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PrairiEDocs e-newsletter #28 Other archived PrairiEDocs e-newsletters Surveying the land
(and web) for news (and more)
Wearable Defibrillator Now FDA Approved New Exercise, Flying Guidelines for Pregnancy Quotable Quotes New
Rapid Bacterial Meningitis Test Approved The Now Antigen Test, which already had FDA clearance for the diagnosis of pneumococcal pneumonia, is built on a platform that requires just 15 minutes to diagnose the presence of streptococcal pneumoniae. Bacterial meningitis, a potentially deadly infection, is often caused by Streptococcus pneumoniae and Neisseria meningitides. Produced by Binax, the companyrecently announced an exclusive distribution partnership with REMEL INC.(Lenexa, KS) to provide rapid tests to hospital and clinical reference laboratories. Antiseptic
Skin Cleaners versus Rhinovirus In both studies, the hands of volunteers were challenged with rhinovirus after being washed with a skin cleanser. The subjects were then instructed to make intentional conjunctiva and nasal mucosa contact with one hand. In the first study, the hands of 85 subjects were challenged with rhinovirus 15minutes after being washed with a salicylic acid, pyroglutamic acid, or control solution. Significantly fewer positive hand cultures were noted among salicylic acid-treated subjects than among control subjects. Both treatment groups had a significantly lower rhinovirus infection rate than the control group, the researchers note. In the second study, the researchers determined the anti-rhinovirus activity of apyroglutamic acid cleanser up to 3 hours after washing. At all time points up to 3 hours, pyroglutamic acid-treated subjects had significantly fewer positive hand cultures than control subjects. The proportion of subjects who became infected, however, did not differ significantly between the groups. The studies indicate that these compounds have residual anti- rhinovirus activity that extends, in some cases, up to 3 hours after application. Some commercially available skin cleansers already contain these compounds. The studiesinvestigated the efficacy of antiseptic skin cleansers in interrupting thetransmission of rhinovirus infections. Further studies are needed to prove that these agents can actually prevent transmission of rhinovirus. FDA
Okays One-Dose Treatment for Pediatric Otitis Previously, the drug was approved as a once-daily five-day regimen for the infections. The company noted that the single-dose regimen is not only effective, but also addresses concerns with patient compliance. Pfizer said it expects to introduce Zithromax as a single-dose regimen early next year. ApoB
and apoA-I Better Predictors of Fatal MI than Cholesterol? The Apolipoprotein-related Mortality Risk Study collected data on 175,553 men and women who were identified mostly from screening programs. Among these subjects, the researchers measured levels of total cholesterol, apoB, apoA-I, and triglycerides. They then calculated the apoB/apoA-I ratio and levels of HDL and LDL cholesterol. During a mean follow-up of 66.8 months, 864 of 98,722 men in the study had fatal MIs. During a mean follow-up of 64.4 months, 359 of 76,831 women had fatal MIs, the researchers report. Multivariate analysis revealed that apoB concentrations and the apoB/apoA-I ratio positively correlated with an increased risk of fatal MI. In addition, apoB concentration was a stronger predictor of fatal MI risk than was LDL cholesterol among men and women. High levels of apoA-I were also identified as protective against fatal MI. ApoB and apoA-I might be of greatest value in diagnosis and treatment in men and women who have common lipid abnormalities, but have normal or low concentrations of LDL-cholesterol. Before apoB and apoA-I can be used in routine clinical practice, assay methods need to be standardized and threshold and target values for diagnosis and treatment need to be agreed upon. Wearable Defibrillator Now FDA Approved The FDA approved the first wearable defibrillator this December. Targeting high risk candidates for ventricular fibrillation and ventricular tachycardia leading to sudden death, the Lifecor Wearable Cardioverter Defibrillator is seen as a temporary fix for transient conditions or a bridge to implanted cardioverter-defibrillators. Theanticipated market focuses on 50,000 recovering high-risk heart-attack patients and another 1,000 people that are awaiting heart transplants each year. The device looks similar to a fabric gun holster, strapped to the lower left chest and over the shoulders. Four sensors monitor the heart and are wired to a battery-operated tiny cardioverter-defibrillator worn on the belt. Inclinical trials, 289 heart patients in the U.S. and Europe wore the defibrillator an average of 20 hours a day for three months. It was 71 percent successful in treating sudden cardiac arrest, compared to an estimated 25 percent success rate when people call 911 for treatment. The device failed to successfully treat two episodes of cardiac arrest because patients had incorrectly assembled the electrodes, but Lifecor subsequently changed the design to eliminate confusion, the FDA said. Untoward effects included a temporary skin rash reported by 5%, while another 2% reported that they received at least one unnecessary shock from the device (a rate similar to implantable defibrillators). The new defibrillator will be available on a rental basis early next year but only in limited numbers while Lifecor redesigns it to be even smaller, according to company spokepersons. New Exercise, Flying Guidelines for Pregnancy The American College of Obstetricians and Gynecologists (ACOG) recently revised their recommendations regarding exercise and air travel for women in the later stages of pregnancy.The new recommendations allow for more exercise and suggest that air travel is safe up to 36 weeks gestation (in the absence of medical or obstetrical complications). There have been no previous formal recommendations regarding flying; ACOG noted that most airlines in the United States allow women to travel until they are about nine months pregnant, but international airlines prohibit women from flying after 35 weeks of pregnancy. The new guidelines specifically cite women who are at risk for preterm delivery, those with poorly controlled diabetes, and those with placental abnormalities, however, to avoid air travel while pregnant. Additionally, some with heart problems may experience vital sign changes with the increase and decrease of cabin pressure and may need to have supplementaloxygen prescribed during air travel. Other comfort and care suggestions include having pregnant women avoid consuming beans, sodas and other gas-producing foods or drinks before flying, wearing support stockings to prevent any fluid from accumulating in their legs, and are advised to move their legs occasionally during their flight to prevent blood clots. ACOG also stated that pregnant women should no longer limit their exercise as previously recommended and should no longer be discouraged from beginning exercising during pregnancy. Pregnant women should exercise in moderation, take necessary precautions and aim for 30 minutes of daily moderate exercise to gain maximum health and heart benefits. More specifics on exercise recommendationsare due to be released by ACOG in January 2002.
Epidemiologic Notes from Iowa MRSA
in Wrestlers: Pertussis:
Help!
The Public Health Training Network (PHTN) is a distance learning system that takes training to the learner. PHTN uses a variety of instructional media ranging from print-based to videotape and multimedia to meet the training needs of the public health workforce nationwide. Since 1993, PHTN has delivered nearly 1,000,000 training opportunities to professionals in public health settings and, increasingly, in healthcare and related settings. In addition to several CME/CEU offerings, their web site houses the Public Health images library--PHILTM which is an extensive collection of still images, image sets, and multimedia files related to public health that you can access. Here are some of the recent programs from the CDC that are accessible from the PHTN website. You can viewthese programs as streaming video (via your computers Real Player software),or as narrative script, or order video versions. CME, CEU, and CHES credit is available with instructions at the site. Instructions are very learner-friendly and available online. Visitors to the site are encouraged to check back frequently for new programming. Go to: www.cdc.gov/phtn/ CDC
Responds Series: Two new courses offered are: Envirorisk- a web-based course in environmental risk assessment and risk communication. The learner plays the role of a public health professional while going through this case-based, problem-solving program. The course will develop the learners ability to investigate an environmental health problem and to serve as a resource and risk communicator in his or her community; and Setting Community Health Priorities-This course is designed to teach public health professionals how to set community health priorities. In this simulation, the learner assumes the role of Local Health Planner for the county health department. The simulation begins as the local Health Officer asks the learner to analyze last years mortality data in order to prioritize health concerns for the following year. The learner proceeds through various tutorials and readings about related topics and then attends a simulated meeting with local community members to set health priorities for the community. The course is based on the eight steps ofThe Community Process, which is one part of the Assessment Protocol for Excellence in Public Health (APEX-PH) program. The goal for this program is for the learner to be able to follow a process that involves both the health department and the community in determining health priorities for the community by evaluating and balancing community-expressed and data-driven priorities. Another Reminder---ACUTE CARE, INC. has put together an impressive list of resources, links, etc. re: medical responses to nuclear, biological andchemical terrorism; just visit http://www.acutecare.com/nbc.htm to see the latest or to research an area of concern. Links to the CDC and military medical resources are included, also. The site is frequently updated. Those readers with children (or grandchildren) may be interested in the following notes on the process and environment of learning; Practice
not only makes perfect, it makes the brain efficient. What has previously
been seen with monkey brains now has been seen on humans. Using
functional MRI, a German University has shown that when learning
a motor movement (in this case learning to play the piano), a great
deal of the motor region of the brain is used. With experience,
smaller and smaller regions of the brain are used. In professional
musicians, only very tiny regions of the motor cortex are involved
in their playing. Thus practice makes neural networks efficient
and frees up regions of the cortex again to be used for other things.
A study
out of Columbia University, suggests praising students more for
their effort than for their intelligence to encourage good work.
The study showed that in 5th graders, praising intelligence actually
caused them to work less, experience less enjoyment and less persistance
in tasks. Praising effort had just the opposite effect. Smaller
class size doesn't seem to make a difference in quantity of material
taught, but certainly does effect quality. A study out of UC-San
Diego, shows that in smaller classes, teachers covered the same
amount of material during the year, but the time spent on individual
assistance, tutoring, and one-on-one help increased. The
University of Illinois studied children's tendency to ask for help.
Children who have lower academic expectations for themselves tend
to ask for help less often. The study found that classrooms that
emphasize self-improvement rather than relative ability seem to
encourage students to ask for help. In other words, letting students
focus on how well they personally have improved rather than on comparing
themselves to others in the room, encouraged such behavior. Willamette
University shows that music therapy is effective in improving emotional
and cognitive skills in individuals with dementia. A University
of Michigan study found a postive correlation between help-seeking
behavior and student's perception of classrooms which address their
social and emotionalneeds. A longitudinal study of middle schoolers
shows that children tend to askfor help in classrooms where the
emphasis was on trying hard, making self improvment, and had an
environment where risk-taking was allowed. In classrooms where relative
ability and criteria goal setting was emphasized, students were
less likely to seek help. It should also be pointed out that this
help-seeking behavior was unrelated to the teacher's view of the
classroom, only the students'view. The US Department of Health and Human Services reports that life expectancy for the U.S.population reached a record high of 76.9 years in 2000. Soldiers disease was the term given to the morphine addiction that 400,000 soldiers of the Civil War went home with. After 27 years, Betty Rubble made her debut as a Flinstone Vitamin in 1996. After human death, post-mortem rigidity starts in the head and travels to the feet, and leaves the same way it came--head to toe. An estimated 10,000 kidneys of executed Chinese prisoners have been sold since 1990. Approximately 36% percent of people who make a New Year's resolution to diet and exercise break it in one month. Banging your head against a wall uses 150 calories an hour. To divide something into squares is to graticulate. A jiffy is an actual unit of time---1/100th of a second. A jumbo jet uses 4,000 gallons of fuel to take off. A large flawless emerald is worth more than a similarly large flawless diamond. A cubic mile of fog is made up of less than a gallon of water. Halloween is the second largest commercially successful holiday in the US; Americans spend 2.5 billion dollars on this holiday. Cellular
Phone Comparisons Thinking about switching your cellular phone contract, but unsure of the best deal? These two sites will help you compare several calling plans by entering your zip code to see what plan works best for you. Puzzling
Addiction? Sharpen the mind with a variety of puzzles. Challenges for adults and kids, the site has hours of challenge available. Currency
Converter Lira, pound, yen, euro, dollar and a whole lot more. This site allows you to compare currencies. A great tool to use if you plan on traveling to a foreign destination. You can even personalize the site by language, date format, and bank. The
IG NOBEL Prizes awarded These are awards given to individuals whose achievements "cannot or should not be reproduced." The Igs, which are sponsored by the science humor magazine Annals of Improbable Research, are intended to celebrate the unusual, honor the imaginative, and take a good-natured poke at some remarkably silly things done in the name ofscience. This year's winners were announced in October and included the following: Physics: David Schmidt for his $28000 partial solution to the question of why shower curtains billow in and stick to your leg. Biology: Buck Weimer for inventing airtight underwear with a replaceable charcoal filter that removes bad-smelling gases. Technology: John Keogh for patenting the wheel. The Australian Patent Office shared the honors for granting Patent #2001100012. Public Health: Chittaranjan Andrade and B.S. Srihari of Bangalore, India, for their probing medical discovery in the field of Rhinotillexomania (a.k.a. nose picking) among adolescents. You can read all about the IG NOBEL prizes, listen to highlights of the ceremony, and peruse the archives of past winners on the above listed website. Louis Pasteur (1822-1895) French chemist, bacteriologist: In the field of observation, chance favors the prepared mind. The greatest disorder of the mind is to let will direct it. There does not exist a category of science to which one can give the name applied science. There are science and the applications of science, bound together as the fruit of the tree. Let me tell you the secret that has led me to my goal. My strength lies solely in my tenacity. 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 e-newsletter is available through the generous unrestricted
support of
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