Help! Our hospitals are filthy!
According to an article by Betsy McCaughey in the U.S. News &World Report Best Hospitals issue hospitals in the U.S. are not inspected for cleanliness.
I would love to hear what others have to say about this - especially health and medical bloggers. Does the article seem accurate to you? Reasonable? Overreactive?
Personally I found it alarming, but I’m a scientist and I don’t work in medicine so maybe I just don’t understand the situation well enough. Please enlighten me.
Here are a few quotes from the article:
“The Joint Commission, which inspects and accredits U.S. hospitals, doesn’t measure cleanliness. Neither do most state health departments, nor the federal Centers for Disease Control and Prevention.”
“Sad to say, cleanliness is not a priority for hospital administrators or most medical professionals. “
“A new University of Maryland study shows that 65 percent of physicians and other medical professionals admitted they hadn’t washed their lab coat in at least a week, even though they knew it was dirty. Nearly 16 percent said they hadn’t put on a clean lab coat in at least a month.”
“In a recent Johns Hopkins Hospital study, 26 percent of supply cabinets were contaminated with a dangerous bacterium, methicillin-resistant Staphylococcus aureus (MRSA) and 21 percent with another stubborn germ, vancomycin-resistant Enterococcus (VRE).”
“Stethoscopes, blood pressure cuffs, and EKG wires are used on successive patients without being cleaned. Studies published as long ago as 1978 warn that blood pressure cuffs frequently carry live bacteria, including MRSA, and are a source of infection. In a newly released British report, one third of blood pressure cuffs were found to be contaminated with Clostridium difficile, a germ that can cause lethal diarrhea if it enters via the mouth. “
“Hospitals once tested surfaces for bacteria, but in 1970, the CDC and the American Hospital Association advised them to stop, saying testing was unnecessary and not cost effective.”
“Asked whether bacterial levels should be measured, Wise [Robert Wise, Joint Commission] answers: “You can only ask hospitals to do so much.”
For more information read the article: Why Aren’t Hospitals Cleaner? and visit the web site of the Committee to Reduce Infection Deaths (chaired by the author of the article).
July 27, 2007
This week in health and science - 7/27/07
(With so many good blog posts and news stories out there - more than I can write about - I’m going to test posting once a week with highlights of the stories that caught my attention. Hopefully you will find them interesting too!)
Allergies
The journal Allergy reports that a new sublingual immunotherapy, called ‘SLIT’, shows promise in treating cat allergies by placing allergen containing drops under the tongue.
In other allergy news, Ruth from Allergizer reports that a new process to inactivate peanut allergens has been discovered.
Cancer
At Lively Women Kristen discusses the recent survey conducted by the American Cancer Society indicating that many Americans do not really have a good understanding of cancer - many people tend to believe popular wisdom rather than facts about cancer.
New data suggests that dietary calcium may reduce the risk of developing breast cancer - read more from Gloria at Dairy Calcium May Reduce Risk of Breast Cancer
Ramunas has a really informative post at www.cancer-genetics.com about gene-expression profiling oncotests: Gene-expression Profiling in Cancer | A Brief Review
That whole cancer and low cholesterol thing that came out this week - I was avoiding it, but thankfully Dr. Val wrote a good post about it. She describes it as a “gross misinterpretation of the metanalysis”.
Biotechnology
Two really cool things this week: a neuroprosthetic chip made to be implanted in the brain which may make it possible in the future for paralyzed people to control a prosthetic device with their thoughts. And a robotic ankle that is light and flexible and also allows people to walk more normally.
Nutrition
At Eating Fabulous Ruth brought up a good point about eating fruit peels and pesticides - we’re usually told the peeling is good for you - has more vitamins, fiber, etc. - but much pesticide residue is left behind?
Longevity
FuturePundit reports the news that in states where people take the latest drugs they have longer life expectancies. I wouldn’t have expected this and didn’t know which state you lived in made that much difference.
Other News
Hsien-Hsien Lei ran a poll on her blog concerning whether or not you would like to have your whole genome sequenced. She also wrote about the Personal Genome Project - which sounds pretty cool, except there is no way I would have my medical records made public - my DNA - yes!, but not the medical records.
July 26, 2007
Breast cancer update - 7/26/07
A few short news bits concerning breast cancer:
Breast cancer and breast feeding
“Breastfeeding can offset the increased risk of invasive breast cancer for women who had their first full-term pregnancy after the age of 25, a study led by researchers at the University of Southern California (USC) suggests.” Read more.
Breast cancer vaccines
Someday vaccines may be developed that can help the body’s immune system to “stimulate an antibody and cellular response against cancer cells”. Some researchers trying to find a vaccine against breast cancer have a new strategy to boost T cells (a type of white blood cell) to fight against cancer cells. They used mice bred to carry the oncogene HER-2/neu and gave them a synthetic peptide vaccine. The vaccine resulted in all “samples either slowing or stopping the progression of breast cancer”. Read more.
Preoperative chemotherapy
A Cochrane Systematic Review indicates that “using chemotherapy to reduce the size of tumours before surgery does not compromise survival rates and enables women to retain better self-image and overall health because of the reduced impact of the surgery.” Read more.
More personalized treatment
A test may someday be available to help identify people who might react badly to radiation. “The research could mean people who might react badly to radiotherapy could be warned in advance or alternative treatments be sought.” Read more.
Abortion / miscarriage
And lastly - no surprises here: “Neither induced abortion nor spontaneous abortion (miscarriage) appears to be associated with breast cancer risk in premenopausal women”. Read more.
July 24, 2007
A possible antiretroviral therapy of the future
Retroviruses, such as HIV, are viruses whose genetic material is coded by RNA rather than DNA. They reproduce by first infecting a host cell, reverse transcribing their RNA into DNA and then integrating this DNA into the host cell’s genome.
So far treatments for retroviral infections like HIV consist of suppressing the virus’s life cycle, but do not actually eliminate the integrated virus’s genetic material from the infected cells.
The June 19 issue of Science has a paper by a group in Germany at the Max-Planck Institute who have found a way to actually cut the genetic material from HIV-1 out of infected cells.
They engineered a recombinase enzyme to recognize and cut out the DNA from HIV-1 using a method called substrate-linked protein evolution. Recombinases are enzymes that recognize a specific DNA segment, delete it and then rejoin the two remaining ends. Cre is a recombinase that recognizes a segment called loxP which is 50% similar to the segments called long terminal repeats (LTR) in HIV-1. Cre doesn’t recognize these LTR’s however. The Max-Planck group, as mentioned above, used a technique to create a modified Cre they called Tre that does recognize and remove DNA between HIV-1’s LTR’s.
They were able to express Tre in cultured human cells that were infected with HIV-1 - and it succeessfully deleted the HIV-1 DNA from the cells.
It is still too far away to be used in people with HIV - safe and efficient ways to deliver it to target cells in the body without causing any harm still need to be developed - but it has the potential to be useful in treating HIV and other retroviral infections among other things at some point in the future.
July 20, 2007
Breast cancer research update - 7/20/07
A few months ago it was discovered that four specific gene products are closely involved in breast cancer cells spreading (metastasize) into the lung. The work was published in PNAS and Nature.
The researchers took human breast cancer cells and using a technique called RNA interference they blocked the expression of each of these 4 genes individually and in different combinations. They then implanted these cancer cells into mice.
When any of the individual genes were inactivated the primary tumor growth and lung metastasis were inhibited a little. But when all four were inactivated - the tumor growth and spread into the lungs was almost completely stopped!
The four genes are:
- epiregulin - involved in the growth and progression of some cancers
- cyclooxygenase-2 (COX2) - involved in inflammation responses
- matrix metalloproteinase 1 (MMP1) - involved with angiogenesis and tumor cell migration
- matrix metalloproteinase 2 (MMP2) - involved with angiogenesis and tumor cell migration
.
Using drugs already available:
- celecoxib (Celebrex) - an inhibitor of COX2
- cetuximab (Erbitux) - and antibody against EGFR
- GM6001 - a broad MMP inhibitor (still in preclinical trials)
.
they were able to get the same results in the mice - almost all the primary tumor growth and metastasis were eliminated.
Future research will include investigating whether or not these four genes are involved in metastasis into other organs and if multidrug targeting of these gene products will be effective in people.
July 19, 2007
Breast cancer update - 7/16/07
A protein that is necessary for breast cancer to metastasize - or spread to other parts of the body - was recently discovered.
Akt1 is a serine-threonine protein kinase which inhibits apoptosis. Breast and some other cancers cells tend to make too much Akt1. A group of researchers at Thomas Jefferson University genetically engineered some mice so that they would no longer make Akt1.
They then bred these mice with mice that overexpressed the HER2/neu/ErbB2 gene. The HER2/neu/ErbB2 protein is a type of epidermal growth factor receptor. Around 25% or so of breast cancers overexpress this protein.
The researchers found mice that ended up with only one copy of the Akt1 gene developed only small and slow growing tumors. But those with 2 copies developed metastatic cancer.
They also found that Akt1 causes cancer cells to release a protein called CXCL16, a cytokine. CXCL16 helps breast cancer cells to migrate to other regions of the body.
These results - published in Proceedings of the National Academy of Sciences - may help in developing drugs that block Akt1 to prevent breast cancer metastases in the future.
July 12, 2007
Breast cancer update - 7/12/07
I’ll do some updates on breast cancer research next - there is lot of research out there, and with being so behind it will take a few postings to get caught up.
Treatment and Survival
According to the Journal of the National Cancer Institute the survival of women with early breast cancer is increased when chemotherapy is used along with tamoxifen although preventing the ovaries from releasing estrogen does not help.
A study in International Journal of Sports Medicine suggests that women who survived breast cancer and participated in an supervised cardiovascular and strength training program improved their cardiorespiratory fitness and strength and muscle function. All but the increases in cardiorespiratory fitness were retained another 8 weeks after the initial 8 week program concluded.
New Research
Transforming growth factor beta (TGF-beta) is a protein that is involved in proliferation and differentiation of cells. Radiation and chemotherapy treatments can increase circulating levels of TGF-beta as well as circulating cancer cells in mice. Research in a mouse model of breast cancer that was published in the Journal of Clinical Investigation shows that blocking TGF-beta could prevent metastases of a tumor. The researchers blocked TGF-beta with antibodies directed against it resulting in the prevention of tumor metastases. There are currently some early stage clinical trials involving TGF-beta inhibitors being added to the treatment regimen. Read more: Treatment-induced growth factor causes cancer progression
Prevention
Eating a lot of red and processed meats may increase the chances of women developing breast cancer according to some researchers in Great Britain. In this study the diets of over 35,000 women between 35 and 69 were analyzed and it was found that the postmenopausal women who ate the most red meat were 56% more likely to develop breast cancer and those who ate the most processed meat had a 64% increase. Why this is the case is not known but it may involve the saturated fat in meat or the heterocyclic amines and polycyclic aromatic hydrocarbons produced in grilled meat. This research was published in the British Journal of Cancer.
Angiogenesis is the process of new blood vessel development which can lead to the increase in growth of tumors by bringing them more nutrients. A protein called VEGF (vascular endothelial growth factor) is involved in this process. It has long been known that drinking alcohol by women increases their risk for breast cancer. A recent study by Dr. Jian-Wei Gu from the University of Mississippi Medical Center in mice showed that alcohol increased breast tumor size as well as increased blood vessel growth near the tumor. They also found evidence of an increase in VEGF levels.
That’s all for now! More breast cancer news coming soon.
July 11, 2007
Bone health
I’m back to blogging again! At least I hope so - if nothing else comes up that prevents me from writing more regularly.
And as I hinted at last time - bone health is what is on my mind lately so I decided that would the topic of my first post back.
I can’t believe that the last time I wrote anything about osteoporosis or bone health was back in February! And unfortunately I don’t see a lot in the news lately about it. Maybe I missed something - but this is all I have for now on the subject:
Estrogen and bone loss
- Way back in March a study was presented that helps explain how the main form of estrogen in humans - called estradiol - helps to keep bones more dense. The bones in our bodies are constantly being broken down and built back up. Osteoblasts are bone cells that are responsible for bone formation. The researchers discovered that the enzyme caspase-3 which is involved in the programmed cell death (also called apoptosis) of osteoblast cells is inhibited by estradiol. After menopause, estrogen levels decrease and women become more likely to have their bones become more brittle and break more easily. The press release for this study can be found here: Study describes action of estrogen in protecting bone.
Bisphosphonates and jaw necrosis
- Another study linking the use of bisphosphonates for the treatment of osteoporosis to jaw and facial bone deterioration was published recently in the Journal of the National Cancer Institute. Osteonecrosis can occur when the blood supply to the area is poor, leading to bone death or deterioration. A causal relationship between the drug’s use and jaw necrosis is not certain at this point however. Read more here: Bisphosphonate treatment is associated with jaw bone problems
SSRI’s and bone health
- A study published in Archives of Internal Medicine provides some evidence that the use of SSRI’s (selective serotonin reuptake inhibitors) prescribed commonly for depression may have a negative effect on bone health in older people. The study showed a correlation between SSRI’s and bone health, but some other factor such as being less physically active could be responsible. Learn more: OHSU scientists find antidepressant, bone loss link.
Exercise in the elderly
- Concerning the elderly is a study in Journal of the American Geriatrics Society showing that exercise training can improve people’s balance and decrease their fear of falling. A related study (BMC Geriatrics) showed that balance-training exercises may improve balance in elderly people and possibly reduce the chance of them falling.
Hip surgery and recovery
- Lastly, a researcher in St. Louis recently published a report indicating that many people recovering from hip surgery may develop problems with depression afterward due to being confined to their bed or home or other factors.
That’s all I have for now - but remember - weight bearing exercise along with calcium and vitamin D can go a long way in preventing osteoporosis!
