UK official apologizes for infections
Mon, 15 Oct 2007 21:37:18 GMT
By RAPHAEL G. SATTER, Associated Press Writer
LONDON - Britain's health chief apologized Monday for an outbreak of a deadly bacterial infection in hospitals that left 90 people dead, but insisted the incident was an isolated one.
A report into the deaths by Britain's health watchdog said nurses working for the Maidstone and Tunbridge Wells hospital trust in southeastern England did not wash their hands and left patients lying in their own excrement. British Health Secretary Alan Johnson said the report, which included photographs of filthy hospital showers, sinks and toilets, was a "horror story."
"On behalf of the government and the , I would like to apologize to all those ... affected," he told lawmakers at an emergency session of Parliament.
"But I hope the House will recognize that the awful failures in Maidstone and Tunbridge are entirely unrepresentative of the standards of care that patients and the public rightly expect and is delivered in hospitals across the country."
The report, made public by the Healthcare Commission last week, found that "significant failings" at all levels contributed to more than 1,000 patients being infected with Clostridium difficile, a potentially fatal antibiotic-resistant "superbug," at three hospitals run by the trust.
Johnson said the trust's chairman, Lee Jordan, had resigned. The trust's chief executive quit earlier this month.
The report on the hospitals followed complaints about cleanliness. The trust has since brought in extra cleaners and nurses at the affected wards and asked family doctors not to send patients with diarrhea, one of Clostridium difficile's symptoms.
In recent years, the rate of infection from antibiotic-resistant diseases has risen dramatically in Britain, although some argue that figures are climbing due to tougher rules on reporting outbreaks.
Clostridium difficile, so named because it was difficult to grow in a laboratory when it was first discovered in the 1930s, is one of the most common hospital-acquired infections around the world and the most frequent cause of diarrhea in hospital patients.
Cancer death rates dropping fast
Mon, 15 Oct 2007 16:46:25 GMT
By LAURAN NEERGAARD, AP Medical Writer
WASHINGTON - Good news on the cancer front: Death rates are dropping faster than ever, thanks to new progress against colorectal cancer.
A turning point came in 2002, scientists conclude Monday in the annual "Report to the Nation" on cancer. Between 2002 and 2004, death rates dropped by an average of 2.1 percent a year.
That may not sound like much, but between 1993 and 2001, deaths rates dropped on average 1.1 percent a year.
The big change was a two-pronged gain against colorectal cancer.
While it remains the nation's No. 2 cancer killer, deaths are dropping faster for colorectal cancer than for any other malignancy — by almost 5 percent a year among men and 4.5 percent among women.
One reason is that colorectal cancer is striking fewer people, the report found. New diagnoses are down roughly 2.5 percent a year for both men and women, thanks to screening tests that can spot precancerous polyps in time to remove them and thus prevent cancer from forming.
Still, only about half the people who need screening — everyone over age 50 — gets checked.
"If we're seeing such great impact even at 50 percent screening rates, we think it could be much greater if we could get more of the population tested," said Dr. Elizabeth Ward of the American Cancer Society, who co-wrote the report with government scientists.
The other gain is the result of new treatments, which are credited with doubling survival times for the most advanced patients.
In 1996, there was just one truly effective drug for colon cancer. Today, there are six more, giving patients a variety of chemotherapy cocktails to try to hold their tumors in check, said Dr. Louis Weiner, medical oncology chief at Philadelphia's Fox Chase Cancer Center and a colorectal cancer specialist.
"I can tell you the offices of gastrointestinal oncologists around the country, and indeed around the world, are busier than ever because our patients are doing better," he said.
Among the report's other findings:
_Cancer mortality is improving faster among men, with drops in death rates of 2.6 percent a year compared with 1.8 percent a year for women.
_Lung cancer explains much of the gender difference. Male death rates are dropping about 2 percent a year while female death rates finally are holding steady after years of increases. Smoking rates fell for men before they did for women, so men reaped the benefits sooner.
_Overall, the rate of new cancer diagnoses is inching down about one-half a percent a year.
_New breast cancer diagnoses are dropping about 3.5 percent a year, a previously reported decline due either to women shunning postmenopausal hormone therapy or to fewer getting mammograms.
The report includes a special focus on cancer among American Indians and Alaskan natives. Overall, cancer incidence is lower among those populations than among white Americans, except for cancers of the stomach, liver, kidney, gallbladder and cervix.
The annual report is a collaboration of the American Cancer Society, National Cancer Institute, Centers for Disease Control and Prevention, and North American Association of Central Cancer Registries.
___
On the Net:
National Cancer Institute: http://www.cancer.gov
Hardees unveils 920calorie burrito
Mon, 15 Oct 2007 18:36:09 GMT
By JIM SALTER, AP Business Writer
ST. LOUIS - The people who brought you the Monster Thickburger and the 1,100-calorie salad are at it again — this time for breakfast.
Hardee's on Monday rolled out its new Country Breakfast Burrito — two egg omelets filled with bacon, sausage, diced ham, cheddar cheese, hash browns and sausage gravy, all wrapped inside a flour tortilla. The burrito contains 920 calories and 60 grams of fat.
Brad Haley, marketing chief for the St. Louis-based fast-food chain, said the burrito offers the sort of big breakfast item normally found in sit-down restaurants with an added advantage.
"It makes this big country breakfast portable," he said.
In 2003 the chain introduced a line of big sandwiches, including the Monster Thickburger. The 1,420-calorie sandwich is made up of two 1/3-pound slabs of beef, four strips of bacon, three slices of cheese and mayonnaise on a buttered bun.
Even Hardees' chicken salad — topped with onion rings and crispy chicken — has 1,100 calories and 83 grams of fat.
The chain does offer some low-calorie options, including roast beef and chicken sandwiches.
The Center for Science in the Public Interest, a Washington-based advocate for nutrition and health, has called the Hardee's line of Thickburgers "food porn."
The group's senior nutritionist, Jayne Hurley, said Monday the burrito was "another lousy invention by a fast-food company."
The "country breakfast bomb," as she called it, represents half a day's calories and a full day's worth of saturated fat and salt, to say nothing of cholesterol.
"That's all before 10 o'clock in the morning," she said.
Haley makes no apologies.
"We don't try to hide what these are," he said. "When consumers go to other fast-food places they feel like they've got to buy two of their breakfast sandwiches or burritos to fill up. This is really designed to fill you up."
The government's Center for Nutritional Policy and Promotion recommends a daily caloric intake ranging from 1,600 calories for sedentary women and older adults to 2,800 calories for teenage boys and active adults. Hardee's sees its core customers as young men ages 18 to 34, Haley said, though it expects a wider range for breakfast items.
The Country Breakfast Burrito is generally available for $2.69 by itself or $4.09 for a combo that includes hash rounds and coffee.
___
On the Net:
Hardee's: http://www.hardees.com.
Center for Science in the Public Interest: http://www.cspinet.org
Web site shows autism videos
Mon, 15 Oct 2007 04:44:23 GMT
By LINDSEY TANNER, AP Medical Writer
CHICAGO - What's so unusual about a baby fascinated with spinning a cup, or a toddler flapping his hands, or a preschooler walking on her toes?
Parents and even doctors sometimes miss these red flags for autism, but a new online video "glossary" makes them startlingly clear.
A new Web site offers dozens of video clips of autistic kids contrasted with unaffected children's behavior. Some of the side-by-side differences can make you gasp. Others are more subtle.
The free site, debuting Monday, also defines and depicts "stimming," "echolalia" and other confusing-sounding terms that describe autistic behavior. Stimming refers to repetitive, self-stimulating or soothing behavior including hand-flapping and rocking that autistic children sometimes do in reaction to light, sounds or excitement. Echolalia is echoing or repeating someone else's words or phrases, sometimes out of context.
The new site is sponsored by two nonprofit advocacy groups: Autism Speaks and First Signs. They hope the site will promote early diagnosis and treatment, which can help young children with autism lead more normal lives.
Pediatrician Dr. Michael Wasserman cautioned that the site might lead some parents to needlessly fret about normal behavior variations, and said they shouldn't use it to try to diagnose their own kids.
"Just as there's a spectrum in autism... there's a spectrum in normal development," said Wasserman, with Ochsner Medical Center in New Orleans. "Children don't necessarily develop in a straight line."
But Amy Wetherby, a Florida State University professor of communications disorders who helped create the site, noted that sometimes "parents are the first to be concerned and the doctors aren't necessarily worried. This will help give them terms to take to the doctor and say, 'I'm worried about it."
And while the children shown in the "Red Flags" video clips on the site have been diagnosed with some form of autism, the sponsors note that not all children who behave this way have something wrong. In fact, the behaviors in some of the short video clips — when viewed individually — look fairly normal.
The important thing is to seek medical help if a child does exhibit persistent unusual behavior, to either rule out autism or get an early diagnosis, said Alison Singer of Autism Speaks.
Added Wetherby, "We now know that one out of 150 children has autism, or one out of 94 boys. It's not a rare disability. We also know that early intervention is critical."
The site was to be available to the public starting Monday on the Autism Speaks Web site http://www.autismspeaks.org.
Several autism specialists who reviewed it at the request of The Associated Press called it an unusually helpful tool for parents and doctors.
"The moving pictures speak a million words," said Dr. Edwin Cook, an autism researcher and educator at the University of Illinois at Chicago.
"Not only do I see this as useful for the general public and for parents who might be wondering ... but I will frankly be using it for education" and training, Cook said. He has received research funding from Autism Speaks but has no connection to the new site.
Stefanie Voss of Tallahassee, Fla., said it will be a great tool "for parents who are in the situation that I was in three years ago, which is, 'I'm not sure if something's wrong with my child.'"
She said she asked her pediatrician about her son Nicholas when he was 14 months old and was told he didn't show "the classic signs" of autism.
"He did smile and have eye contact, but what I've learned since is those aren't the only red flags," Voss said.
Nicholas didn't point, wave, or demonstrate any other nonverbal communication. He'd also spend hours opening and closing cabinet doors or spinning plastic bowls on the floor.
She eventually took him to Florida State where he was diagnosed at age 17 months and intervention began. Nicholas is featured in a video clip on the site.
With speech lessons, physical therapy and behavior training several hours daily, he's now affectionate, social, talking, walking and in preschool.
"It shows you that all your hard work and early intervention pays off," Voss said.
Dr. Karen Ballaban-Gil, a pediatric neurology specialist at Montefiore Medical Center in New York, said the site "will be doing a real service."
The site will eventually feature a section on autism treatments and Ballaban-Gill said the only scientifically sound ones are intensive behavior training. Others, including special diets, are unproven and should not be included, she said.
Singer said there is no decision yet on which treatments will be added to the site.
___
Florida State University Center for Autism and Related Disorders:
http://autism.fsu.edu/
Death risks high after weight loss surgery study
Mon, 15 Oct 2007 20:30:30 GMT
By Michael Conlon
CHICAGO -
Patients who undergo weight-loss
stomach surgery have a higher death rate than is true for the
general population, including more suicides, perhaps linked to
depression, researchers said on Monday.
The higher risk of death generally is due not to the
surgery itself but to the health problems that accompany
obesity, and the damage that the condition does to the body
before and after surgery, the researchers said.
Dr. Bennet Omalu and colleagues at the University of
Pittsburgh said a review of more than 16,000 bariatric
operations done in Pennsylvania over a nine-year period found a
&;substantial excess of deaths owing to suicide and coronary
artery disease&; compared to normal death rates found in the
population at large.
&;It is very likely that the suicide deaths were ...
underestimated because some of the deaths were listed as drug
overdoses rather than suicide on the death certificate,&;
Omalu's team wrote in their report, published in the Archives
of Surgery.
&;The large number of deaths due to suicide and drug
overdose, in excess of what we expected, is also a cause for
concern. Most of them occurred at least one year after surgery,
suggesting that careful follow-up, especially the need to
recognize and treat depression, should be provided,&; they
added.
There were 440 deaths among the patients, who had an
average age of 48 when the operations were performed. About 1
percent of the patients in the study died within a year of the
procedures and 6 percent died within five years.
Heart disease was listed as the cause of death in 76
patients -- about 20 percent of the group -- a rate higher than
would be common in the general population, the researchers
found.
There were 14 suicides, compared to two that would be
likely to occur in the population at large in a group of people
that size, said the study
Omalu's team said surgery is an effective treatment for
severe obesity, with heavily overweight patients often losing
80 percent of their excess body weight within one or two years.
The higher death rates found in the study were likely due
to complications caused by obesity itself, from both before and
after the surgery, they said.
In a second study, Dr. Christopher Still and colleagues at
the Geisinger Health System in Danville, Pennsylvania, found
that bariatric surgery patients who lost some weight beforehand
get out of the hospital quicker.
The study of more than 800 patients who underwent open or
laparoscopic gastric bypass surgery between 2002 and 2006 found
that those who lost more than 5 percent of their excess body
weight before the operation were less likely to stay in the
hospital longer than four days compared to those who did not
lose weight beforehand.
It also found that those who shed 10 percent of the excess
weight ahead of time were more than twice as likely to have
lost 70 percent of their excess weight a year later, compared
to those who lost none at all.
The researchers said the effect has to do with the
beneficial effects of weight loss on high blood pressure,
diabetes and other problems.
