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We give you many useful information about health

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We give you many useful information about health

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We give you many useful information about health

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We give you many useful information about health

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Tampilkan postingan dengan label Hospital. Tampilkan semua postingan
Tampilkan postingan dengan label Hospital. Tampilkan semua postingan

Minggu, 29 Januari 2012

Tiny baby leaves Los Angeles hospital amid fanfare

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Haydee Ibarra looks at her 14-week-old daughter, Melinda Star Guido, at the Los Angeles County-USC Medical Center in Los Angeles, Wednesday, Dec. 14, 2011. At birth, Melinda Star Guido tipped the scales at only 9 1/2 ounces, less than a can of soda. After spending her early months in the neonatal intensive care unit, a team of doctors and nurses will gather Friday Jan. 20, 2012 to see her off as she heads home. She is the world's third smallest baby and the second smallest in the U.S. (AP Photo/Jae C. Hong) Haydee Ibarra looks at her 14-week-old daughter, Melinda Star Guido, at the Los Angeles County-USC Medical Center in Los Angeles, Wednesday, Dec. 14, 2011. At birth, Melinda Star Guido tipped the scales at only 9 1/2 ounces, less than a can of soda. After spending her early months in the neonatal intensive care unit, a team of doctors and nurses will gather Friday Jan. 20, 2012 to see her off as she heads home. She is the world's third smallest baby and the second smallest in the U.S. (AP Photo/Jae C. Hong) Melinda Star Guido, who weighed only 9 ½ ounces at birth— less than a can of soda, is shown Friday Jan. 20, 2012 as she is released from Los Angeles County-USC Medical Center in Los Angeles. Guido spent her early months in the neonatal intensive care unit. Guido now weighs 4 pounds, 17 ounces. (AP Photo/Damian Dovarganes) Baby Melinda Star Guido is hugged by her mother Haydee Ibarra, 22, as her father Yovani Guido, 25, looks on after being discharged from Los Angeles County-USC Medical Center five months after her birth, Friday, Jan. 20, 2012 in Los Angeles. Guido was born 16 weeks early, weighing 9.5 ounces, and was the third smallest baby born in the world. (AP Photo/Damian Dovarganes) Baby Melinda Star Guido is passed by nurses to her mother Haydee Ibarra, right, after being discharged from Los Angeles County-USC Medical Center five months after her birth, Friday, Jan. 20, 2012 in Los Angeles. Guido was born 16 weeks early, weighing 9.5 ounces, and was the third smallest baby born in the world. (AP Photo/Damian Dovarganes)eval("var currentItemd57851005a80479aaeeb90a12c70b9ff = 1;");eval("var nextd57851005a80479aaeeb90a12c70b9ff = 0;");eval("var previousd57851005a80479aaeeb90a12c70b9ff = 0;"); LOS ANGELES (AP) — One of the world's smallest surviving babies was discharged Friday from the hospital where she spent nearly five months in an incubator — but not before getting the Hollywood treatment.

Wearing a pink knit hat and wrapped in a pink princess blanket, Melinda Star Guido was greeted by a mob of television cameras and news photographers outside the Los Angeles County-USC Medical Center.

"I'm just happy that she's doing well," said her 22-year-old mother Haydee Ibarra. "I'm happy that I'm finally going to take her home ... I'm just grateful."

Melinda was born on August 30 weighing just 9 1/2 ounces, less than a can of soda. She was so tiny that she fit into her doctor's hand. Melinda is believed to be the world's third-smallest surviving baby and second smallest in the U.S.

Now weighing 4½ pounds and breathing through an oxygen tube as a precaution, doctors said Melinda has made enough progress to go home. Her brain scan was normal and her eyes were developing well. She also passed a hearing test and a car seat test that's required of premature babies before discharge.

It's too early to know how she will do developmentally and physically, but doctors planned to monitor her for the next six years.

"I am cautiously optimistic that the baby will do well, but again there is no guarantee," said Dr. Rangasamy Ramanathan, who oversees preemies at the hospital.

Most babies as small don't survive even with advanced medical care. About 7,500 babies are born each year in the U.S. weighing less than 1 pound, and about 10 percent survive.

Melinda has come a long way since being delivered by cesarean section at 24 weeks after her mother developed high blood pressure during pregnancy, which can be dangerous for mother and fetus.

She was whisked to the neonatal intensive care unit where she breathed with the help of a machine and received nutrition through a feeding tube. Infants born before 37 weeks are considered premature.

Even after discharge, such extremely premature babies require constant care at home. Their lungs are not fully developed and they may need oxygen at home. Parents also need to watch out for risk of infections that could send infants back to the hospital. Even basic activities like feeding can be challenging.

"They may need extra help and patience while they learn to eat," Dr. Edward Bell, a pediatrician of the University of Iowa who runs an online database of the world's smallest surviving babies born weighing less than a pound.

The list features 130 babies dating back to 1936 and does not represent all survivors since submission is voluntary. Melinda was not eligible to be included until she was discharged.

Two years ago, Bell published a study in the journal Pediatrics that found many survivors have ongoing health and learning concerns. Most also remain short and underweight for their age.

There are some rare success stories. The smallest surviving baby born weighing 9.2 ounces is now a healthy 7-year-old and another who weighed 9.9 ounces at birth is an honors college student studying psychology, according to doctors at Loyola University Medical Center in Illinois where the girls were born.

Soon after birth, Melinda was treated for an eye disorder that's common in premature babies and underwent surgery to close an artery. Ibarra held Melinda for the first time after the operation in November. Her parents said the toughest part was battling traffic after work every day to see their daughter.

___

Online:

Registry: http://www.healthcare.uiowa.edu/tiniestbabies

Associated Press

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Turkish hospital performs triple limb transplant

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ANKARA, Turkey (AP) — A hospital in southern Turkey on Saturday was attempting the world's first triple limb transplant, attaching two arms and one leg to a 34-year-old man, the country's state-run news agency reported.

A team of doctors at Akdeniz University Hospital, in the Mediterranean coastal city of Antalya, was at the same time transplanting the face of the same donor onto another patient — a 19-year-old man. It would be Turkey's first face transplant.

"Today could be a day of many firsts for the medical world," the Anadolu Agency quoted Dr. Zafer Aydin as saying.

"We are hoping that the operation is a success and that it is a world first," said Aydin, who heads the organ transplant unit at the hospital in western Turkey where the donor's limbs were removed. "Two arms and a leg have never been transplanted on one patient until today."

The hospital in Antalya said an announcement would be made after the surgery.

Anadolu said Atilla Kavdir, the 34-year-old receiving the limbs, lost his arms and right leg when he was 11 after he hit power lines outside his home with an iron rod to scare away pigeons and received an electric shock.

The teenage face transplant recipient was burned in a house fire when he was a baby.

The limbs and the face became available early on Saturday and the hospital began the operation at 3:15 a.m., Anadolu said.

The world's first double arm transplant was in Germany in 2008, while the first double leg transplant took place in Spain in July 2011.

More than a dozen face transplants have been carried out around the world, starting in November 2005 with a French woman who was mauled by her dog. The first face transplant in the U.S. was in December 2008.

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Minggu, 04 Desember 2011

Once-conjoined toddlers leave hospital

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Lisandra Sanatis looks at her twin daughter, Teresa Tapia, as daughter Maria Tapia looks on Children’s Hospital of Richmond at Virginia Commonwealth University in Richmond, Va., Thursday Dec. 1, 2011. The conjoined twins were separated during an operation at the hospital Nov. 8, 2011. The twins are expected to be released from the hospital Friday and are expected to go back home to the Dominican Republic before Christmas. (AP Photo/Steve Helber) Lisandra Sanatis looks at her twin daughter, Teresa Tapia, as daughter Maria Tapia looks on Children’s Hospital of Richmond at Virginia Commonwealth University in Richmond, Va., Thursday Dec. 1, 2011. The conjoined twins were separated during an operation at the hospital Nov. 8, 2011. The twins are expected to be released from the hospital Friday and are expected to go back home to the Dominican Republic before Christmas. (AP Photo/Steve Helber) Maria Tapia, and TeresaTapia play in a playroom at Children’s Hospital of Richmond at Virginia Commonwealth University in Richmond, Va., Thursday Dec. 1, 2011. The conjoined twins were separated during an operation at the hospital Nov. 8, 2011. The twins are expected to be released from the hospital Friday and are expected to go back home to the Dominican Republic before Christmas. (AP Photo/Steve Helber) Lisandra Sanatis holds her daughter, Teresa Tapia, in their room at Children’s Hospital of Richmond at Virginia Commonwealth University in Richmond, Va., Thursday Dec. 1, 2011. Sanatis' conjoined twin daughters were separated during an operation at the hospital Nov. 8, 2011. The twins are expected to be released from the hospital Friday and are expected to go back home to the Dominican Republic before Christmas. (AP Photo/Steve Helber) Maria Tapia, and TeresaTapia play in a playroom at Children’s Hospital of Richmond at Virginia Commonwealth University in Richmond, Va., Thursday Dec. 1, 2011. The conjoined twins were separated during an operation at the hospital Nov. 8, 2011. The twins are expected to be released from the hospital Friday and are expected to go back home to the Dominican Republic before Christmas. (AP Photo/Steve Helber) Maria Tapia, and TeresaTapia play in a playroom at Children’s Hospital of Richmond at Virginia Commonwealth University in Richmond, Va., Thursday Dec. 1, 2011. The conjoined twins were separated during an operation at the hospital Nov. 8, 2011. The twins are expected to be released from the hospital Friday and are expected to go back home to the Dominican Republic before Christmas. (AP Photo/Steve Helber)eval("var currentItemd57851005a80479aaeeb90a12c70b9ff = 1;");eval("var nextd57851005a80479aaeeb90a12c70b9ff = 0;");eval("var previousd57851005a80479aaeeb90a12c70b9ff = 0;"); RICHMOND, Virginia (AP) — Two formerly conjoined toddlers from the Dominican Republic have left a Richmond hospital after recovering from separation surgery, and doctors predict they'll be ready to go home by Christmas.

Maria and Teresa Tapia left Children's Hospital of Richmond at Virginia Commonwealth University on Friday. At a news conference before their departure, the girls clapped and waved and one kissed the lead doctor on their surgical team, Dr. David Lanning.

"I thank God and everyone who made this possible," the girls' mother, Lisandra Sanatis, said through a translator.

The 20-month-old twins were attached at the lower chest and underwent complicated, nearly daylong surgery on Nov. 7. In a series of procedures, the surgical team divided the twins' liver, pancreas and other shared organ systems and reconstructed their abdominal walls.

While they're getting accustomed to exploring their surroundings separately, they still stay near each other and hold hands when they walk.

Lanning said Friday that both children have been recovering well, and doctors don't expect them to require any long-term medical treatment, except possible minor surgery to construct belly buttons.

"Overall, I don't think we could have asked for a better outcome," he said at Friday's news conference.

They'll lead healthy, long lives, with the ability to "be together but make independent decisions."

Maria, the smaller of the two, weighs about 19 pounds, and Teresa weighs about 26 pounds. Lanning expects the disparity in their weight, caused by the configuration of their small intestines and blood flow from the liver, to gradually even out.

Maria's pancreas is slow to produce digestive enzymes, but she is taking replacement enzymes, and doctors are monitoring her colon function. Teresa is undergoing treatment on the incision where the girls were separated, Lanning said.

Doctors, nurses, volunteers and others who cared for them gave the girls and their mother and aunt a warm send-off from the hospital Friday afternoon. Lanning pushed a new double stroller to the van that took the family to a nearby residence for patients and their families.

The girls will stay in Richmond for follow-up medical visits and outpatient therapy to continue working on walking and other motor skills now that they're no longer attached. Lanning said they're on track to return to their native country by Christmas.

After being in Richmond for several months now, Sanatis said she and her daughters have grown fond of everyone they've met. But they're more than ready to go home and reunite with the twins' father and three other siblings.

The twins have become celebrities in the Dominican Republic, with supporters including the country's first lady, Margarita Cedeno de Fernandez, who visited Richmond on the day of the surgery.

The World Pediatric Project, a nonprofit surgical-care provider for children in Central America and the Caribbean, sponsored the toddlers' medical care, along with the family's stay in the United States. Lanning has been a surgical volunteer with the group for several years.

About a half-dozen separation surgeries are done in the U.S. annually, and maybe double that number worldwide.

Conjoined twins account for between 1 in 50,000 and 1 in 100,000 live births worldwide. The condition is three times more likely to occur among females than males. A third of conjoined twins are attached at the lower chest, as in the case of the Tapia twins.

___

Online:

Children's Hospital of Richmond at VCU: http://www.childrenshosp-richmond.org/CMS/index.php

World Pediatric Project: http://www.worldpediatricproject.org/

___

Zinie Chen Sampson can be reached on Twitter at http://www.twitter.com/zinie

Associated Press

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Sabtu, 29 Oktober 2011

Hospital patients 'still at risk'

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27 October 2011 Last updated at 18:45 GMT Patients at Romford's Queen's Hospital "remain at risk"

Patients are still at risk at an east London hospital, according to a health watchdog report after the deaths of two pregnant women.

The Care Quality Commission (CQC) review began in June after the deaths of Tebussum Ali and Violet Stephens at Queen's Hospital in Romford.

Mrs Stephens died in April and Ms Ali and her baby died in January.

The Barking, Havering and Redbridge University Hospitals NHS Trust said it would improve.

The CQC report identified "serious problems" and placed requirements on the trust to deliver "fundamental and wide-ranging improvements".

Midwives suspended

The report said: "Despite some signs of improvement in recent months, patients remain at risk of poor care in this trust.

"While the most immediate concerns were around maternity services, failings were also identified in emergency care and in radiology.

Continue reading the main story Verbally abusive and unprofessional behaviour by some staff to patientsLack of leadership from senior managementVacancies repeatedly filled by agency staff, reducing quality of care"Widespread improvement is needed in patient flows, the management of complaints, staff recruitment and governance in order to improve patient experience."

An independent report found in the case of Mrs Stephens, who was admitted with potentially life-threatening pre-eclampsia, there was a failure to give a blood transfusion and a delay in making the decision to deliver her baby.

In the case of Ms Ali, who was also known as Sareena, the report found staff had failed to spot signs of her ruptured womb and tried to resuscitate her with a disconnected oxygen mask.

Tebussum Ali, also known as Sareena Ali Tebussum Ali and her baby died in January

Health Secretary Andrew Lansley said the standard of care provided by the trust must improve substantially.

"We should be prepared to shine a spotlight on problems where they exist, because poor performance is not just a statistic or a line on a graph.

"It means patients being let down, or hurt, or worse."

The CQC inquiry found the most significant problems were at Queen's Hospital, although elements of poor care were present across both of the trust's main sites.

However the CQC said leadership of the trust was improving due to the efforts of a new chief executive and medical director.

Speaking after the publication of the report, the trust's chief executive Averil Dongworth said: "We are taking the findings of this report extremely seriously and have already started work to implement its recommendations.

"We recognise that there have been failures in the past, but we are determined to continue to improve until we are among the best trusts in the country."

She said seven members of staff had already or were in the process of being disciplined and there were more to follow.

The trust also said it had recruited an extra 72 midwives this year and had improved staff support and training.

Lawyer Sarah Harman, who is taking legal proceedings on behalf of 20 maternity patients of Queen's Hospital, said: "For patients to receive a reasonable standard of care there needs to be a significant change in the staff culture.

"Patients' concerns should be listened to and their complaints acted on.

"Had this happened in the past, the tragedies in the maternity unit this year would have been avoided."

Director of nursing Deborah Wheeler said the trust was unable to comment on the legal action.

The government has said plans to move maternity and emergency services to Queen's Hospital from King George Hospital in Ilford can go ahead, as long as ministers are satisfied that services are safe.



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Hospital 'sorry' about revivals

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27 October 2011 Last updated at 05:03 GMT York hospital The hospital's own guidelines say do not attempt resuscitation forms should be updated regularly York Hospital has been criticised for not asking relatives of some patients if they should be resuscitated.

The Care Quality Commission (CQC) said York Teaching Hospital NHS Trust had failed to meet its own guidelines.

It said Do Not Attempt Resuscitation (DNAR) forms should be updated regularly, with relatives' views taken into account.

The trust said it was "sorry" if any distress had been caused and it would "listen" to the CQC's recommendations.

Inspectors visited the York Hospital, St Helen's Rehabilitation Hospital and White Cross Court Rehabilitation Hospital in July 2011.

'Difficult topic'

They found that DNAR forms at York Hospital and St Helen's were not being completed correctly.

The documents were also not being reviewed as required by the hospital's own guidelines.

This meant that some patients may have had an instruction in place which was out of date, incorrect or no longer in their best interests, inspectors said.

Jo Dent, regional director of CQC for Yorkshire and Humber, said: "We found DNAR forms which had been completed by a doctor but that there was no evidence to say that patients had been involved in the decision, or evidence that relatives, even where they were taking an active role in the patient's progress, had been consulted."

She added: "Doctors we spoke to agreed it was best practice to discuss these decisions with the family or next-of-kin and the patient themselves, where possible.

"But one doctor also told us that it was a difficult topic to raise with relatives and patients and that these decisions were often made when relatives were not around."

'Best interests'

Patrick Crowley, chief executive at York Teaching Hospital NHS Foundation Trust said the trust was "disappointed to be found wanting in any area".

He said everyone within the organisation recognised the "importance and sensitivity" of discussions with patients and their families regarding DNAR decisions.

"We are aware of individual cases where patients and relatives have understandably found this difficult and we are sorry if this has caused any undue distress," he said.

"We want to listen to this feedback to help us develop our processes and ensure we demonstrate that we are acting in patients' best interests."

Mr Crowley added that a new system was introduced not long before the CQC's visit, and that the trust was continuing to roll that out across the organisation.

However, he added that while the CQC found "a small number" of concerns, the reports also highlighted "many examples" of good practice.

CQC has given the trust 28 days to provide a report that says what action they are going to take to address the problem.



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Kamis, 06 Oktober 2011

Patient data lost from hospital

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5 October 2011 Last updated at 06:13 GMT A hospital has admitted losing a memory stick containing the confidential medical details of 800 patients.

The unencrypted device went missing from the East Surrey Hospital, run by Surrey and Sussex Healthcare NHS Trust, in 2010 and has never been found.

Details of patients names and operations were on the stick.

The Redhill hospital has been warned by the Information Commissioner's Office (ICO) that any repeat of the action may result in formal regulatory action.

The loss, in September 2010, came to light in the NHS trust's annual report.

Michael Wilson, chief executive of the trust, said there had been no reports of the stick being found by a third party.

He said when the stick was lost it was the trust's policy that all staff should use encrypted memory sticks when transferring patient data.

Further training

"It is regrettable that this didn't happen on this occasion and since then we have put in place new measures that mean that now only encrypted memory sticks can be used with trust computers," he said.

He added the trust had contacted the ICO itself to receive advice shortly after the memory stick was lost.

A spokesman for the ICO said the hospital had subsequently been warned that the trust's policy covering personal data must be followed.

"The trust was also warned that any repetition of such an incident may result in formal regulatory action," he said.

According to the trust, the member of staff who lost the stick has been taken through disciplinary procedures and has received further training.



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Minggu, 02 Oktober 2011

Hospital maternity deaths apology

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29 September 2011 Last updated at 12:14 GMT Tebussum Ali, also known as Sareena Ali Sareena Ali and her baby died in January A hospital trust boss has apologised for failings in the care given to two maternity patients who died.

An external review into Violet Stephens' death at Queen's Hospital in Romford, east London, in April revealed a succession of failures in her care.

Trust chief executive Averil Dongworth said Ms Stephens and Tebussum Ali, who died in January, did not receive the care they were entitled to.

The trust is facing legal action by 12 women and families over maternity care.

According to the independent report, Ms Stephens was admitted with pre-eclampsia, a potentially life-threatening condition in pregnant women.

It found there was a failure to administer a blood transfusion as planned and a delay in making the decision to deliver her baby.

It also revealed that when she was found unresponsive with gasping breath it took 25 minutes for a cardiac arrest call to be made.

Ruptured womb

The report, commissioned by the Barking, Havering and Redbridge University Hospitals NHS Trust, also examined the death of Tebussum Ali, known as Sareena, who died along with her newborn baby.

Staff had failed to spot signs of her ruptured womb and tried to resuscitate her with a disconnected oxygen mask.

The trust's chief executive said: "Our hospitals deliver nearly 10,000 babies each year and it is our highest priority to ensure each woman receives the highest standard of care.

"I am so sorry that both Violet Stephens and Sareena Ali did not receive the standard of care they were entitled to expect.

"I am determined to address problems we identified in their care so that other women can be confident about our maternity service in the future."

In order to improve its maternity service she said they had recruited an extra 72 midwives this year and improved staff support and training.

It is understood 12 women or their families are taking legal action against the trust.

A review of maternity services at the hospital by the Care Quality Commission is due to report back in the next few weeks.



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Peliculas Online

Rabu, 28 September 2011

My unexpected trip to a Libyan hospital

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24 September 2011 Last updated at 13:12 GMT Doctors in a Libyan hospital It was a strange night.

I was woken by two Filipina women in starched nurses' uniforms at the foot of my bed. One was holding a razor.

A little later the lights blinked on again.

A Ukrainian nurse was now gripping a large syringe.

"What are you doing?" I asked.

She shrugged. "This is not your concern."

Let me rewind a little.

A day earlier, I was on the edge of the Libyan desert, outside a town called Bani Walid.

Rebel fighters were racing past in their usual, chaotic manner.

They had been trying to storm the town for days. But Col Gaddafi's forces have bigger guns and better discipline.

Journalists kept edging forwards a kilometre or two, then tearing back after coming under mortar, rocket or sniper fire.

Anti-Gadafi forces heading towards Bani Walid (photo 19 September 2011) Anti-Gaddafi forces are still facing strong opposition in Bani Walid

It had been the same pattern for a week.

Abruptly, we heard news that a BBC colleague - the brave Lebanese journalist Mohammad Ballout, had been shot just ahead of us.

A single sniper's bullet had killed one man, injured another, and finally come to a stop in Mohammed's chest.

It was serious. But not life-threatening. He has had surgery now and is doing well.

At the time - as dusk fell and we pulled back towards Tripoli - it seemed at best inappropriate to make too much of the stomach pains that had been bothering me for a couple of days and preventing me from eating.

Still, the next morning I was feeling worse and - with the looming prospect of a few nights camped in the desert - I decided to find some antibiotics at a local clinic to sort me out.

Wartime spirit

We were recommended a hospital linked to the National Oil Corporation, in a suburb of the capital.

There were armed guards outside, a noisy crowd in the reception. But down the corridors beyond, I had my first glimpse into a different Libya.

From Our Own Correspondent is on Thursdays at 1100 BST and Saturdays at 1130 BST on BBC Radio 4 and weekdays on BBC World Service

It was a place of wealth, and order, and lots of foreigners.

There were Russian surgeons. A chatty Macedonian nurse. Dozens of Filipinos, and a formidable Scottish matron.

In English, even the Libyans had a broad range of accents.

"I studied in Cardiff," explained the first doctor to have a look at me, as he gently suggested that my guts were not the problem.

All the foreigners seemed to have been in Libya for years.

"Sixteen now," said Maria, the Macedonian.

The pay was good. The well-funded hospital served oil workers rich and poor. Expat life was cloistered but enjoyable.

Of course all that changed when the fighting began.

During the battle for Tripoli last month, the casualties were crowded onto every inch of floor.

I surrendered, and stared at the ceiling as the surgical masks loomed over me”

End Quote

The neighbourhood itself came under heavy fire as Col Gaddafi's loyalists withdrew from the city.

"It was terrible," said Maria. "I can show you the bullet holes upstairs."

But all the staff stayed on and by the time I arrived, a month later, a wartime spirit of camaraderie, generosity and optimism still filled the hospital.

I, on the other hand, was feeling trapped and defensive.

The doctors, absurdly I thought, seemed to think it was my appendix. They wanted to operate fast.

I clung to the belief that I must have eaten some dodgy seafood and just needed a few pills.

But the evidence was building solidly against me, and by the next morning I could see that my obstinacy was being interpreted as a lack of faith in their hospital and judgement.

And so, I surrendered, and stared at the ceiling as the surgical masks loomed over me.

I think I remember a Russian anaesthetist, trying to get me to sing along with him. Then the words and the room turned to glue and vanished.

Surgery souvenir

A man called Salahaddin woke me late that evening.

He was on crutches, and had limped in from the next room for a chat.

Salahaddin was 28 years old, a doctor, and a patient.

He had been in the desert outside Bani Walid too. He was in charge of an ambulance crew bringing out the wounded.

A week earlier, he said, his vehicle had been hit by gunfire - a bullet went through his back and out of his leg, shattering his pelvis on the way.

Salahaddin kept smiling, and my grogginess started to feel like bad manners.

During the rebellion, he said, he had treated Col Gaddafi's soldiers during the day at a clinic in central Tripoli, and then slipped out at night to help rebel casualties in the city.

"Now, it is all changed," he grinned. "It is nearly over."

He turned and inched slowly back to his room.

The next morning, the Libyan surgeon walked in with a "told you so" smile. He was brandishing my badly swollen appendix in a plastic jar.

Nurse Maria explained that Libyans like to take home any missing bits to show their relatives and to prove they had not been malingering.

I left mine behind.

How to listen to From Our Own Correspondent:

BBC Radio 4:

A 30-minute programme on Saturdays, 1130.

Second 30-minute programme on Thursdays, 1100 (some weeks only).

Listen online or download the podcast

BBC World Service:

Hear daily 10-minute editions Monday to Friday, repeated through the day, also available to listen online.

Read more or explore the archive at the programme website.



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Peliculas Online

Libyan boy's London hospital op

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23 September 2011 Last updated at 16:54 GMT Fifteen-year-old Abdul Malek El Hamdi A Libyan child injured in the fighting in his home country has been flown to a London hospital for medical treatment.

Fifteen-year-old Abdul Malek El Hamdi was evacuated from Tripoli and brought to St Mary's Hospital on Thursday.

He suffered severe lower limb injuries and infected wounds when a grenade exploded at his school.

Doctors operated immediately to remove the shrapnel and are hopeful that they have saved his leg, but he may need more surgery.

The teenager is the first of up to 50 injured patients the Libyan government has asked the NHS to care for.

The treatment and rehabilitation that Abdul needed is not currently available in his native Tripoli.

On arrival Abdul had a full assessment by the A&E and trauma team at St Mary's Hospital.

Walk again

X-rays revealed Abdul's left leg was littered with fragments of the grenade, large pieces of which were embedded in his foot.

The surgical team decided to operate to remove the shrapnel and stem the spread of infection.

Mr Shehan Hettiaratchy, clinical lead for plastic and reconstructive surgeon, said: "Abdul suffered severe and life-changing injuries to his left leg. His wounds are infected and could have stopped him from walking again.

"We are delighted to be able to continue Abdul's treatment at St Mary's, and hopeful that we've saved his leg.

"Ultimately we want to give him the treatment he can't currently get at home so he'll be able to live a full and normal life again."

Abdul is currently being looked after on a children's ward.

St Mary's is one of London's four major trauma centres. Many of the surgeons have direct experience of dealing with bomb blast injuries, having worked directly in war zones and areas of natural disaster like Afghanistan and Haiti.

The cost of Abdul's care is being funded by the Libyan authorities.



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Peliculas Online

Selasa, 27 September 2011

AP IMPACT: Hospital drug shortages deadly, costly

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In this Aug. 29, 2011 photo, Erin Fox, manager of the Drug Information Service at the University of Utah Hospital in Salt Lake City, stands by a board listing drugs in short supply. At hospitals across the country, "scoring drugs" has taken on a new meaning. Hundreds admit buying medicines at exorbitant prices from "gray market" dealers taking advantage of, and possibly exacerbating, a record shortage of life-saving prescription medicines. (AP Photo/Jim Urquhart) In this Aug. 29, 2011 photo, Erin Fox, manager of the Drug Information Service at the University of Utah Hospital in Salt Lake City, stands by a board listing drugs in short supply. At hospitals across the country, "scoring drugs" has taken on a new meaning. Hundreds admit buying medicines at exorbitant prices from "gray market" dealers taking advantage of, and possibly exacerbating, a record shortage of life-saving prescription medicines. (AP Photo/Jim Urquhart) This Aug. 29, 2011 photo, shows a board listing drugs in short supply at the University of Utah Hospital, in Salt Lake City. At hospitals across the country, "scoring drugs" has taken on a new meaning. Hundreds admit buying medicines at exorbitant prices from "gray market" dealers taking advantage of, and possibly exacerbating, a record shortage of life-saving prescription medicines.(AP Photo/Jim Urquhart) In this Aug. 29, 2011 photo, Kelsey Olsen, a pharmacy buyer at the University of Utah Hospital in Salt Lake City, holds a tray of Magnesium Sulfate, a drug in short supply. At hospitals across the country, "scoring drugs" has taken on a new meaning. Hundreds admit buying medicines at exorbitant prices from "gray market" dealers taking advantage of, and possibly exacerbating, a record shortage of life-saving prescription medicines. (AP Photo/Jim Urquhart) Chart shows the annual number of new drug shortageseval("var currentItemd57851005a80479aaeeb90a12c70b9ff = 1;");eval("var nextd57851005a80479aaeeb90a12c70b9ff = 0;");eval("var previousd57851005a80479aaeeb90a12c70b9ff = 0;"); TRENTON, N.J. (AP) — A drug for dangerously high blood pressure, normally priced at $25.90 per dose, offered to hospitals for $1,200. Fifteen deaths in 15 months blamed on shortages of life-saving medications.

A growing crisis in the availability of drugs for chemotherapy, infections and other serious ailments is endangering patients and forcing hospitals to buy from secondary suppliers at huge markups because they can't get the medications any other way.

An Associated Press review of industry reports and interviews with nearly two dozen experts found the shortages — mainly of injected generic drugs that ordinarily are cheap — have delayed surgeries and cancer treatments, left patients in unnecessary pain and caused hospitals to give less effective treatments. That's resulted in complications and longer hospital stays.

Just over half of the 549 U.S. hospitals responding to a survey this summer by the Institute for Safe Medication Practices, a patient safety group, said they had purchased one or more prescription drugs from so-called "gray market vendors" — companies other than their normal wholesalers.

Most also said they've had to do so more often of late, and 7 percent reported side effects or other problems with those drugs.

Hospital pharmacists "are really looking at this as a crisis. They are scrambling to find drugs," said Joseph Hill of the American Society of Health-System Pharmacists.

At a hearing Friday before the health subcommittee of the House Energy and Commerce Committee, hospital officials and other experts testified that the worsening shortages are preventing them from giving many patients the best care and are driving up costs.

"Considering the nation's budget crisis and our skyrocketing health care bill, these markups are nothing more than profiteering at the expense of patients and providers who are struggling to afford vital medicines," said Mike Alkire, chief operating officer of Premier Healthcare Alliance, a group that helps U.S. hospitals and other health providers improve their patient care and finances.

The shortages could cost hospitals at least $415 million a year, he said, citing data from health care providers across the nation. So far, hospitals have been absorbing the extra costs, but they'll soon have to start passing them on to insurers and patients, according to the American Hospital Association.

The scarcity of mainstay cancer drugs is not only hurting patients but is halting or disrupting clinical studies of potential new treatments, said Dr. Robert S. DiPaola, director of the Cancer Institute of New Jersey.

"The drug shortages of today can have a ripple effect on the availability of new drugs and treatment combinations tomorrow," he told the committee.

On Monday, the Food and Drug Administration is holding a meeting with medical and consumer groups, researchers and industry representatives to discuss the shortages and strategies to fight them.

The FDA says the primary cause of the shortages is production shutdowns because of manufacturing problems, such as contamination and metal particles that get into medicine.

Other reasons include theft of prescription drugs from warehouses or during shipment, as well as the "gray market" vendors who buy scarce drugs from small regional wholesalers, pharmacies or other sources and then sell them to hospitals at many times the normal price. These sellers may not be licensed, authorized distributors.

In addition, many companies have stopped making generic injected drugs because the profit margins are slim. Producing them is far more expensive than stamping out pills, and it takes about three weeks to produce a batch. Making things worse, companies don't have to notify customers or the FDA that they've stopped making a medicine. That means neither FDA nor competitors can fill the gap in time.

Only a half-dozen companies make the vast majority of injected generics. Even if other companies wanted to begin making a drug in short supply, they're discouraged by the lengthy, expensive process of setting up new manufacturing lines and getting FDA approval.

Hospitals that buy scarce medicines from the "gray market" are taking a gamble.

The drugs may be stolen and hospitals can't always tell whether a medicine was properly refrigerated — as required for many injectable drugs — or whether it's past the expiration date, said Michael R. Cohen, a pharmacist and president of the institute. The active ingredient might have degraded and the drug might not work well or could even harm the patient, he said.

Cohen attributes at least 15 recent deaths to drug shortages, either because the right drug wasn't available or because of dosing errors or other problems in administering or preparing alternative medications. But many deaths and injuries go unreported, he said.

In the worst known case, Alabama's public health department this spring reported nine deaths and 10 patients harmed due to bacterial contamination of a hand-mixed batch of liquid nutrition given via feeding tubes because the sterile pre-mixed liquid wasn't available.

So far this year, 210 drugs have been added to the list of those in short supply, one less than the total for all of last year, according to the University of Utah Drug Information Service, which tracks the shortages. That's triple the roughly 70 a year from 2003 to 2006, when shortages began to climb steadily.

"The shortages aren't resolving. They're piling up on top of existing ones," said Erin Fox, a pharmacist who manages the service. She said at least 55 drugs from shortages before this year are still unavailable or scarce.

The average price markup on drugs sold by secondary distributors was 650 percent, according to an Aug. 16 report by the Premier Healthcare Alliance. The figure is based on an analysis of 636 unsolicited sales offers that were faxed and emailed to hospitals from secondary distributors in April and May.

Virtually every offer was for at least double the normal price, the survey found. The drugs with the highest markups were for critically ill patients needing anesthesia or other medicines for surgery or for emergency care, cancer, infectious diseases and pain management.

In an extreme case, one vendor was offering a generic beta blocker for dangerously high blood pressure, normally priced at $25.90 per dose, for $1,200.

The FDA says it must uphold quality standards but also works hard to prevent shortages.

"When FDA detects a contaminant, whether it be shards of glass or metal particles or an infectious agent, we have to take action to protect the public," said Dr. Peter Lurie, a senior adviser in the FDA commissioner's office.

When such problems force a company to shut down production, the FDA urges other manufacturers to boost their output and expedites any approvals needed, said Valerie Jensen, associate director of the agency's drug shortage program. When raw materials used to make drugs are in short supply, the FDA tries to find new sources.

The agency averted 38 shortages last year, Jensen added. Another 99 have been prevented so far this year, Howard K. Koh, assistant secretary for health in the Department of Health and Human Services, told the committee.

Legislation pending in the House and Senate would increase penalties for drug thefts from warehouses and tractor-trailers. Another proposal, which has bipartisan support, would require drug manufacturers anticipating a shortage to immediately notify the FDA.

The pitches hospitals get from secondary distributors generally say they have small batches of specific drugs that are hard or impossible to find. "Are you enjoying this crazy 'roller coaster ride' of pharmaceutical shortages? ... I utilize over 60 vendors to locate and procure needed pharmaceuticals to assist when you have shortage needs," one reads.

Several distributors who sent hospitals solicitations for scarce drugs didn't return calls from the AP. One representative said he wasn't authorized to discuss the issue.

Another company, Novis Pharmaceuticals, defended the higher prices, saying secondary distributors have to charge far more because they don't get the big rebates manufacturers give primary distributors. They also have high costs to locate and transport batches of scarce drugs, although the company, which mainly distributes blood plasma, would not disclose its profit margin.

It's illegal for companies to collude to create a medicine shortage and raise prices, and there's no evidence of that. There's no federal law against price-gouging on prescription drugs, according to the FDA, but it does urge pharmacists to report cases to its Office of Criminal Investigation. An agency spokeswoman said she could not discuss whether any cases are being investigated.

The top three wholesalers say they try to alleviate problems by working with drug manufacturers, updating hospitals on shortages and rationing scarce supplies by giving their regular hospital customers a portion of their normal order. McKesson Corp. and Cardinal Health Inc. say they halt sales to any smaller distributors found to be diverting drugs or otherwise breaking rules. AmerisourceBergen Corp. does background checks on customers.

The hospital association and other groups urge hospitals not to buy from unaccredited vendors, to insist on documentation of the drug's source if they must, and to report price gouging to state authorities. But only three states — Kentucky, Maine and Texas — have price-gouging laws that specifically cover medicines.

"Something has to be done here," said pharmacist Michael O'Neal, head of drug procurement for Vanderbilt University Medical Center in Nashville, which has had to purchase medicines from secondary suppliers about 70 times over the past two years.

"This is unethical," he said. "We're talking about people's lives."

___

Summary of state price-gouging laws: http://www.ncsl.org/default.aspx?tabid=14434

Institute for Safe Medication Practices consumer site: http://www.consumermedsafety.org/

Associated Press

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Peliculas Online

Senin, 26 September 2011

My unexpected trip to a Libyan hospital

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24 September 2011 Last updated at 13:12 GMT Doctors in a Libyan hospital It was a strange night.

I was woken by two Filipina women in starched nurses' uniforms at the foot of my bed. One was holding a razor.

A little later the lights blinked on again.

A Ukrainian nurse was now gripping a large syringe.

"What are you doing?" I asked.

She shrugged. "This is not your concern."

Let me rewind a little.

A day earlier, I was on the edge of the Libyan desert, outside a town called Bani Walid.

Rebel fighters were racing past in their usual, chaotic manner.

They had been trying to storm the town for days. But Col Gaddafi's forces have bigger guns and better discipline.

Journalists kept edging forwards a kilometre or two, then tearing back after coming under mortar, rocket or sniper fire.

Anti-Gadafi forces heading towards Bani Walid (photo 19 September 2011) Anti-Gaddafi forces are still facing strong opposition in Bani Walid

It had been the same pattern for a week.

Abruptly, we heard news that a BBC colleague - the brave Lebanese journalist Mohammad Ballout, had been shot just ahead of us.

A single sniper's bullet had killed one man, injured another, and finally come to a stop in Mohammed's chest.

It was serious. But not life-threatening. He has had surgery now and is doing well.

At the time - as dusk fell and we pulled back towards Tripoli - it seemed at best inappropriate to make too much of the stomach pains that had been bothering me for a couple of days and preventing me from eating.

Still, the next morning I was feeling worse and - with the looming prospect of a few nights camped in the desert - I decided to find some antibiotics at a local clinic to sort me out.

Wartime spirit

We were recommended a hospital linked to the National Oil Corporation, in a suburb of the capital.

There were armed guards outside, a noisy crowd in the reception. But down the corridors beyond, I had my first glimpse into a different Libya.

From Our Own Correspondent is on Thursdays at 1100 BST and Saturdays at 1130 BST on BBC Radio 4 and weekdays on BBC World Service

It was a place of wealth, and order, and lots of foreigners.

There were Russian surgeons. A chatty Macedonian nurse. Dozens of Filipinos, and a formidable Scottish matron.

In English, even the Libyans had a broad range of accents.

"I studied in Cardiff," explained the first doctor to have a look at me, as he gently suggested that my guts were not the problem.

All the foreigners seemed to have been in Libya for years.

"Sixteen now," said Maria, the Macedonian.

The pay was good. The well-funded hospital served oil workers rich and poor. Expat life was cloistered but enjoyable.

Of course all that changed when the fighting began.

During the battle for Tripoli last month, the casualties were crowded onto every inch of floor.

I surrendered, and stared at the ceiling as the surgical masks loomed over me”

End Quote

The neighbourhood itself came under heavy fire as Col Gaddafi's loyalists withdrew from the city.

"It was terrible," said Maria. "I can show you the bullet holes upstairs."

But all the staff stayed on and by the time I arrived, a month later, a wartime spirit of camaraderie, generosity and optimism still filled the hospital.

I, on the other hand, was feeling trapped and defensive.

The doctors, absurdly I thought, seemed to think it was my appendix. They wanted to operate fast.

I clung to the belief that I must have eaten some dodgy seafood and just needed a few pills.

But the evidence was building solidly against me, and by the next morning I could see that my obstinacy was being interpreted as a lack of faith in their hospital and judgement.

And so, I surrendered, and stared at the ceiling as the surgical masks loomed over me.

I think I remember a Russian anaesthetist, trying to get me to sing along with him. Then the words and the room turned to glue and vanished.

Surgery souvenir

A man called Salahaddin woke me late that evening.

He was on crutches, and had limped in from the next room for a chat.

Salahaddin was 28 years old, a doctor, and a patient.

He had been in the desert outside Bani Walid too. He was in charge of an ambulance crew bringing out the wounded.

A week earlier, he said, his vehicle had been hit by gunfire - a bullet went through his back and out of his leg, shattering his pelvis on the way.

Salahaddin kept smiling, and my grogginess started to feel like bad manners.

During the rebellion, he said, he had treated Col Gaddafi's soldiers during the day at a clinic in central Tripoli, and then slipped out at night to help rebel casualties in the city.

"Now, it is all changed," he grinned. "It is nearly over."

He turned and inched slowly back to his room.

The next morning, the Libyan surgeon walked in with a "told you so" smile. He was brandishing my badly swollen appendix in a plastic jar.

Nurse Maria explained that Libyans like to take home any missing bits to show their relatives and to prove they had not been malingering.

I left mine behind.

How to listen to From Our Own Correspondent:

BBC Radio 4:

A 30-minute programme on Saturdays, 1130.

Second 30-minute programme on Thursdays, 1100 (some weeks only).

Listen online or download the podcast

BBC World Service:

Hear daily 10-minute editions Monday to Friday, repeated through the day, also available to listen online.

Read more or explore the archive at the programme website.



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Peliculas Online

Bacteria Show Up in Hospital Rooms, Again

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Silverstock / Getty Images

We get it — hospitals are crawling with germs. If it's not your cell phone, the doctor's coat or even the hands-free water faucet, then it's the privacy curtain around the bed that's tainted with unwanted bacteria.

Researchers from the University of Iowa presented data at a scientific conference in Chicago this week showing that they had found disease-causing bugs, including drug-resistant varieties like MRSA (methicillin-resistant Staphylococcus aureus) and VRE (vancomycin-resistant enterococcus), on 95% of hospital room privacy curtains tested. Brand new curtains were contaminated within a week, the researchers said.

The team tested 43 curtains in 30 hospital rooms twice a week for three weeks, taking 180 swab cultures total. They found:

12 of 13 new curtains were contaminated within 7 days41 of 43 curtains were contaminated on at least one occasionMRSA was found on 21% of curtainsVRE was found on 42% of curtains

One of the authors of the study received consulting fees from PurThread Technologies, a company that makes antimicrobial fabrics for hospitals — including, hey, privacy curtains.

Luckily, there's an easier and cheaper way for doctors to prevent the spread of disease-causing bacteria from curtains (or anywhere) to patients: by washing their hands.



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Peliculas Online

Routine Rotavirus Vaccination Keeps Kids Out of the Hospital

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Savings in health care costs since the 2006 introduction of routine vaccination against rotavirus, a leading cause of diarrhea in infants and young children. A new study from the Centers for Disease Control and Prevention shows that nearly 65,000 fewer American children have been hospitalized since routine vaccination was instituted. Compared with unvaccinated children, those who received the rotavirus vaccine had 89% fewer rotavirus-specific hospitalizations, 48% fewer ER visits and 12% fewer visits to the doctor's office. Before the vaccine was introduced, the virus was responsible for about 200,000 ER visits and 400,000 physician office visits a year. [via USA Today]



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Peliculas Online

Hospital 'risk' over NHS mortgage

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22 September 2011 Last updated at 10:05 GMT By Nick Triggle Health correspondent, BBC News Hospital PFIs use private money for building projects Paying off the "NHS mortgage" is putting so much pressure on the system in England that the future of some hospitals is at risk, ministers say.

The government said 22 trusts - running 60 units - are facing difficulties because of the cost of paying for privately-funded building projects.

The group represents nearly a fifth of the 100-plus PFI schemes in the NHS.

Problems are being encountered because, for some trusts, repayments account for up to a fifth of their budget.

PFI is a way of funding building projects using private money. It was originally introduced by the Tories under John Major, but the use of the scheme was largely expanded into the NHS by Labour.

Under the schemes set up in the health service, private firms pay to build hospitals, leaving the NHS to pay an annual fee or "mortgage" over 30 years or so.

Department of Health figures show yearly bills are forecast to rise by 75% to more than £2.5bn in the next 18 years, because of inflation and the way the deals are structured.

It means once the last scheme signed off by Labour is paid in full - in 2049 - more than £70bn will have been handed over.

Continue reading the main story

On the face of it, annual PFI repayments of £1.57bn out of a £100bn-plus budget for the NHS may not seem too bad.

But when you look at the accounts of individual trusts, the figures are more dramatic.

For some the "mortgage" is accounting for between 10% and 20% of their turnover.

Faced with the prospect of several years of tight finances and rising PFI repayments, it is understandable why some parts of the NHS are worried.

However, in practice the pain may be felt elsewhere in the health service.

PFI deals are notoriously difficult to get out of and so in some places the response has been to channel patients away from non-PFI hospitals to PFI sites.

Services at those non-PFI sites then have to be scaled back. For those trusts that will seem unfair.

That figure also includes, in some cases, fees for services such as building maintenance, cleaning, catering and portering.

But even taking those services into account the sum far exceeds the value of the building projects, which stands at a combined £11.4bn.

Health Secretary Andrew Lansley said: "The truth is that some hospitals have been landed with PFI deals they simply cannot afford.

"Like the economy, Labour has brought some parts of the NHS to the brink of financial collapse."

But a Labour Party spokesman defended the deals, saying investment was needed "to replace the crumbling and unsafe buildings left behind after years of Tory neglect".

Health analysts have also said conventional hospital building projects could take decades to complete.

The Department of Health has said it will set out more details about its plans to resolve the problem later this year.

But sources close to Mr Lansley said if a solution was not found, money would have to be taken from elsewhere in the health service to "prop up" PFI hospitals.

Renegotiation

There is a belief within some government circles that repayments could be reduced.

Professor John Appleby, chief economist at the King's Fund think-tank, believes renegotiation of the deals should be tried.

But he warned the NHS was not in a strong position because lenders feel confident the treasury will bail out trusts that get into financial difficulty.

"When these deals were negotiated there was more money flowing through the system and the NHS was probably a bit too optimistic about the future," he said.

Continue reading the main story There are currently 103 PFI dealsThe combined value of the projects is £11.4bnThe NHS will pay back more than £70bn on current projectionsBut that figure includes, in some cases, services such as building maintenance, cleaning and cateringFor some of the larger schemes the services costs can account for half of the PFI feesThe annual bill is due to keep rising year-on-year for the next 18 yearsAfter that contracts start coming to an end although the final payment will not be made until 2049"Money is getting tighter now and there is a drive to keep patients out of hospital. It is causing problems."

Some trusts named by the Department of Health rejected the suggestion their future was at risk, while others argued if NHS funding kept pace with inflation they could meet the repayments.

Concern was also expressed that the reorganisation of the health service was complicating matters.

David Stout, of the NHS Confederation, which represents health managers, said: "We do need to look at how we remunerate hospitals for their care, and if a hospital has high costs the government I think is right, and we would support this, the government does need to look at how we ensure they get the right amount of money to run that care.

"We don't want the care to be closed simply because of the cost of PFI, that would be foolish."

The 22 NHS trusts that the government believes are at risk because of PFI are: St Helens and Knowsley; South London Healthcare; University Hospitals Coventry and Warwickshire; Wye Valley; Barking, Havering and Redbridge; Worcester; Oxford Radcliffe/Nuffield Orthopaedic Centre; Barts and the London; University Hospitals of North Staffordshire; Dartford and Gravesham; North Cumbria; Portsmouth; Buckinghamshire; West Middlesex; Mid Yorkshire; Walsall; North Middlesex; North Bristol; Mid Essex; Maidstone and Tunbridge Wells; Sandwell and West Birmingham; (not yet fully signed off) and the Royal National Orthopaedic Hospital (not yet fully signed off).

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Peliculas Online

Minggu, 25 September 2011

Libyan boy's London hospital op

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23 September 2011 Last updated at 16:54 GMT Fifteen-year-old Abdul Malek El Hamdi A Libyan child injured in the fighting in his home country has been flown to a London hospital for medical treatment.

Fifteen-year-old Abdul Malek El Hamdi was evacuated from Tripoli and brought to St Mary's Hospital on Thursday.

He was suffering from severe lower limb injuries and infected wounds when a grenade exploded at his school.

Doctors operated immediately to remove the shrapnel and are hopeful that they have saved his leg, but he may need more surgery.

The teenager is the first of up to fifty injured patients who the Libyan government has asked the NHS to provide care for.

The treatment and rehabilitation that Abdul needed is not currently available in his native Tripoli.

On arrival Abdul had a full assessment by the A&E and trauma team at St Mary's Hospital.

Walk again

X-rays revealed Abdul's left leg was littered with fragments of the grenade, large pieces of which were embedded in his foot.

The surgical team decided to operate to remove the shrapnel and stem the spread of infection.

Mr Shehan Hettiaratchy, clinical lead for plastic and reconstructive surgeon, said: "Abdul suffered severe and life-changing injuries to his left leg. His wounds are infected and could have stopped him from walking again.

"We are delighted to be able to continue Abdul's treatment at St Mary's, and hopeful that we've saved his leg.

"Ultimately we want to give him the treatment he can't currently get at home so he'll be able to live a full and normal life again."

Abdul is currently being looked after on a children's ward.

St Mary's is one of London's four major trauma centres. Many of the surgeons have direct experience of dealing with bomb blast injuries, having worked directly in war zones and areas of natural disaster like Afghanistan and Haiti.

The cost of Abdul's care is being funded by the Libyan authorities.



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Peliculas Online

AP IMPACT: Hospital drug shortages deadly, costly

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AppId is over the quota
In this Aug. 29, 2011 photo, Erin Fox, manager of the Drug Information Service at the University of Utah Hospital in Salt Lake City, stands by a board listing drugs in short supply. At hospitals across the country, "scoring drugs" has taken on a new meaning. Hundreds admit buying medicines at exorbitant prices from "gray market" dealers taking advantage of, and possibly exacerbating, a record shortage of life-saving prescription medicines. (AP Photo/Jim Urquhart) In this Aug. 29, 2011 photo, Erin Fox, manager of the Drug Information Service at the University of Utah Hospital in Salt Lake City, stands by a board listing drugs in short supply. At hospitals across the country, "scoring drugs" has taken on a new meaning. Hundreds admit buying medicines at exorbitant prices from "gray market" dealers taking advantage of, and possibly exacerbating, a record shortage of life-saving prescription medicines. (AP Photo/Jim Urquhart) This Aug. 29, 2011 photo, shows a board listing drugs in short supply at the University of Utah Hospital, in Salt Lake City. At hospitals across the country, "scoring drugs" has taken on a new meaning. Hundreds admit buying medicines at exorbitant prices from "gray market" dealers taking advantage of, and possibly exacerbating, a record shortage of life-saving prescription medicines.(AP Photo/Jim Urquhart) In this Aug. 29, 2011 photo, Kelsey Olsen, a pharmacy buyer at the University of Utah Hospital in Salt Lake City, holds a tray of Magnesium Sulfate, a drug in short supply. At hospitals across the country, "scoring drugs" has taken on a new meaning. Hundreds admit buying medicines at exorbitant prices from "gray market" dealers taking advantage of, and possibly exacerbating, a record shortage of life-saving prescription medicines. (AP Photo/Jim Urquhart) Chart shows the annual number of new drug shortageseval("var currentItemd57851005a80479aaeeb90a12c70b9ff = 1;");eval("var nextd57851005a80479aaeeb90a12c70b9ff = 0;");eval("var previousd57851005a80479aaeeb90a12c70b9ff = 0;"); TRENTON, N.J. (AP) — A drug for dangerously high blood pressure, normally priced at $25.90 per dose, offered to hospitals for $1,200. Fifteen deaths in 15 months blamed on shortages of life-saving medications.

A growing crisis in the availability of drugs for chemotherapy, infections and other serious ailments is endangering patients and forcing hospitals to buy from secondary suppliers at huge markups because they can't get the medications any other way.

An Associated Press review of industry reports and interviews with nearly two dozen experts found the shortages — mainly of injected generic drugs that ordinarily are cheap — have delayed surgeries and cancer treatments, left patients in unnecessary pain and caused hospitals to give less effective treatments. That's resulted in complications and longer hospital stays.

Just over half of the 549 U.S. hospitals responding to a survey this summer by the Institute for Safe Medication Practices, a patient safety group, said they had purchased one or more prescription drugs from so-called "gray market vendors" — companies other than their normal wholesalers.

Most also said they've had to do so more often of late, and 7 percent reported side effects or other problems with those drugs.

Hospital pharmacists "are really looking at this as a crisis. They are scrambling to find drugs," said Joseph Hill of the American Society of Health-System Pharmacists.

At a hearing Friday before the health subcommittee of the House Energy and Commerce Committee, hospital officials and other experts testified that the worsening shortages are preventing them from giving many patients the best care and are driving up costs.

"Considering the nation's budget crisis and our skyrocketing health care bill, these markups are nothing more than profiteering at the expense of patients and providers who are struggling to afford vital medicines," said Mike Alkire, chief operating officer of Premier Healthcare Alliance, a group that helps U.S. hospitals and other health providers improve their patient care and finances.

The shortages could cost hospitals at least $415 million a year, he said, citing data from health care providers across the nation. So far, hospitals have been absorbing the extra costs, but they'll soon have to start passing them on to insurers and patients, according to the American Hospital Association.

The scarcity of mainstay cancer drugs is not only hurting patients but is halting or disrupting clinical studies of potential new treatments, said Dr. Robert S. DiPaola, director of the Cancer Institute of New Jersey.

"The drug shortages of today can have a ripple effect on the availability of new drugs and treatment combinations tomorrow," he told the committee.

On Monday, the Food and Drug Administration is holding a meeting with medical and consumer groups, researchers and industry representatives to discuss the shortages and strategies to fight them.

The FDA says the primary cause of the shortages is production shutdowns because of manufacturing problems, such as contamination and metal particles that get into medicine.

Other reasons include theft of prescription drugs from warehouses or during shipment, as well as the "gray market" vendors who buy scarce drugs from small regional wholesalers, pharmacies or other sources and then sell them to hospitals at many times the normal price. These sellers may not be licensed, authorized distributors.

In addition, many companies have stopped making generic injected drugs because the profit margins are slim. Producing them is far more expensive than stamping out pills, and it takes about three weeks to produce a batch. Making things worse, companies don't have to notify customers or the FDA that they've stopped making a medicine. That means neither FDA nor competitors can fill the gap in time.

Only a half-dozen companies make the vast majority of injected generics. Even if other companies wanted to begin making a drug in short supply, they're discouraged by the lengthy, expensive process of setting up new manufacturing lines and getting FDA approval.

Hospitals that buy scarce medicines from the "gray market" are taking a gamble.

The drugs may be stolen and hospitals can't always tell whether a medicine was properly refrigerated — as required for many injectable drugs — or whether it's past the expiration date, said Michael R. Cohen, a pharmacist and president of the institute. The active ingredient might have degraded and the drug might not work well or could even harm the patient, he said.

Cohen attributes at least 15 recent deaths to drug shortages, either because the right drug wasn't available or because of dosing errors or other problems in administering or preparing alternative medications. But many deaths and injuries go unreported, he said.

In the worst known case, Alabama's public health department this spring reported nine deaths and 10 patients harmed due to bacterial contamination of a hand-mixed batch of liquid nutrition given via feeding tubes because the sterile pre-mixed liquid wasn't available.

So far this year, 210 drugs have been added to the list of those in short supply, one less than the total for all of last year, according to the University of Utah Drug Information Service, which tracks the shortages. That's triple the roughly 70 a year from 2003 to 2006, when shortages began to climb steadily.

"The shortages aren't resolving. They're piling up on top of existing ones," said Erin Fox, a pharmacist who manages the service. She said at least 55 drugs from shortages before this year are still unavailable or scarce.

The average price markup on drugs sold by secondary distributors was 650 percent, according to an Aug. 16 report by the Premier Healthcare Alliance. The figure is based on an analysis of 636 unsolicited sales offers that were faxed and emailed to hospitals from secondary distributors in April and May.

Virtually every offer was for at least double the normal price, the survey found. The drugs with the highest markups were for critically ill patients needing anesthesia or other medicines for surgery or for emergency care, cancer, infectious diseases and pain management.

In an extreme case, one vendor was offering a generic beta blocker for dangerously high blood pressure, normally priced at $25.90 per dose, for $1,200.

The FDA says it must uphold quality standards but also works hard to prevent shortages.

"When FDA detects a contaminant, whether it be shards of glass or metal particles or an infectious agent, we have to take action to protect the public," said Dr. Peter Lurie, a senior adviser in the FDA commissioner's office.

When such problems force a company to shut down production, the FDA urges other manufacturers to boost their output and expedites any approvals needed, said Valerie Jensen, associate director of the agency's drug shortage program. When raw materials used to make drugs are in short supply, the FDA tries to find new sources.

The agency averted 38 shortages last year, Jensen added. Another 99 have been prevented so far this year, Howard K. Koh, assistant secretary for health in the Department of Health and Human Services, told the committee.

Legislation pending in the House and Senate would increase penalties for drug thefts from warehouses and tractor-trailers. Another proposal, which has bipartisan support, would require drug manufacturers anticipating a shortage to immediately notify the FDA.

The pitches hospitals get from secondary distributors generally say they have small batches of specific drugs that are hard or impossible to find. "Are you enjoying this crazy 'roller coaster ride' of pharmaceutical shortages? ... I utilize over 60 vendors to locate and procure needed pharmaceuticals to assist when you have shortage needs," one reads.

Several distributors who sent hospitals solicitations for scarce drugs didn't return calls from the AP. One representative said he wasn't authorized to discuss the issue.

Another company, Novis Pharmaceuticals, defended the higher prices, saying secondary distributors have to charge far more because they don't get the big rebates manufacturers give primary distributors. They also have high costs to locate and transport batches of scarce drugs, although the company, which mainly distributes blood plasma, would not disclose its profit margin.

It's illegal for companies to collude to create a medicine shortage and raise prices, and there's no evidence of that. There's no federal law against price-gouging on prescription drugs, according to the FDA, but it does urge pharmacists to report cases to its Office of Criminal Investigation. An agency spokeswoman said she could not discuss whether any cases are being investigated.

The top three wholesalers say they try to alleviate problems by working with drug manufacturers, updating hospitals on shortages and rationing scarce supplies by giving their regular hospital customers a portion of their normal order. McKesson Corp. and Cardinal Health Inc. say they halt sales to any smaller distributors found to be diverting drugs or otherwise breaking rules. AmerisourceBergen Corp. does background checks on customers.

The hospital association and other groups urge hospitals not to buy from unaccredited vendors, to insist on documentation of the drug's source if they must, and to report price gouging to state authorities. But only three states — Kentucky, Maine and Texas — have price-gouging laws that specifically cover medicines.

"Something has to be done here," said pharmacist Michael O'Neal, head of drug procurement for Vanderbilt University Medical Center in Nashville, which has had to purchase medicines from secondary suppliers about 70 times over the past two years.

"This is unethical," he said. "We're talking about people's lives."

___

Summary of state price-gouging laws: http://www.ncsl.org/default.aspx?tabid=14434

Institute for Safe Medication Practices consumer site: http://www.consumermedsafety.org/

Associated Press

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Peliculas Online

Jumat, 23 September 2011

Routine Rotavirus Vaccination Keeps Kids Out of the Hospital

AppId is over the quota
AppId is over the quota

Savings in health care costs since the 2006 introduction of routine vaccination against rotavirus, a leading cause of diarrhea in infants and young children. A new study from the Centers for Disease Control and Prevention shows that nearly 65,000 fewer American children have been hospitalized since routine vaccination was instituted. Compared with unvaccinated children, those who received the rotavirus vaccine had 89% fewer rotavirus-specific hospitalizations, 48% fewer ER visits and 12% fewer visits to the doctor's office. Before the vaccine was introduced, the virus was responsible for about 200,000 ER visits and 400,000 physician office visits a year. [via USA Today]



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Selasa, 20 September 2011

Long hospital waits up by a third

AppId is over the quota
AppId is over the quota
15 September 2011 Last updated at 10:23 GMT By Nick Triggle Health correspondent, BBC News Hospital equipment There is growing pressure on waiting times The number of hospital patients in England waiting over the 18-week guarantee has jumped by a third in the past year, figures show.

Of the 300,000 seen in July, over 28,000 had waited beyond the target - a 34% rise from the same month last year, official statistics showed.

Those who waited over six months rose by 55% to more than 9,000.

But overall the NHS is still hitting its target to see 90% of patients in 18 weeks as 90.6% were.

The 10% leeway is allowed to reflect the fact that some patients may choose to wait longer for valid personal or medical reasons.

However, the rise in the numbers waiting beyond 18 weeks is further proof of the growing pressure on waiting times in the health service.

Pressure

It mirrors similar patterns seen in recent months and means the government's promise to ensure the 18-week standard is kept will be severely tested during the autumn and winter when hospitals tend to get busier.

Some of the longest waits are being seen in the busiest speciality in the NHS. Nearly one in six patients needing orthopaedic treatments, such as knee and hip replacements, waited over 18 weeks in July.

But health minister Simon Burns said the health service was still doing well.

"The vast majority of patients still receive treatment within 18 weeks.

"We are committed to driving improvements in performance and the quality of care that the NHS provides - including keeping waiting times low."



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Peliculas Online

Minggu, 18 September 2011

VIDEO: Minister some cuts to hospital

12. September 2011, to help 20: 21 GMT stand

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Long hospital waiting for up to one-third

15 September 2011 booth 10: 23 GMT by Nick Triggle health correspondent of the BBC News Hospital equipment there is growing pressure on waiting times, wait the number of hospital patients in England on the 18-week guarantee has jumped to one-third in the last year figures show.

More than 28,000 outside of the official statistics showed objective - an increase of 34% from the same month last year, was waiting for had the 300,000 seen in July.

Those who more than six months waiting for rose 55% to more than 9,000.

But as a whole is the NHS still hits his target, to see how were 90.6% 90% of patients in 18 weeks.

The 10%-Spielraum is allowed, to take account of the fact that some patients can choose, wait longer to personal or medical reasons.

However, the increase in the number, the people, is further proof of the growing pressure on waiting times in health care to over 18 weeks.

Pressure

It reflects similar patterns seen in the last few months, meaning that the promises of the Government to ensure the 18-week is strictly to be tested in the autumn and winter when hospitals tend to get busier.

Some of the longest waiting times are seen in the busiest speciality in the NHS. Orthopaedic treatments need more than 18 weeks almost one in six patients as knee and hip replacement, waited in July.

But Health Minister Simon Burns said that health was still good.

"The vast majority of patients get treatment still in 18 weeks."

"We are committed to performance and the quality of care that provides the NHS, including low wait."



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