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PrairiEDocs e-newsletter #23 Other archived PrairiEDocs e-newsletters Surveying
the land (and web) for news (and more)
CDC Plans for Coping With Flu Vaccine Delays for 2001-2002 Wow, and They Say Healthcare is Expensive… Is the Skill of Cardiac Auscultation a Dying Art? Israelis Turn Human Stem Cells Into Heart Cells Artificial Heart Patient 'Doing Well' ATLS Courses for the Remainder of the 2001 in Iowa A Reminder Regarding Terminology CMESurfers-Here's a Free One from CyberRounds Reversal of Symptoms in vCJD Patient Undergoing Treatment Quotable
Quotes CDC Plans for Coping With Flu Vaccine Delays for 2001-2002 The Centers for Disease Control and Prevention (CDC) published in the July 13, 2001, issue of Morbidity and Mortality Weekly Report (MMWR), a Notice to Readers titled Delayed Influenza Vaccine Availability for 2001-02 Season and Supplemental Recommendations of the Advisory Committee on Immunization Practices; According to the notice, manufacturers expect that nearly 50 million doses of influenza vaccine will be available for delivery by the end of October. This is about 26 million fewer doses than were available in October in 1999. Manufacturers expect to supply another 27 million doses in November and December, however, for a total distribution level higher than last year and comparable with 1999. Because of the expected delay, the Advisory Committee on Immunization Practices (ACIP) has developed supplemental recommendations for influenza vaccination, in hopes that people at highest risk for severe flu and complications and their health care providers receive the vaccine early. Providers should have vaccine available in September and October to persons at increased risk for influenza complications and to health-care workers. The optimal time for vaccinating high-risk persons is October through November. To avoid missed opportunities, vaccine also should be offered to high-risk persons when they access medical care in September, if vaccine is available. Beginning in November, providers should offer vaccine to contacts of high-risk persons, healthy persons aged 50-64 years, and any other persons wanting to reduce their risk for influenza. Distribution of vaccine to work sites, where campaigns primarily vaccinate healthy workers, should be delayed until November. Delivery of vaccine to hospitals and chronic-care facilities serving high-risk patients should not be delayed. Organizers of mass vaccination campaigns not in workplaces (e.g., at health departments, clinics, senior centers, and retail stores) should plan campaigns for late October or November or when they are assured of vaccine supply and make special efforts to vaccinate elderly persons and those at high risk for influenza complications. Providers should continue vaccinating patients, especially those at high risk and in other target groups, in December and should continue as long as there is influenza activity and vaccine is available. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5027a3.htm Wow, and They Say Healthcare is Expensive… The Pentagon declared last year's online voting project for overseas personnel a success, despite a price tag of $6.2 million. Officials say the project was designed to test whether Internet voting was possible for the estimated six million service personnel and other Americans living outside the United States. Ballots cast by overseas military personnel were accepted in Florida, South Carolina, Utah, and Texas. Critics say the initiative was too costly--only 84 people participated, for a per-vote cost of nearly $74,000--and also insecure, without safeguards against hacking, viruses, and fraud. (Washington Post, 12 August 2001) Is the Skill of Cardiac Auscultation a Dying Art? This study looked at the auscultation skills of a sampling of residents from three countries. The results revealed surprisingly poor accuracy in cardiac auscultation. The 89 Canadian, 189 U.S., and the 36 residents from Great Britain were tested on their ability to identify and interpret 12 recorded heart sounds/cardiac events; correct responses ranged from 20-26%. (Mangione S. Cardiac auscultatory skills of physicians-in-training: a comparison of three English-speaking countries. Am J Med. 2001;110:210-216.) Israelis Turn Human Stem Cells Into Heart Cells Reuters reported that during the first week of August, Israeli researchers said they had created early-stage human heart cells in petri dishes from embryonic stem cells. They envision using such cells to repair damage inflicted on cardiac muscle by heart attacks. "It was shown for the first time definitely that the cells that are being created are cardiac cells that show electrical, biochemical and morphological characteristics of early or young cardiac muscle," said Dr. Joseph Itskovitz-Eldor of the Faculty of Medicine and Rambam Medical Center in Haifa. The Israeli researchers used human embryonic stem cells to grow an undifferentiated mass of cells using a standard laboratory technique. They then sought to steer the multiplying cells toward transformation Into cardiac cells by optimizing the conditions in the petri dish. As the cells divided, the cells began to clump into groups. In about 10 percent of these, the researchers detected small groups of cells that were contracting spontaneously like cardiomyocytes. The researchers then put these groups of cells through several tests to confirm that they were, in fact, cardiomyocytes and thus destined to differentiate into mature heart cells. The researchers said the cells checked out in every way, including the genes they activated, the proteins they possessed, their electrical activity, they regularly contracted like a beating heart, their use of calcium and their response to hormones such as adrenaline. Artificial Heart Patient 'Doing Well' It has been nearly six weeks and the first recipient of a self-contained artificial heart appears to continue to do well. He recently celebrated a month of survival on the pump by eating ice cream and cheesecake, said one of the surgeons who implanted the device. University of Louisville surgeons Dr. Robert Dowling and Dr. Laman Gray led the team that implanted theAbioCor device July 2 in a seven-hour surgery at Jewish Hospital. Said Dowling recently ''He's doing remarkably well…He talks a lot, he's getting stronger, he's walking great lengths without assistance.'' The patient is described as a diabetic in his 50s with a history of heart and liver problems. The grapefruit-sized, titanium and plastic pump made by Abiomed Inc. is entirely self-contained, withan internal battery and a device that regulates the pumping speed. ATLS Courses for the Remainder of the 2001 in Iowa A comprehensive listing ofthe courses in Iowa are found on the following two web sites: http://www.idph.state.ia.us/pa/ems/Trauma/atls_cal.pdf http://www.acutecare.com/iatraumasystem.htm A Reminder Regarding Terminology Language often shapes our perception of events. Changing the way we think about events, and the words we use to describe them, effect the way we behave. Motor vehicle crashes and injuries are predictable, preventable events. Continued use of the accident; promotes the concepts these events are outside human influence or control. In fact they are predictable results of specific actions. Since we can identify the causes of crashes, we can take action to alter the effect, and avoid collisions, as predictable results of the laws of physics. Crash, collision, incident, and injury are more appropriate terms, and should be encouraged as substitutes for the word accident. Within the U.S. Department of Transportation's National Highway Traffic Safety Administration, the word accident will no longer be used in materials published and distributed by the agency. NHTSA is no longer using the word in speeches or other public remarks, in communications with the news media, individuals or groups in the public or private sector. Recently, two other U.S. Department of Transportation agencies, the Federal Highway Administration and Research and Special Programs Administration joined NHTSA Administrator, Dr. Ricardo Martinez, endorsing his goal to eliminate routine use of the word accident from the agencies' vocabulary. CMESurfers-Here's One from CyberRounds Sepsis, or severe infection,is now the tenth leading cause of death among older adults. Doctors have even coined a new term, Systemic Inflammatory Response Syndrome (SIRS), to describe this most serious reaction to infection. John Morley, M.D., Dammert Professor of Gerontology, St. Louis University School of Medicine, looks at the signs, symptoms and the state-of-the-art treatment that may, one day, save your life. Go to: http://www.tdwsyn.com/articles/senior_living/sepsis_11/ Reversal of Symptoms in vCJD Patient UndergoingTreatment BBC Online carried a story on August 13 about a 20-year-old woman believed to be suffering from variant Creutzfeldt-Jakob disease (vCJD) has shown remarkable improvement after being given a pioneering drug in the US. Doctors had told the patient that she could have the human form of mad cow disease. The British citizen was wheelchair-bound, could not recognize her parents, and was given just a year to live. Transferred to the U.S., she was enrolled by Nobel Prize winning Professor Stanley Prusiner at the University of California's School of Medicine in a new drug trial. Press reports state that after just 19 days of treatment, the patient was able to walk unaided, talk, use a knife and fork, and complete coordination tests that were previously impossible. The drug trials bring hope to sufferers and their families - 99 people have died from the disease since 1996 and 7 more suspected sufferers are still alive. Because there is no reliable test for vCJD, which can be carried out on, a living person means that doctors cannot even be sure if the patient had the illness in the first place. Researchers are optimistic, stating "the reversal of progressive Neurological disease and successful treatment of a prion-related disease would rank among the major achievements of modern medicine," says one, "However, until the evidence is published and the diagnosis of vCJD can be confirmed, this report must be interpreted with extreme caution." Search
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American eat more than 22 pounds of tomatoes each year. More than half of that amount is consumed in the form of ketchup and tomato sauce. Wily E. Coyote, Looney Tunes cartoon character, only speaks when he costars with Bugs Bunny. Three Hot Wheels toy cars are sold every second. A car's maximum fuel efficiency occurs when moving at speeds between 25 and 35 mile per hour. The pad prints from koala bears are nearly identical to human fingerprints. The longest one syllable word in the English language is the word screeched. Rodney Crowell-US singer, songwriter: " Pain comes like the weather, but joy is a choice." "You learn how to do good work by being honest with yourself." " If you're dedicated, if it's something that lives and breathes in your heart, then you've simply got to go ahead and do it." " Try but don't try too hard. Just try hard enough, and things will go better." Philip Larkin-English poet, author, librarian: "Far too many relied on the classic formula of a beginning, a muddle, and an end." "Life
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ERDOCS e-mail group (listserv) As a Clinician
providing acute and emergency medical care, you are invited
to visit and participate in our new ERDOCS group at eGroups,
a free, easy-to-use email group service! You have plenty of
experiences to share, questions to ask, concerns and opinions
to voice, suggestions, news to post, tips to offer, etc. and
can do so within this framework. this is a versatile system
for posting things to be sent to a group to peruse, respond
to, or simply be aware of. It eliminates conventional mail delays
and allows you to review and post at your leisure. (We still
have the more open-ended [any visitor can observe/post] discussion
group at the ACUTE
CARE, INC. web
site). Our goal is to give you a variety of feedback and communication
tools. This
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