28%), or Ophthalmologist (28%)

To help allergy sufferers better understand and manage the condition, AAFA offers a free educational brochure titled Eye Health & Allergies. The brochure, which also includes a free* trial certificate for by 1-DAY ACUVUE(R) MOIST(R), can be viewed or downloaded at www.aafa.org/eyeallergies or www.acuvue.com/seasons.

Clinical research has shown when worn on a daily disposable basis, 1-DAY ACUVUE(R) and other daily disposable etafilcon A contact lenses such as 1-DAY ACUVUE(R) MOIST(R) may provide improved comfort for many patients suffering from mild discomfort and/or itching associated with allergies during contact lens wear compared to lenses replaced at intervals of greater than 2 weeks.

Source: VISTAKON, Division of Johnson & Johnson Vision Care, Inc.


“Outrageous” Proposal Would All But Destroy the IHSS Program

Gov. Schwarzenegger today proposed catastrophic cuts in the In Home Supportive Services (IHSS) program that would all but destroy the program, which provides home care for more than 420,000 low-income elderly, blind and disabled Californians.

Under the latest Schwarzenegger plan, some 380,000 individuals–nearly 90 percent of all IHSS consumers–would be thrown out of the program. This comes on top of an earlier proposal from the governor that would cut the pay for the state’s home care providers back to minimum wage.

“While the governor’s earlier proposals were foolish and shortsighted, his latest scheme is outrageous, vindictive and unconscionable,” said Doug Moore, president of the 65,000 member UDW Homecare Providers Union.

“IHSS saves taxpayers hundreds of millions of dollars each year by keeping some of our most vulnerable citizens out of nursing homes, which cost at least five times more than home care,” Moore said. “It also brings millions in federal revenue to the state. Yet the governor would gut this cost-effective program, while continuing to fully fund more expensive nursing homes.

“We believe that all Californians should do their share to help the state through its financial problems. But Schwarzenegger and his Republican allies would put all of the burden on low-income, working Californians. They won’t call on businesses to give up some of their tax breaks. They won’t ask the oil companies to do their part by taxing the oil produced here in California, just like every other state in the union already does.

“It is time for the leaders of our state legislature to really lead. It is time for them to stand up to the governor and the Republicans and say ‘enough.’ It is time for realistic, common-sense solutions to our budget crisis that call on everyone to contribute.”

UDW Homecare Providers Union represents more than 65,000 providers in 11 California counties. It is the only union in California made up solely of homecare workers.

Source: UDW Homecare Providers Union


New Study Shows Probiotics Linked to Metabolism

  • Author: Health Informer
  • Filed under: Health News
  • Date: May 30,2009

Results of a new study published in the journal Molecular Systems Biology show probiotics have a tangible effect on metabolism.

Researchers from Imperial College London and Nestle Research Center in Lausanne, Switzerland, fed mice two different strains of probiotics, Lactobacillus paracasei and Lactobacillus rhamnosus. Each strain showed a range of biochemical effects that were markedly different.

They also observed that one biological change was in how the treated mice metabolized bile acids. The primary function of bile acids is to emulsify fats in the upper gut. If probiotics influences the way bile acids are metabolized, they could change the amount of fat the body can absorb.

Probiotics are nutritional supplements or foods that contain the good bacteria similar to that found naturally in the body. While there are billions of both bad and good bacteria throughout the digestive tract, most are found in the intestines.

Good bacteria is critical for good health as it aids digestion, supports the immune system, and plays a role in the creation of B-vitamins and certain enzymes.

Foods like yogurt, kefir, and sauerkraut are some of the foods that are high in probiotics. Other foods, known as Prebiotics, are essential as well; they help good bacteria grow. Prebiotic foods include onion, garlic, and the superfood Chlorella.

Sun Chlorella, a single-cell, fresh water green alga, helps to detoxify and rejuvenate the body. It contains more protein and chlorophyll than any other plant; is high in vitamins, minerals, dietary fiber, and nucleic acids; and, includes all the essential amino acids.

According to nutritionist David Nelson, Ph.D., “Nutrition helps every aspect of health, from metabolic to emotional. Sun Chlorella is a wonderful whole food that contains a wide range of nutrients.”

For more information about Sun Chlorella USA, visit their website at www.sunchlorellausa.com. Sun Chlorella USA (www.sunchlorellausa.com) is a distributor of Sun Chlorella “A”, Pet Sun Chlorella, Sun Eleuthero, Wakasa Gold, Wakasa Honey, Sun Eleuthero Extract, Sunergize, Sun Chlorella Cream and Sun Eleuthero Tea.

References

“Probiotics affect metabolism, says new study,” Imperial College London News Release, 1/08

Source: Sun Chlorella USA


A well functioning digestive system is one of the key factors for a healthy and carefree life.

The role of the colon as an integral part of the immune system and the last station of consumed food is easily underrated when it comes to general well-being. It is not until complaints such as obstipation occur that this forgotten organ painfully calls attention to itself. Such problems can be prevented by a balanced diet. And in many cases, hydro-colon therapy has proved itself to be extremely efficient as a prophylactic measure and as a treatment of disorders of the digestive system. Colon Hydromat systems made by the manufacturer of medical equipment HERRMANN Apparatebau GmbH (HAB) guarantee for safe and gentle treatment.

Basically, hydro-colon therapy is a further development of colonic irrigation and subaqual bath applications. High cultures like the ancient Greeks and Egyptians were already aware of the possible positive effects of this treatment. In Ayurveda, the Indian science of life, the process of colonic irrigation has a long tradition, too, and is practised until today. Hydro-colon therapy as a modern medical treatment has originally been developed in the USA and was meant to prepare astronauts for their space flights.

It was not until the middle of the 1980s that this therapy gradually became known in Europe and especially in Germany. Until then, all the medical systems for hydro-colon therapy on the domestic market had to be imported from the USA. HAB decided to adapt the US-American models to European standards. Eventually at the end of the 80s, as one of the first manufacturers in Germany, the company presented its own development. The industry’s standards of modern applications fall back on ideas which had been implemented in the realization of HAB’s first Colon Hydromat. Thanks to committed pioneering work and 20 years of experience in this field, the company from Kleinwallstadt in Lower Franconia was able to establish itself as an important initiator of impulses in its industry.

But in which cases is a treatment with hydro-colon systems indicated? Over time, a biased diet can cause metabolic disorders due to harmful intestinal bacteria or mycosis. A therapy with HAB’s systems ‘Colon Hydromat standard’ and ‘Colon Hydromat comfort’ boosts the body’s defences and fosters purification and the elimination of toxins. Especially when it comes to treating the widespread complaint of obstipation, the systems have proved to be extremely efficient. But there are many therapists who have been very successful in treating patients with conditions such as neurodermatitis, migraine, high blood pressure or allergies, too, thus guaranteeing for more vitality and enjoyment of life. In addition, hydro-colon treatment has beneficial effects in the preparation of therapeutic fasting.

Hydro-colon systems made by HERRMANN Apparatebau offer a thorough purification on the highest technical level. Their intuitive handling and a high degree of suitability for daily use in hospitals and doctors’ surgeries are two of the unique characteristics of the systems. As special highlights, ‘Colon Hydromat comfort’ boasts an integrated colour selection and automatic ventilation. That way, the advantages of light therapy can be incorporated in the treatment easily. The automatic ventilation for its part guarantees for a comfortable treatment for patients. Bowel gases are washed away along with the rinse water. The standard device and the comfort version work in a closed system. Reflux of bacteria or odour nuisance can thus be eliminated. All this makes hydro-colon therapy a safe and relaxed matter – for patients as well as for doctors and health care professionals.

For further information on hydro-colon therapy with the systems ‘Colon Hydromat standard’ und ‘Colon Hydromat comfort’ made by HAB please visit us at www.herrmann-apparatebau.de


Data show superiority of endoscopic ablation therapy using the HALO System for eradicating Barrett’s esophagus in randomized, multicenter, sham controlled trial

Results from a clinical study published in the New England Journal of Medicine reveal that ablative therapy using the HALO system (BARRX Medical, Inc.) is highly effective for complete eradication of a pre-cancerous condition of the esophagus called Barrett’s esophagus afflicting more than 3.3 million Americans. Additionally, ablative therapy using the HALO system reduced the risk of progression to cancer in the highest risk cohort studied (compared to control) from 19.0% to 2.4%.

The study entitled “Radiofrequency Ablation in Barrett’s Esophagus with Dysplasia” is authored by lead investigator Nicholas J. Shaheen, M.D., Associate Professor of Medicine and Epidemiology, The University of North Carolina in Chapel Hill.

“This is a well-designed trial conducted in a rigorous manner at 19 expert U.S. centers, each having experience in the management of Barrett’s esophagus, dysplasia, and cancer,” said Dr. Shaheen. “Our results reported in the Journal are very promising, demonstrating superiority of ablation therapy for eliminating Barrett’s and dysplasia, as well as reducing the rate of disease progression to more severe forms of dysplasia and esophageal cancer. This and data from other recent trials may ultimately change the paradigm for how gastroenterologists manage their patients with this disease.”

As a result of chronic injury from gastroesophageal reflux disease (GERD), the normal esophageal lining is replaced with abnormal cells (Barrett’s tissue), predisposing the patient to a higher risk for developing cancer of the esophagus. Patients with Barrett’s who develop cancer, typically do so through a series of steps, starting with early Barrett’s, then low-grade dysplasia or high-grade dysplasia, and then finally cancer. The present study included patients with the later stages of low- and high-grade dysplasia.

Beginning in 2006, the AIM Dysplasia Trial enrolled 127 patients having a diagnosis of Barrett’s esophagus with dysplasia, the most advanced stage of this condition. Patients were randomly assigned to receive either endoscopic ablation with the HALO system or a sham intervention (control, no treatment). Tissue samples (biopsies) were obtained from the esophagus at regular intervals for one year after enrollment to assess for the presence of early Barrett’s, dysplasia, and esophageal cancer. Comparison of the biopsy results at one year served as the primary outcome for the trial. The study endpoints were the eradication of all early Barrett’s and, separately, all dysplasia in each group, as well as occurrence of new esophageal cancers.

At one-year follow-up, patients treated with ablation had a significantly higher complete eradication rate for both early Barrett’s and dysplasia as compared to the control group. More than three quarters of treated patients had no detectable Barrett’s at the end of the treatment period, compared to sham patients where 98% had persistent disease. The overall rate of disease progression to more severe forms of dysplasia and cancer was significantly lower in the ablation treatment group (3.6%) as compared to the control group (16.3%). In the highest risk cohort (high-grade dysplasia), ablative therapy significantly reduced the risk of progression to cancer by nearly 90% compared to control (2.4% in treated patients versus 19.0% in untreated controls).

Source: BARRX Medical, Inc.


Institute releases report on health care costs

A report issued today by the WellPoint Institute of Health Care Knowledge revealed some startling facts about health care costs in America. The report identified the primary drivers of increased health care services and health insurance premiums, dispelling the notion that insurer profits are the primary drivers spiking costs.

The May 2009 Institute report, titled “What’s Really Driving the Increase in Health Care Premiums?,” compiles research from sources such as PricewaterhouseCoopers, the Robert Wood Johnson Foundation, the Kaiser Family Foundation, the Bureau of Labor Statistics and the Congressional Budget Office.

“The current rate of increase of health care costs is unsustainable,” said John Martie, President, Anthem Blue Cross and Blue Shield. “In Colorado, health insurance for an employee of a small business costs an average of $4,150 per year, or $346 per month. The cost for a one night hospital stay in Colorado now averages $6,000. We have to address the key drivers of health care costs to be able to lower premiums and increase access to health care for all members of the communities we serve,” Martie added.

According to the report the “key drivers” of spiraling U.S. health care costs are:

  • Advances in medical technology and subsequent increases in utilization.
  • Price inflation for medical services that exceeds inflation in other sectors of the economy.
  • Cost-shifting from people who are uninsured and those receiving Medicare and Medicaid to the private sector.
  • High cost of regulatory compliance.
  • Patient lifestyles, such as physical inactivity and increases in obesity.

Citing research from PricewaterhouseCoopers’ December 2008 report, The Factors Fueling Rising Health Care Costs, the report also debunks a commonly held belief about the profitability of health insurance companies. Contrary to public opinion, which puts health insurers’ profitability at somewhere between twenty-five and forty percent, PricewaterhouseCoopers confirms that it in truth only three cents of every health care premium dollar is spent on health insurer profit. This is less than the 2008 profit of 4.9 percent reported to Reuters by auto and truck manufacturers, the 4.8 percent reported by health care facilities, or the 4.7 percent reported by utility companies.

According to the Institute’s report, newer medical technologies tend to increase prices because they are generally more expensive than the older technologies they replace. While the availability of more advanced, superior technologies can yield better results for some patients, these technologies and diagnostic tests can be used inappropriately in some situations where existing, older technologies are more effective and accurate.

“We have learned over time that newer technologies do not always produce better health outcomes,” Martie continued. “We need to focus on outcomes and delivering better quality care and apply the breathtaking advances in technology and treatment when they produce better patient care. The wise application of these expensive new therapies will result in more affordable health care for all Americans.”

The WellPoint Institute of Health Care Knowledge was established with the belief that intimately understanding the factors impacting consumers’ experiences with their health plan and which factors most impact their satisfaction are central to efficiently addressing consumer needs. For more information and a copy of the full report, please visit WellPoint Institute of Health Care Knowledge at www.wellpoint.com/institute

Anthem Blue Cross and Blue Shield is the trade name of Rocky Mountain Hospital and Medical Service, Inc., an independent licensee of the Blue Cross Blue Shield Association. (R) ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Additional information about Anthem Blue Cross and Blue Shield in Colorado is available at www.anthem.com.


In Massachusetts alone, nearly 3,000 people are on the waiting list for lifesaving organ transplants and the number continues to grow. Meanwhile, only 41 percent of licensed drivers in Massachusetts are registered donors, ranking the state 32nd in the country for the percentage of licensed drivers registered, according to the 2009 National Donor Designation Report Card issued by Donate Life America.

Also, a recent survey conducted by Donate Life America, with support from Astellas Pharma US, Inc. (Astellas), found that people in Massachusetts were significantly more likely than all adults nationwide to have not signed up because they “don’t have time” or “haven’t gotten around to it” (22 percent versus 7 percent nationwide). Donate Life New England is launching an online registry this spring in an effort to simplify the registration process.

“There is an organ availability crisis taking place in Massachusetts and around the country,” said David Fleming, Executive Director, Donate Life America. “It is important for the donation and transplant community to continue to educate people about how to register and drive people to take that action.”

Transplant Expo and Making Strides Run/Walk Aim to Inspire and Incite Action

Saturday, May 30, through Monday, June 1, the Transplant Expo, hosted by Astellas, will visit The Shops at Prudential Center, Belvidere Arcade, 800 Boylston Street. The Expo provides an intimate look at the wonders of transplantation and the dedicated heroes who help make it possible, as well as explores the art and science of transplantation, the history of transplantation and inspirational stories of heroic donors. Volunteers from Donate Life New England will be on-site to answer questions and provide visitors with the opportunity to join the state donor registry.

On May 30 and May 31, those visiting the Transplant Expo will have the opportunity to receive a complimentary ticket to Inspiring Action, an evening hosted by The Creative Coalition featuring leaders and personalities from film and television who will participate in a one night performance that brings attention and inspiration to the vital need for health care reform and support for organ donation. The Creative Coalition is the leading nonprofit, nonpartisan, social and public advocacy organization of the arts and entertainment community. The event will take place Sunday evening, May 31 from 6:30 to 7:30 p.m. at the Sheraton Boston Hotel.

Also, on Sunday, May 31, from noon until 4 p.m., Chris Klug, bronze medalist snowboarder and liver transplant recipient, will be on-site at the Expo to greet attendees. On Monday, June 1 at 6 a.m., Astellas First Annual Making Strides: A 5K Run/Walk for Organ Donation will take place on the banks of Boston’s Charles River. Transplant professionals attending the American Transplant Congress, as well as the public are invited to run or walk to show their support for the transplant community. For every finisher, Astellas will donate $1 – up to $20,000 total – to the National Transplant Assistance Fund (NTAF), a 501c3 nonprofit organization that helps transplant patients (hopefuls and recipients) afford critical but uninsured medically related expenses through fundraising guidance, patient resources and support, as well as financial assistance. Celebrating 25 years of service, NTAF has helped patients, their families and communities nationwide raise more than $58 million (and counting) for out-of-pocket expenses related to transplantation.

“Astellas is proud to launch the Transplant Expo and Making Strides Run/Walk in Boston as part of our continued efforts to reach the public with accurate and compelling messages about organ donation and transplantation,” said Maribeth Landwehr, Director, Corporate Communications for Astellas. “We hope people from around the area will visit the Expo and take the dynamic journey through the legacy of transplantation, as well as show their support for the transplant community by running or walking in the Making Strides 5K.”

Both the Transplant Expo and 5K Run/Walk are free of charge. For more information about the Expo, visit www.AstellasTransplant.com. For more information about the 5K Run/Walk or to register online, visit www.tracs.net/makingstridesatc.

For more information about organ donation or to join the state registry, visit www.Facebook.com/DonateLife.

Source: Astellas Pharma US, Inc.


A short, preoperative team briefing prior to cardiac surgery – where each person on the team speaks – improves communication and reduces errors and costs, according to a pilot study conducted at Mayo Clinic.

Mayo researchers believe this is the first such study to use real-time observations to measure the effect of preoperative briefings on specific disruptions to surgery. Disruptions were categorized as patient-related issues, equipment or resource issues, procedural knowledge issues and miscommunication events. Results from the Mayo Clinic pilot are published online in the Journal of the American College of Surgeons.

“The goal of the briefings was to get everyone used to talking when there wasn’t a problem, so they would be more likely to speak up when problems occur,” says Thoralf Sundt, M.D., Mayo Clinic cardiac surgeon who volunteered his surgery team for the study. “We know that miscommunication is a major cause of sentinel events, an unexpected death or serious injury.”

Fifty-six surgical staff members filled out questionnaires and participated in focus groups to develop the format for the briefings. Among the participants were surgical assistants and technicians, registered nurses, nurse anesthetists, and perfusionists, who operate the heart-lung machine during most cardiac surgeries.

The briefings were conducted in the operating room immediately prior to the first surgical procedure of the day, before the patient arrived in the room. Each team member discussed his or her role in the procedure and any concerns specific to the patient. The briefings lasted from one to eight minutes.

“The briefing was not a checklist review,” says Dr. Sundt. Checklists are most helpful in preventing predictable errors, such as confirming if and when medications are administered prior to surgery. No checklist can cover the unexpected scenarios that might occur in surgery.

“Because of the complexity of what we do, errors do happen,” says Dr. Sundt. “Each team member needs to feel comfortable enough to identify errors. Then we catch them and correct them.”

Pre-procedure briefings are not common in operating rooms, but they are standard in other high-risk industries such as aviation and in the military, according to Douglas Wiegmann, Ph.D., the lead researcher on the Mayo study.

“This approach reflects a change in culture in the surgical field – that everyone has a unique contribution to the outcome and care of the patient,” says Dr. Wiegmann, who has since moved to the University of Wisconsin as an associate professor of human factors engineering.

While staff are expected to speak up during surgery, they don’t or don’t always, according to Dr. Wiegmann. Other research has shown that information conveyed in the operating room is often shared in a tense, ad hoc manner that is not conducive to comfortable communication. Previous Mayo Clinic research found that only 32 percent of nonphysician caregivers in cardiovascular surgery thought that surgeon communication was effective. In the same study, 59 percent of nonphysician respondents thought that surgeon attitudes and personalities negatively impacted teamwork.

To measure the briefings’ effectiveness, a trained observer monitored six surgeries where briefings were conducted and 10 surgeries where no briefing occurred. The observer was a medical student who was familiar with cardiac surgery and trained to record errors and flow disruptions.

When the briefings were conducted:

  • Miscommunication events were reduced by 53 percent. None of the miscommunication events observed during the study resulted in adverse events. Examples include the surgeon asking for a medication to be given and the anesthesiologist not hearing the request. There were significantly fewer delays, with fewer interruptions to clarify procedures. And, nurses made fewer trips outside the operating room to retrieve supplies.
  • Waste of medical supplies was reduced because the team better anticipated specific needs for each surgery.

Dr. Sundt says his team has embraced the briefings and continues to conduct them prior to the first procedure of the day. Other surgical teams have since requested implementation of the briefings.

“It’s time well spent that tunes us in to the specific patient’s needs,” says Dr. Sundt. In addition to specific concerns about the surgery, the briefings include information about the patient’s prior procedures, other diagnoses, risks and emotional concerns, such as the patient’s biggest worry regarding surgery.

“It sets the tone for the day. Now, I’m uncomfortable when we don’t do it,” says Dr. Sundt, who was initially skeptical about the benefits of the briefings.

There are barriers to conducting briefings for every procedure. “The structure of the operating room is not conducive to this,” says Dr. Sundt. With multiple surgical suites, surgery times overlap, creating difficulty in assembling the team prior to each procedure. During long, complex surgeries, shift and staff changes occur.

Additional study and pilots are needed to determine ways to incorporate the briefings more broadly, researchers say.

Source: Mayo Clinic


ImmunoVaccine Technologies Inc. (IVT), a Canadian vaccine development company, announced a research partnership with FIT Biotech, a Finland-based , clinical stage company that develops DNA vaccines. This research will formulate FIT Biotech’s GTU(R) MultiHIV DNA plasmid with IVT’s DepoVax(TM) vaccine delivery system to advance a therapeutic HIV vaccine.

“DepoVax(TM) will act as a vector to deliver FIT Biotech’s GTU(R) MultiHIV DNA vaccine and our goal is to develop a more sophisticated and efficient HIV vaccine candidate,” commented Dr. Marc Mansour, Vice President R&D at IVT.

The development of an HIV vaccine is complicated by the ability of the virus to mutate rapidly. FIT Biotech has addressed this challenge by designing a synthetic DNA plasmid, known as GTU(R) MultiHIV that covers the antigenic variability within HIV strains. GTU(R) MultiHIV and is comprised of the multi-epitope/multivalent HIV antigens. As FIT Biotech’s lead vaccine candidate, GTU(R) MultiHIV has the potential to trigger an immune response that slows the progression of HIV in infected individuals.

IVT’s pre-clinical research demonstrates that DepoVax(TM) effectively delivers DNA plasmids into draining lymph nodes with as little as one dose. The DepoVax(TM) platform uses liposomes to encapsulate a target antigen, like GTU(R) MultiHIV, and adjuvant. DepoVax(TM) also relies on a hydrophobic carrier to create a depot effect that significantly enhances vaccine induced cell-mediated and humoral immunity.

This pre-clinical research partnership will combine the complementary technologies of DepoVax(TM) and GTU(R) MultiHIV. Both IVT and FIT Biotech will examine the novel vaccine’s capabilities of inducing cell-mediated and humoral immunity against HIV virus.

“By testing DepoVax(TM) in combination with GTU(R) MultiHIV plasmid, we are working towards developing a superior vaccine candidate for therapeutic use against HIV and AIDS,” said Kalevi Reijonen, President and CEO at FIT Biotech.

The WHO reports that 33 million people are living with HIV and the epidemic is rapidly expanding with 2.7 million people newly infected in 2007. Nearly all of them will develop AIDS-related complications, creating an urgent need for effective HIV therapeutic vaccines. Therapeutic vaccination offers the most hope for HIV infected individuals because it maintains a low viral load and has the potential to modify the course of the infection and its progression towards the AIDS disease.

Source: ImmunoVaccine Technologies Inc.


Categories

Archives

Blogroll

Meta