Nurses often use point-ofcare (POC) blood glucose meters to assess patients’ blood glucose levels at the bedside. Unfortunately, a number of cases have been reported in which falsely elevated blood glucose levels resulted in inappropriate insulin administration and subsequent hypoglycemia, coma, persistent vegetative state, and even death. The falsely elevated readings were caused by a drug device interaction in patients receiving medications that contain maltose or metabolize into maltose. Examples of these products can befound in Table 1.
Some POC blood glucose meters utilize test strips with glucose dehydrogenase pyrroloquinolinequinone(GDH-PQQ) or glucosedye-oxidoreductase (GDO), which cannot distinguish between glucose, maltose, and other sugars. Glucose meters that use these types of test strips include Accu-Chek (Roche), FreeStyle (Abbott), and Ascensia (Bayer).** The maltose in the blood causes falsely elevated glucose readings in meters using GDH-PQQ- or GDO-containing test strips.When the falsely elevated readings are used to guide insulin administration, inappropriate dosing can lead to hypoglycemia. TheUS Food and Drug Administration (FDA) has identified 18 cases of hypoglycemic adverse events associated with EXTRANEAL (icodextrin), a peritoneal dialysis solution that is often delivered directly to dialysis units instead of being dispensed from the pharmacy. In seven of these cases, healthcare providers used glucose meters that reliedon GDH-PQQ- or GDOcontaining test strips. In some of the cases involving serious outcomes, staffhad been informed by patients or the patients’ families about the drugdevice interaction, but staff still reliedon erroneous blood glucose readings to treat these patients with insulin.
One of the most recent cases involved a 62-year-old dialysis patient who had been receiving Extraneal as an outpatient before hospital admission. Over the next few days, the patient’s blood showed glucose was monitored using an Accu-Chek Inform system and GDHPQQ-containing test strips. Staff recorded three elevated glucose readings, which were treated with insulin despite laboratory values that were markedly lower than the meter readings. By the end of the week, the patient died from “severe hypoxia due to untreated hypoglycemia.” Intravenous immunoglobulin (IVIG) is another drug that has been linked toserious drug-device interactions. In one case, an elderly immunocompromised patient with sepsis was treated with OCTAGAM (immune globulin intravenous [human]), which contains maltose (100 mg/mL). Glucose meters and the maltose-sensitive test strips were used to monitor his glucose levels. Since the patient’s blood glucose readings were elevated, he was started on an insulin infusion. The patientexperienced symptoms of severe hypoglycemia, which was confirmed by a laboratory blood glucose level of12 mg/dL. The patient developed irreversible neurological damage, although this outcome could not be definitely linked to severe hypoglycemia. Many practitioners remain unaware of this significant interaction, particularly those who do not routinely care for patients receiving peritoneal dialysis solutions containing icodextrin, maltose-containing immunoglobulin therapy, D-xylose for evaluation of malabsorption syndromes, and other products containing maltose. See checkitout! for ways to reduce the risk of false glucose meter readings in patients taking these medications.
** The list of products is not all inclusive. Various manufacturers, including Abbott, Bayer, Roche,CH Diagnostics, and Home Diagnostics, have glucose strips that use GDH-PQQ. Some of the manufacturers have multiple approved test strips that use this technology, so the product-line names are not all inclusive. In some cases, product lines include test strips that use more than one type of enzyme methodology. For example, some Accu-Chek strips use GDH-PQQ and some use an enzyme that is not reactive to maltose interference. In addition, manufacturers can market devices under additional brand names (e.g., some major companies also make devices sold under distributor names) without obtaining FDA clearance, so it would be impossible to create a comprehensive, up-to-date list of all devices that use GDH-PQQ methodology.
checkitout! (The drug-device interaction can occur up to a week or more after receiving medications that contain maltose or metabolize to maltose.) In this case use an alternative glucose testing method.Establish warnings.Ask pharmacy to set up a special alert in the computer for maltose-containing medications so they can affix an alert sticker to these products. Add a cautionary note to themedication administration record and diabetic flow sheets. Place an alert sticker on the patient’s chart.Develop protocols. Include the risk of false glucose determinations, the specific circumstances surrounding this risk, and the need for laboratory glucose monitoring, in insulin administration protocols and order sets.Be prepared for errors. Establish guidelines for early recognition and treatment of a drug-device interactionor error (e.g., discrepancies between laboratory and glucose meter readings, symptoms of hypoglycemia or hyperglycemia).Conduct periodic reconciliation of laboratory and glucose meter readings whenever an insulin infusionis running, and take steps to verify a suspicious glucose reading.Educate patients. Let patients know why the glucose meter or certain test strips cannot be used for testingtheir glucose levels. Tell patients to alert any staff who may attempt to use a glucose meter during the course of their treatment with involved maltose containing products.
ISMPNurse Newsletter
Sunday, December 21, 2008
Wednesday, December 10, 2008
Paradigm Bytes.......December Issue
PARADIGM BYTES
Newsletter for Paradigm 97
December 10, 2008
PARADIGM DEFINED:1) an outstandingly clear or typical example or archetype.2) a philosophical and theoretical framework of a scientific school or discipline within which theories, laws, and generalizations, and the experiments performed in support of them, are formulated. Our website...... http://paradigm97.blogspot.com/
MISSION STATEMENT
We believe that nurses need each other for support during the "lean and mean" days to help survive them. We offer research results and other ideas to enrich the nursing experience.
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SNIPPETS
Wendie's Inservice on Sodium
Can NS cause hypernatremia? No. OK, thought experiment time: Draw pictures with little molecules or such if you like, it will help. You have a beaker full of salt water, with a Na+ level of, say, 140 (hmmmm, what a coincidence). You pour half of it out. What is the Na+ level in the remainder? Right, 140, because that measurement is a measurement of CONCENTRATION, not a count of the absolute number of sodium molecules. Got that? If not, work on it, because you have to "get" it. -Now you refill the beaker to its previous level, full up, with plain water... or, say, D5W, which is the same thing, physiologically. Now what's your sodium level? Right, 70, because you have twice as much water per amt of sodium. -Go back to the half-full beaker again, the one with a serum (oooh, a Freudian slip! I think I'll leave it. Serum counts as saline.) sodium of 140. Fill it up with an equal volume of....normal saline, which for purposes of this discussion has a sodium level about the same as blood serum. What's the serum sodium now? Right, still 140. As a matter of fact, you can pour quite a bit of NS into a body and not really influence the serum sodium that much at all. The way you change the serum sodium is by changing the amt of WATER. -Repeat to yourself: "Serum sodium tells you about water balance." and "Saline is not sodium and water." (I used to have a poster of this and have my classes chant it three times before going on....I wanted to be sure they would remember it for later) -OK, deep breath. Now we look at water balance from the other side. -Saline pretty much stays in its vascular place (unless you cut a blood vessel and spill some out). But water....ah, water travels. As a matter of fact, that's the other poster. Repeat three times: "Saline stays, water travels." (think: rivers flow from place to place, but the ocean pretty much stays where it is.) What the heck importance is that? -Back to your original beaker.... the one full of stuff with a serum Na+ of 140. Evaporate half of the water. What is the serum sodium now? Right, 280 (whooee, bigtime dehydration) As a matter of fact, if you lose enough water from your body to get your serum sodium up to 170 or so (("Serum sodium tells you about water balance")), you'll probably die, especially if you do it rapidly. Why? Because water travels in and out of all your cells. If you lose water from your intravascular space, sweat it out, or pee it out because your kidneys are unable to concentrate urine for some reason, thus making your bloodstream more concentrated, water molecules on the other side of the cell walls all over town say, "Whoops! Gotta go!"...because water travels across cell membranes from an area of more water per volume (lower salt concentration) to the area of less water per volume (higher salt concentration). So if you are de-hydrated, meaning water-poor, all your cells shrink. Most importantly, if your brain cells shrink enough from water loss, they pull away from your pia mater/meninges and you have an intracerebral bleed. Bummer. -(Interestingly, this is why you have a headache with your hangover after an alcohol binge. Alcohol temporarily disables your kidneys from retaining water, so they let too much out. You pee a lot, and your brain shrinks just enough to put a little tension on your pia mater/meninges. Bingo, headache.) (Ahhh, digressed again....) -OK, now put this all together and tell me why your hematocrit is a lousy indicator of water balance (as a matter of fact, a nigh-on USELESS indicator of dehydration), but a good indication of saline balance. -OK. You are walking down the street with a perfectly good hematocrit of 40 and a serum sodium of 140 (and normal other electrolytes). You are accosted by someone with a sharp thing and before you know it, a whole lot of your circulating volume is running into the storm drain. Fortunately, you are whisked into a nearby ER immediately, having had your bleeding stopped by a nearby Boy Scout with good First Aid Merit Badge training (ummmm, I teach that too). The ER nurse draws a baseline 'crit and 'lytes. What are they? -OK, crit is still 40...because hct is a *percentage of the blood that is red cells*, not a count of the absolute number of red cells you have. So even if you lose a lot of your blood, your crit is unchanged. Until they start fluid-resuscitating you with.... normal (not half-normal) saline (or RL, which acts like it for purposes of this discussion).-Na+ is still 140, because you have lost saline (serum counts as saline) but not water.-Thought experiment time again. Take two tubes of whole blood, that is, serum and red cells. They both have a Hct ( which is often spoken as “crit”) of 40, that is, 40% of the volume of each tube is RBC's. We already know what happens if you add saline to one of them: the crit drops, right? But what happens to the crit of a tube of blood if you add water-- like D5W? Answer: Nothing. Why? Because the crit is a % of volume....and when you add water, the water travels into the cells too. So they swell up, and their %age size change means no change in the crit of the tube. They still take up (in this example) 40% of the volume. What happens if, instead of adding water to your original tube of hct=40 blood, you evaporate half of the water out of it? (The answer is NOT, "Make gravy." Shame on you.) No, the hct stays the same, because the cells lose water too, and they shrink as much as the liquidy part did. Same percentage of red cells in the resulting volume = no change in hematocrit.-So. When you have someone dehyrated (as evidenced by their elevated serum Na+), you give him water (or D5W). This dilutes his serum Na+ back towards normal and allows his shrunken dehydrated cells to regain their girlish plumpness. Normal saline will not help, as it will not change the serum sodium level ("Saline is not sodium and water") and will not move into cells to restore their lost water content ("Saline stays, water travels.") -If you have someone who is hypovolemic, as evidenced by (hmmm? what? how do you assess hypovolemia? How about BP, CVP, JVD, PAd, LVEDP, etc? You pick 'em), you give him saline, which goes into his vascular space where you want it for circulating volume but doesn't go anywhere else. D5W will not do the job, as it will travel into cells (not just RBC's, but all cells, and most of it will thus not be available in the vascular space to make blood pressure). -So why do dehydrated old ladies have high crits AND high serum Na+'s? Well, as I was fond of telling my students, it's perfectly possible to have two things wrong at once. -Let's look at a couple of people and see if that helps.1) Serum Na+ 140, Hct 25, BP 110/60. OK, so this guy is relatively anemic, but his circulating volume is OK (as evidenced by an adequate BP) and his water balance is fine (as evidenced by his normal Na+). Who does this? Well, anemia can have many causes, but if he comes in with a hx of a recent bleed with fluid resuscitation, you could guess that he had a perfectly good crit until he lost some red cells out his GI bleed or stab wound or bloody ortho surgery or something, and we were stingy and just gave him NS back. His crit is called "dilutional," as in, "His red cells are floating in saline."2) Serum Na+ 118, Hct 40, BP 110/60. This guy has 'way too much water on board, as evidenced by his Na+ that's 'way low ("dilutional" too). We call him hyponatremic, but it's not that he has lost sodium (in most cases), it's that he retained too much water. He hasn't lost saline, as evidenced by his decent BP ("Saline is not sodium and water"). Who does this? Well, remember the dread "SIADH"? "Syndrome of inappropriate antidiuretic hormone"? Lessee.... inappropriate, ummm, too much. Antidiuretic, ummmm, doesn't allow diuresis, holds onto water.... Bingo. He's retaining water, and his Na+ is called "dilutional" because all those little Na+s are floating around in too much water. Some degree of SIAHD is actually pretty common--- you can do it with anesthesia, mechanical ventilation (there's stretch receptors in the lungs, see, and....oh, later), and a host of common meds. Of course, you can also get a low serum sodium in a hurry if some fool tanks you rapidly with a liter or two of D5W, or , like that poor woman in a SoCal radio contest, you drink a ton of plain water over a short period of time. She died of acute cerebral edema when her brain swelled up faster than her skull would stretch to accommodate it. best, Wendie
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I usually don't have more than one article for the Snippet...... but just had to include the following:
BOSTON (Reuters 11/12) - A large European study has confirmed that simple measurements of the waist and hips may offer a better way of predicting obesity-related death than a standard, but more complicated, system of relating weight to height.
The standard body mass index, or BMI, method does not work very well for some people, such as the elderly or body builders, and researchers have begun building a case that it is better to look at waist circumference or the ratio of waist size to hip size.
Among people with comparable BMIs, having an extra 2 inches around the waist increased the annual risk of death by 17 percent for men and 13 percent for women, according to the team led by Dr. Tobias Pischon of the German Institute of Human Nutrition Potsdam-Rehbruecke in Nuthetal, Germany.
When they calculated the waist-to-hip ratio by dividing a person's waist size, measured at the navel, by the biggest part of their hips, the Pischon group found that the risk of death increased by 34 percent for men and 24 percent for women every time that ratio increased by 0.1.
Hip circumference alone did not predict death any better than BMI, which is a person's weight in kilograms divided by the square of the height in meters, the researchers found.
They used data from the European Prospective Investigation into Cancer and Nutrition database, involving 359,387 people in nine countries.
Even among people of normal weight, men with the biggest bellies had more than twice the death rate of the slimmest. For women, the rate was 79 percent higher if their weight was in the normal range yet their bellies were big.
The findings, published in the New England Journal of Medicine, "underscore the importance of assessing the distribution of body fat even among persons of normal weight and challenge the use of cutoff points to define abdominal obesity, at least when they are used to predict the risk of death," the researches wrote.
Earlier research had suggested that men should not have a waist-to-hip ratio above 0.95, and in women it should be no higher than 0.8. http://www.reuters.com/article/healthNews/idUSTRE4AB92120081112?feedType=nl&feedName=ushealth1100
We believe that nurses need each other for support during the "lean and mean" days to help survive them. We offer research results and other ideas to enrich the nursing experience.
~~**~~**~~**~~**~~**~~
SNIPPETS
Wendie's Inservice on Sodium
Can NS cause hypernatremia? No. OK, thought experiment time: Draw pictures with little molecules or such if you like, it will help. You have a beaker full of salt water, with a Na+ level of, say, 140 (hmmmm, what a coincidence). You pour half of it out. What is the Na+ level in the remainder? Right, 140, because that measurement is a measurement of CONCENTRATION, not a count of the absolute number of sodium molecules. Got that? If not, work on it, because you have to "get" it. -Now you refill the beaker to its previous level, full up, with plain water... or, say, D5W, which is the same thing, physiologically. Now what's your sodium level? Right, 70, because you have twice as much water per amt of sodium. -Go back to the half-full beaker again, the one with a serum (oooh, a Freudian slip! I think I'll leave it. Serum counts as saline.) sodium of 140. Fill it up with an equal volume of....normal saline, which for purposes of this discussion has a sodium level about the same as blood serum. What's the serum sodium now? Right, still 140. As a matter of fact, you can pour quite a bit of NS into a body and not really influence the serum sodium that much at all. The way you change the serum sodium is by changing the amt of WATER. -Repeat to yourself: "Serum sodium tells you about water balance." and "Saline is not sodium and water." (I used to have a poster of this and have my classes chant it three times before going on
>>>>>>>>>>>>>>>>>>> !!!!! <<<<<<<<<<<<<<<<<<
I usually don't have more than one article for the Snippet...... but just had to include the following:
BOSTON (Reuters 11/12) - A large European study has confirmed that simple measurements of the waist and hips may offer a better way of predicting obesity-related death than a standard, but more complicated, system of relating weight to height.
The standard body mass index, or BMI, method does not work very well for some people, such as the elderly or body builders, and researchers have begun building a case that it is better to look at waist circumference or the ratio of waist size to hip size.
Among people with comparable BMIs, having an extra 2 inches around the waist increased the annual risk of death by 17 percent for men and 13 percent for women, according to the team led by Dr. Tobias Pischon of the German Institute of Human Nutrition Potsdam-Rehbruecke in Nuthetal, Germany.
When they calculated the waist-to-hip ratio by dividing a person's waist size, measured at the navel, by the biggest part of their hips, the Pischon group found that the risk of death increased by 34 percent for men and 24 percent for women every time that ratio increased by 0.1.
Hip circumference alone did not predict death any better than BMI, which is a person's weight in kilograms divided by the square of the height in meters, the researchers found.
They used data from the European Prospective Investigation into Cancer and Nutrition database, involving 359,387 people in nine countries.
Even among people of normal weight, men with the biggest bellies had more than twice the death rate of the slimmest. For women, the rate was 79 percent higher if their weight was in the normal range yet their bellies were big.
The findings, published in the New England Journal of Medicine, "underscore the importance of assessing the distribution of body fat even among persons of normal weight and challenge the use of cutoff points to define abdominal obesity, at least when they are used to predict the risk of death," the researches wrote.
Earlier research had suggested that men should not have a waist-to-hip ratio above 0.95, and in women it should be no higher than 0.8. http://www.reuters.com/article/healthNews/idUSTRE4AB92120081112?feedType=nl&feedName=ushealth1100
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MEDICAL NEWS
LONDON (Reuters 11/17) - A dangerous, drug-resistant bacterium normally found in soil and water is on the increase in hospitals worldwide, an infectious disease expert warned on Tuesday. Acinetobacter baumannii is more resistant than the MRSA superbug and accounts for about 30 percent of drug-resistant hospital infections, said Matthew Falagas, director of the Alfa Institute of Biomedical Sciences in Greece.
"There is a growing frequency of A baumannii infections in various hospitals around the world," Falagas, also a professor at Tufts University School of Medicine in Boston, said in a telephone interview. "The infections are difficult to treat because the bugs are resistant to most agents."
Bacteria such as methicillin-resistant Staphylococcus Aureus, or MRSA, are a growing problem worldwide. They can cause life-threatening and disfiguring infections and can only be treated with expensive drugs.... http://www.reuters.com/article/healthNews/idUSTRE4AH0CE20081118?feedType=nl&feedName=ushealth1100
MEDICAL NEWS
LONDON (Reuters 11/17) - A dangerous, drug-resistant bacterium normally found in soil and water is on the increase in hospitals worldwide, an infectious disease expert warned on Tuesday. Acinetobacter baumannii is more resistant than the MRSA superbug and accounts for about 30 percent of drug-resistant hospital infections, said Matthew Falagas, director of the Alfa Institute of Biomedical Sciences in Greece.
"There is a growing frequency of A baumannii infections in various hospitals around the world," Falagas, also a professor at Tufts University School of Medicine in Boston, said in a telephone interview. "The infections are difficult to treat because the bugs are resistant to most agents."
Bacteria such as methicillin-resistant Staphylococcus Aureus, or MRSA, are a growing problem worldwide. They can cause life-threatening and disfiguring infections and can only be treated with expensive drugs.... http://www.reuters.com/article/healthNews/idUSTRE4AH0CE20081118?feedType=nl&feedName=ushealth1100
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INTERESTING READING
Please remember that the REUTERS articles usually good for 30 days.
LONDON (Reuters 11/25) - Near-universal HIV tests and immediate drug treatment for people who test positive would almost eliminate transmission of the deadly virus within a decade, a computer model showed on Wednesday. Doing this would cost more initially but then save money down the road because there would be fewer HIV-infected people to treat, Reuben Granich and colleagues at the World Health Organization was reported in the The Lancet.
The researchers emphasized their findings do not represent new WHO policy or any other guidance but rather stand as a call for discussion on how to better tackle the AIDS epidemic and the role of so-called antiretroviral drugs. "Although other prevention strategies, alone or in combination, could substantially reduce HIV incidence, our model suggests that only universal voluntary HIV testing and immediate initiation of antiretroviral drugs could reduce transmission to the point at which elimination might be feasible by 2020 for a generalized epidemic, such as that in South Africa," they wrote....
INTERESTING READING
Please remember that the REUTERS articles usually good for 30 days.
LONDON (Reuters 11/25) - Near-universal HIV tests and immediate drug treatment for people who test positive would almost eliminate transmission of the deadly virus within a decade, a computer model showed on Wednesday. Doing this would cost more initially but then save money down the road because there would be fewer HIV-infected people to treat, Reuben Granich and colleagues at the World Health Organization was reported in the The Lancet.
The researchers emphasized their findings do not represent new WHO policy or any other guidance but rather stand as a call for discussion on how to better tackle the AIDS epidemic and the role of so-called antiretroviral drugs. "Although other prevention strategies, alone or in combination, could substantially reduce HIV incidence, our model suggests that only universal voluntary HIV testing and immediate initiation of antiretroviral drugs could reduce transmission to the point at which elimination might be feasible by 2020 for a generalized epidemic, such as that in South Africa," they wrote....
http://www.reuters.com/article/healthNews/idUSTRE4AP03220081126?feedType=nl&feedName=ushealth1100
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RANDOM FACT... Ice cream novelties such as ice cream on sticks and ice cream bars were introduced in the 1920s. Seems like kid stuff, but today, adults consume nearly one-half of all such treats.
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RANDOM FACT... Ice cream novelties such as ice cream on sticks and ice cream bars were introduced in the 1920s. Seems like kid stuff, but today, adults consume nearly one-half of all such treats.
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Burn Treatment Cream May Delay Healing A cream (Silvadene) commonly used to treat burns may actually delay healing. In addition, despite the wide range of wound dressings available for burns, there is no consensus on the most effective alternative treatment, say Cochrane Researchers who carried out a systematic review of existing data.
Increased understanding of the wound healing process means that there are now a large number of different ways to treat burns. Films, gels, artificial skins and fibre dressings may all help to heal wounds, but doctors still often turn to traditional gauze dressings, as well as silver sulphadiazine (SSD) cream (Silvadene). Healthcare providers have used SSD cream since the 1960s to minimize the risk of burns becoming infected, although concerns have recently been raised about its toxic effects on skin cells. (in my opinion, removing SSD is almost impossible to avoid causing the patient pain....I completely agree with this article).
The Cochrane Team who carried out the research found 26 relevant trials. Although each trial was relatively small they concluded that SSD cream increases the time taken for a wound to heal, as well as increasing the number of dressing applications required.
“We think that the use of SSD cream on burn wounds needs to be reconsidered,” says lead researcher, Jason Wasiak, who works for the Victorian Adult Burns Service at the Alfred Hospital in Melbourne, Australia.
Trials showed that a number of different dressing types, including polyurethane films, hydrocolloid gels and biosynthetic dressings, can be more effective for treatment of moderate burns than SSD or standard chlorhexidine impregnated gauze dressings. As well as reducing healing times, some alternative dressings also reduced pain associated with burns.
Many of the trials, however, failed to adequately assess the depth of burns suffered, so the data was less easy to interpret. The researchers say there is a strong case for larger and better designed trials that will help inform doctors about the most appropriate treatments for burns of different severities.
“There is a need to clearly estimate burn depth in order to make proper recommendations as to the best products for treating burns,” says Wasiak.
Wasiak J, Cleland H, Campbell F. Dressings for superficial and partial thickness burns. Cochrane Database of Systematic Reviews 2008, Issue 4. Art. No.: CD002106. DOI: 10.1002/14651858.CD002106.pub3.
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Irena Sandler was a definitely a Heroine........ This woman was nominated for the Nobel Peace Prize last year. Al Gore won it. What an amazing story! http://en.wikipedia.org/wiki/Irena_Sendler
She rescued 2500 Jewish children, sometimes sedating them so she could smuggle them out in packages, or coffins. She was tortured by the Gestapo. They broke her feet and legs. She went on to continue her work in hiding... February 15, 1910 – May 12, 2008 http://www.auschwitz.dk/rescuers/id17.htm
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Honey Helps To Heal Wounds Honey may reduce healing times in patients suffering mild to moderate burn wounds. A systematic review by Cochrane Researchers concluded that honey might be useful as an alternative to traditional wound dressings in treating burns.
“We’re treating these results with caution, but it looks like honey can help speed up healing in some burns,” says lead researcher Dr Andrew Jull, of the Clinical Trials Research Unit at the University of Auckland, New Zealand.
Honey has been used in wound treatment since ancient times. The mechanism of action is unclear. While honey may help the body remove dead tissue and provide a favourable environment for the growth of new, healthy tissue, current interest in medicinal honey focuses largely on its antibacterial effects.
The review brings together data from 19 clinical trials involving 2554 patients with a range of different wounds. Honey was more effective in reducing healing time compared to some gauze and film dressings that are often used to treat moderate burns. However, the researchers were unable to show any clear benefits for the healing of grazes, lacerations, surgical wounds and leg ulcers.
The researchers don’t advise using honey to treat other types of wounds. “Health services should invest in treatments that have been shown to work,” says Dr Jull. “But, we will keep monitoring new research to try and establish the effect of honey.” Jull AB, Rodgers A, Walker N. Honey as a topical treatment for wounds. Cochrane Database of Systematic Reviews 2008, Issue 4. Art. No.: CD005083. DOI: 10.1002/14651858.CD005083.pub2.
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Overnite dialysis saves lives; Study FRIDAY, Nov. 7 (HealthDay News) -- Dialysis for eight hours a night, three times a week, reduced the risk of death for kidney patients by nearly 80 percent, compared to conventional, four-hour dialysis three times a week, a new study found. This type of improvement is important and necessary, the study's lead author said. "Unfortunately, the mortality rate of patients treated by conventional four hours, three times weekly hemodialysis remains unacceptably high, despite several improvements in dialysis technology and general medical care," said Dr. Ercan Ok, who's with the department of nephrology at Ege University, in Izmir, Turkey.... http://www.healthday.com/Article.asp?AID=621183
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NEW ORLEANS (Reuters 11/09) - AstraZeneca's cholesterol fighter Crestor dramatically cut deaths, heart attacks and strokes in patients with healthy cholesterol levels but who had high levels of a protein associated with heart disease, researchers said on Sunday.
Crestor, known chemically as rosuvastatin, reduced heart attack, stroke, need for bypass or angioplasty procedures and cardiovascular death by a surprising 45 percent over less than two years.
Results of the study, funded by AstraZeneca and called Jupiter, could help open a vast new market for statins as it shines a bright light on C-reactive protein -- an indicator of arterial inflammation -- and its connection to serious heart risks.... http://www.reuters.com/article/healthNews/idUSTRE4A81LH20081109?feedType=nl&feedName=ushealth1100
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LOME (Reuters 11/25) - Togo will start distributing free of charge from November 17 the anti-retroviral drugs that extend the lives of HIV/AIDS patients, its government said Saturday.
"Anti-retroviral medicines distributed by the network of the Central Supply of Essential and Generic Medicines (CAMEG) will be free of charge from Monday 17 November throughout the country," an official statement broadcast on state radio said. Around 25,000 people will benefit from the measure, said Augustin Dokla, who represents a network of HIV/AIDS sufferers, up from 8,000 who already have access to the drugs from CAMEG.... http://www.reuters.com/article/healthNews/idUSTRE4AE32420081115?feedType=nl&feedName=ushealth1100
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Discovery offers way of tracking cancer in the blood (Reuters 11/25) - Tiny sacs released from tumor cells and circulating in the blood carry genetic information about the tumor, offering a new way to track and treat the cancer, U.S. researchers said on Sunday.
"They contain a little piece of the tumor cell in the blood stream. If you just look at these packets, you basically know what kind of mutations are in the tumor cell," said Xandra Breakefield of Massachusetts General Hospital in Boston, whose study appears in the journal Nature Cell Biology.
These membrane-covered packets, called exosomes, represent a new way of getting information about a cancer, offering a means of choosing the best therapy, seeing how a patient responds to treatment, and possibly offering a way to deliver therapies back to the tumor, Breakefield said.... http://www.reuters.com/article/healthNews/idUSTRE4AF1XN20081116?feedType=nl&feedName=ushealth1100
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Group therapy may extend lives of breast cancer patients (Reuters 11/16) - Psychological group therapy for women with breast cancer may help them not only to cope better with their disease but also live longer, U.S. researchers said on Monday. The idea that such therapy can extend survival in cancer patients has been controversial for two decades. Past studies have yielded conflicting results.
Researchers led by Ohio State University's Barbara Andersen studied 227 women with breast cancer. About half took part in a year of therapy in groups of eight to 12 patients led by two clinical psychologists, while the others did not.... http://www.reuters.com/article/healthNews/idUSTRE4AG0SU20081117?feedType=nl&feedName=ushealth1100
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RANDOM TIDBITS 249 women have been elected or appointed to the U.S. Congress. Jeannette Rankin, Republican from Montana, was the first woman elected to serve in Congress. On November 9, 1916, she was elected to the House of Representatives as Montana's Representative-at-Large to the 65th Congress; she served from 1917–1919. *** 214 women have served in the House of Representatives. Of these, 36 were elected to fill vacancies caused by their husbands' deaths.
Burn Treatment Cream May Delay Healing A cream (Silvadene) commonly used to treat burns may actually delay healing. In addition, despite the wide range of wound dressings available for burns, there is no consensus on the most effective alternative treatment, say Cochrane Researchers who carried out a systematic review of existing data.
Increased understanding of the wound healing process means that there are now a large number of different ways to treat burns. Films, gels, artificial skins and fibre dressings may all help to heal wounds, but doctors still often turn to traditional gauze dressings, as well as silver sulphadiazine (SSD) cream (Silvadene). Healthcare providers have used SSD cream since the 1960s to minimize the risk of burns becoming infected, although concerns have recently been raised about its toxic effects on skin cells. (in my opinion, removing SSD is almost impossible to avoid causing the patient pain....I completely agree with this article).
The Cochrane Team who carried out the research found 26 relevant trials. Although each trial was relatively small they concluded that SSD cream increases the time taken for a wound to heal, as well as increasing the number of dressing applications required.
“We think that the use of SSD cream on burn wounds needs to be reconsidered,” says lead researcher, Jason Wasiak, who works for the Victorian Adult Burns Service at the Alfred Hospital in Melbourne, Australia.
Trials showed that a number of different dressing types, including polyurethane films, hydrocolloid gels and biosynthetic dressings, can be more effective for treatment of moderate burns than SSD or standard chlorhexidine impregnated gauze dressings. As well as reducing healing times, some alternative dressings also reduced pain associated with burns.
Many of the trials, however, failed to adequately assess the depth of burns suffered, so the data was less easy to interpret. The researchers say there is a strong case for larger and better designed trials that will help inform doctors about the most appropriate treatments for burns of different severities.
“There is a need to clearly estimate burn depth in order to make proper recommendations as to the best products for treating burns,” says Wasiak.
Wasiak J, Cleland H, Campbell F. Dressings for superficial and partial thickness burns. Cochrane Database of Systematic Reviews 2008, Issue 4. Art. No.: CD002106. DOI: 10.1002/14651858.CD002106.pub3.
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Irena Sandler was a definitely a Heroine........ This woman was nominated for the Nobel Peace Prize last year. Al Gore won it. What an amazing story! http://en.wikipedia.org/wiki/Irena_Sendler
She rescued 2500 Jewish children, sometimes sedating them so she could smuggle them out in packages, or coffins. She was tortured by the Gestapo. They broke her feet and legs. She went on to continue her work in hiding... February 15, 1910 – May 12, 2008 http://www.auschwitz.dk/rescuers/id17.htm
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Honey Helps To Heal Wounds Honey may reduce healing times in patients suffering mild to moderate burn wounds. A systematic review by Cochrane Researchers concluded that honey might be useful as an alternative to traditional wound dressings in treating burns.
“We’re treating these results with caution, but it looks like honey can help speed up healing in some burns,” says lead researcher Dr Andrew Jull, of the Clinical Trials Research Unit at the University of Auckland, New Zealand.
Honey has been used in wound treatment since ancient times. The mechanism of action is unclear. While honey may help the body remove dead tissue and provide a favourable environment for the growth of new, healthy tissue, current interest in medicinal honey focuses largely on its antibacterial effects.
The review brings together data from 19 clinical trials involving 2554 patients with a range of different wounds. Honey was more effective in reducing healing time compared to some gauze and film dressings that are often used to treat moderate burns. However, the researchers were unable to show any clear benefits for the healing of grazes, lacerations, surgical wounds and leg ulcers.
The researchers don’t advise using honey to treat other types of wounds. “Health services should invest in treatments that have been shown to work,” says Dr Jull. “But, we will keep monitoring new research to try and establish the effect of honey.” Jull AB, Rodgers A, Walker N. Honey as a topical treatment for wounds. Cochrane Database of Systematic Reviews 2008, Issue 4. Art. No.: CD005083. DOI: 10.1002/14651858.CD005083.pub2.
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Overnite dialysis saves lives; Study FRIDAY, Nov. 7 (HealthDay News) -- Dialysis for eight hours a night, three times a week, reduced the risk of death for kidney patients by nearly 80 percent, compared to conventional, four-hour dialysis three times a week, a new study found. This type of improvement is important and necessary, the study's lead author said. "Unfortunately, the mortality rate of patients treated by conventional four hours, three times weekly hemodialysis remains unacceptably high, despite several improvements in dialysis technology and general medical care," said Dr. Ercan Ok, who's with the department of nephrology at Ege University, in Izmir, Turkey.... http://www.healthday.com/Article.asp?AID=621183
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NEW ORLEANS (Reuters 11/09) - AstraZeneca's cholesterol fighter Crestor dramatically cut deaths, heart attacks and strokes in patients with healthy cholesterol levels but who had high levels of a protein associated with heart disease, researchers said on Sunday.
Crestor, known chemically as rosuvastatin, reduced heart attack, stroke, need for bypass or angioplasty procedures and cardiovascular death by a surprising 45 percent over less than two years.
Results of the study, funded by AstraZeneca and called Jupiter, could help open a vast new market for statins as it shines a bright light on C-reactive protein -- an indicator of arterial inflammation -- and its connection to serious heart risks.... http://www.reuters.com/article/healthNews/idUSTRE4A81LH20081109?feedType=nl&feedName=ushealth1100
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LOME (Reuters 11/25) - Togo will start distributing free of charge from November 17 the anti-retroviral drugs that extend the lives of HIV/AIDS patients, its government said Saturday.
"Anti-retroviral medicines distributed by the network of the Central Supply of Essential and Generic Medicines (CAMEG) will be free of charge from Monday 17 November throughout the country," an official statement broadcast on state radio said. Around 25,000 people will benefit from the measure, said Augustin Dokla, who represents a network of HIV/AIDS sufferers, up from 8,000 who already have access to the drugs from CAMEG.... http://www.reuters.com/article/healthNews/idUSTRE4AE32420081115?feedType=nl&feedName=ushealth1100
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Discovery offers way of tracking cancer in the blood (Reuters 11/25) - Tiny sacs released from tumor cells and circulating in the blood carry genetic information about the tumor, offering a new way to track and treat the cancer, U.S. researchers said on Sunday.
"They contain a little piece of the tumor cell in the blood stream. If you just look at these packets, you basically know what kind of mutations are in the tumor cell," said Xandra Breakefield of Massachusetts General Hospital in Boston, whose study appears in the journal Nature Cell Biology.
These membrane-covered packets, called exosomes, represent a new way of getting information about a cancer, offering a means of choosing the best therapy, seeing how a patient responds to treatment, and possibly offering a way to deliver therapies back to the tumor, Breakefield said.... http://www.reuters.com/article/healthNews/idUSTRE4AF1XN20081116?feedType=nl&feedName=ushealth1100
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Group therapy may extend lives of breast cancer patients (Reuters 11/16) - Psychological group therapy for women with breast cancer may help them not only to cope better with their disease but also live longer, U.S. researchers said on Monday. The idea that such therapy can extend survival in cancer patients has been controversial for two decades. Past studies have yielded conflicting results.
Researchers led by Ohio State University's Barbara Andersen studied 227 women with breast cancer. About half took part in a year of therapy in groups of eight to 12 patients led by two clinical psychologists, while the others did not.... http://www.reuters.com/article/healthNews/idUSTRE4AG0SU20081117?feedType=nl&feedName=ushealth1100
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RANDOM TIDBITS 249 women have been elected or appointed to the U.S. Congress. Jeannette Rankin, Republican from Montana, was the first woman elected to serve in Congress. On November 9, 1916, she was elected to the House of Representatives as Montana's Representative-at-Large to the 65th Congress; she served from 1917–1919. *** 214 women have served in the House of Representatives. Of these, 36 were elected to fill vacancies caused by their husbands' deaths.
***
Margaret Chase Smith, a Republican from Maine, holds the record for the being the first woman to serve in both houses of Congress. Originally elected in 1940 to fill the vacancy left by her dying husband, she was then elected to the Senate in 1948.
Representative Patsy Mink, a Democrat from Hawaii, was the first Asian-American woman elected to Congress, in 1965.
***
Edith Nourse Rogers, a Republican from Massachusetts, holds the record for the longest service by a woman in the House of Representatives. Originally elected to fill the vacancy caused by her husband's death, she served from June 25, 1925, until her death on September 10, 1960. ***
Shirley Chisholm, a Democrat from New York, became the first black woman in Congress when she was elected to the House in 1968.
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WASHINGTON (Reuters 11/17) - Women with a family history of breast cancer but who test negative for two genetic mutations commonly linked to it still have a very high risk of developing the disease, Canadian researchers said on Monday. "These women are four times more likely to develop breast cancer than the average woman, translating to roughly a 40 percent lifetime risk of getting the disease", according to researchers led by Dr. Steven Narod of the University of Toronto.
"I think we were surprised that it was that high. But certainly at that level of risk, one would think about preventive measures," Narod, who presented the findings at a meeting of the American Association for Cancer Research, said in a telephone interview.... http://www.reuters.com/article/healthNews/idUSTRE4AG6EN20081117?feedType=nl&feedName=ushealth1100
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Vitamin B12 and Folate and the Risk of Anemia in Old Age : The Leiden 85-Plus Study
Wendy P. J. den Elzen, MSc; Rudi G. J. Westendorp, MD, PhD; Marijke Frölich, PhD; Wouter de Ruijter, MD; Willem J. J. Assendelft, MD, PhD; Jacobijn Gussekloo, MD, PhD Arch Intern Med. 2008;168(20):2238-2244.
Background Screening for deficiencies in vitamin B12 and folate is advocated to prevent anemia in very elderly individuals. However, the effects of vitamin B12 and folate deficiency on the development of anemia in old age have not yet been established.
Methods The current study is embedded in the Leiden 85-Plus Study, a population-based prospective study of subjects aged 85 years. Levels of vitamin B12, folate, and homocysteine were determined at baseline. Hemoglobin levels and mean corpuscular volume (MCV) were determined annually during 5 years of follow-up.
Results We analyzed data from 423 subjects who did not use any form of cyanocobalamin, hydroxocobalamin, or folic acid supplementation, neither at baseline nor during follow-up. Folate deficiency (<7 n =" 34)">13.5 µmol/L; n = 194) were associated with anemia at baseline (adjusted odds ratio [OR], 2.44; 95% confidence interval [CI], 1.06-5.61; and adjusted OR, 1.82; 95% CI, 1.08-3.06, respectively), but vitamin B12 deficiency (<150 n =" 68)" p =" .77)."> .30).
Conclusion In the general population of very elderly individuals, anemia in 85-year-old subjects is associated with folate deficiency and elevated homocysteine levels but not with vitamin B12 deficiency.
Author Affiliations: Departments of Public Health and Primary Care (Ms den Elzen and Drs de Ruijter, Assendelft, and Gussekloo), Gerontology and Geriatrics (Dr Westendorp), and Clinical Chemistry (Dr Frölich), Leiden University Medical Center, Leiden, the Netherlands.
http://archinte.ama-assn.org/cgi/content/abstract/168/20/2238
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(Thanks to BAcello (Barbara) The following starts off slowly similarly to Dickens--- but WOW keep on reading) I truly believe all hospital personnel especially the nurses/ CNAs should be checked for MRSA.
In the spring of 1980, when he was wheeled into Harborview Medical Center, Norman Hurst already had the bug. It was in his blood, his saliva, on his skin, in his burns.
Harborview, atop Seattle's First Hill, was the city's safety net, a public hospital that embraced the poor and scrambled to save people hurt the worst. But Harborview was also a contagion's land of dreams — 300 beds, with a burn unit and bustling intensive-care ward, a concentration of patients with weakened immune systems and open wounds.
At the time, the public had no idea what MRSA was, much less how virulent it could be. But Harborview's doctors knew. The hospital's first case had appeared in 1968. A year after that, an outbreak killed two patients. Doctors wrote up the lessons learned — the need for heightened hygiene among doctors and nurses, the need to identify infected patients and to isolate them.... http://seattletimes.nwsource.com/html/localnews/2008399313_mrsaday20.html
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RANDOM FACT... Immigrants at Ellis Island were served vanilla ice cream as part of their Welcome to America meal.
**********
Don't forget the tetanus shot! Tetanus is an acute, often fatal disease caused by wound contamination with Clostridium tetani. Human tetanus immunoglobulin (TIG) should be given to all individuals who have had skin integrity interrupted by a non-surgical mechanism and who have not received a tetanus toxoide (Td) inoculation in the past 10 years. The TIG should be given before wound debridement because exotoxin may be released during wound manipulation. ( Tetanus shot is recommended for patients with skin tears, also).From Carden DL. Tetanus. In Tintinalli JE, Kelen GD, Stapczynski JS, (eds.). Emergency Medicine: A Comprehensive Study Guide, Sixth Edition. American College of Emergency Physicians. 2004.
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Caregiver supports delay nursing home placement In fact, a recent study suggests that spousal caregivers who get help are able to delay nursing home placement of their loved ones an average of 557 days ... November is National Family Caregivers' Month. “I don't see myself as a caregiver,” more than one older woman has protested, when friends or advisers suggest that they call the Caregiver Resource Center at the Office for the Aging. Yet you can often see in their faces the toll that caring for a frail husband/partner is taking on them. For a variety of reasons, women are more susceptible than men to caregiver burnout and thus becoming an additional victim of their spouse's disabling disease or condition.... http://www.theithacajournal.com/article/20081110/OPINION02/811100318
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This was sent in by Bacello (Barbara) Thank you ! Scabies Scabies is an infestation of the skin caused by parasitic mites called Sarcoptes scabei. Sarcoptes scabiei. Mites are small eight-legged parasites (in contrast to insects, which have six legs). They are tiny, just 1/3 millimeter long, and burrow into the skin to produce intense itching, which tends to be worse at night. The mites which cause scabies are not visible with the naked eye but can be seen with a magnifying glass or microscope. Scabies mites are found worldwide and can affect all races and socioeconomic classes in all climates. The female mite burrows under the top layer of the skin to lay eggs and can remain there for two months. The eggs hatch and become adult mites within ten days and can continue the infestation until proper treatment is applied. http://www.cdph.ca.gov/pubsforms/Guidelines/Pages/HAIandIC.aspx
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WASHINGTON (Reuters 11/9) - The American Medical Association threw its weight behind legislation to ban the use of artificial trans fats in restaurants and bakeries nationwide on Monday.
The group, which represents about 240,000 doctors and medical students, said it would move away from a previous, gentler position that advised people to reduce their use and move to healthier fats and oils instead.
"Trans fats have been proven to raise LDL (low density lipoprotein), the bad cholesterol, while lowering HDL (high density lipoprotein), the good cholesterol, which significantly increases the risk for heart disease," said AMA board member Dr. Mary Anne McCaffree.
"By supporting a ban on the use of artificial trans fats in restaurants and bakeries, we can help improve the quality of the food Americans eat and may ultimately save lives."... http://www.reuters.com/article/healthNews/idUSTRE4A982M20081111?feedType=nl&feedName=ushealth1100
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Release of Report - Freedom from Unnecessary Physical Restraints: Two Decades of National Progress This report evaluates the efforts to reduce the use of physical restraints after Congressional Passage of the 1987 Nursing Home Reform Act. Because of the hard work of practitioners, providers, advocates, and government agencies, the percentage of nursing home residents physically restrained daily substantially declined from 21.1 percent in 1991 to less than 5.0 percent in 2007... http://www.cms.hhs.gov/SurveyCertificationGenInfo/downloads/SCLetter09-11.pdf
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RANDOM FACT... 40% of all people who come to a party in your home snoop in your medicine cabinet.
Olive oil -- the unsaturated fat that’s great for your heart -- is making headlines again. But this time it’s for helping something a little lower down: your stomach. Research suggests that polyphenols in olive oil may inhibit the bacterium that causes most stomach ulcers: H. Pylori.
Antibiotics are the treatment gold standard for Helicobacter pylori, the ulcer-causing bacterium that’s tough enough to survive the acidity of people’s stomachs. But resistant strains of H. pylori are now found worldwide. Fortunately, some researchers are seeking alternative therapies, and in recent studies, the polyphenols in olive oil showed tremendous potential. Not only could they withstand the harsh gastric juices of the stomach, but they also seemed to kill off H. pylori pretty handily -- even antibiotic-resistant strains. Find out how to tell the difference between the burn of a stomach ulcer and the heat of heartburn. Olive Oil Power BoostersTo protect the polyphenols in your olive oil and get the most out of the stuff, store it in a dark bottle away from sunlight, and don’t overheat it. (Check out how the YOU Docs suggest heating your olive oil.) Recipe CornerSqueeze more olive oil into your day with these simple-to-do EatingWell recipes:
Give sauteed veggies a lift with Herbed Extra-Virgin Olive Oil.
Kick up the flavor of salads with a quick homemade dressing. Try this easy Basic Vinaigrette.
Set out these 10-minute Garlic-Herb Marinated Olives at your next soiree.
Reference: In vitro activity of olive oil polyphenols against Helicobacter pylori. Romero, C. et al., Journal of Agriculture and Food Chemistry 2007 Feb 7;55(3):680-686.
********************
Stress Zapping Mineral: It may not get the fanfare that other nutrients do, but this mineral is a stress-fighting superstar: magnesium. As your freak-out level rises, your need for magnesium jumps as well, according to Amy Wechsler, MD, RealAge skin expert and author of The Mind-Beauty Connection. Get at least 400 milligrams a day to soothe an overactive stress-response system.
Mighty Magnesium You can get the magnesium you need from foods like soymilk, black beans, poultry, and halibut -- or you can pop a supplement. If you don’t get enough magnesium, it may elevate your levels of substance P, a chemical that promotes pain and also plays a role in your skin’s stress response (yes, stress attacks your skin, too). So the bonus of getting enough is that you’ll feel better and look better. (Use this online tool to find other good food sources of magnesium.) Another Stress-Fighting Hero Along with magnesium, zinc is another workhorse nutrient you need to zap stress and look and feel your best, notes Wechsler. And you may not be getting enough if you are a vegetarian, take calcium or iron supplements, or are trying to lose weight. You want at least 12 mgms.daily, but no more than 15 mgms. A possible sign that you’re low: itchy and flaky skin. Besides dry skin, see what else zinc can help ward off. For simply beautiful skin, follow Dr. Wechsler’s simple 9-Day Renewal Plan.
Reference: The Mind-Beauty Connection: 9 Days to Reverse Stress Aging and Reveal More Youthful, Beautiful Skin. Wechsler, A., New York: Simon & Schuster, 2008.
******************
RANDOM FACT... Did You Know, Donald Duck comics were banned from Finland because he doesn't wear pants?
******************
Heads up…if you tend to give gift cards around the holidays, you need to be careful that the cards will be honored after the holidays. Stores that are planning to close after Christmas are still selling the cards through the holidays even though the cards will be worthless January 1. There is no law preventing them from doing this. On the contrary, it is referred to as 'Bankruptcy Planning).
Below is a partial list of stores that you need to be cautious about.
"I think we were surprised that it was that high. But certainly at that level of risk, one would think about preventive measures," Narod, who presented the findings at a meeting of the American Association for Cancer Research, said in a telephone interview.... http://www.reuters.com/article/healthNews/idUSTRE4AG6EN20081117?feedType=nl&feedName=ushealth1100
*******************
Vitamin B12 and Folate and the Risk of Anemia in Old Age : The Leiden 85-Plus Study
Wendy P. J. den Elzen, MSc; Rudi G. J. Westendorp, MD, PhD; Marijke Frölich, PhD; Wouter de Ruijter, MD; Willem J. J. Assendelft, MD, PhD; Jacobijn Gussekloo, MD, PhD Arch Intern Med. 2008;168(20):2238-2244.
Background Screening for deficiencies in vitamin B12 and folate is advocated to prevent anemia in very elderly individuals. However, the effects of vitamin B12 and folate deficiency on the development of anemia in old age have not yet been established.
Methods The current study is embedded in the Leiden 85-Plus Study, a population-based prospective study of subjects aged 85 years. Levels of vitamin B12, folate, and homocysteine were determined at baseline. Hemoglobin levels and mean corpuscular volume (MCV) were determined annually during 5 years of follow-up.
Results We analyzed data from 423 subjects who did not use any form of cyanocobalamin, hydroxocobalamin, or folic acid supplementation, neither at baseline nor during follow-up. Folate deficiency (<7 n =" 34)">13.5 µmol/L; n = 194) were associated with anemia at baseline (adjusted odds ratio [OR], 2.44; 95% confidence interval [CI], 1.06-5.61; and adjusted OR, 1.82; 95% CI, 1.08-3.06, respectively), but vitamin B12 deficiency (<150 n =" 68)" p =" .77)."> .30).
Conclusion In the general population of very elderly individuals, anemia in 85-year-old subjects is associated with folate deficiency and elevated homocysteine levels but not with vitamin B12 deficiency.
Author Affiliations: Departments of Public Health and Primary Care (Ms den Elzen and Drs de Ruijter, Assendelft, and Gussekloo), Gerontology and Geriatrics (Dr Westendorp), and Clinical Chemistry (Dr Frölich), Leiden University Medical Center, Leiden, the Netherlands.
http://archinte.ama-assn.org/cgi/content/abstract/168/20/2238
*******************
(Thanks to BAcello (Barbara) The following starts off slowly similarly to Dickens--- but WOW keep on reading) I truly believe all hospital personnel especially the nurses/ CNAs should be checked for MRSA.
In the spring of 1980, when he was wheeled into Harborview Medical Center, Norman Hurst already had the bug. It was in his blood, his saliva, on his skin, in his burns.
Harborview, atop Seattle's First Hill, was the city's safety net, a public hospital that embraced the poor and scrambled to save people hurt the worst. But Harborview was also a contagion's land of dreams — 300 beds, with a burn unit and bustling intensive-care ward, a concentration of patients with weakened immune systems and open wounds.
At the time, the public had no idea what MRSA was, much less how virulent it could be. But Harborview's doctors knew. The hospital's first case had appeared in 1968. A year after that, an outbreak killed two patients. Doctors wrote up the lessons learned — the need for heightened hygiene among doctors and nurses, the need to identify infected patients and to isolate them.... http://seattletimes.nwsource.com/html/localnews/2008399313_mrsaday20.html
*******************
RANDOM FACT... Immigrants at Ellis Island were served vanilla ice cream as part of their Welcome to America meal.
**********
Don't forget the tetanus shot! Tetanus is an acute, often fatal disease caused by wound contamination with Clostridium tetani. Human tetanus immunoglobulin (TIG) should be given to all individuals who have had skin integrity interrupted by a non-surgical mechanism and who have not received a tetanus toxoide (Td) inoculation in the past 10 years. The TIG should be given before wound debridement because exotoxin may be released during wound manipulation. ( Tetanus shot is recommended for patients with skin tears, also).From Carden DL. Tetanus. In Tintinalli JE, Kelen GD, Stapczynski JS, (eds.). Emergency Medicine: A Comprehensive Study Guide, Sixth Edition. American College of Emergency Physicians. 2004.
***********************
Caregiver supports delay nursing home placement In fact, a recent study suggests that spousal caregivers who get help are able to delay nursing home placement of their loved ones an average of 557 days ... November is National Family Caregivers' Month. “I don't see myself as a caregiver,” more than one older woman has protested, when friends or advisers suggest that they call the Caregiver Resource Center at the Office for the Aging. Yet you can often see in their faces the toll that caring for a frail husband/partner is taking on them. For a variety of reasons, women are more susceptible than men to caregiver burnout and thus becoming an additional victim of their spouse's disabling disease or condition.... http://www.theithacajournal.com/article/20081110/OPINION02/811100318
****************
This was sent in by Bacello (Barbara) Thank you ! Scabies Scabies is an infestation of the skin caused by parasitic mites called Sarcoptes scabei. Sarcoptes scabiei. Mites are small eight-legged parasites (in contrast to insects, which have six legs). They are tiny, just 1/3 millimeter long, and burrow into the skin to produce intense itching, which tends to be worse at night. The mites which cause scabies are not visible with the naked eye but can be seen with a magnifying glass or microscope. Scabies mites are found worldwide and can affect all races and socioeconomic classes in all climates. The female mite burrows under the top layer of the skin to lay eggs and can remain there for two months. The eggs hatch and become adult mites within ten days and can continue the infestation until proper treatment is applied. http://www.cdph.ca.gov/pubsforms/Guidelines/Pages/HAIandIC.aspx
************************
WASHINGTON (Reuters 11/9) - The American Medical Association threw its weight behind legislation to ban the use of artificial trans fats in restaurants and bakeries nationwide on Monday.
The group, which represents about 240,000 doctors and medical students, said it would move away from a previous, gentler position that advised people to reduce their use and move to healthier fats and oils instead.
"Trans fats have been proven to raise LDL (low density lipoprotein), the bad cholesterol, while lowering HDL (high density lipoprotein), the good cholesterol, which significantly increases the risk for heart disease," said AMA board member Dr. Mary Anne McCaffree.
"By supporting a ban on the use of artificial trans fats in restaurants and bakeries, we can help improve the quality of the food Americans eat and may ultimately save lives."... http://www.reuters.com/article/healthNews/idUSTRE4A982M20081111?feedType=nl&feedName=ushealth1100
**************
Release of Report - Freedom from Unnecessary Physical Restraints: Two Decades of National Progress This report evaluates the efforts to reduce the use of physical restraints after Congressional Passage of the 1987 Nursing Home Reform Act. Because of the hard work of practitioners, providers, advocates, and government agencies, the percentage of nursing home residents physically restrained daily substantially declined from 21.1 percent in 1991 to less than 5.0 percent in 2007... http://www.cms.hhs.gov/SurveyCertificationGenInfo/downloads/SCLetter09-11.pdf
***********************
RANDOM FACT... 40% of all people who come to a party in your home snoop in your medicine cabinet.
Olive oil -- the unsaturated fat that’s great for your heart -- is making headlines again. But this time it’s for helping something a little lower down: your stomach. Research suggests that polyphenols in olive oil may inhibit the bacterium that causes most stomach ulcers: H. Pylori.
Antibiotics are the treatment gold standard for Helicobacter pylori, the ulcer-causing bacterium that’s tough enough to survive the acidity of people’s stomachs. But resistant strains of H. pylori are now found worldwide. Fortunately, some researchers are seeking alternative therapies, and in recent studies, the polyphenols in olive oil showed tremendous potential. Not only could they withstand the harsh gastric juices of the stomach, but they also seemed to kill off H. pylori pretty handily -- even antibiotic-resistant strains. Find out how to tell the difference between the burn of a stomach ulcer and the heat of heartburn. Olive Oil Power BoostersTo protect the polyphenols in your olive oil and get the most out of the stuff, store it in a dark bottle away from sunlight, and don’t overheat it. (Check out how the YOU Docs suggest heating your olive oil.) Recipe CornerSqueeze more olive oil into your day with these simple-to-do EatingWell recipes:
Give sauteed veggies a lift with Herbed Extra-Virgin Olive Oil.
Kick up the flavor of salads with a quick homemade dressing. Try this easy Basic Vinaigrette.
Set out these 10-minute Garlic-Herb Marinated Olives at your next soiree.
Reference: In vitro activity of olive oil polyphenols against Helicobacter pylori. Romero, C. et al., Journal of Agriculture and Food Chemistry 2007 Feb 7;55(3):680-686.
********************
Stress Zapping Mineral: It may not get the fanfare that other nutrients do, but this mineral is a stress-fighting superstar: magnesium. As your freak-out level rises, your need for magnesium jumps as well, according to Amy Wechsler, MD, RealAge skin expert and author of The Mind-Beauty Connection. Get at least 400 milligrams a day to soothe an overactive stress-response system.
Mighty Magnesium You can get the magnesium you need from foods like soymilk, black beans, poultry, and halibut -- or you can pop a supplement. If you don’t get enough magnesium, it may elevate your levels of substance P, a chemical that promotes pain and also plays a role in your skin’s stress response (yes, stress attacks your skin, too). So the bonus of getting enough is that you’ll feel better and look better. (Use this online tool to find other good food sources of magnesium.) Another Stress-Fighting Hero Along with magnesium, zinc is another workhorse nutrient you need to zap stress and look and feel your best, notes Wechsler. And you may not be getting enough if you are a vegetarian, take calcium or iron supplements, or are trying to lose weight. You want at least 12 mgms.daily, but no more than 15 mgms. A possible sign that you’re low: itchy and flaky skin. Besides dry skin, see what else zinc can help ward off. For simply beautiful skin, follow Dr. Wechsler’s simple 9-Day Renewal Plan.
Reference: The Mind-Beauty Connection: 9 Days to Reverse Stress Aging and Reveal More Youthful, Beautiful Skin. Wechsler, A., New York: Simon & Schuster, 2008.
******************
RANDOM FACT... Did You Know, Donald Duck comics were banned from Finland because he doesn't wear pants?
******************
Heads up…if you tend to give gift cards around the holidays, you need to be careful that the cards will be honored after the holidays. Stores that are planning to close after Christmas are still selling the cards through the holidays even though the cards will be worthless January 1. There is no law preventing them from doing this. On the contrary, it is referred to as 'Bankruptcy Planning).
Below is a partial list of stores that you need to be cautious about.
Circuit City (filed Chapter 11) ,Ann Taylor- 117 stores nationwide closing, Lane Bryant, Fashion Bug , Catherine's to close 150 stores nationwide , Eddie Bauer to close stores 27 stores and more after January, Cache will close all stores, Talbots closing down specialty stores , J. Jill closing all stores (owned by Talbots) , Pacific Sunwear (also owned by Talbots) , GAP closing 85 stores , Footlocker closing 140 stores more to close after January, Wickes Furniture closing down , Levitz closing down remaining stores , Bombay closing remaining stores, Zales closing down 82 stores and 105 after January. Whitehall closing all stores , Piercing Pagoda closing all stores, Disney closing 98 stores and will close more after January, Home Depot closing 15 stores, Macys to close 9 stores after January , Linens and Things closing all stores , Movie Galley Closing all stores , Pep Boys Closing 33 stores , Sprint/Nextel closing 133 stores, JC Penney closing a number of stores after January , Ethan Allen closing down 12 stores, Wilson Leather closing down all stores , Sharper Image closing down all stores , K B Toys closing 356 stores, Loews to close down some stores , Dillard's to close some stores.
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FDA receives 930 reports of wrinkle-filler issues WASHINGTON (Reuters 11/17) - U.S. regulators have received reports of serious and unexpected problems in people treated with wrinkle-fighting injections known as dermal fillers, Food and Drug Administration staff said in a report released on Friday. The problems included facial palsy, disfigurement and "rare but life-threatening events such as severe allergic reactions and anaphylactic shock," the FDA staff said.
The agency said it received a total of 930 reports of health problems over the past six years. Many included known complications such as minor swelling. The FDA did not identify which products had reports of more serious problems.... http://www.msnbc.msn.com/id/27720360/
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this is from Melva (MJSolon@AOL.com) Thank you ! WASHINGTON (Reuters 11/19) – Banning fast-food advertising on television in the United States could reduce the number of overweight children by as much as 18 percent, researchers said on Wednesday. But the team at the National Bureau of Economic Research questioned whether it would be practical to impose that kind of government regulation -- something only Sweden, Norway and Finland have done.
"We have known for some time that childhood obesity has gripped our culture, but little empirical research has been done that identifies television advertising as a possible cause," said economist Shin-Yi Chou of Lehigh University in Pennsylvania.... http://news.yahoo.com/s/nm/20081119/hl_nm/us_obesity_advertising
********************
This is from BAcello (Thanks Barbara) Nurses Finding a Better Way The focus on best practices in all areas of health care has expanded the role of many nurses. In addition to their jobs as caregivers, educators, advanced practitioners or administrators, nurses are now adding one more role: researcher.
Health care leaders say that having nurses identify problems, ask questions and share outcomes is not only good for patients; it’s good for the profession.ursing is still evolving as a profession, and research adds to nursing theory and knowledge. We all learn a lot from it,” said JoEllen Dattilo, Ph.D., RN, professor and associate dean of the Georgia Baptist College of Nursing of Mercer University in Atlanta.
Nurses are often involved in clinical trials led by doctors and scientists. Increasingly, they also are making their own qualitative and quantitative studies into education, medications, procedures and day-to-day practice.
“There’s more emphasis placed on research in nursing today, and evidence-based practice is driving it,” said Helen Hodges, Ph.D., RN, professor and coordinator of the RN and BSN programs at the Georgia Baptist College of Nursing. “More and more, nurses are taking research out of the ivory tower and putting it at the bedside in order to facilitate the best patient outcomes.... http://www.ajc.com/services/content/hotjobs/careercenter/pulse/2008/11/16/nurses_research.html
~~**~~**~~**~~**~~**~~
HUMOR SECTION
Buying Monkeys ( A lesson)
************************
FDA receives 930 reports of wrinkle-filler issues WASHINGTON (Reuters 11/17) - U.S. regulators have received reports of serious and unexpected problems in people treated with wrinkle-fighting injections known as dermal fillers, Food and Drug Administration staff said in a report released on Friday. The problems included facial palsy, disfigurement and "rare but life-threatening events such as severe allergic reactions and anaphylactic shock," the FDA staff said.
The agency said it received a total of 930 reports of health problems over the past six years. Many included known complications such as minor swelling. The FDA did not identify which products had reports of more serious problems.... http://www.msnbc.msn.com/id/27720360/
**************************
this is from Melva (MJSolon@AOL.com) Thank you ! WASHINGTON (Reuters 11/19) – Banning fast-food advertising on television in the United States could reduce the number of overweight children by as much as 18 percent, researchers said on Wednesday. But the team at the National Bureau of Economic Research questioned whether it would be practical to impose that kind of government regulation -- something only Sweden, Norway and Finland have done.
"We have known for some time that childhood obesity has gripped our culture, but little empirical research has been done that identifies television advertising as a possible cause," said economist Shin-Yi Chou of Lehigh University in Pennsylvania.... http://news.yahoo.com/s/nm/20081119/hl_nm/us_obesity_advertising
********************
This is from BAcello (Thanks Barbara) Nurses Finding a Better Way The focus on best practices in all areas of health care has expanded the role of many nurses. In addition to their jobs as caregivers, educators, advanced practitioners or administrators, nurses are now adding one more role: researcher.
Health care leaders say that having nurses identify problems, ask questions and share outcomes is not only good for patients; it’s good for the profession.ursing is still evolving as a profession, and research adds to nursing theory and knowledge. We all learn a lot from it,” said JoEllen Dattilo, Ph.D., RN, professor and associate dean of the Georgia Baptist College of Nursing of Mercer University in Atlanta.
Nurses are often involved in clinical trials led by doctors and scientists. Increasingly, they also are making their own qualitative and quantitative studies into education, medications, procedures and day-to-day practice.
“There’s more emphasis placed on research in nursing today, and evidence-based practice is driving it,” said Helen Hodges, Ph.D., RN, professor and coordinator of the RN and BSN programs at the Georgia Baptist College of Nursing. “More and more, nurses are taking research out of the ivory tower and putting it at the bedside in order to facilitate the best patient outcomes.... http://www.ajc.com/services/content/hotjobs/careercenter/pulse/2008/11/16/nurses_research.html
~~**~~**~~**~~**~~**~~
HUMOR SECTION
Buying Monkeys ( A lesson)
Once upon a time a man appeared in a village and announced to the villagers that he would buy monkeys for $10 each. The villagers, seeing that there were many monkeys around, went out to the forest and started catching them. The man bought thousands at $10 and, as supply started to diminish, the villagers stopped their effort. He next announced that he would now buy monkeys at $20 each. This renewed the efforts of the villagers and they started catching monkeys again. Soon the supply diminished even further and people started going back to their farms. The offer increased to $25 each and the supply of monkeys became so scarce it was an effort to even find a monkey, let alone catch it!
The man now announced that he would buy monkeys at $50 each! However, since he had to go to the city on some business, his assistant would buy on his behalf. In the absence of the man, the assistant told the villagers: "Look at all these monkeys in the big cage that the man has already collected. I will sell them to you at $35 and when the man returns from the city, you can sell them to him for $50 each."
The villagers rounded up all their savings and bought all the monkeys for 700 billion dollars. They never saw the man or his assistant again, only lots and lots of monkeys! Now you have a better understanding of how the WALL STREET BAILOUT PLAN WILL WORK !!!
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CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise.........IF you have a favorite CEU/CME site, please share ! Send your links to me: RNFrankie@AOL.com
Free CEs http://www.myfreece.com/welcome.asp
https://nursing.advanceweb.com/CE/TestCenter/Main.aspx
Can either pay $8 / course OR pay $26.99 for a year for all the CE courses you want to take
.
www.nurse.com Pay Only $34.99 for a full year of CONTACT HOURS .
CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise.........IF you have a favorite CEU/CME site, please share ! Send your links to me: RNFrankie@AOL.com
Free CEs http://www.myfreece.com/welcome.asp
https://nursing.advanceweb.com/CE/TestCenter/Main.aspx
Can either pay $8 / course OR pay $26.99 for a year for all the CE courses you want to take
.
www.nurse.com Pay Only $34.99 for a full year of CONTACT HOURS .
~~**~~**~~**~~**~~**~~
WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to:RNFrankie@AOL.com.
http://www.thebreastcancersite.com/clickToGive/home.faces?siteId=2
http://www.snopes.com
the National Nurse's new website: http://nationalnurse.org/
WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to:RNFrankie@AOL.com.
http://www.thebreastcancersite.com/clickToGive/home.faces?siteId=2
http://www.snopes.com
the National Nurse's new website: http://nationalnurse.org/
http://www.solutionsoutsidethebox.net/ (nursing)
This website (for registering the CELL PHONES) was sent in by Laregis@AOL.com (Laura) who sends in a prodigious amount of articles for the Newsletter. Thank you !
https://www.donotcall.gov/
http://www.thebreastcancersite.com/clickToGive/home.faces?siteId=2
Very interesting website on analyzing handwriting and finding those who lie:
http://www.aolhealth.com/healthy-living/handwriting-personality?icid=200100397x1212557405x1200829748
Any time you want to check a rumor ... this is the link: http://www.snopes.com/
This is fun! See if you can place the state:
http://www.sheppardsoftware.com/states_experiment_drag-drop_Intermed_State15s_500.html
This website (for registering the CELL PHONES) was sent in by Laregis@AOL.com (Laura) who sends in a prodigious amount of articles for the Newsletter. Thank you !
https://www.donotcall.gov/
http://www.thebreastcancersite.com/clickToGive/home.faces?siteId=2
Very interesting website on analyzing handwriting and finding those who lie:
http://www.aolhealth.com/healthy-living/handwriting-personality?icid=200100397x1212557405x1200829748
Any time you want to check a rumor ... this is the link: http://www.snopes.com/
This is fun! See if you can place the state:
http://www.sheppardsoftware.com/states_experiment_drag-drop_Intermed_State15s_500.html
This site has passed the Snopes.com test
http://www.theanimalrescuesite.com/clickToGive/home.faces?siteId=3
Nursing practice manual-also see the menu on the left for other items http://nursing.uchc.edu/nursing_standards/index.html Hospital forms repository-many forms are relevant to or can be modified for LTC. You can download and open the files marked as 'view' for free. They charge for the others.http://www.hospital-forms.com/#E
*******************************************************
********************************************
*
MEDICAL RECALLS
*
*******************************************
******************************************************
Zhen De Shou Fat Loss Capsules Fashion Sanctuary announced a recall of Zhen De Shou Fat Loss Capsules because FDA analysis found the product to contain undeclared sibutramine, an FDA approved drug used as an appetite suppressant for weight loss. This poses a potential threat to consumers because sibutramine is known to substantially increase blood pressure and/or pulse rate in some patients and may present a significant risk for patients with a history of coronary artery disease, congestive heart failure, arrhythmias or stroke. The product was primarily distributed in the U.S and sold via the Internet and the recall affects all lot codes and use by dates. Consumers who may have purchased product from this company should immediately discontinue using the product.
http://www.fda.gov/medwatch/safety/2008/safety08.htm#Zhen
********************************
Starcaps Dietary Supplement Capsules Balanced Health Products, Inc. announced a recall of STARCAPS due to the presence of an undeclared drug ingredient, Bumetanide. Bumetanide is a diuretic indicated for the treatment of edema associated with congestive heart failure, hepatic and renal disease including nephrotic syndrome. Potential risks associated with the use of Bumetanide include serious and significant fluid and electrolyte loss and an elevation in uric acid concentrations. Consumers should not take Bumetanide if they are allergic to sulfonamides. Significant drug interactions with Bumetanide, such as with digoxin and lithium, may lead to an increase risk of toxicity. Patients may also be at an increased risk of hypotension (low blood pressure), fainting (syncope) and resultant injury if they have normal blood pressure or are already taking an antihypertensive medication and take STARCAPS with undeclared Bumetanide. Consumers who have this product should immediately discontinue taking it and return the product to the manufacturer. See the company's press release for specific lot number information. http://www.fda.gov/medwatch/safety/2008/safety08.htm#Starcaps
***********************
Follow-up to the October 1, 2007, Early Communication about the Ongoing Safety Review of Bisphosphonates: marketed as Alendronate (Fosamax, Fosamax Plus D) Etidronate (Didronel) Ibandronate (Boniva) Pamidronate (Aredia) Risedronate (Actonel, Actonel W/Calcium) Tiludronate (Skelid) Zoledronic acid (Reclast, Zometa)
FDA issued an update about the Agency's review of safety data regarding the potential increased risk of atrial fibrillation in patients treated with a bisphosphonate drug. Bisphosphonates are a class of drugs used primarily to increase bone mass and reduce the risk for fracture in patients with osteoporosis, slow bone turnover in patients with Paget’s disease of the bone, and to treat bone metastases and lower elevated levels of blood calcium in patients with cancer. FDA reviewed data on 19,687 bisphosphonate-treated patients and 18,358 placebo-treated patients who were followed for 6 months to 3 years. The occurrence of atrial fibrillation was rare within each study, with most studies containing 2 or fewer events. Across all studies, no clear association between overall bisphosphonate exposure and the rate of serious or non-serious atrial fibrillation was observed. Additionally, increasing dose or duration of bisphosphonate therapy was not associated with an increase rate of atrial fibrillation. Healthcare professionals should not alter their prescribing patterns for bisphosphonates and patients should not stop taking their bisphosphonate medication. http://www.fda.gov/medwatch/safety/2008/safety08.htm#bisphosphonates2
*********************************
Infants' Mylicon Gas Relief Dye Free Drops (Simethicone-Antigas) Johnson & Johnson- Merck Consumer Pharmaceuticals Company and FDA notified consumers and healthcare professionals of a voluntary recall of Infants' Mylicon Gas Relief Dye Free Drops ( Lot No. SMF007 and SMF008) sold in 1 oz plastic bottles that were distributed after October 5, 2008, nationwide. The product was recalled because some bottles could include metal fragments that were generated during the manufacturing process. Parents who have given the product to their infant and are concerned should contact their healthcare professional. http://www.fda.gov/medwatch/safety/2008/safety08.htm#mylicon
********************
CSI USA Inc. and FDA informed consumers and healthcare professionals of a nationwide recall of all lots of 1 ounce tubes of 10% Benzoyl Peroxide Acne Cream. The products were recalled because samples of the products were found to contain bacteria, Burkholderia Cepacia, formerly known as Pseudomonas Cepacia. There may be an increased health risk of infections for individuals with cuts, scrapes, rashes or other compromised skin conditions; or those with weakened or suppressed immune systems. Consumers should discontinue using the product and should return it to the place of purchase. http://www.fda.gov/medwatch/safety/2008/safety08.htm#Benzoyl
*********************
Animas Corporation and FDA informed consumers and healthcare professionals of a nationwide recall of battery caps used with the OneTouch Ping System, Animas 2020 Insulin Pump, Animas IR1200 Insulin Pump, and Animas IR1250 Insulin Pump. The battery caps used with the above infusion pumps were manufactured from June 1, 2008 through July 31, 2008, and were distributed from June 16, 2008 through August 1, 2008. There may be an intermittent loss of contact between the battery cap and the battery compartment in the pump which may result in the device resetting. This can cause the device to stop administering insulin, which could result in an excess level of glucose in the blood (hyperglycemia). Additionally, this failure may lead to user confusion in the amount of insulin administered, contributing to errors in future doses, which may result in lower than normal level of glucose in the blood (hypoglycemia). Healthcare professionals are advised to ensure that their patients replace the battery cap on their insulin pump. http://www.fda.gov/medwatch/safety/2008/safety08.htm#batterycap
~~**~~**~~**~~**~~**~~
NURSING HINTS CORNER
Finding needed numbers easily... We tape the materials'management'order numbers for defibrillator pads, electrocardiogram machine paper, and electrodes to the defibrillator. This makes it easy for the person who uses these supplies in an emergency or who finds them missing during daily code cart checks to replace them. All the nurse has to do is look at the defibrillator for the order numbers, not having to hunt through the supply book. Julie R. Welsh, RN, MS
Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p. 13 Springhouse Corporation/www.springnetcom.
http://www.theanimalrescuesite.com/clickToGive/home.faces?siteId=3
Nursing practice manual-also see the menu on the left for other items http://nursing.uchc.edu/nursing_standards/index.html Hospital forms repository-many forms are relevant to or can be modified for LTC. You can download and open the files marked as 'view' for free. They charge for the others.http://www.hospital-forms.com/#E
*******************************************************
********************************************
*
MEDICAL RECALLS
*
*******************************************
******************************************************
Zhen De Shou Fat Loss Capsules Fashion Sanctuary announced a recall of Zhen De Shou Fat Loss Capsules because FDA analysis found the product to contain undeclared sibutramine, an FDA approved drug used as an appetite suppressant for weight loss. This poses a potential threat to consumers because sibutramine is known to substantially increase blood pressure and/or pulse rate in some patients and may present a significant risk for patients with a history of coronary artery disease, congestive heart failure, arrhythmias or stroke. The product was primarily distributed in the U.S and sold via the Internet and the recall affects all lot codes and use by dates. Consumers who may have purchased product from this company should immediately discontinue using the product.
http://www.fda.gov/medwatch/safety/2008/safety08.htm#Zhen
********************************
Starcaps Dietary Supplement Capsules Balanced Health Products, Inc. announced a recall of STARCAPS due to the presence of an undeclared drug ingredient, Bumetanide. Bumetanide is a diuretic indicated for the treatment of edema associated with congestive heart failure, hepatic and renal disease including nephrotic syndrome. Potential risks associated with the use of Bumetanide include serious and significant fluid and electrolyte loss and an elevation in uric acid concentrations. Consumers should not take Bumetanide if they are allergic to sulfonamides. Significant drug interactions with Bumetanide, such as with digoxin and lithium, may lead to an increase risk of toxicity. Patients may also be at an increased risk of hypotension (low blood pressure), fainting (syncope) and resultant injury if they have normal blood pressure or are already taking an antihypertensive medication and take STARCAPS with undeclared Bumetanide. Consumers who have this product should immediately discontinue taking it and return the product to the manufacturer. See the company's press release for specific lot number information. http://www.fda.gov/medwatch/safety/2008/safety08.htm#Starcaps
***********************
Follow-up to the October 1, 2007, Early Communication about the Ongoing Safety Review of Bisphosphonates: marketed as Alendronate (Fosamax, Fosamax Plus D) Etidronate (Didronel) Ibandronate (Boniva) Pamidronate (Aredia) Risedronate (Actonel, Actonel W/Calcium) Tiludronate (Skelid) Zoledronic acid (Reclast, Zometa)
FDA issued an update about the Agency's review of safety data regarding the potential increased risk of atrial fibrillation in patients treated with a bisphosphonate drug. Bisphosphonates are a class of drugs used primarily to increase bone mass and reduce the risk for fracture in patients with osteoporosis, slow bone turnover in patients with Paget’s disease of the bone, and to treat bone metastases and lower elevated levels of blood calcium in patients with cancer. FDA reviewed data on 19,687 bisphosphonate-treated patients and 18,358 placebo-treated patients who were followed for 6 months to 3 years. The occurrence of atrial fibrillation was rare within each study, with most studies containing 2 or fewer events. Across all studies, no clear association between overall bisphosphonate exposure and the rate of serious or non-serious atrial fibrillation was observed. Additionally, increasing dose or duration of bisphosphonate therapy was not associated with an increase rate of atrial fibrillation. Healthcare professionals should not alter their prescribing patterns for bisphosphonates and patients should not stop taking their bisphosphonate medication. http://www.fda.gov/medwatch/safety/2008/safety08.htm#bisphosphonates2
*********************************
Infants' Mylicon Gas Relief Dye Free Drops (Simethicone-Antigas) Johnson & Johnson- Merck Consumer Pharmaceuticals Company and FDA notified consumers and healthcare professionals of a voluntary recall of Infants' Mylicon Gas Relief Dye Free Drops ( Lot No. SMF007 and SMF008) sold in 1 oz plastic bottles that were distributed after October 5, 2008, nationwide. The product was recalled because some bottles could include metal fragments that were generated during the manufacturing process. Parents who have given the product to their infant and are concerned should contact their healthcare professional. http://www.fda.gov/medwatch/safety/2008/safety08.htm#mylicon
********************
CSI USA Inc. and FDA informed consumers and healthcare professionals of a nationwide recall of all lots of 1 ounce tubes of 10% Benzoyl Peroxide Acne Cream. The products were recalled because samples of the products were found to contain bacteria, Burkholderia Cepacia, formerly known as Pseudomonas Cepacia. There may be an increased health risk of infections for individuals with cuts, scrapes, rashes or other compromised skin conditions; or those with weakened or suppressed immune systems. Consumers should discontinue using the product and should return it to the place of purchase. http://www.fda.gov/medwatch/safety/2008/safety08.htm#Benzoyl
*********************
Animas Corporation and FDA informed consumers and healthcare professionals of a nationwide recall of battery caps used with the OneTouch Ping System, Animas 2020 Insulin Pump, Animas IR1200 Insulin Pump, and Animas IR1250 Insulin Pump. The battery caps used with the above infusion pumps were manufactured from June 1, 2008 through July 31, 2008, and were distributed from June 16, 2008 through August 1, 2008. There may be an intermittent loss of contact between the battery cap and the battery compartment in the pump which may result in the device resetting. This can cause the device to stop administering insulin, which could result in an excess level of glucose in the blood (hyperglycemia). Additionally, this failure may lead to user confusion in the amount of insulin administered, contributing to errors in future doses, which may result in lower than normal level of glucose in the blood (hypoglycemia). Healthcare professionals are advised to ensure that their patients replace the battery cap on their insulin pump. http://www.fda.gov/medwatch/safety/2008/safety08.htm#batterycap
~~**~~**~~**~~**~~**~~
NURSING HINTS CORNER
Finding needed numbers easily... We tape the materials'management'order numbers for defibrillator pads, electrocardiogram machine paper, and electrodes to the defibrillator. This makes it easy for the person who uses these supplies in an emergency or who finds them missing during daily code cart checks to replace them. All the nurse has to do is look at the defibrillator for the order numbers, not having to hunt through the supply book. Julie R. Welsh, RN, MS
Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p. 13 Springhouse Corporation/www.springnetcom.
~~**~~**~~**~~**~~**~~
ADVERTISEMENTS
from the members
This ad is from Decubqueen (Gerry)..........Accu-RulerAccurate wound measurement designed by nurses, for nurses. Now carrying wound care and first-aid supplies at prices you can afford. By using the following code: Paradigm10 , you will get 10% off of their first order.
( I have ordered through Gerry...and it was a very satisfactory )
Visit us at http://www.accu-ruler.com/
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NEW MEMBERS
Please send the prospective members' first and screen names to me: RNFrankie@AOL.com
WELCOME TO: lesliemostly@gmail.com Leslie 11/14/08
~~**~~**~~**~~**~~**~~
NOTICE:
I attempt to send newsletters to your current email addresses on file and if the newsletters are rejected THREE consecutive times, I must then delete the email address until you contact me with an updated email address; I have no way to reach you without a correct email address....You could always send me your Home number.......lol. So please send me your new name/address, ok? RNFrankie@AOL.com
ADVERTISEMENTS
from the members
This ad is from Decubqueen (Gerry)..........Accu-RulerAccurate wound measurement designed by nurses, for nurses. Now carrying wound care and first-aid supplies at prices you can afford. By using the following code: Paradigm10 , you will get 10% off of their first order.
( I have ordered through Gerry...and it was a very satisfactory )
Visit us at http://www.accu-ruler.com/
~~**~~**~~**~~**~~**~~
NEW MEMBERS
Please send the prospective members' first and screen names to me: RNFrankie@AOL.com
WELCOME TO: lesliemostly@gmail.com Leslie 11/14/08
~~**~~**~~**~~**~~**~~
NOTICE:
I attempt to send newsletters to your current email addresses on file and if the newsletters are rejected THREE consecutive times, I must then delete the email address until you contact me with an updated email address; I have no way to reach you without a correct email address....You could always send me your Home number.......lol. So please send me your new name/address, ok? RNFrankie@AOL.com
~~**~~**~~**~~**~~**~~
EDITORIAL STAFF:
GingerMyst @AOL.com (Anne), GALLO RN @AOL.com (Sue), HSears9868 @AOL.com (Bonnie), Laregis @AOL.com (Laura), Mrwrn @AOL.com (Miriam), and Schulthe @AOL.com (Susan)
~~**~~**~~**~~**~~**~~
PARADIGM 97 CO-FOUNDERS:
MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (Frankie)
EDITORIAL STAFF:
GingerMyst @AOL.com (Anne), GALLO RN @AOL.com (Sue), HSears9868 @AOL.com (Bonnie), Laregis @AOL.com (Laura), Mrwrn @AOL.com (Miriam), and Schulthe @AOL.com (Susan)
~~**~~**~~**~~**~~**~~
PARADIGM 97 CO-FOUNDERS:
MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (Frankie)
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DISCLAIMER: The intent of this PARADIGM BYTES Newsletter is to provide communication and information for our members. Please research the hyperlinks and information provided by our members. The articles and web sites are not personally endorsed by the editors, nor do the articles necessarily reflect the staff's views.
DISCLAIMER: The intent of this PARADIGM BYTES Newsletter is to provide communication and information for our members. Please research the hyperlinks and information provided by our members. The articles and web sites are not personally endorsed by the editors, nor do the articles necessarily reflect the staff's views.
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THOUGHT FOR THE DAY
"He that displays too often his wife and his wallet-- is in danger of having both of them borrowed."
- Benjamin Franklin
Hope to see you online..... Frankie
( RNFrankie@AOL.com )
THOUGHT FOR THE DAY
"He that displays too often his wife and his wallet-- is in danger of having both of them borrowed."
- Benjamin Franklin
Hope to see you online..... Frankie
( RNFrankie@AOL.com )
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