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Monthly Archives: August 2016

Dangerous Bacteria Hide Out in Nurses’, Doctors’ Uniforms

 Where you live may have a bigger impact on your brain health than you thought. Find out where your state ranks in America’s Brain Health Index.

The white coats and medical scrubs worn by hospital staff may harbor hazardous bacteria, a new study finds.

Researchers in Israel swabbed nurses’ and physicians’ uniforms and found potentially dangerous bacteria on more than 60 percent of the clothing items.

The team, from the Shaare Zedek Medical Center in Jerusalem, analyzed swab samples collected from three parts — sleeve ends, pockets and abdominal area — of the uniforms of 75 registered nurses and 60 doctors.

Potentially dangerous bacteria were found on 60 percent of the doctors’ uniforms and 65 percent of the nurses’ uniforms. Especially dangerous drug-resistant bacteria were found in 21 of the samples from nurses’ uniforms and six samples from doctors’ uniforms. Eight of the samples had methicillin-resistant Staphylococcus aureus(MRSA), which is becoming tough to fight using conventional antibiotics.

The bacteria on the uniforms may not pose a direct risk of disease transmission, but the findings suggest that many hospital patients are in close proximity to antibiotic-resistant strains of bacteria, the researchers said.

“It is important to put these study results into perspective,” Russell Olmsted, president of the Association for Professionals in Infection Control and Epidemiology (APIC), said in an association news release. “Any clothing that is worn by humans will become contaminated with microorganisms. The cornerstone of infection prevention remains the use of hand hygiene to prevent the movement of microbes from these surfaces to patients.”

The study appears in the September issue of the American Journal of Infection Control, the official publication of APIC.

Pose Health Risks May Cause Global Warming

 Medical and public health groups are banding together to explain how global warming has taken a toll on human health and will continue to cause food-borne illnesses, respiratory problems, and deaths unless policy changes are enacted.

In a conference call with reporters, the heads of the American Medical Association (AMA) and the American Public Health Association (APHA) joined with a pediatrician and a scientist to lay out what they say is a major public health issue: climate change caused by global warming.

The “evidence has only grown stronger” that climate change is responsible for an increasing number of health ills, including asthma, diarrheal disease, and even deaths from extreme weather such as heat waves, said Dr. Georges Benjamin, executive director of the APHA.

For one, rising temperatures can mean more smog, which makes children with asthma sicker, explained pediatrician Dr. Perry Sheffield, assistant professor in the Department of Pediatrics and the Department of Preventive Medicine at the Mount Sinai School of Medicine, in New York.

There is also evidence that pollen season is also getting longer, she said, which could lead to an increase in the number of people with asthma.

Climate change also is thought to lead to increased concentrations of ozone, a pollutant formed on clear, cloudless days. Ozone is a lung irritant which can affect asthmatics, those with chronic obstructive pulmonary disease, and those with heart disease, said Dr. Kristie Ebi, who is a member of the Intergovernmental Panel on Climate Change.

More ozone can mean more health problems and more hospital visits, she said.

Aside from air-related ailments and illnesses, extreme weather can have a devastating effect on health, Sheffield said.

“As a result of global warming, extreme storms including hurricanes, heavy rainfall, and even snowstorms are expected to increase,” Sheffield said. “And these events pose risk of injury and disruption of special medical services, which are particularly important to children with special medical needs.”

Extreme heat waves and droughts are responsible for more deaths than any other weather-related event, Sheffield said.

The 2006 heat wave that spread through most of the U.S. and Canada saw temperatures that topped 100 degrees. In all, 450 people died, 16,000 visited the emergency room, and 1,000 were hospitalized, said Dr. Cecil Wilson, president of the AMA.

Climate change has already caused temperatures to rise and precipitation to increase, which, in turn, can cause diseases carried by tics, mosquitoes, and other animals to spread past their normal geographical range, explained Ebi.

For instance, Lyme disease is increasing in some areas, she said, including in Canada, where scientists are tracking the spread of Lyme disease north.

Ebi also recounted the 2004 outbreak of the leading seafood-related cause of gastroenteritis, Vibrio parahaemolyticus, from Alaskan seafood, which was attributed to increased ocean temperatures causing infected sea creatures to travel 600 miles north.

Salmonella outbreaks also increase when temperatures are very warm, Sheffield said.

A 2008 study also projected that global warming will lead to a possible increase in the prevalence of kidney stones due to increased dehydration, although the link hasn’t been proven.

Wilson said the AMA wants to make doctors aware of the projected rise in climate-related illnesses. To combat climate change, Wilson says physicians and public health groups can advocate for policies that improve public health, and should also serve as role models by adopting environmentally-friendly policies such as eliminating paper waste and using energy-efficient lighting in their practices.

“Climate instability threatens our health and life-supporting system, and the risk to our health and well-being will continue to mount unless we all do our part to stabilize the climate and protect the nation’s health,” said Wilson.

Benjamin added that doctors should pay attention to the Air Quality Index. For instance, if there’s a “Code Red” day, which indicates the air is unhealthy, physicians should advise patients (particularly those with cardiac or respiratory conditions) that it’s not the day to try and mow the grass.

“ER docs are quite aware of Code Red days because we know that when those occur, we’re going to see lots of patients in the emergency room,” Benjamin said.

The conference call came as Congress is considering what role the Environmental Protection Agency (EPA) should have in updating its safeguards against carbon dioxide and other pollutants.

While the EPA has the authority to regulate levels of CO2, a budget bill passed by the House of Representatives last the weekend prohibited the EPA from exercising that authority. Meanwhile, other bills are pending in Congress that would significantly delay the agency’s ability to regulate air pollutants.

AMA has a number of policies on the books regarding climate change, including a resolution supporting the EPA’s authority to regulate the control of greenhouse gases, and a statement endorsing findings from the most recent Intergovernmental Panel on Climate Change report that concludes the Earth is undergoing adverse climate changes, and that humans are a significant contributor to the changing weather.

In that statement, the AMA said it supports educating the medical community about climate change and its health implications through medical education on topics such as “population displacement, heat waves and drought, flooding, infectious and vector-borne diseases, and potable water supplies.”

The statement also said the AMA supports physician involvement in policymaking to “search for novel, comprehensive, and economically sensitive approaches to mitigating climate change to protect the health of the public.”

Judge Tosses Out Healthcare Reform Law

A federal judge in Florida has ruled that the healthcare reform law is unconstitutional, siding with the 26 states that sued to block enforcement of the law.

The lawsuit, filed by 26 states that sued to block the Affordable Care Act (ACA), is considered likely to go all the way to the Supreme Court.

Judge Roger Vinson, of the U.S. District Court in Pensacola, Fla., stopped short of directing the federal government to stop implementing the law. Still, the ruling is the harshest legal action yet against the ACA.

Unlike a ruling last month by a judge in Richmond, Va., stating that the individual mandate portion of the ACA violates the Constitution, Vinson ruled the entire law “void” because the individual mandate provision can’t be separated out from the rest of the law.

Congress “exceeded the bounds of its authority in passing the Act with the individual mandate,” Vinson wrote in his 78-page ruling, which was released Monday afternoon. The mandate requires all citizens to have health insurance by 2014 or else pay a penalty.

“Because the individual mandate is unconstitutional and not severable, the entire Act must be declared void,” he concluded.

He did contend that Congress has the power to address the “problems and inequities in our health care system,” but that Congress overstepped its power in passing the ACA.

“There is widespread sentiment for positive improvements that will reduce costs, improve the quality of care, and expand availability in a way that the nation can afford,” Vinson wrote. “This is obviously a very difficult task. Regardless of how laudable its attempts may have been to accomplish these goals in passing the Act, Congress must operate within the bounds established by the Constitution.”

While it was widely expected that Vinson would side with the states, it comes as somewhat of a surprise that he declared the entire law “void.”

The original lawsuit — which filed just hours after Obama signed the ACA into law on March 23, 2010 — alleged that the “individual mandate” in the law exceeded Congress’ authority under the Commerce Clause of the Constitution, but didn’t argue that the whole of the law is unconstitutional. The Commerce Clause permits the federal government to regulate interstate commerce.

In October, when Vinson ruled the case could proceed, he said the states “had a plausible claim” in their argument that the law’s individual mandate violated the Commerce Clause.

The states argued that the government cannot force individuals to participate in the stream of commerce — in this case, the health insurance market.

The federal government responded that at some point, every U.S. citizen will seek medical care, and if that person chooses to not have insurance, the cost of his or her medical care is passed on to those with insurance. Thus, a choice to not participate in the commerce of healthcare doesn’t actually exist.

Two other judges have rejected challenges to the law, ruling that the ACA’s individual mandate provision is constitutional.

Other states that have joined the lawsuit are: Alabama, Alaska, Arizona, Colorado, Georgia, Indiana, Idaho, Iowa, Kansas, Louisiana, Maine, Michigan, Mississippi, Nebraska, Nevada, North Dakota, Ohio, Pennsylvania, South Carolina, South Dakota, Texas, Utah, Washington, Wisconsin and Wyoming.

The National Federation of Independent Business is also part of the lawsuit.

Colon Cancer May be Less Likely Smoker’s Survive

 Current smokers diagnosed with colorectal cancer are more likely to die from it than former smokers or people who never tried cigarettes, a recent study suggests.

Researchers examined five-year survival odds for 18,166 people diagnosed with colorectal cancer and found current smokers were 14 percent more likely to die during the study period than people who never smoked. The effect was seen mainly among smokers treated with surgery but no chemotherapy, who were 21 percent more likely to die.

“We don’t know exactly how smoking causes colorectal cancer in this case or makes prognosis worse; however it clearly does just like in many other human cancers,” said Dr. David Weinberg of the Fox Chase Cancer Center in Philadelphia.

“Not smoking, maintaining a healthy body weight, exercising regularly and drinking in moderation have been shown to consistently reduce risk for many common cancers including lung and colorectal cancers,” Weinberg, who wasn’t involved in the study, added by email.

Worldwide each year, about 750,000 new cases of colorectal cancers are diagnosed, with about two-thirds developing in the colon.

For the current study, researchers examined cancer registry data for patients diagnosed with colorectal cancers in Ireland from 1994 to 2012.

Most patients were at least 55 years old at the time of diagnosis, though 13 percent were younger. About 35 percent of patients were at least 75 years old.

Overall, 3,572 patients, or 20 percent, were current smokers, and another 4,199, or 23 percent, were former smokers.

About 53 percent of them had only surgery, while 33 percent had chemotherapy in addition to operations and 5 percent had only chemotherapy. Roughly 10 percent of patients had none of these interventions.

During five years of follow-up, 7,488 people died of cancer, researchers report in Alimentary Pharmacology and Therapeutics.

After adjusting for patients’ age and marital status as well as characteristics of their cancer, current smokers had a statistically meaningful increased risk of death but former smokers did not.

When researchers examined different treatment groups, they found the increased risk of death associated with smoking was limited to patients who were only treated with surgery.

The study authors write that more research is needed to understand this higher mortality among surgery-only patients, but there are several possible explanations. Past studies have found that smokers are more likely to be diagnosed at an advanced stage and to present as emergency cases requiring immediate surgery, for example. And people who received chemo in addition to surgery might have been in generally better health than the surgery-only group.

The study wasn’t a controlled experiment designed to prove that smoking causes colorectal cancer or deaths from the disease, the authors note. Researchers also didn’t have data on how much patients smoked after their diagnosis, other lifestyle factors that may influence survival, or how long patients lived without tumors growing and spreading.

Lead study author Dr. Linda Sharp of Newcastle University in the U.K. didn’t respond to emails seeking comment.

The current study is the largest to date to demonstrate the link between smoking and colorectal cancer that has been seen in previous studies, said Dr. Sidney Winawer of Memorial Sloan Kettering Cancer Center in New York.

Too often, people tend to think of smoking only in terms of lung cancer, and not other malignancies or diseases that are tied to the habit, Winawer, who wasn’t involved in the study, said by email.

“People are generally deniers especially when it comes to pleasurable habits or when a life style change is recommended for their health,” Winawer added. “They need to be told over and over about colorectal cancer, cancer of the liver, pancreas, esophagus, kidney, bladder, head and neck, etc. as well as heart disease, chronic obstructive pulmonary disorder, reflux, etc.”