September 17th, 2007 by Dr. Val Jones in News
Tags: Emergency Medicine, Hospitals, Infectious Disease, News, Research
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Physicians have known for at least 40 years that infectious bacteria (like staphylococcus aureus) can be transmitted on clothing. And now, as part of a comprehensive plan to reduce hospital infection rates, Britain’s National Health Service has recommended against physicians wearing white coats.
An interesting research study showed (back in 1991) that the dirtiest part of physicians’ coats are the sleeve tips and pockets. But surprisingly, coats that were washed at 1 week intervals and coats that were washed at 1 month intervals were equally capable of transmitting bacteria. Now that multi-drug resistant bacteria have become so common, they too can hitch a ride on coat sleeves and make their way from patient to patient.
During my residency, I clearly remember being horrified by the grunge I saw on my colleagues’ coats, all hanging up together on hooks outside the O.R.s. and in various parts of the hospital. I used to wonder if they were spreading diseases – but comforted myself that many bacteria need a moist environment to survive – so while the coats were certainly filthy, by and large they were not moist. Unfortunately my self-comfort was somewhat ill conceived – gram negative bacteria (like E. coli) do indeed need moisture for survival, but many viruses and gram positive bacteria (they usually live on the skin) do just fine in a dry environment. Other studies have confirmed that stethoscopes also carry a high bacterial load if not cleaned between patients. In fact, in reviewing some research studies for this blog post, I found that researchers have analyzed everything from hospital computer keyboards, to waiting room toys and patient charts. Infectious bacteria have been cultured from each of these sites.
Which leaves me to wonder: can we ever create a sterile hospital environment? Not so much. Although I agree that infections can be spread by white coats, and that a short sleeved clothing approach might help to reduce disease spread, I’d like to see some clear evidence of infection rates being reduced by not wearing coats before I’d prescribe this practice uniformly (pun intended). Bacteria can be spread on any type of clothing, by blood pressure cuffs, by stethoscopes, by dirty hands, by hospital charts… and we certainly can’t dispose of all of these. What would be left?
White Coat Rants (a wonderful new ER blog) describes the “ER of the future” – adhering to all the possible safety concerns of oversight bodies. Take a look at this whimsical perspective on what it would take to make the Emergency Department truly “safe” and imagine what it would take to make the hospital totally sterile.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
September 16th, 2007 by Dr. Val Jones in Health Policy, News
Tags: Cancer, Finance, International, News, Technology
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I was glad to to hear from Wendy from wendysbattle.com … like my friend, she is battling stage IV colon cancer. Unlike my friend, she lives in Ontario and has no assistance to pay for her chemotherapy. In a jaw dropping video from a cancer press conference in Ontario, Wendy and 2 other colon cancer patients testify about being denied coverage for standard of care colon cancer therapy. Wendy says that Ontario has valued her life at less than $18 thousand dollars.
In a recent interview with Senator Mike Kirby, I learned that one of the major problems facing the Canadian healthcare system is the cost of expensive new drugs. The universal system was designed to have patients pay out of pocket for their medicines and have the government cover almost everything else. When this health insurance strategy was created, drugs were very inexpensive. However, with all of the technological advances in medicine – diseases like HIV/AIDS and cancer have become chronic, manageable illnesses with expensive treatment price tags. And now, the lack of drug coverage is shifting unmanageable costs directly to the patient. Sadly, Wendy is one of many victims of lack of drug coverage in Canada.
All this to say that the grass is not really greener in Canada – especially for cancer patients.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
September 13th, 2007 by Dr. Val Jones in News
Tags: Diabetes, News
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My friend and fellow blogger, Kelly Close, tipped me off to a very powerful new diabetes awareness ad campaign that begins today. These will run as TV commercials and Internet ads. I thought they were really thought provoking and original. They feature every day scenarios (like a boating trip, ordering food at a restaurant, and greeting a new dog) and then reveal the hidden danger in each “innocent” situation. Then they go on to say that you don’t have to be taken by surprise by diabetes, as there is a test (hemoglobin A1C) that can give you a glimpse into the future.
As many as a third of people who have diabetes are unaware that they have it. As many as 80% of diabetics do not know what their hemoglobin A1C level is. These are shocking statistics for a disease that is treatable, and complications that are preventable. If you haven’t been checked for diabetes and you have reason to suspect that you might be at risk for it (you are substantially overweight, you have diabetes in your family, or you have symptoms of diabetes such as abnormal thirst and frequent urination) please go to your primary care physician for a check up. Diabetes is one disease that we can control well and sometimes cure – but ignoring it could result in kidney failure, blindness, amputations, and heart disease. Let’s take these TV ads to heart and get blood sugar under control in America.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
September 5th, 2007 by Dr. Val Jones in News
Tags: Genetics, International, Reproductive Endocrinology, Research
1 Comment »
Like most of us, this headline made me squirm – visions of the Minotaur, mermaids, and Dolly the sheep with a human face, danced in my head. But as much as this form of experimentation seemed ethically wrong, I decided to figure out what exactly they were proposing.
The Human Fertilisation and Embryology Authority (HFEA) ruled that British scientists could now use animal eggs to host human stem cells. Because there is a shortage of human eggs to use for experimentation, they asked that rabbit or cow eggs be used.
Stem cells are the first kind of cells created when an egg is fertilized and divides. They are capable of developing into any kind of human cell – and are therefore quite interesting in terms of their potential to heal. (Transplanting these cells into damaged tissue can actually repair the tissue to some extent – no matter if its brain, heart muscle or other tissue). But these stem cells have to incubate inside an egg (kind of like a tiny soft shell) if they are to divide.
So the scientists are asking to use animal egg shells (without the nucleus that contains the majority of their DNA) as mini incubators for human stem cells. The HFEA approved that use – but has NOT approved mixing human and animal DNA in a human egg. Such a blend would serve no useful scientific purpose.
Ultimately, the goal of this human-animal embryo experiment is to allow for the creation of many more human stem cells without harvesting human eggs to do so. It also may help scientists to understand what these egg “shells” do to influence the growth of stem cells – if we knew how that worked, we may not need to use human eggs to retrieve stem cells, but could create them from any cell in the body.
So, although this embryo experiment sounds alarming at first – it’s actually a way to do stem cell research without using so many human eggs. Now, that doesn’t mean that I necessarily condone the idea – but it helps put into perspective what the scientists are proposing. Rest assured that there will be no Minotaurs resulting from these particular experiments.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
September 4th, 2007 by Dr. Val Jones in News
Tags: Genetics, Hematology, Infectious Disease, News, Research, Surgery
2 Comments »
I subscribe to Eureka Alert Breaking News – and although a lot of their press releases are on small studies of questionable relevance, I do think that some of the basic science research is provocative. Let’s see if I can pique your interest with the best of this week’s Petri dish news:
1. Tylenol may inhibit bone growth? A small study conducted at the University of Granada suggested that bone forming cells (called osteoblasts) were inhibited by a Tylenol bath. As far as pain killers are concerned, we’ve known for a while that non steroidal anti-inflammatory medications (NSAIDs) may indeed inhibit bone growth. But since Tylenol is not an NSAID, we were hoping that it would not adversely affect bone healing. Could this mean that Tylenol is not so great for bone surgery pain after all? That’s a stretch… but an interesting question.
2. Can you clean blood with a laser? Boy it sure would be nice to be able to kill all the potential viruses in blood used for transfusions. Apparently there’s a new pulsed laser technique that shows some promise in fracturing viruses with laser vibrations. So far, the laser was successful in reducing bacterial viruses by 1000x. Next up? Let’s see what the technique can do to Hepatitis C and HIV viruses.
3. Skinny people might have a “skinny gene.” Scientists have been studying a gene called Adipose (Adp) for over 50 years now. It was first discovered in fat fruit flies (I kid you not). Apparently if the Adp gene doesn’t work well, the flies become fat and “have difficulty getting around.” Worms, mice, and humans seem to have the same gene. Further analysis might unlock the secret to the genetics of thinness. Or maybe we should just eat less and exercise more?This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
