Health is wealth.Health is the main asset for every human nation.We can not thinking our happiness without good heath.Because A man can happy only for his good health.But when we feel various disease at that time we can not thinking our happy life.At that time we find best doctor and big hospital.Now world health threat for various dangerous disease.
U.S. Health Care
Pittsburgh hospitals' care costs top in country
Per person spending tops other big cities
Pittsburgh spends more on hospital care per person than any other major U.S. city, including New York, Philadelphia, Chicago and Los Angeles. This region is also near the top in the number of hospital admissions for chronic conditions that should be managed without being hospitalized, such as diabetes or asthma.
That's what local consultant Harold D. Miller found after analyzing price-adjusted Medicare data collected by the Dartmouth Atlas of Health Care (http://www.dartmouthatlas.org/).
The stark numbers don't reveal why we spend more and why we don't manage chronic conditions better.
But they do suggest an interesting dichotomy about medical care in Pittsburgh: We don't do well handling the low-end, manageable and preventable health problems and, perhaps as a result, we may end up paying more for the high-end conditions. But that's not all.
"A number of things contribute to it," said Mr. Miller, executive director of Center for Healthcare Quality and Payment Reform, a national health care policy organization. Mr. Miller, who is also president of the Future Strategies LLC management and policy consulting firm Downtown, writes a monthly column for the Pittsburgh Post-Gazette.
Pittsburgh seems to be sicker than most cities, he said, with more obesity, more diabetes, more chronic obstructive pulmonary disorder and other chronic conditions. It could be, however, that those conditions are simply recognized more often here.
Yet the data are stark -- Medicare spends about $5,500 in hospital care per beneficiary in Pittsburgh, while places such as Washington, D.C., San Francisco and Seattle are all under $4,000. And only Nashville has a higher rate of hospitalizations that might have been prevented with better-managed care.
The analysis is based on Medicare data because private insurers' cost information is not publicly available. With Western Pennsylvania's large Medicare population, though, it does shed light on overall practice patterns.
While high spending might indicate over utilization, Mr. Miller said the trend carries over into West Virginia and so should not be attributed to one particular healthcare provider, such as UPMC or West Penn Allegheny, or one particular insurer, such as Highmark.
Rather, Mr. Miller said, "I think it's the regional culture" such as small physician practices and overall poor health that are the main drivers.
Another factor could be something else Mr. Miller found -- that Pittsburgh spends less for physician care than other places. He said national research has shown that when more is spent on primary care, there is less need for hospitalization.
Health care consultant Jan Jennings, president and CEO of American Healthcare Solutions, Downtown, sees in the numbers a manifestation of how medicine has traditionally been practiced in this region.
"People practice medicine the way they're trained and I think it's been long known that the training programs in Southwest Pennsylvania are in many ways antiquated," he said. "It goes back generations.
"There is a tendency to put people in the hospital, whether they need it or not, and there's a tendency to operate on people, whether they need it or not."
Gerard Anderson, a health policy specialist at Johns Hopkins University, agreed that "places like Pittsburgh develop certain practice patterns and all the doctors seem to conform to those practice patterns." So, for example, while a child with a sore throat might be treated with antibiotics in one region, she might be scheduled for a tonsillectomy more quickly here.
But Mr. Anderson also said the high number of preventable hospitalizations is striking, with more than 90 per 1,000 Medicare enrollees being admitted for conditions that should not have required hospitalization, while places such as Denver, Portland and Seattle had just over 40 per 1,000 enrollees.
"That tells me that we're not getting good care in the ambulatory setting. A lot of things are being missed in Pittsburgh that result in hospitalization," he said.
He added that the data don't tell whether problems are missed because doctors don't make the diagnosis, or because patients do not follow the doctor's advice for managing conditions such as diabetes.
"We don't know the answer to that. What we do know is that essential care is not being provided to these people."
There are larger factors nationwide that contribute to higher health care costs, of course. Mr. Miller pointed out that because hospitals and physicians only get paid when they do procedures, there's no financial incentive for promoting preventive care.
"Nobody makes any money in health care if everyone's well."
And while responsibility for high spending here may be shared among many, he did say the current contract standoff between Highmark and UPMC makes it less likely that issues such as high spending for hospital care and excessive preventable hospitalizations will be addressed in an effective manner.
"If you have a multi-part system that requires all the stakeholders to collaborate, then the less collaborative the stakeholders are, the less likely you're going to come up with a solution."
Screen all Children for Cholesterol
It doesn’t have a particularly snappy title, but the Summary Report of the Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents makes for surprisingly accessible and interesting reading.
For one thing, it’s well written, especially for a scientific report and a set of clinical guidelines. For another, the report, published in late 2011 in the journal Pediatrics, takes on a question at once basic and profound: What do we know about how the hearts of children become the hearts of adults?
To look at this question, the panel, convened by the National Heart, Lung and Blood Institute, reviewed numerous research studies and suggested new clinical guidelines for monitoring — and improving — cardiovascular health in childhood.
But one recommendation in particular has been the subject of much controversy within the pediatric profession: that pediatricians screen all children for cholesterol by doing a blood test in 9- to 11-year-olds. Until now, only children considered at high risk for cholesterol problems were to be routinely screened.
Two prominent commentaries on the issue have appeared in The Journal of the American Medical Association. In December, Dr. Bruce M. Psaty and Dr. Frederick P. Rivara, from the University of Washington School of Medicine, argued that universal screening may lead to children being put on medication regimens, like statins, that are not justified by the medical evidence.
In January, Dr. Stephen R. Daniels, chairman of pediatrics at the University of Colorado College of Medicine and chairman of the guidelines panel, and Dr. Matthew W. Gillman, director of the obesity prevention program in the department of population medicine at Harvard Medical School, who also served on the panel, published a response titled “Is Universal Pediatric Lipid Screening Justified?”
They described many points of agreement, but Dr. Daniels’s answer to the title question was yes — and Dr. Gillman’s was no.
The argument over universal lipid screening in children is by its nature also a discussion of the ethics of screening tests, the limits of scientific evidence and even the theoretical morality of treating lifestyle issues with pills.
Everyone on every side of the issue agrees on the overarching problem, the chain of risks and bad outcomes.
“We know the process of atherosclerosis begins in childhood and is progressive,” Dr. Daniels said in an interview. “We also know that individuals who are able to maintain low-risk or optimum-risk status throughout their childhood and throughout their young adulthood then get to a point where they’re very unlikely to have cardiovascular disease.”
Those who reach age 45 or 50 with no risk factors (they don’t smoke, and they have normal weight, body mass index, blood pressure and cholesterol) have life expectancies stretching into the 90s, he continued. But with even a single risk factor, like high cholesterol, life expectancy drops to the early 80s.
“I think you could put all this together and argue that the job of parents and the job of pediatricians and primary care physicians is to work to deliver children to young adulthood with minimum risk,” Dr. Daniels said.
Those who support universal screening say that it will find the children with familial hypercholesterolemia, a genetic condition that can lead to early heart disease and death. Almost everyone agrees that if these children have high cholesterol, they should be considered for long-term treatment with statins, the cholesterol-lowering drugs commonly used in adults.
In theory, you could also find those children by asking about a family history of cardiovascular problems, but that does not always work.
“Families don’t know the history or don’t talk about it,” said Dr. Sarah de Ferranti, director of the preventive cardiology clinic at Children’s Hospital Boston.
Still, if we screen all children, we will find many with abnormal lipid levels who do not have familial hypercholesterolemia. Proponents of universal screening suggest that the discovery of such elevated lipid levels might prompt lifestyle interventions — counseling and help with diet and exercise.
Of course, you don’t need a blood test to tell you that an obese child needs to lose weight. Those who oppose the new recommendation worry that universal screening is expensive and requires repeated testing, with the risk of false positives. And it has not been shown to result in better outcomes down the line.
Critics also worry that doctors will perhaps feel pressured to start children on cholesterol-lowering medications — not only children with the genetic predisposition, but also the obese.
“Is this kind of trying to treat obesity by giving them a pill?” asked Dr. Rivara, a professor of pediatrics. “If you have a fat kid, should you be doing lipid screening for those kids? I sort of don’t think so. I don’t think they should be put on statins, and we already know that they need to lose weight.”
We lack evidence that long-term use of statins in children without genetic familial hypercholesterolemia is effective in preventing cardiovascular disease, or even that it is safe. Even for children with the genetic condition, we lack long-term data, but there is more consensus about the risks and benefits.
“We’re trying to attack a public health problem, an environment that encourages unhealthy behaviors, overeating and obesity, in precisely the wrong way,” said Dr. Darshak Sanghavi, chief of pediatric cardiology at the University of Massachusetts. “We’re looking at all the markers and trying to reverse the biochemical indicators through drugs, rather than focusing on the very obvious public health changes.”
Even the proponents of routine screening agree that neither the screening nor medication is the real issue for most families.
“I think parents should first be asking about overall risk for heart disease, for a discussion with their pediatrician about what are the risk factors and why are they important,” Dr. Daniels said.
“The majority of these discussions are really about lifestyle. You really can, by having the right kind of lifestyle, create a low-risk situation for your child across the life span.”
Children and Adolescents drug treatment
Over the last few decades, the theory that adult diseases begin in childhood has been widely discussed. Smoking, the most common underlying cause of death for adults in the United States, begins before the age of 18 years in the majority of adult smokers. Obesity has become the largest health problem in the United States, and the difficulty of long-term weight loss for obese children and adolescents means that many of them will be overweight as adults. The rationale for considering cardiovascular disease prevention efforts in childhood is compelling. Not only do risk factors track from childhood into adult life, but the development and progression of atherosclerosis, which often starts in childhood, are also directly related to the number of risk factors and their severity.
The recent report of the National Heart, Lung, and Blood Institute (NHLBI) Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children.
Cardiac function & Vitamin D Therapy in Patients with Chronic kidney disease
"I'm thinking about getting the HPV vaccine which protects me from cervical cancer next time I travel to Hong Kong because it's not yet available on the mainland," said Liu, a math teacher at a Beijing middle school.
According to the World Health Organization, cancer of the cervix is the second most common cancer in women globally, with about 500,000 new cases and 250,000 deaths each year.
In China, at least 100,000 women are diagnosed and about 40,000 die from it each year on the mainland, statistics from the Ministry of Health show.
Chen Yong, a director of the Ciming Check-up Group, which specializes in health screening, said they had received an increasing number of enquiries in recent years about the vaccine that prevents genital infection by the human papilloma virus (HPV), a cause of cervical cancer.
Two HPV vaccines, Gardasil and Cervarix, are being used in more than 100 countries and regions but are not yet available in China, except in Hong Kong.
In some countries, such as UK and Japan, and in regions of Italy, Spain and Malaysia, HPV vaccination is provided free.
"Unfortunately, the Chinese drug authority has yet to approve any of the vaccines," said Chen. "So we can only refer our customers to partner clinics in HK that provide them."
Francois Fong, a sex therapist at Neo-Health Care in Hong Kong, said they launched a HPV vaccine service for mainland women three years ago and there were about 40 to 50 coming each year.
"Most are between 20 and 30 years old," he said.
The best time for HPV immunization for girls is before they become sexually active. It can be given to girls as young as 9, according to Qiao Youlin, vice-chairman of the advisory board for early detection and treatment of cancers at the Ministry of Health.
It is not recommended for pregnant women.
Esthel Kong, a nurse from TY Healthcare Center in Hong Kong, said the HPV vaccine should be given in three doses over a period of 6 months. Each dose cost HK$ 1,280 ($165).
"As far as I see, the number of mainland consumers has increased a little recently," she said.
Qiao Youlin expected that the availability of the vaccines on the mainland would help contain HPV infection.
"It's kind of urgent because as the Chinese become more open about sex, HPV infections would be on the rise," he said.
According to the State Food and Drug Administration (SFDA), manufacturers of both vaccines had filed applications to market them in China.
"We have submitted the application to SFDA and the clinical trials for Cervarix are under way in China," said Sharon Zhang, corporate communications and public relations director of GlaxoSmithKline China.
Newborns suffer withdrawal resulting from Moms drug use
"The neonatal unit isn't supposed to be a drug rehab ward. But the drugs their mothers took are causing more newborns…to spend their first days of life suffering through [neonatal withdrawal syndrome]…Its symptoms are similar to what addicts often experience when stopping a drug…While the syndrome is more prevalent, it is still rare…More babies…are affected in some way by maternal drug use but do not suffer withdrawal symptoms, the state data show. That figure…has grown at a moderate pace for years…Clinicians blame the rise in newborn drug withdrawal on increased use…of prescription painkillers…Infants born with neonatal withdrawal syndrome regularly endure a long, expensive, painful hospital stay…Many…require follow-up care…The public picks up most of the bill. Three-quarters of these newborns are covered by Medi-Cal, the state's insurance program for the poor…The upward trend could continue as funding declines for local programs that find and treat pregnant addicts."
Substance Abuse & Policy
U.K.: Alcohol Pricing: A Battleground Between Health Groups and Drinks Industry
"The price of a drink -- or more to the point, the cost of getting drunk -- has been a battleground between the alcohol industry and health groups for years now. Campaigners want minimum unit pricing, which would push up sharply the cost of the booze that hardened drinkers choose...The drinks industry has adamantly refused to accept that price makes a difference. Andrew Lansley, the...health secretary, went along with the industry line. There was no evidence that putting up prices would curb dangerous drinking, he said. But the prime minister…David Cameron has already dropped hints that he may support minimum pricing…Although Cameron puts the emphasis on young drinkers, older drinkers cause huge harm too. And deaths from alcohol damage are a major concern. Lansley's answer was a responsibility deal with the alcohol industry, which argues that the vast majority of people drink responsibly...The industry promised education campaigns…But major health groups...walked out of negotiations over the alcohol responsibility deal a year ago, and it has been a one-sided affair since. The main bone of contention was Lansley's refusal to allow discussion of price."
Smoking & Tobacco
Public Bans Mean Smokers Also Light Up Less at Home
"Smoking bans in offices, restaurants and other public places don't drive smokers to light up more at home, but in fact prompt them to impose their own extra restrictions on the habit, according to a European study…The research, carried out in Britain, Ireland, France, Germany and the Netherlands, found that a significant proportion of smokers also decided to ban smoking in their own homes after national public smoke-free laws were introduced. Some opponents of workplace or public smoking bans have argued that smoke-free laws might lead to a displacement of the habit into smokers' homes, possibly increasing the exposure of non-smokers, particularly children, to second hand smoke. But Ute Mons of the German Cancer Research Center and the Unit of Cancer Prevention at the World Health Organization (WHO) Collaborating Center for Tobacco Control in Heidelberg…said her findings suggested just the opposite…based on two surveys conducted in 2003/4 and 2008/9 and involved more than 4,600 smokers in the four countries with smoke-free legislation, as well as 1,080 smokers in Britain which served as comparison country at a time when it had no public smoke-free laws…after smoke-free legislation was enacted, the percentage of smokers who banned smoking at home rose by 25 percent in Ireland, 17 percent in France, 38 percent in Germany and 28 percent in the Netherlands, the study showed.''
Development, Aid & Malnutrition
Development Aid & Malnutrition Special Report,
"A quarter of young children around the world are not getting enough nutrients to grow properly, and 300 die of malnutrition every hour…There are 170 million children aged under five whose development has been stunted by malnutrition because of lack of food for them and their breastfeeding mothers…according to research by the charity Save the Children…Over the past five years the price of food has soared across the globe…The poor, who spend the bulk of their income on food, are hit hardest…malnutrition is often not recorded as a cause of death on birth certificates, leading to a lack of action across the developing world. With early intervention, the life-long physical and mental stunting from hunger can be eased, enabling individuals to reach their potential…high-profile campaigning and investment accorded to other causes of child mortality such as malaria, measles or Aids…has produced results. Child deaths from malaria have been slashed by a third since 2000, yet child malnutrition in Africa has fallen by less than 0.3 per cent each year over the same time frame… Most malnourished children…do not die but are diminished, physically and mentally. The World Bank estimates that stunting reduces the GDP of developing countries by between 2 and 3 per cent."
Health-care fraud crackdown nets $4.1b. It's lot?
The federal government recovered nearly $4.1 billion last year in an escalating, nationwide crackdown against health-care fraud, Obama administration officials announced Tuesday.
Health and Human Services Secretary Kathleen Sebelius and Attorney General Eric Holder made the announcement in Washington as they released an annual report on health-care fraud enforcement.
The report shows a sharp increase in the amount of fines and restitution recovered from health-care scams during the Obama administration.
During President Bush’s eight years in office, nearly $1.6 billion was recovered on average each year by federal agents and prosecutors. In contrast, the Obama administration has recovered an average $3.6 billion per year during each of the past three years.
“These accomplishments reflect this administration’s ongoing and intensive efforts to protect the American people and to safeguard precious taxpayer dollars,” Attorney General Holder said.
“It is just one of many ways this administration is working to help the American people at a time when budgets are tight,” he said.
The announcement comes as the president’s health-care reform law – the Affordable Care Act – is under siege among Republicans in Congress and at the US Supreme Court, where lawyers for 26 states will argue next month that it is unconstitutional.
Fighting health-care fraud is essential in an administration that is seeking to dramatically increase the level of federal control over the nation’s health insurance system.
But it is unclear from the report to what extent the increased recoveries are a function of more efficient law enforcement or simply the rampant nature of fraud against the government. Estimates are that health-care fraud diverts more than $60 billion a year from public health care to criminal enrichment.
Administration officials insist they are bringing fraud, waste, and abuse under control.
“We are regaining the upper hand in our fight against health-care fraud,” Secretary Sebelius said. “It has never been harder to rip off Medicare and Medicaid, as it is today,” she said.
Prevalence of Oral HPV Infection (2009-2010) in the United States
Context Human papillomavirus (HPV) infection is the principal cause of a distinct form of oropharyngeal squamous cell carcinoma that is increasing in incidence among men in the United States. However, little is known about the epidemiology of oral HPV infection.
May You see Anytime, Anywhere the Therapist
The very idea of psychotherapy seems to defy the instant-access,Not for long, if some scientists have their way. In the past few years researchers have been testing simple video-game-like programs aimed at relieving common problems like anxiety and depression. These recent results have been encouraging enough that investigators are now delivering the programs on smartphones — therapy apps, in effect, that may soon make psychological help accessible anytime, anywhere, whether in the grocery store line, on the bus or just before a work presentation.
"Living in a crowded city or near a busy highway may be tied to a higher chance of having a stroke or losing your memory…'One of the important points is that at levels that are considered to be generally safe by the U.S. EPA (Environmental Protection Agency), we're seeing important health effects,' said Gregory Wellenius, the lead author of the stroke study from Brown University in Providence…Using data from a local air pollution monitoring station, the team found that the risk of having a stroke was 34 percent higher in the 24 hours after 'moderate' EPA pollution readings compared to 'good' pollution days. That increased risk was greatest within 12 to 14 hours of pollution exposure, and was linked to nitrogen dioxide, a traffic-related pollutant…air pollution might be associated with declining thinking and memory skills…researchers led by Jennifer Weuve of Rush University Medical Center in Chicago analyzed a series of cognitive tests given to close to 20,000 women, mostly in their 70s, and also estimated the air pollution around their homes through the EPA's monitoring system. They found that more air pollution was tied to faster rates of cognitive decline. For two different sizes of pollution particles, the difference in thinking and memory skills between women with some of the highest and lowest exposures was similar to a year or two of age-related decline.''
North Carolina:House Infection Data share will hospital
North Carolina Hospital share will house infection data
"Under a new North Carolina law, state health officials have begun collecting data on infections that patients get while in the hospital, and plan to begin making it public this fall. Hospital-Acquired Infections (HAI) are at once a major killer, a huge health care cost and a delicate topic among the fiercely-competitive hospital systems. Data that would allow comparison between all the hospitals in the state has never been public, but the new law is part of a national trend. Public reporting of HAI is now required in 27 states, and more have laws in the works...The U.S. Centers for Disease Control and Prevention has estimated that 1.7 million infections are acquired in hospitals each year, causing nearly 100,000 deaths and $28 billion to $33 billion in excess costs. Because there hasn't been an effort to collect comprehensive data until recently, there aren't solid statistics for North Carolina...By October, the state Division of Public Health hopes to begin posting data for three of the most important infections online for every hospital in the state, something that patient advocates say will not only allow comparison-shopping for safer hospitals but also spur the hospitals to work harder to reduce such infections."
U.S. Health Care
Pittsburgh hospitals' care costs top in country
Per person spending tops other big cities
Pittsburgh spends more on hospital care per person than any other major U.S. city, including New York, Philadelphia, Chicago and Los Angeles. This region is also near the top in the number of hospital admissions for chronic conditions that should be managed without being hospitalized, such as diabetes or asthma.
That's what local consultant Harold D. Miller found after analyzing price-adjusted Medicare data collected by the Dartmouth Atlas of Health Care (http://www.dartmouthatlas.org/).
The stark numbers don't reveal why we spend more and why we don't manage chronic conditions better.
But they do suggest an interesting dichotomy about medical care in Pittsburgh: We don't do well handling the low-end, manageable and preventable health problems and, perhaps as a result, we may end up paying more for the high-end conditions. But that's not all.
"A number of things contribute to it," said Mr. Miller, executive director of Center for Healthcare Quality and Payment Reform, a national health care policy organization. Mr. Miller, who is also president of the Future Strategies LLC management and policy consulting firm Downtown, writes a monthly column for the Pittsburgh Post-Gazette.
Pittsburgh seems to be sicker than most cities, he said, with more obesity, more diabetes, more chronic obstructive pulmonary disorder and other chronic conditions. It could be, however, that those conditions are simply recognized more often here.
Yet the data are stark -- Medicare spends about $5,500 in hospital care per beneficiary in Pittsburgh, while places such as Washington, D.C., San Francisco and Seattle are all under $4,000. And only Nashville has a higher rate of hospitalizations that might have been prevented with better-managed care.
The analysis is based on Medicare data because private insurers' cost information is not publicly available. With Western Pennsylvania's large Medicare population, though, it does shed light on overall practice patterns.
While high spending might indicate over utilization, Mr. Miller said the trend carries over into West Virginia and so should not be attributed to one particular healthcare provider, such as UPMC or West Penn Allegheny, or one particular insurer, such as Highmark.
Rather, Mr. Miller said, "I think it's the regional culture" such as small physician practices and overall poor health that are the main drivers.
Another factor could be something else Mr. Miller found -- that Pittsburgh spends less for physician care than other places. He said national research has shown that when more is spent on primary care, there is less need for hospitalization.
Health care consultant Jan Jennings, president and CEO of American Healthcare Solutions, Downtown, sees in the numbers a manifestation of how medicine has traditionally been practiced in this region.
"People practice medicine the way they're trained and I think it's been long known that the training programs in Southwest Pennsylvania are in many ways antiquated," he said. "It goes back generations.
"There is a tendency to put people in the hospital, whether they need it or not, and there's a tendency to operate on people, whether they need it or not."
Gerard Anderson, a health policy specialist at Johns Hopkins University, agreed that "places like Pittsburgh develop certain practice patterns and all the doctors seem to conform to those practice patterns." So, for example, while a child with a sore throat might be treated with antibiotics in one region, she might be scheduled for a tonsillectomy more quickly here.
But Mr. Anderson also said the high number of preventable hospitalizations is striking, with more than 90 per 1,000 Medicare enrollees being admitted for conditions that should not have required hospitalization, while places such as Denver, Portland and Seattle had just over 40 per 1,000 enrollees.
"That tells me that we're not getting good care in the ambulatory setting. A lot of things are being missed in Pittsburgh that result in hospitalization," he said.
He added that the data don't tell whether problems are missed because doctors don't make the diagnosis, or because patients do not follow the doctor's advice for managing conditions such as diabetes.
"We don't know the answer to that. What we do know is that essential care is not being provided to these people."
There are larger factors nationwide that contribute to higher health care costs, of course. Mr. Miller pointed out that because hospitals and physicians only get paid when they do procedures, there's no financial incentive for promoting preventive care.
"Nobody makes any money in health care if everyone's well."
And while responsibility for high spending here may be shared among many, he did say the current contract standoff between Highmark and UPMC makes it less likely that issues such as high spending for hospital care and excessive preventable hospitalizations will be addressed in an effective manner.
"If you have a multi-part system that requires all the stakeholders to collaborate, then the less collaborative the stakeholders are, the less likely you're going to come up with a solution."
Screen all Children for Cholesterol
It doesn’t have a particularly snappy title, but the Summary Report of the Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents makes for surprisingly accessible and interesting reading.
For one thing, it’s well written, especially for a scientific report and a set of clinical guidelines. For another, the report, published in late 2011 in the journal Pediatrics, takes on a question at once basic and profound: What do we know about how the hearts of children become the hearts of adults?
To look at this question, the panel, convened by the National Heart, Lung and Blood Institute, reviewed numerous research studies and suggested new clinical guidelines for monitoring — and improving — cardiovascular health in childhood.
But one recommendation in particular has been the subject of much controversy within the pediatric profession: that pediatricians screen all children for cholesterol by doing a blood test in 9- to 11-year-olds. Until now, only children considered at high risk for cholesterol problems were to be routinely screened.
Two prominent commentaries on the issue have appeared in The Journal of the American Medical Association. In December, Dr. Bruce M. Psaty and Dr. Frederick P. Rivara, from the University of Washington School of Medicine, argued that universal screening may lead to children being put on medication regimens, like statins, that are not justified by the medical evidence.
In January, Dr. Stephen R. Daniels, chairman of pediatrics at the University of Colorado College of Medicine and chairman of the guidelines panel, and Dr. Matthew W. Gillman, director of the obesity prevention program in the department of population medicine at Harvard Medical School, who also served on the panel, published a response titled “Is Universal Pediatric Lipid Screening Justified?”
They described many points of agreement, but Dr. Daniels’s answer to the title question was yes — and Dr. Gillman’s was no.
The argument over universal lipid screening in children is by its nature also a discussion of the ethics of screening tests, the limits of scientific evidence and even the theoretical morality of treating lifestyle issues with pills.
Everyone on every side of the issue agrees on the overarching problem, the chain of risks and bad outcomes.
“We know the process of atherosclerosis begins in childhood and is progressive,” Dr. Daniels said in an interview. “We also know that individuals who are able to maintain low-risk or optimum-risk status throughout their childhood and throughout their young adulthood then get to a point where they’re very unlikely to have cardiovascular disease.”
Those who reach age 45 or 50 with no risk factors (they don’t smoke, and they have normal weight, body mass index, blood pressure and cholesterol) have life expectancies stretching into the 90s, he continued. But with even a single risk factor, like high cholesterol, life expectancy drops to the early 80s.
“I think you could put all this together and argue that the job of parents and the job of pediatricians and primary care physicians is to work to deliver children to young adulthood with minimum risk,” Dr. Daniels said.
Those who support universal screening say that it will find the children with familial hypercholesterolemia, a genetic condition that can lead to early heart disease and death. Almost everyone agrees that if these children have high cholesterol, they should be considered for long-term treatment with statins, the cholesterol-lowering drugs commonly used in adults.
In theory, you could also find those children by asking about a family history of cardiovascular problems, but that does not always work.
“Families don’t know the history or don’t talk about it,” said Dr. Sarah de Ferranti, director of the preventive cardiology clinic at Children’s Hospital Boston.
Still, if we screen all children, we will find many with abnormal lipid levels who do not have familial hypercholesterolemia. Proponents of universal screening suggest that the discovery of such elevated lipid levels might prompt lifestyle interventions — counseling and help with diet and exercise.
Of course, you don’t need a blood test to tell you that an obese child needs to lose weight. Those who oppose the new recommendation worry that universal screening is expensive and requires repeated testing, with the risk of false positives. And it has not been shown to result in better outcomes down the line.
Critics also worry that doctors will perhaps feel pressured to start children on cholesterol-lowering medications — not only children with the genetic predisposition, but also the obese.
“Is this kind of trying to treat obesity by giving them a pill?” asked Dr. Rivara, a professor of pediatrics. “If you have a fat kid, should you be doing lipid screening for those kids? I sort of don’t think so. I don’t think they should be put on statins, and we already know that they need to lose weight.”
We lack evidence that long-term use of statins in children without genetic familial hypercholesterolemia is effective in preventing cardiovascular disease, or even that it is safe. Even for children with the genetic condition, we lack long-term data, but there is more consensus about the risks and benefits.
“We’re trying to attack a public health problem, an environment that encourages unhealthy behaviors, overeating and obesity, in precisely the wrong way,” said Dr. Darshak Sanghavi, chief of pediatric cardiology at the University of Massachusetts. “We’re looking at all the markers and trying to reverse the biochemical indicators through drugs, rather than focusing on the very obvious public health changes.”
Even the proponents of routine screening agree that neither the screening nor medication is the real issue for most families.
“I think parents should first be asking about overall risk for heart disease, for a discussion with their pediatrician about what are the risk factors and why are they important,” Dr. Daniels said.
“The majority of these discussions are really about lifestyle. You really can, by having the right kind of lifestyle, create a low-risk situation for your child across the life span.”
Children and Adolescents drug treatment
Over the last few decades, the theory that adult diseases begin in childhood has been widely discussed. Smoking, the most common underlying cause of death for adults in the United States, begins before the age of 18 years in the majority of adult smokers. Obesity has become the largest health problem in the United States, and the difficulty of long-term weight loss for obese children and adolescents means that many of them will be overweight as adults. The rationale for considering cardiovascular disease prevention efforts in childhood is compelling. Not only do risk factors track from childhood into adult life, but the development and progression of atherosclerosis, which often starts in childhood, are also directly related to the number of risk factors and their severity.
The recent report of the National Heart, Lung, and Blood Institute (NHLBI) Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children.
Cardiac function & Vitamin D Therapy in Patients with Chronic kidney disease
Context Vitamin D is associated with decreased cardiovascular-related morbidity and mortality, possibly by modifying cardiac structure and function, yet firm evidence for either remains lacking.
Objective To determine the effects of an active vitamin D compound, paricalcitol, on left ventricular mass over 48 weeks in patients with an estimated glomerular filtration rate of 15 to 60 mL/min/1.73 m2.
Design, Setting, and Participants Multinational, double-blind, randomized placebo-controlled trial among 227 patients with chronic kidney disease, mild to moderate left ventricular hypertrophy, and preserved left ventricular ejection fraction, conducted in 11 countries from July 2008 through September 2010.
Intervention Participants were randomly assigned to receive oral paricalcitol, 2 ÎĽg/d (n =115), or matching placebo (n = 112).
Main Outcome Measures Change in left ventricular mass index over 48 weeks by cardiovascular magnetic resonance imaging. Secondary end points included echocardiographic changes in left ventricular diastolic function.
Results Treatment with paricalcitol reduced parathyroid hormone levels within 4 weeks and maintained levels within the normal range throughout the study duration. At 48 weeks, the change in left ventricular mass index did not differ between treatment groups (paricalcitol group, 0.34 g/m2.7 [95% CI, −0.14 to 0.83 g/m2.7] vs placebo group, −0.07 g/m2.7 [95% CI, −0.55 to 0.42 g/m2.7]). Doppler measures of diastolic function including peak early diastolic lateral mitral annular tissue velocity (paricalcitol group, −0.01 cm/s [95% CI, −0.63 to 0.60 cm/s] vs placebo group, −0.30 cm/s [95% CI, −0.93 to 0.34 cm/s]) also did not differ. Episodes of hypercalcemia were more frequent in the paricalcitol group compared with the placebo group.
Conclusion Forty-eight week therapy with paricalcitol did not alter left ventricular mass index or improve certain measures of diastolic dysfunction in patients with chronic kidney disease.
Sedentary Time & Physical Activity & Cardiometabolic Risk Factors in Children and Adolescents
Sedentary Time & Physical Activity & Cardiometabolic Risk Factors in Children and Adolescents
Context Sparse data exist on the combined associations between physical activity and sedentary time with cardiometabolic risk factors in healthy children.
Objective To examine the independent and combined associations between objectively measured time in moderate- to vigorous-intensity physical activity (MVPA) and sedentary time with cardiometabolic risk factors.
Design, Setting, and Participants Pooled data from 14 studies between 1998 and 2009 comprising 20 871 children (aged 4-18 years) from the International Children's Accelerometry Database. Time spent in MVPA and sedentary time were measured using accelerometry after reanalyzing raw data. The independent associations between time in MVPA and sedentary time, with outcomes, were examined using meta-analysis. Participants were stratified by tertiles of MVPA and sedentary time.
Main Outcome Measures Waist circumference, systolic blood pressure, fasting triglycerides, high-density lipoprotein cholesterol, and insulin.
Results Times (mean [SD] min/d) accumulated by children in MVPA and being sedentary were 30 (21) and 354 (96), respectively. Time in MVPA was significantly associated with all cardiometabolic outcomes independent of sex, age, monitor wear time, time spent sedentary, and waist circumference (when not the outcome). Sedentary time was not associated with any outcome independent of time in MVPA. In the combined analyses, higher levels of MVPA were associated with better cardiometabolic risk factors across tertiles of sedentary time. The differences in outcomes between higher and lower MVPA were greater with lower sedentary time. Mean differences in waist circumference between the bottom and top tertiles of MVPA were 5.6 cm (95% CI, 4.8-6.4 cm) for high sedentary time and 3.6 cm (95% CI, 2.8-4.3 cm) for low sedentary time. Mean differences in systolic blood pressure for high and low sedentary time were 0.7 mm Hg (95% CI, −0.07 to 1.6) and 2.5 mm Hg (95% CI, 1.7-3.3), and for high-density lipoprotein cholesterol, differences were −2.6 mg/dL (95% CI, −1.4 to −3.9) and −4.5 mg/dL (95% CI, −3.3 to −5.6), respectively. Geometric mean differences for insulin and triglycerides showed similar variation. Those in the top tertile of MVPA accumulated more than 35 minutes per day in this intensity level compared with fewer than 18 minutes per day for those in the bottom tertile. In prospective analyses (N = 6413 at 2.1 years’ follow-up), MVPA and sedentary time were not associated with waist circumference at follow-up, but a higher waist circumference at baseline was associated with higher amounts of sedentary time at follow-up.
Conclusion Higher MVPA time by children and adolescents was associated with better cardiometabolic risk factors regardless of the amount of sedentary time.
China
Concern rises same as cancer vaccines
Concern rises same as cancer vaccines
When 23-year-old teacher Liu Yuqi had her annual medical check-up recently, her main concern was about cervical cancer.
Her aunt was diagnosed with the disease in 2010. "I'm thinking about getting the HPV vaccine which protects me from cervical cancer next time I travel to Hong Kong because it's not yet available on the mainland," said Liu, a math teacher at a Beijing middle school.
According to the World Health Organization, cancer of the cervix is the second most common cancer in women globally, with about 500,000 new cases and 250,000 deaths each year.
In China, at least 100,000 women are diagnosed and about 40,000 die from it each year on the mainland, statistics from the Ministry of Health show.
Chen Yong, a director of the Ciming Check-up Group, which specializes in health screening, said they had received an increasing number of enquiries in recent years about the vaccine that prevents genital infection by the human papilloma virus (HPV), a cause of cervical cancer.
Two HPV vaccines, Gardasil and Cervarix, are being used in more than 100 countries and regions but are not yet available in China, except in Hong Kong.
In some countries, such as UK and Japan, and in regions of Italy, Spain and Malaysia, HPV vaccination is provided free.
"Unfortunately, the Chinese drug authority has yet to approve any of the vaccines," said Chen. "So we can only refer our customers to partner clinics in HK that provide them."
Francois Fong, a sex therapist at Neo-Health Care in Hong Kong, said they launched a HPV vaccine service for mainland women three years ago and there were about 40 to 50 coming each year.
"Most are between 20 and 30 years old," he said.
The best time for HPV immunization for girls is before they become sexually active. It can be given to girls as young as 9, according to Qiao Youlin, vice-chairman of the advisory board for early detection and treatment of cancers at the Ministry of Health.
It is not recommended for pregnant women.
Esthel Kong, a nurse from TY Healthcare Center in Hong Kong, said the HPV vaccine should be given in three doses over a period of 6 months. Each dose cost HK$ 1,280 ($165).
"As far as I see, the number of mainland consumers has increased a little recently," she said.
Qiao Youlin expected that the availability of the vaccines on the mainland would help contain HPV infection.
"It's kind of urgent because as the Chinese become more open about sex, HPV infections would be on the rise," he said.
According to the State Food and Drug Administration (SFDA), manufacturers of both vaccines had filed applications to market them in China.
"We have submitted the application to SFDA and the clinical trials for Cervarix are under way in China," said Sharon Zhang, corporate communications and public relations director of GlaxoSmithKline China.
Newborns suffer withdrawal resulting from Moms drug use
"The neonatal unit isn't supposed to be a drug rehab ward. But the drugs their mothers took are causing more newborns…to spend their first days of life suffering through [neonatal withdrawal syndrome]…Its symptoms are similar to what addicts often experience when stopping a drug…While the syndrome is more prevalent, it is still rare…More babies…are affected in some way by maternal drug use but do not suffer withdrawal symptoms, the state data show. That figure…has grown at a moderate pace for years…Clinicians blame the rise in newborn drug withdrawal on increased use…of prescription painkillers…Infants born with neonatal withdrawal syndrome regularly endure a long, expensive, painful hospital stay…Many…require follow-up care…The public picks up most of the bill. Three-quarters of these newborns are covered by Medi-Cal, the state's insurance program for the poor…The upward trend could continue as funding declines for local programs that find and treat pregnant addicts."
Substance Abuse & Policy
U.K.: Alcohol Pricing: A Battleground Between Health Groups and Drinks Industry
"The price of a drink -- or more to the point, the cost of getting drunk -- has been a battleground between the alcohol industry and health groups for years now. Campaigners want minimum unit pricing, which would push up sharply the cost of the booze that hardened drinkers choose...The drinks industry has adamantly refused to accept that price makes a difference. Andrew Lansley, the...health secretary, went along with the industry line. There was no evidence that putting up prices would curb dangerous drinking, he said. But the prime minister…David Cameron has already dropped hints that he may support minimum pricing…Although Cameron puts the emphasis on young drinkers, older drinkers cause huge harm too. And deaths from alcohol damage are a major concern. Lansley's answer was a responsibility deal with the alcohol industry, which argues that the vast majority of people drink responsibly...The industry promised education campaigns…But major health groups...walked out of negotiations over the alcohol responsibility deal a year ago, and it has been a one-sided affair since. The main bone of contention was Lansley's refusal to allow discussion of price."
Smoking & Tobacco
Public Bans Mean Smokers Also Light Up Less at Home
"Smoking bans in offices, restaurants and other public places don't drive smokers to light up more at home, but in fact prompt them to impose their own extra restrictions on the habit, according to a European study…The research, carried out in Britain, Ireland, France, Germany and the Netherlands, found that a significant proportion of smokers also decided to ban smoking in their own homes after national public smoke-free laws were introduced. Some opponents of workplace or public smoking bans have argued that smoke-free laws might lead to a displacement of the habit into smokers' homes, possibly increasing the exposure of non-smokers, particularly children, to second hand smoke. But Ute Mons of the German Cancer Research Center and the Unit of Cancer Prevention at the World Health Organization (WHO) Collaborating Center for Tobacco Control in Heidelberg…said her findings suggested just the opposite…based on two surveys conducted in 2003/4 and 2008/9 and involved more than 4,600 smokers in the four countries with smoke-free legislation, as well as 1,080 smokers in Britain which served as comparison country at a time when it had no public smoke-free laws…after smoke-free legislation was enacted, the percentage of smokers who banned smoking at home rose by 25 percent in Ireland, 17 percent in France, 38 percent in Germany and 28 percent in the Netherlands, the study showed.''
Development, Aid & Malnutrition
Development Aid & Malnutrition Special Report,
"A quarter of young children around the world are not getting enough nutrients to grow properly, and 300 die of malnutrition every hour…There are 170 million children aged under five whose development has been stunted by malnutrition because of lack of food for them and their breastfeeding mothers…according to research by the charity Save the Children…Over the past five years the price of food has soared across the globe…The poor, who spend the bulk of their income on food, are hit hardest…malnutrition is often not recorded as a cause of death on birth certificates, leading to a lack of action across the developing world. With early intervention, the life-long physical and mental stunting from hunger can be eased, enabling individuals to reach their potential…high-profile campaigning and investment accorded to other causes of child mortality such as malaria, measles or Aids…has produced results. Child deaths from malaria have been slashed by a third since 2000, yet child malnutrition in Africa has fallen by less than 0.3 per cent each year over the same time frame… Most malnourished children…do not die but are diminished, physically and mentally. The World Bank estimates that stunting reduces the GDP of developing countries by between 2 and 3 per cent."
Health-care fraud crackdown nets $4.1b. It's lot?
The federal government recovered nearly $4.1 billion last year in an escalating, nationwide crackdown against health-care fraud, Obama administration officials announced Tuesday.
Health and Human Services Secretary Kathleen Sebelius and Attorney General Eric Holder made the announcement in Washington as they released an annual report on health-care fraud enforcement.
The report shows a sharp increase in the amount of fines and restitution recovered from health-care scams during the Obama administration.
Health care reform bill 101: what the bill means to you
“These accomplishments reflect this administration’s ongoing and intensive efforts to protect the American people and to safeguard precious taxpayer dollars,” Attorney General Holder said.
“It is just one of many ways this administration is working to help the American people at a time when budgets are tight,” he said.
The announcement comes as the president’s health-care reform law – the Affordable Care Act – is under siege among Republicans in Congress and at the US Supreme Court, where lawyers for 26 states will argue next month that it is unconstitutional.
Fighting health-care fraud is essential in an administration that is seeking to dramatically increase the level of federal control over the nation’s health insurance system.
But it is unclear from the report to what extent the increased recoveries are a function of more efficient law enforcement or simply the rampant nature of fraud against the government. Estimates are that health-care fraud diverts more than $60 billion a year from public health care to criminal enrichment.
Administration officials insist they are bringing fraud, waste, and abuse under control.
“We are regaining the upper hand in our fight against health-care fraud,” Secretary Sebelius said. “It has never been harder to rip off Medicare and Medicaid, as it is today,” she said.
Prevalence of Oral HPV Infection (2009-2010) in the United States
Context Human papillomavirus (HPV) infection is the principal cause of a distinct form of oropharyngeal squamous cell carcinoma that is increasing in incidence among men in the United States. However, little is known about the epidemiology of oral HPV infection.
Objective To determine the prevalence of oral HPV infection in the United States.
Design, Setting, and Participants A cross-sectional study was conducted as part of the National Health and Nutrition Examination Survey (NHANES) 2009-2010, a statistically representative sample of the civilian noninstitutionalized US population. Men and women aged 14 to 69 years examined at mobile examination centers were eligible. Participants (N = 5579) provided a 30-second oral rinse and gargle with mouthwash. For detection of HPV types, DNA purified from oral exfoliated cells was evaluated by polymerase chain reaction and type-specific hybridization. Demographic and behavioral data were obtained by standardized interview. Statistical analyses used NHANES sample weights to provide weighted prevalence estimates for the US population.
Main Outcome Measures Prevalence of oral HPV infection.
Results The prevalence of oral HPV infection among men and women aged 14 to 69 years was 6.9% (95% CI, 5.7%-8.3%) and of HPV type 16 was 1.0% (95% CI, 0.7%-1.3%). Oral HPV infection followed a bimodal pattern with respect to age, with peak prevalence among individuals aged 30 to 34 years (7.3%; 95% CI, 4.6%-11.4%) and 60 to 64 years (11.4%; 95% CI, 8.5%-15.1%). Men had a significantly higher prevalence than women for any oral HPV infection (10.1% [95% CI, 8.3%-12.3%] vs 3.6% [95% CI, 2.6%-5.0%], P < .001; unadjusted prevalence ratio [PR], 2.80 [95% CI, 2.02-3.88]). Infection was less common among those without vs those with a history of any type of sexual contact (0.9% [95% CI, 0.4%-1.8%] vs 7.5% [95% CI, 6.1%-9.1%], P < .001; PR, 8.69 [95% CI, 3.91-19.31]) and increased with number of sexual partners (P < .001 for trend) and cigarettes smoked per day (P < .001 for trend). Associations with age, sex, number of sexual partners, and current number of cigarettes smoked per day were independently associated with oral HPV infection in multivariable models.
Conclusion Among men and women aged 14 to 69 years in the United States, the overall prevalence of oral HPV infection was 6.9%, and the prevalence was higher among men than among women. May You see Anytime, Anywhere the Therapist
The very idea of psychotherapy seems to defy the instant-access,Not for long, if some scientists have their way. In the past few years researchers have been testing simple video-game-like programs aimed at relieving common problems like anxiety and depression. These recent results have been encouraging enough that investigators are now delivering the programs on smartphones — therapy apps, in effect, that may soon make psychological help accessible anytime, anywhere, whether in the grocery store line, on the bus or just before a work presentation.
The prospect of a therapy icon next to Angry Birds and Fruit Ninja is stirring as much dread as hope in some quarters. “We are built as human beings to figure out our place in the world, to construct a narrative in the context of a relationship that gives meaning to our lives,” said Dr. Andrew J. Gerber, a psychiatrist at Columbia University. “I would be wary of treatments that don’t allow for that.”
The upside is that well-designed apps could reach millions of people who lack the means or interest to engage in traditional therapy and need more than the pop mysticism, soothing thoughts or confidence boosters now in use.
“That is what makes the idea so promising,” said Richard McNally, a psychologist at Harvard whose lab recently completed a study of 338 people using a simple program accessible on their smartphones. “But there are big questions about how it could work, and how robust the effect really is.”
The smartphone study is only one of the most recent tests of an approach called cognitive bias modification, or C.B.M., that seeks to break some of the brain’s bad habits. The premise, pioneered by Colin MacLeod of the University of Western Australia, is straightforward. Consider people with social anxiety, a kind of extreme shyness that can leave people breathless with dread. Studies have found that many who struggle with such anxiety fixate subconsciously on hostile faces in a crowd of people with mostly relaxed expressions, as if they see only the bad apples in a bushel of mostly good ones.
Modifying that bias — that is, reducing it — can interrupt the cascade of thoughts and feelings that normally follow, short-circuiting anxiety, lab studies suggest. In one commonly used program, for instance, people see two faces on the screen, one with a neutral expression and one looking hostile. The faces are stacked one atop the other, and a split-second later they disappear, and a single letter flashes on the screen, in either the top half or the bottom.
Users push a button to identify the letter, but this is meaningless; the object is to snap the eyes away from the part of the screen that showed the hostile face, conditioning the brain to ignore those bad apples. That’s all there is to it. Repeated practice, the researchers say, may train the eyes to automatically look away, or the frontal areas of the brain to exercise more top-down control.
“It’s a little boring, because it’s repetitive, but you’re only doing it for a few minutes a few times a day,” said Stefanie Block, 26, a University of Michigan graduate student who took part in the Harvard study while living in Boston. “I just did it when commuting to work on the subway; it’s crowded, there isn’t much you can do, it was the perfect time.”
In lab experiments, some researchers have gotten very strong results, “with effect sizes like you’d see in regular therapy,” said Nader Amir, a psychologist at San Diego State University. In a series of experiments, Dr. Amir has found that about half of people with an anxiety disorder who complete a full course — practicing on a computer for about 30 minutes twice a week, for four to six weeks — improve enough that the diagnosis no longer applies. He has tested programs that target social anxiety and generalized anxiety disorder and is part owner of a company that is marketing the technology.
A study among 40 children with chronic anxiety, published in December, found that a similar attention bias program produced “significant reductions in the number of anxiety symptoms and symptom severity,” according to the authors, who included Dr. Daniel Pine of the National Institute of Mental Health and Yair Bar-Haim of Tel Aviv University.
Psychologists in Europe have even tried a bias modification program aimed at heavy drinking — a computer task in which people push away images of alcoholic drinks, using a joystick, and zoom in on nonalcoholic ones — and found that it improved the effectiveness of talk therapy aimed at reducing the habit.
Environmental Health & Pollution Exposure
Air Pollution Tied to Stroke, Memory Loss,"Living in a crowded city or near a busy highway may be tied to a higher chance of having a stroke or losing your memory…'One of the important points is that at levels that are considered to be generally safe by the U.S. EPA (Environmental Protection Agency), we're seeing important health effects,' said Gregory Wellenius, the lead author of the stroke study from Brown University in Providence…Using data from a local air pollution monitoring station, the team found that the risk of having a stroke was 34 percent higher in the 24 hours after 'moderate' EPA pollution readings compared to 'good' pollution days. That increased risk was greatest within 12 to 14 hours of pollution exposure, and was linked to nitrogen dioxide, a traffic-related pollutant…air pollution might be associated with declining thinking and memory skills…researchers led by Jennifer Weuve of Rush University Medical Center in Chicago analyzed a series of cognitive tests given to close to 20,000 women, mostly in their 70s, and also estimated the air pollution around their homes through the EPA's monitoring system. They found that more air pollution was tied to faster rates of cognitive decline. For two different sizes of pollution particles, the difference in thinking and memory skills between women with some of the highest and lowest exposures was similar to a year or two of age-related decline.''
North Carolina:House Infection Data share will hospital
North Carolina Hospital share will house infection data
"Under a new North Carolina law, state health officials have begun collecting data on infections that patients get while in the hospital, and plan to begin making it public this fall. Hospital-Acquired Infections (HAI) are at once a major killer, a huge health care cost and a delicate topic among the fiercely-competitive hospital systems. Data that would allow comparison between all the hospitals in the state has never been public, but the new law is part of a national trend. Public reporting of HAI is now required in 27 states, and more have laws in the works...The U.S. Centers for Disease Control and Prevention has estimated that 1.7 million infections are acquired in hospitals each year, causing nearly 100,000 deaths and $28 billion to $33 billion in excess costs. Because there hasn't been an effort to collect comprehensive data until recently, there aren't solid statistics for North Carolina...By October, the state Division of Public Health hopes to begin posting data for three of the most important infections online for every hospital in the state, something that patient advocates say will not only allow comparison-shopping for safer hospitals but also spur the hospitals to work harder to reduce such infections."
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