Friday, March 7, 2008

PARADIGM BYTES


PARADIGM BYTES

Newsletter for Paradigm 97
March 7, 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.

~~**~~**~~**~~**~~**~~
Please drop in ...the AOL chatroom is Paradigm97 chatroom is always there....door open, lights on, waiting for you to come in. Check your Buddy List.....and invite your friends in for a short or long chat
***~~~***~~~***~~~***
SNIPPETS
This isn't my usual SNIPPET, as you well know, but I thought this was a very good idea..and wanted to share. Frankie

Q: Should we create a Modern Museum of Nursing to show the world how vital, exciting, and technologically advanced nursing really is?

A: Why, yes, what a great idea!

We should establish a Modern Museum of Nursing where people from all over the world can come to learn about what nurses today do to save lives and improve outcomes. Public understanding of nursing is abysmally poor. This is a major factor underlying many of the more immediate causes of the deadly global nursing shortage. By increasing understanding of the profession, nursing can attract the new members and resources it needs to meet the health care challenges of the 21st century. A landmark, high-tech science museum devoted to nursing could be a powerful tool in these efforts.
We envision an interactive nursing science museum in a major city that would garner national and local financial support and become one of the sites that travelers to that city "must visit." The museum would show not only the development of nursing, but also the diverse and exciting modern reality: that nursing is an autonomous profession whose members use innovative practice and the latest technologies to help people regain and maintain health, and that nurse scholars work on the cutting edge of health research. Visitors would be invited to put themselves in the place of nurses on the front lines, in settings ranging from the extreme high-tech of teaching hospital ICU's, to chaotic urban level one trauma centers, to major health policymaking and research centers, to small community health projects in remote locations, to development and humanitarian relief projects around the world.
Imagine a museum visitor walks into a "patient's room" in a "hospital." The visitor might be asked what he has seen in the first few seconds. Then the visitor might be shown, through audio and visual displays, the countless things a skilled nurse would have seen in this same time--aspects of the patient's physical and emotional state, things that provide clues to the patient's condition. Suddenly, monitors starting beeping. The patient is coding! What will the visitor do? Again the visitor can be shown the many things a skilled nurse would have done in the first few moments. Perhaps the visitor can take part in simulated versions of some of them, like defibrillation (obviously without live current). Or perhaps the patient is not in immediate physical danger, but is in despair because of the toll her chronic illness has taken on her and her family. What would the "visitor" say and do? What would a skilled nurse say and do?
But aren't there already museums of nursing? There are, and we believe that many of these museums play an important role in preserving the profession's history, particularly as to specific geographic and specialty areas and institutions. Such museums often focus on preserving artifacts of nursing in prior eras. However, to our knowledge there is no major museum devoted to showing the broader public what nursing really is today and why it matters.
The new museum we propose might utilize the kind of evolving technologies that major science museums are now using to bring scientific endeavors alive for the public. Examples include the Field Museum in Chicago, the Science Museum in London, and the Deutsches Museum in Munich. The Science Museum's Health Matters gallery includes a range of interactive exhibits to give visitors a sense of the scope and importance of modern health science. Philadelphia's Franklin Institute currently devotes significant resources not only to its giant walk-through heart, but a range of related health exhibits and equipment.
These museums convey the value of modern science and technology. They inspire public support for the ongoing work of science--support that nursing needs desperately. A world-class Museum of Modern Nursing could attract new generations of potential nurses, and just as importantly, build the widespread community support that will translate into the clinical, educational, and research resources needed to strengthen the profession and combat the shortage.
We urge nursing advocates to consider how a Modern Museum of Nursing might be developed, financed, and managed. http://www.nursingadvocacy.org/faq/museum.html
~~**~~**~~**~~**~~**~~
MEDICAL NEWS

Health Care Spending Expected To Double By 2017, Federal Report SaysBy 2017, U.S. health care spending is expected to nearly double from 2007¹s projected level, reaching $4.3 trillion and consuming 19.5 percent of the nation¹s gross domestic product (GDP), analysts at the Centers for Medicare and Medicaid Services report in today¹s Health Affairs Web Exclusive.The authors note that they expect the leading edge of the baby-boom generation to begin to affect the Medicare program. Over the next decade, a slowdown in growth in private spending is expected to be offset by accelerating growth in public-sector spending, partially attributable to the baby-boomer generation enrolling in Medicare. The CMS analysts say that this increase in the number of Medicare enrollees is projected to contribute 2.9 percentage points to growth in Medicare spending by 2017. You can read the article by Sean Keehan and colleagues athttp://content.healthaffairs.org/cgi/content/abstract/hlthaff.27.2.w145

*************

Coverage Losses Continued Even As The Economy Improved From 2004 Through 2006 The number of uninsured people in the United States grew by 3.4 million from 2004 to 2006, even as a resurgent economy raised incomes and lowered poverty rates, Urban Institute researchers say in a Health Affairs Web Exclusive study published today.The economy¹s emergence from recession did not interrupt the rise in uninsurance dating back to 2000. In fact, on an annual basis, the ranks of the uninsured grew faster in 2005 and 2006 than they did during the four years from 2000 through 2004, when a total of 6 million people became uninsured.You can read the study by John Holahan and Allison Cook at http://content.healthaffairs.org/cgi/content/abstract/hlthaff.27.2.w135


~~**~~**~~**~~**~~**~~
ANNOUNCEMENT

ISMP High-Alert Medications Series teleconferences. Please join us for the 1st of ISMP’s three teleconferences focusing on high-alert medications. Reducing the Risk of Patient Harm with Anticoagulation Therapy, was held on February 21, 2008. This presentation provided you with the building blocks necessary to define and implement an anticoagulation management program in your hospital, as required by one of The Joint Commission (TJC) National Patient Safety Goals for 2008. With a special focus on heparin and warfarin, speakers from ISMP will describe the causes of harmful errors with these anticoagulants.

Part two of ISMP’s three-part teleconference series on high-alert medications, Reducing the Risk of Patient Harm with Opiates, will be held on March 26, 2008 from 1:30 to 3:00 pm ET. To assist your organization with reducing the risk of patient harm, this teleconference will explore the current trends in opiate therapy, barriers to optimal therapy and safety, and common types of errors that occur with opiates.

Please join us for the 3rd part of ISMP’s High Alert Medications Series teleconference, Preventing Errors with Insulin: A Multidisciplinary Approach, to be held on April 23, 2008 from 1:30 to 3:00 pm ET. This teleconference will explore the current trends in insulin therapy, barriers to optimal therapy and safety, and common types of errors that occur with insulin. To register visit: www.ismp.org/educational/teleconferences.asp.

~~**~~**~~**~~**~~**~~
INTERESTING READING

Please remember that the REUTERS articles are usually good for only 30 days
The U.S. is in desperate need of more nurses. And many young people would like to become nurses. So why is the nurse shortage worse than ever? The problem is there aren’t enough educational programs to train nurses. And there aren’t enough teachers of nursing. For this reason, Dr. Cindy Mailloux recently went to Washington and joined nurse educators from across the country to urge their legislators to designate more funding for nurse education.Dr. Mailloux is the chairman of the nursing department at Misericordia University. “By increasing our legislators’ awareness, we’re hoping funding can be found to meet the needs of the profession and improve the quality of care patients receive,” said Mailloux. Specifically, Mailloux and her colleagues are asking their U.S. senators to support Nursing Workforce Development programs under Title VIII, the largest source of federal funding for nursing education.To their credit, both Pennsylvania senators, Alren Specter and Bob Casey, through their aids, indicated support for more funding for nursing education. http://www.zwire.com/site/news.cfm?newsid=19044840&BRD=2259&PAG=461&dept_id=456222&rfi=6
****************

How many of you would advocate for breast feeding with these odds? HIV Drugs make breast feeding safer WASHINGTON (Reuters 2/4) A drug that helps prevent babies from catching the AIDS virus at birth can also protect them while nursing, researchers reported on Monday.
Babies of HIV-infected women who were given the drug nevirapine while they breast-fed were half as likely to become infected, the researchers told a meeting in Boston of AIDS experts.
Nevirapine is already widely used to protect babies at birth. A single dose given to the mother as she goes into labor and to the baby at birth cuts transmission by 47 percent.
But babies continue to become infected after birth, via their mothers' breast milk, which can carry the virus. In many developing countries breast-feeding is the only option.... http://www.reuters.com/article/healthNews/idUSN0461960320080204?feedType=nl&feedName=ushealth1100
************************
I wanted to share this information despite it concerning animal vaccinations. This is from a newspaper in West Palm Beach...the column is entitled: Ask The Vet by Dr. Michael Fox

(A woman wrote in asking how often the pet should be vaccinated and with which vaccine. Her dog had died.)
He answered " There are several core vaccinations that dogs should be given: canine parvovirus, canine, distemper, canine adenovirus-2, and rabies.
Adult dogs with a record of shots during puppyhood up to a year old do not need to be revaccinated for three years with any of the above vaccines unless a 1-year-duration rabies shot was given. Revaccination may not be needed if a blood-titer test is done to determine whether each vaccine is still providing protection. If your veterinarian insists that all these core vacinations be given annually, have him or her read the American Animal Hospital Association's 2006 Canine Vaccine Guidelines, or find another doctor".
************************

Surgical Fires An important priority for health care organizations is to reduce the risk of surgical fires. Organizations should educate staff, including operating licensed independent practitioners and anesthesia providers, on how to control heat sources and manage fuels and establish guidelines to minimize oxygen concentration under drapes.A wide range of combustibles and flammables are found in the surgical suite. As a result, all staff, including operating room licensed independent practitioners and anesthesia providers, need to know how to control heat sources and manage fuels to reduce the risk of fire. ... http://www.medinfonow.com/min/ct/5/62730/fuwluz/KAAK/569/default.aspx © 2006 Joint Commission on Accreditation of Healthcare Organizations
***********************
Bull's eye Target for Child Leukemia Found LONDON (Reuters 1/17/08) - British researchers have identified the cancer stem cells that spawn tumors in the most common form of childhood leukemia, and said on Thursday it provided a "bull's eye" target for new drugs.
These rare stem cells are a minute component of the blood but self-renew and act like a control centre, producing millions of cancerous leukemia cells that overwhelm the normal system, said Tariq Enver, a researcher at the University of Oxford, who worked on the study.
"Our next goal is to target both the pre-leukaemic stem cell and the cancer stem cell itself with new or existing drugs to cure leukemia while avoiding the debilitating and often harmful side effects of current treatments," Enver said. ... http://health.yahoo.com/news/reuters/leukaemia_target_dc.html;_ylt=A0S02_DaBZBH0ZsAykmz5xcB
*******************************
[ I had three children...and drank black coffee during all three pregnancies sans miscarriage problems....guess I was just lucky (?) ]
CHICAGO (Reuters 1/21) - Pregnant women who drink two or more cups of coffee a day have twice the risk of having a miscarriage as those who avoid caffeine, U.S. researchers said on Monday. They said the study provides strong evidence that high doses of caffeine during pregnancy -- 200 milligrams or more per day or the equivalent of two cups of coffee -- significantly increase the risk of miscarriage. And they said the research may finally put to rest conflicting reports about the link between caffeine consumption and miscarriage.
"Women who are pregnant or are actively seeking to become pregnant should stop drinking coffee for three months or hopefully throughout pregnancy," said Dr. De-Kun Li of Kaiser Permanente Division of Research, whose study appears in the American Journal of Obstetrics and Gynecology.... http://www.reuters.com/article/healthNews/idUSN2034583320080121?feedType=nl&feedName=ushealth1100
***************
Gene studies home in on lupus cause WASHINGTON (Reuters 1/20) - Four separate studies published on Sunday identify a series of genes linked with lupus, a debilitating illness that can affect various parts of the body at once.
The studies show that, as suspected, the immune system is going haywire in lupus. But it also points to some previously unsuspected causes of the once-mysterious disease.
And the findings may not only help scientists find better treatments for the disease -- but may help in diagnosing it in the first place, as it is easily confused with other conditions.
Systemic lupus erythematosus, lupus for short, affects at least 1.4 million people in the United States and 50,000 in Britain, advocacy groups say....
http://www.reuters.com/article/healthNews/idUSN2033315020080120?feedType=nl&feedName=ushealth1100
*****************************
Please pass the following on to your patients........
Signs of a Stroke..............STR
S* Ask the individual to SMILE
T* Ask the person to TALK and SPEAK a simple Sentence (coherently) (i.e. It is sunny out today)
R* Ask him or her to RAISE BOTH ARMS
A new sign: Stick the tongue out. If it isn't centered.........

Call 911 immediately.......get the person to the hospital
******************
Cervical cancer vaccine cost-effective: EU agency LONDON (Reuters 1/22) - The vaccine against the sexually transmitted virus that causes the most cases of cervical cancer is cost-effective and should be given to adolescent girls before they start having sex, an EU agency said on Tuesday.
The European Centre for Disease Prevention and Control said in a report that Merck & Co Inc's Gardasil and GlaxoSmithKline Plc's Cervarix vaccines could best help reduce cervical cancer when used with screening programs.
"We are saying the vaccine is probably cost effective and should be given to girls before they start their sexual life," Johan Giesecke, the agency's chief scientist, said in a telephone interview.... http://www.reuters.com/article/healthNews/idUSL2233091420080122?feedType=nl&feedName=ushealth1100
****************************
Child Mortality Toll dips below 10 million: UNICEF GENEVA (Reuters 1/22) - About 9.7 million children die each year before their fifth birthday, mostly from diseases that could be prevented with simple, affordable measures, the U.N. Children's Fund (UNICEF) said on Tuesday. While the annual toll fell below 10 million for the first time, it still means more than 26,000 young children succumb every day to pneumonia, malaria and other scourges. Four million of them die in their first month of life.
"It is still completely and totally unacceptable that nearly 10 million children die every year of largely preventable causes," UNICEF Executive Director Ann Veneman said, noting that many infants also lose their mothers in childbirth. ... http://www.reuters.com/article/healthNews/idUSL1819018020080122?feedType=nl&feedName=ushealth1100
***************************
Under the tongue flu vaccinations HONG KONG (Reuters 1/29) - Administering flu vaccines under the tongue may be more effective and offer more protection than injecting or inhaling the drug, a study with mice in South Korea has found.
The base of the mouth is a "very good absorbent and competent tissue ... in taking vaccine and presenting it to the immune system ... to initiate an immune response," Cecil Czerkinsky, biological sciences professor at the Seoul National University, said in a telephone interview.
There is currently no vaccine that is administered under the tongue, or what is known as the sublingual area. But there have been recent studies testing its effectiveness in inducing immune responses in mucosal tissues in the respiratory system, gut and inside of the cheek, and blood.... http://www.reutershealth.com/archive/2008/01/29/eline/links/20080129elin012.html
******************
Drug-name mix-ups hurt patients, getting worse WASHINGTON (Reuters 1/30) - Dr. Julius Pham's stomach churned when he saw a critically ill heart patient getting an antibiotic instead of a drug to support his blood pressure -- the kind of mix-up that is increasingly common in the United States, according to a new report.
"If you have ever had that sinking feeling that drops to the bottom of your stomach, I had it," Pham, then a critical care physician at Johns Hopkins University in Baltimore, told reporters. "Unfortunately, the patient did not do well."
A nurse had confused Levophed, which can boost blood pressure, with the antibiotic Levaquin.
The rate of drug name mix-ups has more than doubled since 2004, the U.S. Pharmacopeia said in a report on Tuesday. The group, which regulates the generic names of drugs and advises pharmaceutical companies, reviewed more than 26,000 records and identified 1,470 unique drugs involved in errors due to similar brand or generic names.... http://www.reuters.com/article/healthNews/idUSN2960814420080130?feedType=nl&feedName=ushealth1100
******************
Infant study casts doubt on vaccine-autism link WASHINGTON (Reuters 1/31) - The mercury in a vaccine preservative is pumped out of a baby's body too quickly for it to do any damage, researchers reported on Wednesday in a study they say should further absolve shots of causing autism.
The study in the journal Pediatrics reinforces what many vaccine experts have said for years -- that the form of mercury found in the preservative is handled differently by the body than the kind found in pollution and contaminated fish.... http://www.reuters.com/article/healthNews/idUSN3050545420080131?feedType=nl&feedName=ushealth1100
*******************
Elephants are the only mammal that cannot jump... just a random fact..........
**************
Premature births lower in women taking folic acid WASHINGTON (Reuters 1/31) - Women who take folic acid supplements for at least a year before becoming pregnant can greatly reduce their risk of delivering a baby prematurely, researchers said on Thursday. Folic acid, a B vitamin, already is known to prevent major birth defects that involve a baby's brain or spine.
This study shows it may provide another benefit -- cutting down on premature births in which babies have less time to develop in the womb and are more likely to experience serious medical problems....http://www.reuters.com/article/healthNews/idUSN3024373620080131?feedType=nl&feedName=ushealth1100
********************
If you've ever had a pulsating, throbbing headache for several hours or even a few days which was possibly accompanied by an upset stomach and sensitivity to light, you're probably familiar with migraines. Experts think migraines are caused by a chemical or electrical problem in certain parts of the brain. When your nervous system responds to a trigger, such as stress, spasms then occur in the nerve-rich areas at the base of the brain and constrict the blood vessels supplying blood to the brain. The migraine pain comes from other blood vessels that open up further to compensate for the constricted blood vessels. Pain also comes from the excitation of the nerve pathway that runs from the brain stem to the head and face. Here are the nine most common triggers for migraines. If you can learn what your triggers are, you can learn ways to avoid them. http://slideshow.ivillage.com/health/dealing_with_9_common_migraine_triggers/causes_and_triggers.html?nlcid=pa03-05-2008
*********************
Hand washing can reduce diarrhoea episodes by about one third Both in institutions and in communities, interventions that promote hand washing lead to significant reductions in the incidence of diarrhoea. The WHO* estimates that diarrhoea kills around 2.2 million people annually, mostly young children in middle- or low-income countries. Encouraging children and adults to wash their hands after using the lavatory is one intervention that has potential to reduce the risk. A team of Cochrane Researchers set out to assess the strength of evidence for the benefits of hand washing. They studied data in 14 randomised controlled trials, eight of which had been conducted in day-care centres and schools mainly in high-income countries; five had been community-based trials in low- and middle-income countries, and one looked at a specific high-risk group of HIV- infected adults living in the USA. The data showed that interventions promoting hand washing can reduce diarrhoea episodes by 29% in day-care centres in high-income countries and by 31% in communities in low- or middle- income countries. “This is a huge benefit. For people in low-income areas this effect is comparable to providing clean water,” says lead author Dr Regina Ejemot. “The challenge is to find ways of promoting hand washing, as well as to set up long term trials that test whether good practice has become part of a person’s way of life,” says Ejemot. Ejemot RI, Ehiri JE, Meremikwu MM, Critchley JA. Hand washing for preventing diarrhoea. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD004265. DOI: 10.1002/14651858.CD004265.pub2. * http://www.who.int/water_sanitation_health/diseases/diarrhoea/en
***********************
Cranberry juice may help women with recurrent urinary tract infections There is some evidence that cranberry juice may decrease the number of occasions when people notice they have a urinary tract infection (UTI), a Cochrane Systematic Review has found. This is particularly the case for those who have recurrent UTIs. UTIs are one of the most common reasons why people seek outpatient medical treatment, and lead to over one million hospital admissions a year in the USA alone. Cranberries, and particularly cranberry juice, have been used for decades as a means of preventing or treating UTIs. The mechanism of action is unsure. One theory is that molecules in the juice may make it harder for bacteria such as E. coli to stick to surfaces, and therefore make it difficult for an infection to build up. ...
Jepson RG, Craig JC. Cranberries for preventing urinary tract infections. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD001321. DOI: 10.1002/14651858.CD001321.pub4.
********************
Got this from the list serve.....Check this out weekly, on the weekend, as they update the site daily. It is a sampling of abstracts from reputable journals from all over the world. If you enjoy getting news about science, health, medicine, nursing, education, astronomy, geriatrics,psychiatry, nutrition, etc. before your newspaper gets it, you'll love this web site. http://www.eurekalert.org/pubnews.php
*****************************
This was sent to me from another list. Health-evidence.ca (http://health-evidence.ca) is a free, searchable online registry that provides public health practitioners, program planners, and polciy makers with quality research evidence to inform public health decision making. Health-evidence.ca saves you time since the searching, screening, and appraising the systematic review evidence has been done for you. Health-evidence.ca houses over 1000 reviews - all related to public health, health promotion and/or population health. On this site, you can locate references to systematic reviews and meta-analyses, gathered through a comprehensive search of electronic databases, journal tables of contents, and reference lists. All reviews in this online registry have been screened for relevance to public health, and appraised for quality. You can see whether reviews are strong, moderate, or weak in terms of their methodological quality. This is important information that you need to determine whether and how to incorporate the evidence from the reviews in your practice, program, or policy decisions.Full reviews have been located and are linked wherever access is possible through the public domain. Direct links are also provided through IP authentication wherever a user may already have access through an existing subscription that is linked to the IP address of their workstation or home computer.We are also working to provide summary statements for each of the reviews in the registry. A summary statement is a short (2 page) synopsis of the review¢s content, highlighting key evidence points and corresponding implications for practice, programs, and policy. Not all reviews in the registry have summary statements at present, but we are working to find funding (and authors!) to fill in the gaps. Future plans for the website include development of a discussion group, offering the opportunity for users to ask questions and connect with other Canadian and internationally-based public health decision makers. We hope to provide education, information, and networking opportunities through this site and we look forward to receiving your feedback and suggestions.
*****************************
Homocysteine inversely tied to cognitive function after age 60 By Megan Rauscher NEW YORK (Reuters Health) - Data from the Framingham Offspring Study provide more evidence that increasing levels of homocysteine are associated with lower cognitive functioning in adults older than 60, but not in younger and middle-aged adults. The finding suggests to researchers that folate and vitamin B6 and B12 supplements may help prevent homocysteine-related cognitive decline.
"My concern," Dr. Merrill F. Elias said, "is that many physicians still do not routinely include homocysteine determinations as part of the physical examination."
High levels of homocysteine are related to risk of stroke, cardiovascular disease and must be controlled for when relating homocysteine to cognitive ability, the Boston University researcher explained.
For persons over age 60 in the Framingham Offspring Study, statistically significant inverse associations between plasma total homocysteine and multiple cognitive domains were evident, regardless of adjustment for risk for stroke, cardiovascular disease, cerebrovascular disease, vitamins B6, B12, and folate, he and colleagues report in the October 1st issue of the American Journal of Epidemiology.... http://www.realage.com/news_features/articler.aspx?id=11169
*****************************
The following three articles are from : www.rnweb.com Vol. 70, No. 4 April 2007 RN p.55
What is JBI and What does it do? The Joanna Briggs Institute (JBI) established in 1996, is a growing, dynamic international collaboration of more than 200 researchers, clinicians, academicians, and quality managers who have set out to promote and support evidence-based practices (EBP) in healthcare. There are currently more than 2,000 JBI members from 34 countries.
Of the ten JBI Collaborating Centers dedcated exclusively to nursing, three are located in the United States: The New Jersey JBI center of Evidence Based Nursing Practice, University of Medicine and Dentistry of New Jersey, School of Nursing, Newark, NJ; The Northwest Indiana JBI Center of Evidence-Based Nursing Practice, Purdue University Calumet, School of Nursing, Hammond, IN; and the JBI EBP Practice Center of Oklahoma, University of Oklahoma, School of Nursing, Oklahoma City, OK. For additional information and to download the JBI Best Practice Information Sheets... www.joannabriggs.edu.au D. Anthony (Tony) Forrester, RN, PhD Morristown, NJ
******************
Don't Come Back to Work Too Soon After The Flu Noroviruses, the culprits responsible for the stomach flu, cause muscle aches, vomiting, diarrhea, and low-grade fever and chills about 24-48 hours after exposure. They are highly contagious. For most the flu is self-limiting. children often have more vomiting than adults, but it is th elderly who are at risk for a severe case and possibly death. While handwashing is critical to prevention, sick employees should be told to stay home for 72 hours after diarrhea and vomiting stop. Hospitals should also limit visitors (for the same reasons). Rebecca Ruppert, RN, MS, Salem, OR
*******************
Encourage Your Patients to Breastfeed The American College of Obstetricians and Gynecologists (ACOG) is encouraging healthcare providers to support women who elect to breastfeed their infants. Breastfeeding offers a number of benefits for the mother and infant, and is the preferred method of feeding, according to ACOG. Moreover, the group emphasizes that nearly all women are capable of breastfeeding their children. There are only a few contraindications to breastfeeding: use of illegal drugs or high alcohol intake, HIV or certain other infections, and an infant with galactosemia. ACOG continues to recommend exclusive breastfeeding for at least the first six months of life. The group emphasized that education and support for breastfeeding can improve breastfeeding rates for all women and would be a positive economic investment for both health plans and employers because there are lower rates of illness among infants who are breastfed. (Home Health nurses are especially important in this situation...hospitals are "set up" to help new mothers. If any problem occurs, one can always find a Lactation Consultant to give advice if needed. Frankie)

The American College of Obstetricians and Gynecologists. "ACOG calls on ob-gyns, health care professionals, hospitals, and employers for increased support for breastfeeding." 2007. www.acog.org/from_home/publicatins/press_releases/nr02-01-07-1.cfm (1 Feb. 2007)
******************
Did you remember this fact?
Your stomach has to produce a new layer of mucus every two weeks otherwise it will digents itself.
*******************
Nurses again perceived as having highest honesty and ethical standards December 10, 2007 by Jeffrey M. Jones PRINCETON, NJ -- Gallup's annual update on the honesty and ethical standards of people in various professions finds a new entry ranking at the bottom of the list. For the first time, Gallup asked the public to rate the honesty and ethical standards of lobbyists, and only 5% describe their ethics as "very high" or "high." Lobbyists, car salesmen (5%), and advertising practitioners (6%) are the lowest-rated professions. Nurses, typically the top-rated profession each year, again get the highest ratings. Ratings of congressmen are the worst Gallup has ever recorded.
The Nov. 30-Dec. 2 USA Today/Gallup poll asked Americans to rate the honesty and ethical standards of people in each of 22 different professions, using a five-point scale ranging from "very high" to "very low."
Eighty-three percent of Americans rate nurses' honesty and ethical standards as very high or high, easily the most positively rated profession. Nurses were first included in 1999 and have averaged an 81% very high/high rating since then. That has been good for first place each year except 2001, when firefighters were included after the 9/11 terrorist attacks and received a 90% rating.
After nurses, grade-school teachers (74%) and pharmacists (71%) are rated next most highly this year. Just under two-thirds of Americans give high ratings to military officers and medical doctors. Clergy and policemen are the only other two professions that receive positive ratings above 50%.... http://www.gallup.com/poll/103123/LobbyistsDebut-Bottom-Honesty-Ethics-List.aspx
******************
Glucosamine no better than placebo for hip arthritis NEW YORK (Reuters 2/18) - Many people take glucosamine for arthritis-like symptoms but results of a new study suggest that glucosamine has no clinically meaningful effect on pain, function, or disease progression in patients with arthritis of the hip.
In a study lasting 2 years, Dr. Rianne M. Rozendaal and colleagues at the Erasmus Medical Center in Rotterdam, the Netherlands randomly assigned 222 patients to glucosamine (1500 milligrams daily) or to placebo. The patients had relatively early stages of the hip arthritis; about half of them had mild arthritis for a period of 3 years or less.
The research team took care to ensure the integrity of their results. The supplier of the glucosamine was required to double-check that the tablets were the correct dose, and all physicians, patients, and researchers were blinded to group assignment. The rate of completion was high (93 percent), and the study was conducted without drug company funding.... http://www.reutershealth.com/archive/2008/02/18/eline/links/20080218elin028.html
****************
WASHINGTON (Reuters 2/20) - The U.S. death rate from cancer has continued a steady decline that began in the early 1990s but it will still kill a projected 565,650 Americans this year, the American Cancer Society said on Wednesday.
The death rate from lung, colorectal, prostate, breast and other cancer types fell in 2005, the most recent year for which figures were available, but not as much as in 2003 and 2004, the group said. The actual number of cancer deaths rose.
The cancer death rate for men has fallen by 18.4 percent since peaking in 1990 and for women has fallen by 10.5 percent since peaking in 1991. Cancer is the No. 2 cause of death in the United States, behind heart disease. http://www.reuters.com/article/healthNews/idUSN1926392720080220?feedType=nl&feedName=ushealth1100
*******************
CHICAGO (Reuters) - People who have a cardiac arrest in the hospital at night or on the weekend are far less likely to survive than those who suffer one during the day, U.S. researchers said on Tuesday.
Studies suggest this may be at least partly because of inadequate staffing at off-peak hours. (DUH my comment to the above statement)
The researchers found only 14.7 percent of people whose hearts stop pumping during the night survive, compared with nearly 20 percent of people during the day.
Those who had a cardiac arrest at around 3 p.m. had the survival rate, Dr. Mary Ann Peberdy of Virginia Commonwealth University in Richmond and colleagues reported in the Journal of the American Medical Association. http://www.reuters.com/article/healthNews/idUSN1929246120080220?feedType=nl&feedName=ushealth1100
***************
Single pill helps control Bp, cholesterol NEW YORK (Reuters 2/19) - In African-Americans with poorly controlled high blood pressure (hypertension) and high cholesterol, treatment with a single pill containing a blood pressure-lowering drug and a cholesterol-lowering drug may prove particularly useful, researchers say.
Getting blood pressure and "bad" LDL-cholesterol under control has been harder to do in African Americans than in the overall U.S. population, note the researchers in a report in Mayo Clinic Proceedings, a medical journal. The current study, they say, suggests that the single-pill option may help more of them reach their goals.
The single pill combo is marketed as Caduet by Pfizer, the company that supported the study. Caduet contains the drug amlodipine, used to treat high blood pressure and atorvastatin, used to lower cholesterol.
In the study, 499 African Americans with uncontrolled hypertension and "dyslipidemia" (elevations in cholesterol or triglycerides) received Caduet in eight different dosage strengths, which were flexibly increased as needed.... http://www.reuters.com/article/healthNews/idUSKIM95148120080219?feedType=nl&feedName=ushealth1100
******************
More E. Coli Conservation Than Ever Sam Boyd 2/19/08 The USDA issued a recall over the weekend for 143 million pounds of beef produced over the last two years by a California company which, the USDA has recently learned had not been properly reporting "downer" cows--those too sick to stand. These cows have entered the food supply (links to a summary, see the USDA's recall notice here) and may carry E. Coli or mad-cow disease (BSE)
The USDA’s largest-ever recall is now under way — "approximately 143,383,823 pounds" (give or take a few ounces?) of raw and frozen beef products from the disgraced Hallmark/Westland Meat Packing Co. in Chino, California. That’s almost half the amount of beef and poultry recalled since 1994 in the United States
What's more, the use of downer cows (see more on the topic from Rick) by the company was reported three weeks ago by the Washington Post after the Humane Society provided video evidence of downer cows being lifted with forklifts and sprayed with water in the nose for the same reason.
This is just the latest in a series of steadily increasing E. Coli recalls that have reached record levels in recent years. What's more, just because meat is recalled by the USDA does not mean it actually comes off store shelves... http://www.ourfuture.org/blog-entry/more-e-coli-conservatism-ever
********************
This editorial is from the New York Times....2/18/08 Have health insurers been systematically cheating patients and doctors of fair reimbursement for medical services? That is the disturbing possibility raised by an investigation of the industry’s arcane procedures for calculating “reasonable and customary” rates
The investigation, by the New York State attorney general, Andrew Cuomo, and his staff, suggests that these procedures — used by major insurance companies to determine what they will pay when patients visit a doctor who is not in the company’s network — may be rigged to shortchange the beneficiaries..... http://www.nytimes.com/2008/02/18/opinion/18mon1.html?_r=1&oref=slogin
****************
Top Internet Threats Right Now While it may not feel quite like the Wild West anymore, the Internet is still full of people looking to rip you off -- the anonymity and secretive nature of online dealings makes them much more prone to fraud than in the real world. We've compiled a list of the top threats to your security lurking around the Internet -- and what you can do to avoid them. While it may not feel quite like the Wild West anymore, the Internet is still full of people looking to rip you off -- the anonymity and secretive nature of online dealings makes them much more prone to fraud than in the real world. We've compiled a list of the top threats to your security lurking around the Internet -- and what you can do to avoid them. ...
http://www.switched.com/2008/02/14/top-internet-threats- **********************
Daytime dozing may be warning sign of stroke CHICAGO (Reuters 2/21) - Older people who have significant trouble staying awake during the day have more than four times the normal risk of having a stroke, U.S. researchers said on Thursday.
They also found a higher risk of heart attacks and other cardiovascular problems in seniors who regularly nod off during the day without planning to.
"Even when we controlled for things like hypertension, diabetes, physical activity, obesity and socioeconomic status, we found that people who had significant daytime dozing were much more likely to end up with stroke," said Bernadette Boden-Albala of Columbia University in New York.... http://www.reuters.com/article/healthNews/idUSN2148427820080221?feedType=nl&feedName=ushealth1100
***************************
Swimming eases pain of "mystery ailment": study LONDON (Reuters 2/21) - Swimming can significantly ease the debilitating pain of fibromyalgia, an ailment with no known cure, European researchers said on Friday.
The condition mainly strikes women and can cause severe pain and tenderness in muscles, ligaments and tendons. Shoulder and neck pain is common but some people with the condition also have problems sleeping, and suffer anxiety and depression.
In their study of 33 women, the researchers had one group exercise in warm water for more than an hour three times a week for eight months while the others did no aquatic training.... http://www.reuters.com/article/healthNews/idUSL2182563120080222?feedType=nl&feedName=ushealth1100
******************
Besides boosting your bone health, taking vitamin D with your calcium could give you another big benefit: protection from cancer. It's true. This powerful pair may help reduce the risk of five different kinds of cancer, according to a recent study.
Cancer D-fense Healthy postmenopausal women taking vitamin D daily with their calcium over 4 years had fewer breast, colon, lung, lymph/leukemia, and uterine cancers than women taking calcium alone.When calcium and vitamin D get together, their powers multiply. Not only do they help build your bones and boost your immune system function, but, according to new research, they also help ward off type 2 diabetes. Research shows you'll be a whopping 33 percent less likely to develop the condition if you get at least 1,200 milligrams (mg) of calcium and 800 international units (IU) of vitamin D per day compared to an intake of only 600 mg of calcium and less than 400 IU of vitamin D daily. How the vitamin might defend against cancer still needs to be determined, but researchers know that certain genes and cells need adequate D to do their jobs flawlessly. A dose of vitamin D is 400 IU per day for people under age 70 and 600 IU per day for people over age 70. But the upper intake level is 2,000 IU -- meaning anything up to that level is generally considered safe. Reference: Vitamin D and calcium intake in relation to type 2 diabetes in women. Pittas, A. G., Dawson-Hughes, B., Li, T., Van Dam, R. M., Willett, W. C., Manson, J. E., Hu, F. B., Diabetes Care 2006 Mar;29(3):650-656.
**************************
Pedometers help people lose weight: U. S. study WASHINGTON (Reuters 1/17) - Walking can help people lose weight, especially if they use a pedometer to make sure they are going far enough, U.S. researchers reported on Tuesday.
People who added 20 to 40 minutes of walking a day lost a small but steady amount of weight, the team at the University of Michigan found.
"The increase in physical activity can be expected to result in health benefits that are independent of weight loss," said Dr. Caroline Richardson, who led the study.
"Increasing physical activity reduces the risk of cardiovascular problems, lowers blood pressure and helps dieters maintain lean muscle tissue when they are dieting."
Writing in the Annals of Family Medicine, Richardson and colleagues said they reviewed nine studies involving 307 men and women. They took part in studies of pedometer use that ranged from four weeks to a year.... http://www.reuters.com/article/healthNews/idUSN165157820080117?feedType=nl&feedName=ushealth1100
***************
Undernutrition behind third of child deaths: studies LONDON (Reuters 1/17) - Undernutrition causes more than a third of child deaths worldwide, but simple programs like promoting breastfeeding and providing supplements could keep some of those children alive, experts said on Thursday.
The new figures, which were taken from surveys of some 139 countries and a re-analysis of existing data, are lower than previous estimates attributing 50 percent of childhood deaths to undernutrition -- a severe form of malnutrition, the international team of researchers said.
The researchers estimated that problems relating to a severe lack of food resulted in 2.2 million deaths of children under the age of five in 2005.... http://www.reuters.com/article/healthNews/idUSL1652413820080117?feedType=nl&feedName=ushealth1100
*********************
Half of all hospital patients at clot risk: study LONDON (Reuters 1/31) - More than half of all hospital patients are at risk of blood clots but many do not receive simple treatment that could prevent them, British researchers said on Thursday.
The study published in the journal Lancet looked at more than 68,000 patients at 358 hospitals in 32 countries and found that people who had undergone surgery were most likely to develop venous thromboembolism, or blood clots.
"The data show that, worldwide, more than half of all hospitalized patients are at risk for venous thromboembolism and that surgical patients seem to be at higher risk than medical patients," Ander Cohen of King's College London and Ajay Kakkar at Barts and The London School of Medicine and Dentistry wrote.
The condition includes deep vein thrombosis and pulmonary embolism, which most commonly occurs when the blood clot dislodges to the lungs. Such clots account for an estimated 10 percent of all in-hospital patient deaths.... http://www.reuters.com/article/healthNews/idUSL3192716220080131?feedType=nl&feedName=ushealth1100
*********************
An Oldie Vies for Nutrient of the Decade By Jane E. Brody, the New York times (Feb. 19) - The so-called sunshine vitamin is poised to become the nutrient of the decade, if a host of recent findings are to be believed. Vitamin D, an essential nutrient found in a limited number of foods, has long been renowned for its role in creating strong bones, which is why it is added to milk.Now a growing legion of medical researchers have raised strong doubts about the adequacy of currently recommended levels of intake, from birth through the sunset years. The researchers maintain, based on a plethora of studies, that vitamin D levels considered adequate to prevent bone malformations like rickets in children are not optimal to counter a host of serious ailments that are now linked to low vitamin D levels....
http://body.aol.com/news/health/article/_a/an-oldie-vies-for-nutrient-of-the-decade/20080221113709990001
**********************
This article will make you sit up and take notice.......for sure !
Reduced exercise capacity an ominous sign NEW YORK (Reuters 2/7) - People who have trouble exercising on a treadmill are at increased risk of suffering a heart attack or other heart-related event and of dying, according to results of a study.
"Exercise capacity" is one of many important prognostic factors measured during an exercise treadmill test, a simple procedure often performed in doctors' offices. But "little is known about the association between exercise capacity among patients referred for exercise treadmill testing and nonfatal cardiac events," Dr. Pamela N. Peterson, of the University of Colorado at Denver and Health Sciences Center, and colleagues note in a report.
Among 9191 adults who had a treadmill test and who were followed for a median of 2.7 years, 119 were hospitalized for heart attack and 259 for chest pain. Moreover, 749 required revascularization procedures to restore blood flow to the heart, and 132 patients died.
According to Peterson's team, people with low exercise capacity, relative to those with normal exercise capacity, on the treadmill test, had more than a twofold increased risk of having a heart attack, experiencing chest pain, or needing a revascularization procedure.... http://www.reuters.com/article/healthNews/idUSCOL77254720080207?feedType=nl&feedName=ushealth1100
****************
Adults Understand Factors of High Blood Pressure, Not Risks Most Americans say they are knowledgeable about high blood pressure, but less than 50 percent know that it's associated with heart attack and stroke, a survey by the National Association of Chronic Disease Directors (NACDD) has found.
The survey found that 72 percent of Americans are aware of the multiple factors contributing to high blood pressure, including obesity, lack of exercise, salt intake and alcohol consumption. Yet, only 42 percent associate high blood pressure with stroke and heart attack. High blood pressure is a major risk factor for heart disease, but it can be controlled through medication, diet and exercise... http://nursing.advanceweb.com/editorial/content/editorial.aspx?cc=107133
~~**~~**~~**~~**~~**~~
HUMOR SECTION
Thanks to Rozalfaro (Roz) here is the humor for March.
These are actual comments made on students' report cards teachers in the New York City public school system. All teachers were reprimanded.
1. Since my last report, your child has reached rock bottom and has started to dig.
2. I would not allow this student to breed.
3. Your child has delusions of adequacy.
4. Your son is depriving a village somewhere of an idiot.
5. Your son sets low personal standards and then consistently fails to achieve them. 6. The student has a "full six-pack" but lacks the plastic thing to hold it all together. 7. This child has been working with glue too much.
8. When your daughter's IQ reaches 50, she should sell.
9. The gates are down, the lights are flashing, but the train isn't coming.
10. If this student were any more stupid, he'd have to be watered twice a week.
11. It's impossible to believe the sperm that created this child beat out 1,000,000 others.
12. The wheel is turning but the hamster is definitely dead.
These 16 Police comments were taken off actual police car videos around the country:
16 "You know, stop lights don't come any redder than the one you just went through."
15 "Relax, the handcuffs are tight because they're new. They'll stretch after
you wear them a while."
14 "If you take your hands off the car,
I'll make your birth certificate a worthless document."
13 "If you run, you'll only go to jail tired."
12 "Can you run faster than 1200 feet per second? Because that's the speed
of the bullet that'll be chasing you."
11 "You don't know how fast you were going? I guess that means I can
write anything I want to on the ticket, huh?"
10 "Yes, sir, you can talk to the shift supervisor, but I don't think it will help.
Oh, did I mention that I'm the shift supervisor?"
9 "Warning! You want a warning? O.K, I'm warning you not to do that again or
I'll give you another ticket."
8 "The answer to this last question will determine whether you are drunk or
not. Was Mickey Mouse a cat or a dog?"
7 "Fair? You want me to be fair? Listen, fair is a place where you go to ride
on rides, eat cotton candy and corn dogs and step in monkey poop."
6 "Yeah, we have a quota. Two more tickets and my wife gets a toater oven.
5 "In God we trust, all others we run through NCIC."
4 "How big were those 'two beers' you say you had?"
3 "No sir, we don't have quotas anymore. We used to, but now we're allowed
to write as many tickets as we can."

2. "I'm glad to hear that the Chief (of Police) is a personal friend of yous. So you know someone who can post your bail ."
AND THE WINNER IS....
1 "You didn't think we give pretty women tickets? You're right, we don't. Sign here."
~~**~~**~~**~~**~~**~~
CEU SITES---(CME and CE)
Those that are-----Free and Otherwise..........

A CME/CE/CPE online slide presentation recorded in Chicago IL on October 4, 2007. The effectiveness of opioids for chronic pain is unchallenged, but issues of potential dependence and abuse, as well as social legal concerns, have rendered their use in chronic non-malignant pain controversial. Under treatment of chronic pain persists despite the availability of pharmaceuticals and other therapies that are effective for the management of pain. Physicians and other healthcare providers are sometimes reluctant to prescribe appropriate pain medications because of the perceived danger of misuse, abuse and diversion of these drugs.http://www.pain.com/sections/professional/cme_slide_presentations/Alpharma/aafp/

This site contains a huge number of CME/CE offerings....check it out. http://www.medscape.com/nurses/ce

Chronic Pain, Addiction and the Law A CME/CE/CPE online monograph discussing the controversy of the appropriate role of prescription medications for moderate to severe pain-specifically, the role of opioid analgesics. As with any medication, selecting a prescription pain medication involves assessing benefits and risks. Unlike the risks of most other classes of medications, the risks of opioid pain medications also include the potential for abuse and diversion to illicit channels of distribution for illegal use.
http://www.pain.com/sections/professional/cme_article/Chronic_Pain_Addiction_and_The_Law.pdf

***********************
C-Reactive Protein (270) CEU.....RN/LPN $8.00 *(couldn't find the # of hrs)
C-reactive protein is a plasma protein produced by the liver in response to acute infection or inflammation. When the body's immune system is activated, C-reactive protein is one of the first substances to be released by the liver.It is released in conjunction with interleukin-6, which is produced from macrophages, endothelial cells and T-cells. Once released, C-reactive protein binds to a chemical on the surface of microbes or damaged tissues, helping the body recognize the foreign invader or injured cells. Once this recognition occurs, the process of phagocytosis from macrophages can begin, eliminating or reducing the infectious agent or diseased or damaged tissues.The goal of this continuing education offering is to acquaint nurses with the role of C-reactive protein in the body and increase awareness of how this protein is viewed diagnostically. After reading this article, you will be able to:...
https://nursing.advanceweb.com/CE/TestCenter/Course.aspx?CourseID=649&CreditID=1
**********
Pay Only $34.99 for a full year of CONTACT HOURS http://www.nursingspectrum.com /
~~**~~**~~**~~**~~**~~
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/

Criminal Mapping in your neighborhood: http://www.felonspy.com/

Leaky gut is increased intestinal permeability. Here are a couple sites withcomplete explanations. http://www.mdheal.org/leakygut.htm http://altmedicine.about.com/od/healthconditionsdisease/a/TestLeakyGut.htm
http://www.healthaffairs.org/Most_Read.php for the most read articles. Individual subscriptions for full text

Reuters News
Growth potential seen in heart structures after treatment of aortic valve stenosis
Nephron-sparing surgery feasible in renal cancer
Male osteoporosis not always correlated with severity of ankylosing spondylitis
Vildagliptin effective monotherapy for treatment-naive elderly type 2 diabetics
Vacuum assisted closure dressing improves skin graft healing

The research articles in all journals published by BioMed Central are 'Open Access'. They are immediately and permanently available online without charge. A number of journals require an institutional or a personal subscription to view other content, such as reviews or paper reports. Free trial subscriptions to these journals are available. http://www.biomedcentral.com/browse/journals/

If the following aren't enough.......go to http://www.eurekalert.org/nih/ for all the rest !
4-Mar-2008 - Genome-wide association study on Parkinson's disease finds public home at NIH
NIH/National Human Genome Research Institute
4-Mar-2008 - Irritating smells alert special cells, NIH-funded study finds
NIH/National Institute on Deafness and Other Communication Disorders
3-Mar-2008 - NIDDK releases new awareness and prevention series for community health events
NIH/National Institute of Diabetes and Digestive and Kidney Diseases
3-Mar-2008 - New test for joint infection could spare some patients an unnecessary procedure
NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases
3-Mar-2008 - Clinical depression raises risk of death for heart attack patients years after attack
Washington University School of Medicine
3-Mar-2008 - Restricting kids' video time reduces obesity, randomized trial shows
University at Buffalo
3-Mar-2008 - Researchers develop new tool to predict who will use microbicides
Lifespan
3-Mar-2008 - Gender differences in language appear biological
Northwestern University

*******************************************************
********************************************
*
MEDICAL RECALLS
*
*******************************************
******************************************************
If I have printed this before ...Excuse the repetition, please.
Heparin Sodium Injection (Baxter) [Posted 02/11/2008] FDA informed healthcare professionals of important warnings and instructions for Heparin Sodium Injection use. There have been reports of serious adverse events including allergic or hypersensitivity-type reactions, with symptoms of oral swelling, nausea, vomiting, sweating, shortness of breath, and cases of severe hypotension. Most events developed within minutes of heparin initiation although the possibility for a delayed response has not been excluded. The reports have largely involved use of multiple-dose vials. However, there have been several cases in which product from multiple, single-dose vials have been combined to administer a bolus dose. Heparin sodium is an anticoagulant (blood thinner) that is used in patients undergoing kidney dialysis, certain types of cardiac surgery, and treatment or prevention of other serious medical conditions, including deep venous thrombosis and pulmonary emboli. Heparin treatment is initiated using high doses (5000-50,000 units) given directly into the blood stream (intravenously) as a bolus. Serious adverse events have recently been reported in patients who received these higher bolus doses. The manufacture of multiple-dose vials of heparin sodium has been suspended pending the completion of an extensive ongoing investigation to determine the root cause of the problem. Because heparin sodium is a medically necessary product and serious public health consequences would result if there were a sudden shortage of the drug, the multiple-dose vials of heparin sodium manufactured by Baxter that are currently in distribution will not be recalled. See the FDA Public Health Advisory for Agency recommendations to healthcare professionals on the use of heparin sodium for injection. http://www.fda.gov/medwatch/safety/2008/safety08.htm#HeparinInj2
***********************
Spiriva (tiotropium bromide inhalation powder) capsules/ Foradil (formoterol fumarate inhalation powder) capsules FDA informed healthcare professionals and consumers of the correct way to use Spiriva and Foradil inhalation powder capsules. FDA and the National Poison Control Center have received many reports of patients swallowing Spiriva and Foradil capsules rather than placing the capsules in the inhalation devices. Both products are to be used in the HandiHaler (Spiriva) and Aerolizer (Foradil) devices to deliver the medicine to the lungs to improve breathing in patients with asthma, and in individuals affected by chronic obstructive lung disease and bronchitis. Both products will not treat a patient's breathing condition if the contents of a capsule are swallowed rather than inhaled. Healthcare professionals should discuss with patients how to correctly use the Spiriva HandiHaler or Foradil Aerolizer. See the Public Health Advisory for important information on the correct use of both products. http://www.fda.gov/medwatch/safety/2008/safety08.htm#Spiriva
****************
Leukine (sargramostim) Bayer and FDA informed healthcare professionals of the market withdrawal of the current liquid formulation of Leukine, a growth factor that helps fight infection and disease in appropriate patients by enhancing immune cell function. The product was withdrawn because of an upward trend in spontaneous reports of adverse reactions, including syncope (fainting), which are temporally correlated with a change in the formulation of liquid Leukine to include edetate disodium (EDTA). The upward trend in adverse reaction reporting rates has not been observed with the use of lyophilized Leukine. Healthcare professionals should immediately stop using liquid Leukine and return unused vials to the manufacturer.... http://www.fda.gov/medwatch/safety/2008/safety08.htm#Leukine
********************

Injectable Colchicine (including drugs containing colchicine) FDA announced its intention to take enforcement action against companies marketing unapproved, injectable colchicine, a drug used to treat gout. Colchicine is a highly toxic drug that can easily be administered in excessive doses, especially when given intravenously. There is a narrow margin between an effective dose of the drug and a toxic dose that can result in serious health risks, including death. The FDA is aware of 50 reports of adverse events associated with the use of intravenous colchicine, including 23 deaths. Potentially fatal effects include low blood cell counts, cardiac events, and organ failure. This action does not affect colchicine products that are dispensed in tablet form.... http://www.fda.gov/medwatch/safety/2008/safety08.htm#colchicine
*****************
Medtronic SynchroMed EL Implantable Infusion Pump FDA issued a Class I Recall of Medtronic Inc, SynchroMed EL Implantable Infusion Pump Models 8626-10, 8626L-10, 8626-18, 8626L-18, 8627-10, 8627L-10, 8627-18, and 8627L-18. The device administers drugs to a specific site in the body to treat pain, spasticity (continuous muscle contraction), and cancer. The pump is implanted in the patient, either with or without a side catheter access port, catheters, and catheter accessories. The models were recalled because there is a potential pump motor stall issue that affects SynchroMed EL infusion pumps with motors manufactured before September 1999. If a pump motor stalls, drug delivery will stop suddenly and without warning. This stoppage will result in loss of therapy, return of the patient's symptoms, and/or symptoms of drug under infusion or withdrawal. Healthcare professionals and patients with questions should contact the manufacturer.... http://www.fda.gov/medwatch/safety/2008/safety08.htm#SynchroMed
******************
Varenicline (marketed as Chantix) FDA informed healthcare professionals and consumers of important revisions to the WARNINGS and PRECAUTIONS sections of the prescribing information for Chantix regarding serious neuropsychiatric symptoms experienced in patients taking Chantix. These symptoms include changes in behavior, agitation, depressed mood, suicidal ideation, and attempted and completed suicide. While some patients may have experienced these types of symptoms and events as a result of nicotine withdrawal, some patients taking Chantix who experienced serious neuropsychiatric symptoms and events had not yet discontinued smoking. In most cases, neuropsychiatric symptoms developed during Chantix treatment, but in others, symptoms developed following withdrawal of Chantix therapy. See the FDA Information for Healthcare Professionals Sheet for recommendations and considerations for healthcare professionals on using Chantix therapy for patients.... http://www.fda.gov/medwatch/safety/2008/safety08.htm#Varenicline
***********************
PriCara and Sandoz Inc. announced a nationwide recall of all lots of 25 mcg/hr Duragesic Patches sold in the United States. The product is being recalled because the patches may have a cut along one side of the drug reservoir within the patch which may result in the possible release of fentanyl gel that may expose patients or caregivers directly to fentanyl gel on the skin. Fentanyl is a potent Schedule II opioid medication and exposure to the gel may lead to serious adverse events, including respiratory depression and possible overdose, that may be fatal. Patches with a cut edge should not be used. These recalled patches have expiration dates on or before December 2009 and are all manufactured by ALZA Corporation. ... http://www.fda.gov/medwatch/safety/2008/safety08.htm#Duragesic ~~**~~~**~~**~~**~~**~~**~~
~~**~~**~~**~~**~~**~~**~~
NURSING HINTS CORNER

Preventing traction reaction An orthopedic surgeon gave me a tip for preventing blisters on the heels and ankles of pediatric patients in Buck's or Byant's tractioon. First paint the affected leg with tincture of benzoin too toughen the skin. Then wrap the leg with web roll, followed by foam strips. Finally, wrap the leg in an elastick bandage.
Now you are ready to add the appropriate weights. Don't forget to check frequently for skin breakdown. Always get a doctor's order before using this procedure.
Margaret P. Carson, RN, MS
Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.75 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.Visit us at http://www.accu-ruler.com/.
~~**~~**~~**~~**~~**~~
This ad is from: GShort @AOL.com (Gwen) These are great little cakes ! http://www.delightfulgreetingcakes.com/worldsgreatest.php

~~**~~**~~**~~**~~**~~

This ad is from Wendie
The eLifeCard can save your life when seconds count! Carry this life-saving card in your wallet in case of emergency at home, at work, at school, traveling, or on vacation! NEW online estate planning system membership makes it possible for you to buy, upload, change and securely store your health care directive, allergies and medication lists, emergency contacts, and more. Exceptional package of other benefits. Give yourself and your family the gift of peace of mind. For FREE information, email name & phone number. All responses kept confidential and answered promptly.
Wendie Howland, CEO Miracle Group TFN Affiliate #10136
508-564-9556 (office) 915-990-1367 (fax)
whowland1@mac.com www.thefoundationnetwork.com
~~**~~**~~**~~**~~**~~
NEW MEMBERS
No new members this issue Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com
~~**~~**~~**~~**~~**~~
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)

Membership BIO Committee...(if you haven't sent in your BIO....Please send it to the appropriate section below) : Check by your screen name's first letter.........BCK131 @AOL.com (Chris) A thru B section,Dick515 @AOL.com (Eileen) C thru D section,GALLO RN@AOL.com (Sue) E thru I section, RNFrankie @AOL.com (Frankie) J thru K section,Jntcln@AOL.com (Janet) L thru M section,GALLO RN @AOL.com (Sue) N thru Q section Schulthe@AOL.com (Susan) R thru T sectionSandy1956@AOL.com (Sandy) U thru Z section.
~~**~~**~~**~~**~~**~~
PARADIGM 97 CO-FOUNDERS:
MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (Frankie) ~~**~~**~~**~~**~~**~~
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.~~**~~**~~**~~**~~**~~
THOUGHT FOR THE DAY

To eat bread without hope is still slowly to starve to death.
--PEARL S. BUCK


Dreams do not vanish, so long as people do not abandon them.
Phantom F. Harlock


Hope to see you online..... Frankie
(RNFrankie@AOL.com)

Friday, February 8, 2008

PARADIGM BYTES


PARADIGM BYTES
Newsletter for Paradigm 97
February 8, 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/ Please copy, paste, and bookmark it.
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.

~~**~~**~~**~~**~~**~~
Please drop in ...the AOL chatroom is "manned" by GingerMyst for 45 min on Tuesday evenings: 9 pm EST, 8 pm CST, 7 pm MST, 6 pm PST The Click here: PARADIGM97 is always there....door open, lights on, waiting for you to come in. Check your Buddy List.....
and invite your friends in for a little chat Let me know if you want others involved.
***~~~***~~~***~~~***
SNIPPETS

A nurse wrote in to a list serve asking for advice. She wrote:

"I'd like some input on an interesting situation I've encountered in two patients and also with
my mother (all elderly).In all 3 cases, dementia was present. Two of the three had a history of severe COPD.Here's what happened: Every morning, these three individuals would awaken soaked in urine. They would require bathing from head to toe as well as linen change. In all three cases, the intake of fluid during the day was quite minimal (maybe 3 glasses of liquid) - certainly not enough to account for the volume of urine that was being released at night. One of the individuals is my current patient. I placed an indwelling catheter in her and the next morning her husband reported 1000 ml in the bag and she was soaked head to toe as well. Seems like somewhere I have heard that if someone stops breathing at night, momentarily, urine is produced. I don't remember exactly what the mechanism is but I believe it has something to do with the inhibition of ADH (anti-diuretic hormone). That in the case of undiagnosed sleep apnea, for example, if someone is getting up frequently to urinate in the night, it may be because this person has sleep apnea and does not know it. He or she thinks she has a bladder or prostate problem but really has sleep apnea.I'd appreciate any and all information about my case studies as well as inventive solutions. Thanks!

Wendie answered as follows: (I just love her inservices)

One classic cause for bigtime night diuresis is steroids. Are these old birds on any prednisone (or anything else that promotes Na+/H2O retention) for their COPD/arthritis/other reason? The mechanism is that you retain a lot of sodium and water with prednisone, which esp in old people with weaker hearts (including right heart failure such as you see in COPD) tends to go extracellular in dependent areas all day long, due to increased venous pressure in those dependent veins, which makes for peripheral edema. Remember that you can have up to 10L of extra fluid on board before edema is noticeable. This is one reason why they have fat feet when they go to bed, esp if they aren't that active during the day (as old ladies with COPD and/or dementia tend to be inactive/restrained, too).So then you take one old bird with a lot of extra fluid on board and lie her down for the night. Venous pressure in legs goes down to next to nothing, increased intravenous venous volume makes for suppressing ADH production in lungs, better LV loading makes more BP, kidneys see more pressure and lower osmolarity and less AHD, and bingo! Lots of peeing. I'll bet that night-time urine has a specific gravity of close to 1.0001. You could check the one with the Foley for different SG during the day time and overnight, another clue.You could do the quick and dirty check for CVP over the course of the day, including positional when they lie down at night (remember how to do that without an intravascular monitor? Hah! There IS some use for old knowledge!) Jugular venous distention is the way to do it. Most old ladies gave transparent enough skin that it's really easy to see the jugular unless they are really, really fat (another risk factor for immobility and not seeing edema). You should see the level fluctuate with respiration efforts.The other classic cause for nocturnal diuresis is, of course, CHF, for more or less the same reason-- fluid retention in dependent areas during the day, then migration of this fluid into the vascular space when the legs are no longer dependent.These are the folks for whom an afternoon nap with a hit of
vitamin L (Lasix) (good dose in mg is age + BUN, even if it is a joke in House of God) is a good idea. Also compression stockings, as much active leg movement as possible, to keep those dependent veins undistended and the lymphatics chugging along. Maybe a coupla hours in the late afternoon/dinner with compression booties would get the diuresis started before bedtime. Wendie
~~**~~**~~**~~**~~**~~
FROM THE MEMBERS

The University of Florida presented Linda B. Jenkins, RN ( JenxL@AOL.com) with an award as the 'Alumni Service Leadership Award in the area of Community Service'. Her comment: "Seems strange that I would be recognized and honored when I already feel I've gotten far more than I've ever been able to give."
*****************
One of our members: ExceptionalNurse@AOL.com (Donna) is a Registered Nurse, Pediatric Nurse Practitioner, Author, and Founder of a Non-Profit Resource Network for Nurses and Nursing Students with Disabilities was featured on “Disability Matters" with Joyce Bender.
Dr. Donna Carol Maheady, Ed.D., ARNP, author of "Nursing Students with Disabilities Change the Course" and "Leave No Nurse Behind: Nurses working with disAbilities", was featured with Joyce Bender on “Disability Matters” on Tuesday, December 4, 2007. Discussion included her advocacy work for the inclusion of nurses with disabilities in nursing practice and her non-profit resource network for nurses and nursing students with disabilities www.ExceptionalNurse.com.

Listen to the show on the VoiceAmerica Channel (www.voice.voiceamerica.com)
http://www.modavox.com/VoiceAmericaCMS/Webmodules/nowPlaying.aspx?BroadcastId=24486&ShowId=15&ScheduleTime=11&ScheduleDate=12/4/07

~~**~~**~~**~~**~~**~~
INTERESTING READING

Please remember that the REUTERS articles are good for 30 days only (however, this is not always the case....check it out anyway)
Your daily cup of java may do more than get you going and out the door. It might also reduce your risk for blood sugar disorders. Research shows that coffee might decrease the risk of developing diabetes by about 25 percent. But watch the sugar. Here's why.
Make It Black People who add sugar to coffee or tea don't get the protective blood sugar effect, and they may run a higher risk of developing cancer of the pancreas. That's because the risk of developing pancreatic cancer is related, in part, to the amount of sugar in the diet. People who drink fizzy or syrup-based sweet drinks twice a day or more have a 90 percent higher risk of getting cancer of the pancreas than those who never drink them. Suddenly, that sweet stuff doesn't seem so sweet! Caffeine Caution Coffee isn't for everyone. If you're sensitive to caffeine's effects, you may want to avoid it. And even if you aren't, it's best to limit yourself to about 250 milligrams of caffeine a day. For a caffeine-free blood-sugar helper, try this brew.
Reference: Coffee drinking induces incorporation of phenolic acids into LDL and increases the resistance of LDL to ex vivo oxidation in humans. Natella, F., Nardini, M., Belelli, F., Scaccini, C., American Journal of Clinical Nutrition 2007 Sep;86(3):604-609.
*************************
Please take the time to read this article......definitely an eye opening for us all. The article indicated that a person was designated to be at least 62 years old !! YIKES, I am now elderly! I didn't think of myself as elderly before I read this article ! Where does the time go?
Response to Elder Abuse Varies Widely across the United States Diane Lewis was asleep in her Portsmouth home on May 14 when she was awakened by her beeper about 5:30 a.m. It was the first night for Rhode Island’s new elder-abuse hot line service. Someone needed her help. It was a police officer at T.F. Green Airport. He told her he was concerned about an 80-year-old woman who’d been sitting for hours in the airport terminal. The woman was disoriented and didn’t seem to know anyone in the state to call to pick her up. ... http://www.projo.com/news/content/ELDER_ABUSE_HOTLINE_12-16-07_AP81P46_v87.1bd52f8.html
****************
Scientists Discover new Key to Flu Transmission CHICAGO (Reuters 1/7) - Flu viruses must be able to pick a very specific type of lock before entering human respiratory cells, U.S. researchers said on Sunday, offering a new understanding of how flu viruses work. The discovery may help scientists better monitor changes in the H5N1 bird flu virus that could trigger a deadly pandemic in humans. It may lead to better ways to fight it, they said.
http://www.reuters.com/article/healthNews/idUSN0326764520080107?feedType=nl&feedName=ushealth1100
********************
Scientists move toward helping paralysis patients WASHINGTON (Reuters 1/7) - Scientists have figured out how mice can regain some ability to walk after spinal cord injuries, and hope this insight can lead to a new approach to restoring function in people paralyzed by similar damage.
The research, published on Sunday in the journal Nature Medicine, showed that the brain and spinal cord are able to reorganize functions after a spinal cord injury to restore communication at the cellular level needed for walking. http://www.reuters.com/article/healthNews/idUSN0428923520080107?feedType=nl&feedName=ushealth1100
*****************
Drug Addiction genes identified HONG KONG (Reuters 1/8) - Scientists in China have identified about 400 genes that appear to make some people more easily addicted to drugs, opening the way for more effective therapies and addiction control.
Experts believe genetic factors account for up to 60 percent of a person's vulnerability to drug addiction, with environmental factors accounting for the remainder.
The researchers focused on four addictive substances -- cocaine, opiate, alcohol and nicotine -- and mapped out five main routes, or "molecular pathways", that lead to addiction, they wrote in the journal PLoS Computational Biology. http://www.reuters.com/article/healthNews/idUSHKG24467620080108?feedType=nl&feedName=ushealth
***************************
DNA defect linked to 1 percent of autism cases... BOSTON (Reuters 1/9/08) - Researchers have identified a genetic defect responsible for 1 percent of the various forms of autism, and other experts said the DNA region involved could cause many more autism cases.
Identifying the genetic defect also offers another way to screen early for the disease, and perhaps to help children with treatments that can reduce some effects of the developmental disorder, researchers said.
A test for such genetic defects already is helping to inform parents with a child who has just been diagnosed with autism whether siblings might be at risk and whether future children might develop some form of autism, said Dr. Mark Daly of Massachusetts General Hospital, who led the study released on Wednesday.
Autism includes a range of disorders, from the mild Asperger's syndrome to profound mental retardation and lack of ability to socialize. It affects as many as 1 in 150 children in the United States -- up to 1.5 million children and adults.
Because "early intervention such as behavioral and educational therapy can have a positive impact on children who develop autism and other forms of developmental delay, any tool that can help give an earlier diagnosis at ages well before the formal diagnostic criteria kick in can be very useful," Daly said in a telephone interview.... http://www.reuters.com/article/healthNews/idUSN0959974420080109?feedType=nl&feedName=ushealth1100
***********************
WASHINGTON (Reuters 1/11/08) - More U.S. women are taking daily supplements of folic acid, a B vitamin crucial to prevent some major birth defects, but the number remains too low, federal health officials said on Thursday.
Forty percent of women ages 18 to 45 said in a survey last year that they took the supplements each day, the U.S. Centers for Disease Control and Prevention said in a report. That compares to 28 percent in 1995, the CDC said.
"A lot of women are not getting enough folic acid," said CDC epidemiologist Heather Hamner, who worked on the report.... http://www.reuters.com/article/healthNews/idUSN1021762120080111?feedType=nl&feedName=ushealth1100
***********************
Patient and Staff Immunization Because influenza can cause severe health problems for the elderly and other people with weakened immune systems, organizations must determine how to care for infected patients and ensure adequate protection of staff and other patients already in the facility. Immunization programs are a highly effective, proactive strategy to reduce the incidence of influenza among health care staff and the general population, but a vaccine is not always available, nor are all individuals willing to be vaccinated. Appropriate protocols must be developed for determining whether to vaccinate a patient after he or she is admitted. Although influenza vaccinations are administered annually, the pneumococcal vaccine is generally a once-in-a-lifetime vaccination that can be given at any time.
http://www.medinfonow.com/min/ct/5/61267/fuwluz/KAAK/565/default.aspx © 2006 Joint Commission on Accreditation of Healthcare Organizations
**********************
(Thank you Laregis@AOL.com Laura for this article) New Heart Pump Helps Women Awaiting Transplants It's smaller than the first-generation device, researchers report SUNDAY, Nov. 4 (HealthDay News) -- An implantable device that helps the heart pump blood -- and is about the size of a "D" battery, one-quarter the weight of the traditional device -- benefits women as well as men who are waiting for heart transplants.
That's the conclusion of new research that's expected to be presented Sunday at the American Heart Association annual meeting in Orlando, Fla.
"In the past, they were not as beneficial in women as in men, partly because of size," said Dr. Suzanne Steinbaum, director of Women and Heart Disease at Lenox Hill Hospital in New York City. "It didn't match up anatomically."
The new device in question, the HeartMate II, is an implantable left ventricular assist device that helps heart function in people with severe congestive heart failure. The U.S. Food and Drug Administration is currently reviewing an application to approve the pump-like device.... http://www.nursingknowledge.org/Portal/main.aspx?PageId=56&channelid=2&HeaderText=Nursing%20News&ContentID=86625&WT.mc_id=&WT.dcsvid=1136548159
*********************
Today, the Space and Science Research Center, (SSRC) in Orlando, Florida announces that it has confirmed the recent web announcement of NASA solar physicists that there are substantial changes occurring in the sun’s surface. The SSRC has further researched these changes and has concluded they will bring about the next climate change to one of a long lasting cold era.Today, Director of the SSRC, John Casey has reaffirmed earlier research he led that independently discovered the sun’s changes are the result of a family of cycles that bring about climate shifts from cold climate to warm and back again.“We today confirm the recent announcement by NASA that there are historic and important changes taking place on the sun’s surface. This will have only one outcome - a new climate change is coming that will bring an extended period of deep cold to the planet. This is not however a unique event for the planet although it is critically important news to this and the next generations. It is but the normal sequence of alternating climate changes that has been going on for thousands of years. Further according to our research, this series of solar cycles are so predictable that they can be used to roughly forecast the next series of climate changes many decades in advance. I have verified the accuracy of these cycles’ behavior over the last 1,100 years relative to temperatures on Earth, to well over 90%.” ...
More information at: www.spaceandscience.net The previous NASA announcement was made at:http://science.nasa.gov/headlines/y2006/10may_longrange.htm
************************************
New Breast cancer screening test would use saliva WASHINGTON (Reuters 1/10/08) - Scientists in the United States are developing a screening test for breast cancer that checks a woman's saliva for evidence of the disease to help find tumors early, when they are most treatable.
In research published on Thursday, the scientists said they identified 49 proteins in saliva that the screening test would track to distinguish healthy women from those with benign breast tumors and those with malignant breast tumors....
http://health.yahoo.com/news/reuters/cancer_breast_screening_dc.html;_ylt=
AglCAmitSdRz5Bb8RiOYQQyz5xcB
*************************
Look-Alike/Sound-Alike Medications National Patient Safety Goal 3 states that organizations must improve the safety of using medications. Goal 3B requires organizations to identify and, at a minimum, annually review a list of look-alike/sound-alike drugs used in the organization and take action to prevent errors involving the interchange of these drugs. Health care organizations have taken a number of steps to reduce the risk of medication errors, including the following:• Removing concentrated electrolytes from patient care units• Standardizing the limit and number of drug concentrations available in the organization• Identifying and annually reviewing a list of look-alike/sound-alike drugs used in the organization and taking action to prevent errors involving the interchange of these drugs;;;;http://www.medinfonow.com/min/ct/5/59671/fuwluz/KAAK/499/default.aspx © 2006 Joint Commission on Accreditation of Healthcare Organizations
***********************
Older antibiotic might speed TB treatment CHICAGO (Reuters 12/17/07) - An older antibiotic once used against tuberculosis but since abandoned may work to treat the most common and actively contagious form of the disease more quickly, U.S. researchers said on Monday.
By substituting a high-dose version of the drug rifapentine for another antibiotic in the standard TB treatment cocktail, researchers cured mice with the disease two to three times faster.
If confirmed in people, using the drug could cut the average treatment time from six months to three months or less, said Dr. Eric Nuermberger, an infectious disease specialist at Johns Hopkins University, whose study appears in the Public Library of Science journal PLoS Medicine.... http://www.reuters.com/article/healthNews/idUSN1741977720071218?feedType=nl&feedName=ushealth1100
******************
Walking packs huge health punch, study confirms NEW YORK (Reuters 12/17/07) - A brisk 30-minute walk 6 days a week is enough to trim waistlines and cut the risk of metabolic syndrome -- an increasingly common condition that is linked to obesity and a sedentary lifestyle, a new study indicates.
"Our study shows that you'll benefit even if you don't make any dietary changes," study leader Johanna L. Johnson, a clinical researcher at Duke University Medical Center, Durham, North Carolina, said in a statement.
It's estimated that about one quarter of all U.S. adults have metabolic syndrome -- a cluster of risk factors that raise the odds of developing heart disease, diabetes and stroke. To be diagnosed with metabolic syndrome, a person must have at least three of these five risk factors -- a large waistline, high blood pressure, high levels of harmful triglycerides, low levels of "good" HDL cholesterol, and high blood sugar -- and according to many studies, a growing number of people have these problems.
The new findings stem from the STRRIDE study -- an acronym for Studies of a Targeted Risk Reduction Intervention through Defined Exercise -- in which investigators examined the effects of varying amounts and intensity of exercise on 171 middle-aged, overweight men and women.... http://www.reuters.com/article/healthNews/idUSTON78551520071217?feedType=nl&feedName=ushealth1100
**********************
Cigarette makers face flood of Florida lawsuits MIAMI (Reuters 1/11/08) - U.S. tobacco companies have been hit with thousands of new lawsuits in Florida from smokers and their families seeking compensation before Friday's court-imposed deadline for filing individual claims in what is shaping up as a major challenge for the industry.
The deadline was set after the Florida Supreme Court overturned a $145 billion punitive award in a class-action case against the cigarette makers but cleared the way for individuals to proceed with their own lawsuits against tobacco companies in state court.
"The Supreme Court found that cigarette manufacturers are negligent and that their products are defective, unreasonably dangerous, addictive and the cause of 16 separate diseases in human beings," said Ed Sweda, lead attorney for the Tobacco Products Liability Project at Northeastern University in Boston.
"This is a major serious problem for the tobacco companies to be facing here," he said. "We're very much encouraged." ... http://www.reuters.com/article/healthNews/idUSN1128975220080111?feedType=nl&feedName=ushealth1100
*******************
(This falls under the heading of " Now they tell us" )!!!
Soy may thwart belly-fat gain after menopause NEW YORK (Reuters 1/11/08) - A daily serving of soy may help postmenopausal women avoid gaining fat around the middle, preliminary research suggests.
In a study of 18 postmenopausal women, researchers found that those who drank a soy-based shake every day for three months tended to gain less abdominal fat than those who had a milk-based shake.
Soy contains compounds called isoflavones that are structurally similar to estrogen and bind to estrogen receptors in fat tissue. So in theory, soy isoflavones could help regulate body fat metabolism.
The new findings appear to be the first to show that soy protein may affect abdominal fat distribution, according to the researchers, led by Dr. Cynthia K. Sites of the University of Alabama at Birmingham. They report the results in the medical journal Fertility and Sterility. ... http://www.reutershealth.com/archive/2008/01/11/eline/links/20080111elin001.html
***********************
(This was sent in by a member) IMPORTANT "I'll never forget the look in my patients eyes when I had to tell them they had to go home with the drains, new exercises and no breast. I remember begging the Doctors to keep these women in the hospital longer, only to hear that they would, but their hands were tied by the insurance companies. They needed to take care of themselves, knowing full well they didn't grasp half of what I was saying, because the glazed, hopeless, frightened look spoke louder than the quiet 'Thank You" they muttered. " S/P Mastectomy the patient suffers great discomfort and pain afterwards. Insurance companies are trying to make mastectomies an outpatient procedure. Which, in my opinion , is outrageous. Let's give women the chance to recover properly in the hospital for 2 days after surgery. Why not longer..at least until the drains, etc. are removed!!!! It takes 2 seconds to do this and is very important . Please take the time and do it really quick! Please send this to everyone in your address book. If there was ever a time when our voices and choices should be heard, this is one of those times. If you're receiving this, it's because I think you will take the 30 seconds to go to vote on this issue and send it on to others. You know who will do the same. There's a bill called the Breast Cancer Patient Protection Act which will require Insurance Companies to cover a minimum 48-hour hospital stay for patients undergoing a mastectomy. It's about eliminating the 'drive-through mastectomy' where women are forced to go home just a few hours after surgery, against the wishes of their doctor, still groggy from anesthesia and sometimes with drainage tubes still attached. Lifetime Television has put this bill on their Web page with a petition drive to show your support. Last year over half the House signed on. Sign the petition by clicking on the Web site below. You need not give more than your name and zip code number. http://www.lifetimetv.com/breastcancer/petition/signpetition.php
***********************
Unified Health Communication 101: Addressing Health Literacy, Cultural Competency, and Limited English Proficiency is a free on-line learning experience that will help you improve your patient communication skillsincrease your awareness and knowledge of the three main factors that affect your communication with patients: health literacy, cultural competency and low English proficiency implement patient-centered communication practices that demonstrate cultural competency and appropriately address patients with limited health literacy and low English proficiency. You may choose to take the course for credit (CEU/CE, CHES, CME, CNE) or not for credit. The course has five modules and is estimated to take a total of 5 hours to complete. You may complete the course at your own pace. http://www.hrsa.gov/healthliteracy/training.htm
***************************
The Center for Nursing Advocacy is announcing its 5th Golden Lamp Awards, the annual list of the best and worst media portrayals of nurses we've seen in the past year. The 2007 list includes influential media from Hollywood shows to reports on the nursing crisis in Africa. Most of the best depictions of nursing continued to appear in the print media. Among the best were pieces in The Wall Street Journal and The Star-Ledger (Newark), and on WBUR, a Boston NPR affilliate. Among the "worst" award recipients were "Grey's Anatomy," "Private Practice," "House," Kelly Ripa, New York Times puzzle master Will Shortz, New Jersey Governor Jon Corzine, and Members of the U.K. Parliament. The Center also recognizes nursing scholars and advocates who have made a positive impact in the general media. See our full press release on the awards.
***************************

Experts: Hand-held devices pose threat of infection for hospitals Mobile computing devices can help hospitals through RFID-assisted medication administration and decision support, but they can also increase the risk of hospital-acquired infections, according to two experts. They advise emphasizing clinician hand-hygiene, collaboration between hospital IT leaders and infection control practitioners,
and investing in easily cleaned devices to reduce the risk of infection. H&HN's Most Wired Magazine (1/2008) http://tinyurl.com/yrvv45
**********************
Not everything is easily prevented by popping a pill. But strokes? Maybe. Both folate and vitamin B12 seem to reduce the risk of a very common kind of stroke. It’s All About HomocysteineIn a study, men who had the highest folate intake reduced their risk of ischemic stroke by about 30 percent. The study is part of a growing body of research showing that both folate and vitamin B12 lower levels of homocysteine, and that may be the key to their stroke-stopping powers. High blood levels of homocysteine are linked to cardiovascular problems like stroke. http://www.realage.com/news_features/articler.aspx?id=11169
Where to Get It Your diet is a good source of folate and B12. Use this online tool to look up food sources. But you should also take a multivitamin with folate and vitamin B12 daily, to help make sure you get enough on a regular basis.
Folate, vitamin B6, and B12 intakes in relation to risk of stroke among men. He, K., Merchant, A., Rimm, E. B., Rosner, B. A., Stampfer, M. J., Willett, W. C., Ascherio, A., Stroke 2004 Jan;35(1):169-174.
*****************
Hormones raise breast cancer risk quickly: study WASHINGTON (Reuters 1/15) - Hormone replacement therapy can raise the risk of an uncommon type of breast cancer fourfold after just three years, U.S. researchers reported on Monday.
They found women who took combined estrogen/progestin hormone-replacement therapy for three years or more had four times the usual risk of lobular breast cancer.
Their study, published in the January issue of Cancer Epidemiology, Biomarkers and Prevention, is one of dozens trying to paint a clearer picture of what dangers might come from taking HRT to treat menopause symptoms.... http://www.reuters.com/article/healthNews/idUSN1440874820080115?feedType=nl&feedName=ushealth1100
*******************
ER waits dangerously long in U.S.: study WASHINGTON (Reuters 1/15) - Patients seeking urgent care in U.S. emergency rooms are waiting longer than in the 1990s, especially people with heart attacks, U.S. researchers reported on Tuesday.
They found a quarter of heart attack victims waited 50 minutes or more before seeing a doctor in 2004. Waits for all types of emergency department visits became 36 percent longer between 1997 and 2004, the team at Harvard Medical School reported.
Especially unsettling, people who had seen a triage nurse and been designated as needing immediate attention waited 40 percent longer -- from an average of 10 minutes in 1997 to an average 14 minutes in 2004, the researchers report in the journal Health Affairs. ... http://www.reuters.com/article/healthNews/idUSN1549047220080115?feedType=nl&feedName=ushealth1100
*******************
Time-Out before Procedures As part of the Universal Protocol for Preventing Wrong Site, Wrong Procedure, Wrong Person Surgery™, staff should conduct a “time-out” immediately before a surgical or invasive procedure to do a final verification of the correct patient, procedure, site, and implants, if applicable.The time-out should occur in the location where the procedure will be performed, just before the procedure is started. A designated team member should consistently initiate this process, which involves active communication among all members of the surgical/procedure team.
http://www.medinfonow.com/min/ct/5/62996/fuwluz/KAAK/599/default.aspx
*********************

Publication Charts Staffing Standards for All 50 States A new publication from Dr. Charlene Harrington of the University of California San Francisco lists the state staffing standards for nursing homes in all 50 states and the District of Columbia. Laid out in chart form, Nursing Home Staffing Standards in State Statutes and Regulations summarizes the requirements for direct-care staff, as well as for licensed staff and caregiving staff overall. The report also estimates the difference between the state requirements and the federal standard for facilities with 100 beds, based on a formula that is explained in an endnote. Links are included to each relevant statute and regulation."The information is important for state advocates to have because any meaningful improvements in staffing will probably have to be made at the state level," Harrington told Quality Care/Quality Jobs. "For instance, Florida has the highest standards at this time, but the state did not set a minimum limit for RNs, so nursing facilities are substituting licensed vocational nurses for RNs because they are less costly. This can have a negative impact on quality." ... Thanks to Genevive Gipson, MS, RN for the link to this valuable information.
http://www.nccnhr.org/uploads/HarringtonStatestaffingtableRevisedJan2008.pdf
******************************
Australian girl changes blood group, immune system CANBERRA (Reuters 1/25) - An Australian teenage girl has become the world's first known transplant patient to change blood groups and take on the immune system of her organ donor, doctors said on Friday, calling her a "one-in-six-billion miracle."
Demi-Lee Brennan, now 15, received a donor liver when she was 9 years old and her own liver failed.
"It's like my second chance at life," Brennan told local media, recounting how her body achieved what doctors said was the holy grail of transplant surgery. "It's kind of hard to believe."
Brennan's body changed blood group from O negative to O positive when she became ill while on drugs to avoid rejection of the organ by her body's immune system. http://www.reuters.com/article/healthNews/idUSSYD90620080125?feedType=nl&feedName=ushealth1100
******************************
Cancer treatment may also help osteoporosis WASHINGTON (Reuters 1/26) - A drug used to treat bone marrow cancer may also help treat osteoporosis by stimulating stem cells, U.S. researchers reported on Friday.
They found that Velcade, made by Millennium Pharmaceuticals Inc to treat multiple myeloma, activated stem cells that differentiate into bone.
Tests in mice showed it apparently helps regenerate bone tissue and be may be a potential treatment for osteoporosis, a team at Massachusetts General Hospital and the Harvard Stem Cell Institute reported in the Journal of Clinical Investigation.
Harvard stem cell expert Dr. David Scadden said scientists have been hoping to find ways to use drugs to stimulate stem cells, which are the body's master cells.http://www.reuters.com/article/healthNews/idUSN2537473620080126?feedType=nl&feedName=ushealth1100
****************
Studies find corticosteroids, insulin don't combat mortality WEDNESDAY, Jan. 9 (HealthDay News) -- Two new studies on the treatment of septic shock question the conventional wisdom of treating with corticosteroids, intensive insulin therapy or with the synthetic fluid replacement substance called pentastarch.
The first study compared the use of hydrocortisone to a placebo in people in septic shock and found no improvement in survival rates.
The second study looked at the use of intensive insulin therapy versus a placebo, and the use of pentastarch to the more commonly used Ringer's lactate, which is saline with added lactate, chloride, potassium and calcium. Both intensive insulin and pentastarch failed to improve survival rates, and, in fact, increased the rates of serious complications so much that the trial was stopped early....
Results of both studies are published in the Jan. 10 issue of the New England Journal of Medicine.... http://www.nursingknowledge.org/Portal/main.aspx?PageId=56&channelid=2&ContentID=87271&utm_source=ertraumaspcltyJan08%2B012808&utm_medium=email&utm_campaign=SpecialtyNewsletters&WT.mc_id=ET_
ERTraumaspcty_Jan08&WT.dcsvid=742097280
*************************
Tainted Drugs Tied to Maker of Abortion Pill-- New York Times BEIJING — A huge state-owned Chinese pharmaceutical company that exports to dozens of countries, including the United States, is at the center of a nationwide drug scandal after nearly 200 Chinese cancer patients were paralyzed or otherwise harmed last summer by contaminated leukemia drugs.
Chinese drug regulators have accused the manufacturer of the tainted drugs of a cover-up and have closed the factory that produced them. In December, China’s Food and Drug Administration said that the Shanghai police had begun a criminal investigation and that two officials, including the head of the plant, had been detained.
The drug maker, Shanghai Hualian, is the sole supplier to the United States of the abortion pill, mifepristone, known as RU-486. It is made at a factory different from the one that produced the tainted cancer drugs, about an hour’s drive away.
The United States Food and Drug Administration declined to answer questions about Shanghai Hualian, because of security concerns stemming from the sometimes violent opposition to abortion. But in a statement, the agency said the RU-486 plant had passed an F.D.A. inspection in May. “F.D.A. is not aware of any evidence to suggest the issue that occurred at the leukemia drug facility is linked in any way with the facility that manufactures the mifepristone,” the statement said.... http://www.nytimes.com/2008/01/31/world/asia/31pharma.html?_r=1&th&emc=th&oref=slogin
~~**~~**~~**~~**~~**~~
HUMOR SECTION
Yes, it's again that magical time of the year when the Darwin Awards are bestowed, honoring the least evolved among us. Here is the glorious Winner:
1. When his .38 caliber revolver failed to fire at his intended victim during a hold-up in Long Beach, California , would-be robber James Elliot did something that can only inspire wonder. He peered down the barrel and tried the trigger again. This time it worked.
And now, the Honorable Mentions: 2. The chef at a hotel in Switzerland lost a finger in a meat-cutting machine and submitted a claim to his insurance company. The company suspecting negligence sent out one of its men to have a look for himself. He tried the machine and he also lost a finger. The chef's claim was approved.
3. A man who shoveled snow for an hour to clear a space for his car during a blizzard in Chicago returned with his vehicle to find a woman had taken the space...understandably, he shot her.
4 After stopping for drinks at an illegal bar, a Zimbabwean bus driver found that the 20 mental patients he was supposed to be transporting from Harare to Bulawayo had escaped. Not wanting to admit his incompetence, the driver went to a nearby bus stop and offered everyone waiting there a free ride. He then delivered the passengers to the mental hospital, telling the staff that the patients were very excitable and prone to bizarre fantasies. The deception wasn't discovered for 3 days
5. An American teenager was in the hospital recovering from serious head wounds received from an oncoming train. When asked how he received the injuries, the lad told police that he was simply trying to see how close he could get his head to a moving train before he was hit.
6. A man walked into a Louisiana Circle-K, put a $20 bill on the counter, and asked for change. When the clerk opened the cash drawer, the man pulled a gun and asked for all the cash in the register, which the clerk promptly provided. The man took the cash from the clerk and fled, leaving the $20 bill on the counter. The total amount of cash he got from the drawer: $15. (If someone points a gun at you and gives you money, is a crime committed?)
7. Seems an Arkansas guy wanted some beer pretty badly. He decided that he'd just throw a cinder block through a liquor store window, grab some booze, and run. So he lifted the cinder block and heaved it over his head at the window. The cinder block bounced back and hit the would-be thief on the head, knocking him unconscious. The liquor store window was made of Plexiglas. The whole event was caught on videotape.
8. As a female shopper exited a New York convenience store, a man grabbed her purse and ran. The clerk called 911 immediately, and the woman was able to give them a detailed description of the snatcher. Within minutes, the police apprehended the purse snatcher. They put him in the car and drove back to the store . The thief was then taken out of the car and told to stand there for a positive ID. To which he replied, "Yes, officer, that's her. That's the lady I stole the purse from."
9. The Ann Arbor News crime column reported that a man walked into a Burger King in Ypsilanti, Michigan , at 5 a.m. flashed a gun, and demanded cash. The clerk turned him down because he said he couldn't open the cash register without a food order. When the man ordered onion rings, the clerk said they weren't available for breakfast. The man, frustrated, walked away.
***** A 5-STAR STUPIDITY AWARD WINNER***** 10. When a man attempted to siphon gasoline from a motor home parked on a Seattle street, he got much more than he bargained for. Police arrived at the scene to find a very sick man curled up next to a motor home near spilled sewage. A police spokesman said that the man admitted to trying to steal gasoline and plugged his siphon hose into the motor home's sewage tank by mistake The owner of the vehicle declined to press charges, saying that it was the best laugh he'd ever had.
~~**~~**~~**~~**~~**~~
CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise..........

Pay Only $34.99 for a full year of CONTACT HOURS http://www.nursingspectrum.com /

http://www.aapicme.com/Home.aspx (From FNPMSN@AOL.com ) Cindy
This site was sent in by FNPMSN@aol.com (Cindy) http://cmepain.com/ This site looks GREAT!

~~**~~**~~**~~**~~**~~
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.nationalnurse3.blogspot.com/

http://nursingsite.blogspot.com

The Nursing Site
http://thenursingsite.com .

http://www.pain.com/sections/consumers/pain_clinics/

http://www.fengshulforreallife.com/

National Do Not Call Registry

http://content.healthaffairs.org/current.shtml current articles

If you're buying a used car, it is recommended having a mechanic inspect it first.
And screen the car's VIN through the free database at carfax.com/flood

Master the Scholarship Game by Donna Cardillo, RN, MA
http://www.dcardillo.com/articles/scholargame.html

*******************************************************
********************************************
*
MEDICAL RECALLS
*
*******************************************
******************************************************

FDA informed healthcare professionals about serious patient injuries, including third degree burns, associated with the use of poorly maintained electric dental handpieces during dental procedures. Some patients had third degree burns which required plastic surgery. Burns may not be apparent to the operator or the patient until after the tissue damange occurred, because the anesthetized patient can not feel the tissue burning and the handpiece housing insulates the operator from the heated attachment. Although the reported burns occurred during the cutting of tooth and bone, tooth extraction, and other dental surgical procedures, overheating can also occur during any dental procedure. This probelm is not limited to dentistry. Rotary surgical handpieces can cause patient burns during orthopedic procedures as resported in the July 2003 edition of FDA Patient Safety News. http://www.fda.gov/cdrh/psn/show17-burns.html http://www.fda.gov/medwatch/safety/2007/safety07.htm#dentalhand
****************************
FDA informed healthcare professionals and patients that the Agency sent letters warning seven pharmacy operations that the claims they make about the safety and effectiveness of their so-called "bio-identical hormone replacement therapy," or "BHRT" products are unsupported by medical evidence, and are considered false and misleading by the agency. The pharmacy operations improperly claim that their drugs, which contain hormones such as estrogen, progesterone, and estriol (which is not a component of an FDA-approved drug and has not been proven safe and effective for any use) are superior to FDA-approved menopausal hormone therapy drugs and prevent or treat serious diseases, including Alzheimer's disease, stroke, and various forms of cancer. FDA is concerned that the claims for safety, effectiveness, and superiority that these pharmacy operations are making mislead patients, as well as doctors and other healthcare professionals. Compounded drugs are not reviewed by the FDA for safety and effectiveness. Patients who use compounded hormone therapy drugs should discuss menopausal hormone therapy options with their healthcare provider to determine if compounded drugs are the best option for their specific medical needs. http://www.fda.gov/medwatch/safety/2008/safety08.htm#Menopause
*******************
FDA issued an early communication about an ongoing safety review regarding Botox and Botox Cosmetic. FDA has received reports of systemic adverse reactions including respiratory compromise and death following the use of botulinum toxins types A and B for both FDA-approved and unapproved uses. The reactions reported are suggestive of botulism, which occurs when botulinum toxin spreads in the body beyond the site where it was injected. The most serious cases had outcomes that included hospitalization and death, and occurred mostly in children treated for cerebral palsy-associated limb spasticity. Use of botulinum toxins for treatment of limb spasticity (severe arm and leg muscle spasms) in children or adults is not an approved use in the U.S. See the FDA's "Early Communication about an Ongoing Safety Review" for Agency recommendations and additional information for healthcare professionals. http://www.fda.gov/medwatch/safety/2008/safety08.htm#botox
*****************
FDA advised healthcare professionals of serious adverse events associated with unretrieved device fragments (UDFs). A UDF is a fragment of a medical device that has separated unintentionally and remains in the patient after a procedure. Patients may not be aware that this has occurred. The FDA Center for Devices and Radiological Health receives nearly 1000 adverse event reports each year related to UDFs. The adverse events reported included local tissue reaction, infection, perforation and obstruction of blood vessels, and death. Contributing factors may include biocompatibility of the device materials, location of the fragment, potential migration of the fragment, and patient anatomy. During MRI procedures, magnetic fields may cause metallic fragments to migrate, and radiofrequency fields may cause them to heat, causing internal tissue damage and/or burns.... http://www.fda.gov/medwatch/safety/2008/safety08.htm#Fragments
********************
Cordis Corporation and FDA informed healthcare professionals of a Class I recall of All Fire Star and Dura Star balloon catheters, lots 13173912 through 13315455, plus 52 additional lots above 13315455. Balloon catheters are used in a medical procedure (known as percutaneous transluminal coronary angioplasty or PTCA) to open narrowed or blocked blood vessels or arteries of the heart. The product has a potential for slow deflation or no deflation of the angioplasty balloon when inserted into the artery or other blood vessels. This may potentially result in a total blockage of the artery or blood vessels, resulting in a change in the heart rate or heart rhythm, injury to the heart artery, a heart attack, need for a surgical procedure, or death....
http://www.fda.gov/medwatch/safety/2008/safety08.htm#DuraStar
***************************
(this was dated 1/25/08) FDA provided healthcare professionals with an early communication about an ongoing data review for Ezetimibe/Simvastatin (marketed as Vytorin), Ezetimibe (marketed as Zetia), and Simvastatin (marketed as Zocor). This early communication is in keeping with FDA’s commitment to inform the public about ongoing postmarketing drug issues. Merck/Schering Plough Pharmaceuticals reported preliminary results from the Effect of Combination Ezetimibe and High-Dose Simvastatin vs. Simvastatin Alone on the Atherosclerotic Process in Patients with Heterozygous Familial Hypercholesterolemia (ENHANCE) trial. This trial was designed to evaluate the amount of atherosclerotic plaque in blood vessels located in the neck based on images obtained through ultrasound in patients treated with Vytorin (ezetimibe plus simvastatin) or simvastatin alone. Merck/Schering Plough stated that there was no significant difference between Vytorin and simvastatin in the amount of atherosclerotic plaque in the inner walls of the carotid (neck) arteries despite greater lowering of LDL-cholesterol (bad cholesterol) with Vytorin compared to simvastatin. Once Merck/Schering Plough completes the analysis of the unblinded data from ENHANCE, it will submit a final study report to FDA. Once FDA receives the final study report, FDA estimates it will take approximately 6 months to fully evaluate the data. After reviewing the data from the ENHANCE study, and considering all other available information about the link between LDL lowering and reduction of cardiovascular events, FDA will determine whether any further regulatory action is warranted with regard to Zetia and Vytorin and also whether any changes to FDA’s current approach to drugs that lower LDL cholesterol are warranted.
http://www.fda.gov/medwatch/safety/2008/safety08.htm#Ezetimibe
*******************
FDA informed healthcare professionals that the Agency has analyzed reports of suicidality (suicidal behavior or ideation) from placebo-controlled clinical studies of eleven drugs used to treat epilepsy as well as psychiatric disorders, and other conditions. In the FDA's analysis, patients receiving antiepileptic drugs had approximately twice the risk of suicidal behavior or ideation (0.43%) compared to patients receiving placebo (0.22%). The increased risk of suicidal behavior and suicidal ideation was observed as early as one week after starting the antiepileptic drug and continued through 24 weeks. The results were generally consistent among the eleven drugs. The relative risk for suicidality was higher in patients with epilepsy compared to patients who were given one of the drugs in the class for psychiatric or other conditions. Healthcare professionals should closely monitor all patients currently taking or starting any antiepileptic drug for notable changes in behavior that could indicate the emergence or worsening of suicidal thoughts or behavior or depression. The drugs included in the analyses include (some of these drugs are also available in generic form): Carbamazepine (marketed as Carbatrol, Equetro, Tegretol, Tegretol XR) Felbamate (marketed as Felbatol) Gabapentin (marketed as Neurontin) Lamotrigine (marketed as Lamictal) Levetiracetam (marketed as Keppra) Oxcarbazepine (marketed as Trileptal) Pregabalin (marketed as Lyrica) Tiagabine (marketed as Gabitril) Topiramate (marketed as Topamax) Valproate (marketed as Depakote, Depakote ER, Depakene, Depacon) Zonisamide (marketed as Zonegran) Although the 11 drugs listed above were the ones included in the analysis, FDA expects that the increased risk of suicidality is shared by all antiepileptic drugs and anticipates that the class labeling changes will be applied broadly. http://www.fda.gov/medwatch/safety/2008/safety08.htm#Antiepileptic
********************
NuCel Labs and FDA informed consumers and healthcare professionals of a voluntary nationwide recall of all Eye Drops and Eye/War Wash Products. The products were recalled after testing indicated the presence of bacteria and particulate matter, deeming these products non-sterile. Non-sterile eye drops pose an unacceptable risk of causing eye infections, which in rare cases could lead to blindness. No illnesses or injuries have been reported to date. There are no lot numbers or expiration dates on the products. Consumers who have the product should discontinue use of the product and return it to NuCel Lab. See the manufacturer's press release for return shipping information.
~~**~~**~~**~~**~~**~~
NURSING HINTS CORNER

Urinal comfort from a cup When a male patient wants to keep a urinal in place, I tear off teh bottom of a 6-oz foam cup and slide the tapered end into the urinal. The cup provides a soft surface for the penis, decreasing tissue trauma, and increasing patient comfort. It also traps urine away from the skin keeping the skin dry. Barbara Dagastine, RN, EdMS
Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.59, 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.Visit us at http://www.accu-ruler.com/.
**************************
This ad is from: GShort @AOL.com (Gwen) These are great little cakes ! http://www.delightfulgreetingcakes.com/worldsgreatest.php
~~**~~**~~**~~**~~**~~
NEW MEMBERS
Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com
WELCOME TO:

Npaez@BrowardHealth.org (Nancy)
~~**~~**~~**~~**~~**~~
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
Old Address: Pd3RN@AOL.com New Address: Pd3RN@oh.rr.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)

Membership BIO Committee...(if you haven't sent in your BIO....Please send it to the appropriate section below) : Check by your screen name's first letter.........BCK131 @AOL.com (Chris) A thru B section,Dick515 @AOL.com (Eileen) C thru D section,GALLO RN@AOL.com (Sue) E thru I section, RNFrankie @AOL.com (Frankie) J thru K section,Jntcln@AOL.com (Janet) L thru M section,GALLO RN @AOL.com (Sue) N thru Q section Schulthe@AOL.com (Susan) R thru T sectionSandy1956@AOL.com (Sandy) U thru Z section.
~~**~~**~~**~~**~~**~~
PARADIGM 97 CO-FOUNDERS:
MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (Frankie) ~~**~~**~~**~~**~~**~~
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.
~~**~~**~~**~~**~~**~~
THOUGHT FOR THE DAY
“Apprehension, uncertainty, waiting, expectation,
fear of surprise, do a patient more harm than any exertion.”
Florence Nightingale

Hope to see you online..... Frankie
RNFrankie@AOL.com