Fit heart can slow brain ageing, US researchers say

Keeping your heart fit and strong can slow down the ageing of your brain, US researchers say.

A Boston University team found healthy people with sluggish hearts that pumped out less blood had "older" brains on scans than others.

Heart and brain health appear to go hand in hand

Out of the 1,500 people studied, the team observed that the brain shrinks as it ages.

A poor cardiac output aged the brain by nearly two years on average, Circulation journal says.

The link was seen in younger people in their 30s who did not have heart disease, as well as elderly people who did.

End Quote Dr Angela Jefferson Lead researcher

Lead researcher Dr Angela Jefferson said: "These participants are not sick people. A very small number have heart disease. The observation that nearly a third of the entire sample has low cardiac index and that lower cardiac index is related to smaller brain volume is concerning and requires further study."

The participants with smaller brain volumes on magnetic resonance imaging did not show obvious clinical signs of reduced brain function.

But the researchers say the shrinkage may be an early sign that something is wrong.

More severe shrinkage or atrophy occurs with dementia.

Dr Jefferson said there were several theories for why reduced cardiac index - how much blood the heart pumps out relative to body size - might affect brain health.

For example, a lower volume of blood pumping from the heart might reduce flow to the brain, providing less oxygen and fewer nutrients needed for brain cells.

"It is too early to dole out health advice based on this one finding but it does suggest that heart and brain health go hand in hand," she said.

Experts say a person's cardiac index is fairly static - meaning it would be difficult to change it if it were low, without doing pretty intensive exercise training.

Dr Clinton Wright, a brain and memory expert from the University of Miami, said: "Whether lower cardiac index leads to reduced brain volumes and accelerates neurodegeneration on an eventual path to dementia is not yet clear.

"To address the health needs of our ageing population, a better understanding of the links between cardiovascular disease and brain structure and function will be required."

The Boston School of Medicine team will now continue to study the individuals in the trial to see if and how the brain changes affect memory and cognitive abilities over time.

The BBC.

Low self-esteem leads to obesity

Children with self-esteem problems are more likely to be obese as adults, a research team has found.

A study of 6,500 participants in the 1970 British Birth Cohort Study found that 10-year-olds with lower self esteem tended to be fatter as adults.

The affect was particularly true for girls, researchers from King's College London reported.

One obesity expert said the results highlighted that early intervention was key to tackling obesity.

This is not about people with deep psychological problems, all the anxiety and low self-esteem were within the normal range Professor David Collier, King's College London

The children had their weight and height measured by a nurse at the age of 10 and they self-reported when they were 30.

Their emotional states were also noted, the researchers reported in the journal BMC Medicine.

Children with a lower self-esteem, those who felt less in control of their lives, and those who worried often were more likely to gain weight over the next 20 years, the results showed.

Professor David Collier, who led the research, said: "What's novel about this study is that obesity has been regarded as a medical metabolic disorder - what we've found is that emotional problems are a risk factor for obesity.

"This is not about people with deep psychological problems, all the anxiety and low self-esteem were within the normal range."

Strategies

Another researcher, Andrew Ternouth, said: "While we cannot say that childhood emotional problems cause obesity in later life, we can certainly say they play a role, along with factors such as parental weight, diet and exercise.

"Strategies to promote the social and emotional aspects of learning, including the promotion of self-esteem, are central to a number of recent policy initiatives.

"Our findings suggest that approaches of this kind may carry positive benefits for physical health as well as for other aspects of children's development."

Dr Ian Campbell, of the charity, Weight Concern, said: "This study presents some disturbing evidence that, as we suspected, childhood psychological issues have an influence on future weight gain and health.

"Many of the adults we work with have identifiable underlying emotional and self esteem issues and are often resistant to treatment.

"The message here is that early intervention, in childhood, can be the key to combating adult obesity.

"That requires much more than health practitioners can deliver alone and needs greater alertness from parents, teachers, and anyone involved in the welfare of children."

The BBC

Tories hit back in NHS attack row

The Conservatives have sought to reassure voters that the NHS is safe in their hands after one of their MEPs joined in with US attacks on it.

Daniel Hannan added his voice to criticism of Barack Obama's health reforms, telling US TV he "wouldn't wish" the NHS "on anyone".

But shadow health secretary Andrew Lansley said the MEP's comments gave a "distorted" view of the health service.

It came after PM Gordon Brown joined a Twitter campaign to defend the NHS.

The welovetheNHS tag has received tens of thousands of messages of support during the past few days from NHS staff and former patients after it was branded "Orwellian" and "evil" by Republican critics of Mr Obama's health reforms.

The prime minister took the unusual step of adding his voice to the campaign in a message posted from Downing Street's Twitter feed, in which he said "thanks for always being there". His wife Sarah, also sent a message of support to the campaign.

'Powerful examples'

Tory leader David Cameron, who is not on Twitter, has also weighed in to defend the NHS, saying his party was 100% behind it. He has sent an e-mail message to supporters saying: "Millions of people are grateful for the care they have received from the NHS - including my own family.

"One of the wonderful things about living in this country is that the moment you're injured or fall ill - no matter who you are, where you are from, or how much money you've got - you know that the NHS will look after you."

Many of the Twitter messages reacted angrily to Mr Hannan's criticism of the NHS, which he attacked on US TV as a "60 year mistake".

Shadow health secretary Andrew Lansley, who has sought to rebrand the Conservatives as the "party of the NHS", stressed Mr Hannan's views were not those of the party but he would not be disciplined for expressing them.

He told BBC Radio 4's Today programme: "We don't extend discipline in parties to political censorship of people's views, we encourage free speech in the Conservative Party.

"It's just that we don't, David Cameron and I, don't happen to agree with Dan Hannan.

"What he said was both a negative view of the NHS, but more to the point was a distorted view of the NHS."

'Duped'

He also suggested the NHS could set examples for America's healthcare system - but added that elements of the US model could be used to improve the NHS.

Liberal Democrat health spokesman Norman Lamb claimed Mr Hannan's views, far from being "maverick", were shared by "many people within the Conservative Party".

He also criticised

Mr Hannan, who came to prominence with a strongly-worded YouTube attack on Gordon Brown, has been a longstanding critic of the NHS, but he has stressed that it is his personal view and not party policy.

Nevertheless, the row has been seized on by David Cameron's political opponents - particularly as the Tory leader has made support for the NHS a key part of his efforts to rebrand the party and has vowed to protect it from spending cuts if he comes to power.

US critics of the NHS see it as an overly-bureaucratic "socialized" system which rations care.

But one British woman said she felt duped after becoming the unwitting star of an anti-Obama health campaign.

Kate Spall, who appeared in a US free market group's TV commercial opposing Mr Obama's health bill, said her views were misrepresented.

She told the Times: "It has been a bit of a nightmare. It was a real test of my naivety. I am a very trusting person and for me it has been a big lesson. I feel I was duped."

Ms Spall and fellow Briton Katie Brickell's descriptions of poor treatment at the hands of the NHS featured in the Conservatives for Patients' Rights (CPR) advert.

(news.bbc.co.uk)

No shows' cost the NHS millions

Between 2007 and 2008, 6.5 million appointments were missed in the UK, with hospitals losing around £100 per patient in revenue.

The Patients Association said missing an appointment was "unforgivable".

The Department of Health in England says initiatives such as text message reminders are being rolled out.

But Unison said patients were not always to blame as check-ups are often arranged months in advance and easily forgotten.

news.bbc.co.uk

The public service trade union said primary care trusts should find ways of reminding patients of their appointments, which could include text or e-mail alerts.

Some are already doing this.

'Did not attends'

Young men in their early 20s are the worst offenders and people aged 70 to 74 are the most conscientious about keeping an appointment, the figures from UK health departments and analysts Dr Forster showed.

There has been a slight improvement in attendance over the last few years in England, Wales and Northern Ireland.

In Scotland, however, the figure is higher than in recent years.

Some clinics in the UK are now over-booking patients in anticipation of no shows.

But Karen Jennings, Unison's head of health, warned: "Hospitals who go down the route of over-booking, based on previous experience of missed appointments, must ensure that it doesn't disadvantage patients if there is a 100% turn-out."

Michael Summers, vice-chair of the Patients Association, said: "It's unforgivable really.

"It doesn't take much to lift a phone and say that you have recovered or to apologise because you will have to miss an appointment.

"We owe a responsibility to our doctors to behave properly. Missed appointments waste healthcare professionals' time and a great deal of money."

A Department of Health spokesman said successful initiatives, such as text messages to remind patients, were on the rise.

He said the choose and book, which allows patients to select a chosen time, date and place for an appointment at their own convenience, was also helping reduce the number of missed appointments.

He added: "The NHS Constitution gives patients the right to access NHS services, but patients have responsibilities too - it is important to keep appointments, or cancel within reasonable time.

"Otherwise, receiving treatment within the maximum waiting times may be compromised."

Drink blamed for oral cancer rise

Chloe Hammond: "I was lucky, you might not be"

Alcohol is largely to blame for an "alarming" rise in the rate of oral cancers among men and women in their forties, say experts.

Numbers of cancers of the lip, mouth, tongue and throat in this age group have risen by 26% in the past decade.

Alcohol consumption has doubled since the 1950s and is the most likely culprit alongside smoking, says Cancer Research UK.

Each year in the UK around 1,800 people die from the disease.

There are 5,000 newly diagnosed cases per year.

Other risk factors that may be involved include a diet low in fruit and vegetables, and the sexually transmitted human papillomavirus (HPV), which also causes cervical cancer.

Figures produced by Cancer Research UK show that since the mid-1990s, rates of oral cancers have gone up by 28% for men in their forties and 24% for women.

The charity's health information manager Hazel Nunn said: "These latest figures are really alarming.

"Around three-quarters of oral cancers are thought to be caused by smoking and drinking alcohol.

"Tobacco is, by far, the main risk factor for oral cancer, so it's important that we keep encouraging people to give up and think about new ways to stop people taking it up in the first place.

"But for people in their 40s, it seems that other factors are also contributing to this jump in oral cancer rates.

"Alcohol consumption has doubled since the 1950s and the trend we are now seeing is likely to be linked to Britain's continually rising drinking levels."

Oral cancer can be treated successfully if diagnosed early enough.

The most common signs of the disease are ulcers, sores, or red or white patches in the mouth that last longer than three weeks, together with unexplained pain in the mouth or ear.

Alcohol Concern chief executive Don Shenker said: "Many people are not aware of the connection between alcohol and cancer, yet as this research shows, it can be a major contributor or cause of the disease.

"While alcoholic liver disease remains the number one killer linked to alcohol, more and more people are suffering from oral cancers - and record drinking levels have undeniably played a part."

He said it was time to introduce tobacco-style health warnings on alcohol.

"It's a consumer issue - people have a right to know the full range of health risks associated with drinking alcohol above recommended guidelines.

"This research will hopefully help people realise the full extent of the damage that alcohol can do, then they're better placed to make informed decisions about how much they drink."

Professor Ian Gilmore, president of the Royal College of Physicians and chair of the Alcohol Health Alliance, said: "These latest figures demonstrate once again that people are being struck down at ever younger ages with alcohol-related illnesses that they might never have previously associated with heavy drinking.

"There is an urgent need to rethink how we communicate the risks of misuse. The first step is to challenge the widespread notion that the only chronic health damage is suffered by a minority of older drinkers."

Professor Alan Maryon-Davis, president of the UK Faculty of Public Health, said: "The really lethal cocktail is drinking strong spirits and smoking - a carcinogenic double whammy for the delicate lining of the mouth and throat. My advice is if you drink, don't smoke - and if you must smoke, avoid spirits."

---

We asked you for your views on oral cancer. Please find a selection of your comments below.

The emphasis here should be public awareness of oral health and the added risk of drinking and smoking. I am a 38 year old consultant working within the NHS and seven and a half years down the line from being diagnosed with a tongue tumour. I had major surgery with half my tongue removed and then rebuilt from my forearm and a full neck dissection and all lymph nodes removed, tracheostomy and adjuvant radiotherapy. Thankfully I am still here. I didn't drink excessively, neither have I ever smoked and my diet varied and healthy. Promote public awareness, the evidence from the lofty Professor is scant and all drinkers and smokers should be extra vigilant of oral health.
Mark, York

My mouthwash contains alcohol! My toothpaste contains all sorts of chemicals! Comparing trends as a method of identifying a cause seems very unscientific. The total number of migrants has doubled since 1960. I am sure this has a direct link to the increase in skin cancers..!! Daft!!
Andy B, Merseyside, England

At the age of 57 was diagnosed with tongue cancer. I was a moderate smoker from the age of 15 till the age of 50, when I gave up. I have always had the odd drink, but never to excess, although there have been the odd exceptions. My cancer was Stage 3. The treatment consisted of four chemotherapy sessions followed by 35 consecutive sessions of radiotherapy and two blood transfusions. I am now in remission, my treatment having been completed in November 2008. I have been advised it will take two years for the healing to take place. The treatment itself has left me with many permanent issues, such as aching joints, tinnitus, associated muscle pain within the neck area, saliva glands that no longer work and a lack of taste. For six months I was unable to swallow and had to be fed via a peg tube fitted into my stomach. I urge anyone who is currently a smoker and/or drinker to reconsider any thoughts of "Why should I give up?" My experience should be a warning to all.
John Nelson, Maidstone UK

What concerns me is lack of dentists. If we cannot get a check-up, that's one line of early detection removed.
Iris, Cumbria

My sister Rose died in 1984 at the age of 33 from oral cancer; it was originally misdiagnosed as ordinary mouth ulcers. an operation to remove half of her face was her final option which she could not bring herself to do. Rose consumed alcohol and continued to smoke throughout her life; she is sadly missed.
Chris Straker, Padstow, UK

Regarding the item on oral cancer, do you not think that the pub trade has already been decimated by the smoking ban? Now you are telling people that drinking is the major cause of oral cancer. What do you think that will do for the pub trade? It will kill it. So what you are saying is that drinking will more than likely give people oral cancer. We are struggling in the pub trade with customers staying away due to the smoking ban, now how many pubs will have to close due to this item?
Mick Cox, Bromsgrove

I was diagnosed with oral cancer at 31. I'd previously been a heavy drinker and smoker, although I'd abstained from both for over 3 years before my diagnosis. Most people think that it's just smoking that causes these types of cancer, but alcohol can play a big part too. And when you put the two together, you are actually more than doubling your chances of developing a cancer of this type. I was lucky, it was caught early and easily treated. All I needed was two ops, and five years of regular checkups. But I've seen pictures off the Web of people who left it, and have ended up having major surgery removing parts of the neck and face. My advice is, if you suspect something see your GP straight away. Just like testicular cancer, it's a lot easier to treat in the early stages than if it's just left for far too long.
Simon Metcalfe, Carlisle, UK

I am a newly qualified dentist and I am glad that these alarming statistics are being reported in the national news. Oral cancer is largely preventable and if caught early can be treated, but it has generally had a very low profile compared to breast and cervical cancers for example. Every patient who has a check-up with a dentist is visually screened for oral cancer, and the dentist is best placed to notice the warning signs and refer for investigation. Another important reason to regularly visit your dentist.
Angela Waugh, Elgin, UK

My husband has just completed treatment for cancer of the tongue. He had major surgery and 6 weeks of radiotherapy. He has drunk alcohol in moderation - well below the weekly units recommended. He is only 36. Our dentist didn't spot the problem on two occasions and it was just lucky that he went to the doctor about a painless mark on his tongue. I feel that this illness can strike anyone and can't just be attributed to alcohol.
Sera Byrne, Bradninch, Devon

"Around three-quarters of oral cancers are thought to be caused by smoking and drinking alcohol" - so it's unproven then isn't it? I think Cancer Research should wait until it's been scientifically proven before publishing such scare stories, just the same as the BBC shouldn't publish PR material without checking it out first, you are supposed to be publishing the "truth" after all not just every item that someone feeds you.
Kevin Crossinggum, Bromley, Kent.

My husband died in 2007 at the age of 44 from squamous cell carcinoma of the tongue and neck. He was a heavy drinker and smoked hand rolling tobacco, and these were identified as the cause of his disease. He died seven months after his initial diagnosis having had part of his tongue removed, his neck cut open from ear to ear, 35 radiotherapy treatments, and eventually with half his face eaten away when the cancer returned .It is a horrible, disfiguring and agonising disease, and the survival rates are very poor, and the quality of life if you do survive is severely diminished, with facial deformities, pain, loss of speech, loss of the ability to eat ,just a few of the problems after treatment.
Liz Arrand, Harewood West Yorkshire

So why does alcohol get the blame? Is there any empirical research evidence to back up this claim? Other than there's been a rise in alcohol consumption and that's not research. It took years to make the link between smoking and cancer. What about the rise the number of people having piercings in their mouths, tongues, cheeks and lips and noses. Has anyone checked this out as a cause? I doubt it. Unfortunately this sounds to me like all part of the very well orchestrated lobby, of which Cancer Research UK is a part, by the Government and others to completely control our lives. Drinking is the new smoking. When do you think it will be banned?
Mick, Leeds

11 years ago, my grandmother died from oral cancer. She was an alcoholic and heavy smoker. She was just 72. My parents nursed her until her death in their home and it wasn't a dignified death. In July 2008, my father was diagnosed with oral cancer. He is also an alcoholic and heavy smoker. It was only discovered at Stage 4 and was in most of the mouth, tongue, throat, jawbone and it had spread to the lymph. He had a major operation in which all his teeth and most of his gums, 50% of his tongue, the floor of his mouth and part of his lower jaw were removed. He is still fighting the good fight despite turning down any chemo or radiotherapy but his days was few. I can't do anything for them but I don't have many toxins in my mouth i.e. I don't drink very often or much and I don't smoke. I also go to the dentist regularly and try to eat a healthy diet. The saddest thing is that this cancer is treatable if it's caught in the early stages and my dad knew he was ill at least 5 years ago. It's not a nice way to die.
Tracy, Stevenage, England

My sister (a teetotaller) had a pre-cancerous condition in her mouth which simply went away within a few months of dumping her 'all powerful' 'whitening', 'antibacterial' toothpaste and rinse! The rise in oral cancer is more due to the massive surge in chemical additives in dentifrices, (which of course includes alcohol in mouth rinses). The amount of chemicals in toothpastes is unprecedented, many of the chemicals being known skin irritants. The pity of the health service is that there is no correlation between the sources of chronic irritation and the treatment for its consequences. The corporations who manufacture dentifrices do not bear the burden of the consequences of their products. Many toothpastes now contain bleaching agents which in conjunction with foaming agents and other chemicals have the potential to act as carcinogens. Solution: reduce alcohol AND chemicals in toothpaste etc.
truthseeker-e, london

I'm 32, lived the good life since 18 (drinking most weekends etc.) have never smoked but last month I was diagnosed with cancer. I can't help but think that my lifestyle of the last 14 years has played a major part. Fingers crossed for my recovery but I'm now committed to a major lifestyle change, no booze and as little junk food as possible.
AJ, Australia

After drinking my way through uni, I stopped and thought about why I was doing it. I looked at how much I was drinking and it surprised me. It wasn't good for my health, it meant most of the next day was a write-off and getting home was always going to be a problem. I didn't need it to have a good time when I went out. So I stopped. That was seven years ago and I don't regret my decision at all. I feel better for it and am glad I did it. New medical evidence like this just renews that. What does surprise me is society's attitude towards me when I say I don't drink, like there's something wrong with me. Some groups actually now consider me a social leper based on this!
Ali, Hants

My mother died of oral cancer last year , she had never smoked in her life and drink was only ever consumed on rare occasions like at a family party and then she would only have 2 - 3 drinks, her cancer started on her tongue and spread to the right side of her face it was a very aggressive cancer .
John Charkewycz, Bolton, United Kingdom

I am an oncology research sister working in this area and during my time spent on some head and neck wards I have noticed that this disease is affecting younger people. The public should be kept informed about oral cancers as it affects a very public area of the body. Whenever you meet a person the first place you look at is the face. These cancers are devastating and prevention advice must be given in the advertisement of any alcoholic products.
By Carly Munro, Derby ( BBC)

Health care's big money wasters

More than $1.2 trillion spent on health care each year is a waste of money. Members of the medical community identify the leading causes.
Down the drain: $1.2 trillion.
That's half of the $2.2 trillion the United States spends on health care each year, according to the most recent data from accounting firm PricewaterhouseCoopers' Health Research Institute.
What counts as waste? The report identified 16 different areas in which health care dollars are squandered. But in talking to doctors, nurses, hospital groups and patient advocacy groups, six areas totaling nearly $500 billion stood out as issues to be dealt with in the health care reform debate.
Too many tests
Doctors ordering tests or procedures not based on need but concern over liability or increasing their income is the biggest waste of health care dollars, costing the system at least $210 billion a year, according to the report. The problem is called "defensive medicine."
"Sometimes the motivation is to avoid malpractice suits, or to make more money because they are compensated more for doing more," said Dr. Arthur Garson, provost of the University of Virginia and former dean of its medical school. "Many are also convinced that doing more tests is the right thing to do."
"But any money that is spent on a patient that doesn't improve the outcome is a waste," said Garson.
Some conservatives have suggested that capping malpractice awards would help solve the problem.
President Obama doesn't agree; instead, his reform proposal encourages doctors to practice "evidence-based" guidelines as a way to scale back on unnecessary tests.
Those annoying claim forms
Inefficient claims processing is the second-biggest area of wasteful expenditure, costing as much as $210 billion annually, the PricewaterhouseCoopers report said.
"We spend a lot of time and money trying to get paid by insurers," said Dr. Terry McGenney, a Kansas City, Mo.-based family physician.
"Every insurance company has its own forms," McGenney said. "Some practices spend 40% of their revenue filling out paperwork that has nothing to do with patient care. So much of this could be automated."
Dr. Jason Dees, a family doctor in a private practice based in New Albany, Miss., said his office often resubmits claims that have been "magically denied."
"That adds to our administrative fees, extends the payment cycle and hurts our cash flow," he said.
Dees also spends a lot of time getting "pre-certification" from insurers to approve higher-priced procedures such as MRIs. "We're already operating on paper-thin margins and this takes times away from our patients," he said.
Susan Pisano, spokeswoman for America's Health Insurance Plans, said "hundreds of billions" of dollars can be saved by standardizing procedures and using technology -- something the White House has mentioned as a key to health care reform.
"For that to happen, we need the technology," she said. "Doctors and hospitals must adopt the technology, and we have to develop rules for exchanging of information between doctors, hospitals and health plans."
Pisano said the industry is launching a pilot program later this year that will allow physicians to communicate with all health plans using a standardized process.
Using the ER as a clinic
More insured and uninsured consumers are getting their primary care in emergency rooms, wasting $14 billion every year in health care spending.
"This is an inappropriate use of the ER," said Dee Swanson, president of the American Academy of Nurse Practitioners. "You don't go to the ER for strep throat."
Since emergency rooms are legally obligated to treat all patients, Swanson said providers ultimately find ways to pass on the cost for treating the uninsured to other patients, such as to those who pay out-of-pocket for their medical care.
Dees also took issue with consumers who don't get primary care for their diabetes or blood pressure on a timely basis, hence finding themselves in the ER.
"Going to the doctor for strep throat would cost $65-$70. In the ER, it's $600 to $800," he said.
The $787 billion stimulus bill signed passed by President Obama earlier this year allocates $1 billion for a wellness and prevention fund, including $300 million for immunizations and $650 million for prevention programs to combat the rapid growth in chronic diseases such as obesity and diabetes.
Medical "Oops"
Medical errors are costing the industry $17 billion a year in wasted expenses, something that makes patient advocacy groups irate.
"Do we have a good health IT system in place to prevent this?" asked Kim Bailey, senior health policy analyst with consumer advocacy group Families USA.
Bailey suggested that processes such as computerized order entry for drugs and use of electronic health records (EHR) could help ensure that patients get the correct dosage of medications in hospitals.
The stimulus bill calls for the government to take a leading role in developing standards by 2010 to facilitate the adoption of health information exchanges across the system, including patient electronic health records by 2014.
Obama has repeatedly said that the use of technology in the health sector will help boost savings, enhance the coordination of care and reduce medical errors and unnecessary procedures.
Going back to the hospital
Bailey suggested that processes such as computerized order entry for drugs and use of electronic health records (EHR) could help ensure that patients get the correct dosage of medications in hospitals. Discharging patients too soon is a "huge waste of money," said Swanson.
"This happens a lot with elderly patients who are discharged prematurely because of insurance, bed unavailability or ageism," she said.
Many times, patients also don't follow instructions for care after discharge. "So complications arise and they are readmitted in a week," Swanson said.
PricewaterhouseCoopers estimates the cost of preventable hospital readmissions at $25 billion annually.
Among the reform plans, one proposal being considered is for Medicare to potentially penalize hospitals who readmit patients within 30 days of discharge.
You forgot to wash your hands!
Those ubiquitous dispensers of hand sanitizer are in hospitals for a reason: PricewaterhouseCoopers estimates that about $3 billion is wasted every year as a result of infections acquired during hospital stays.
"The general belief is that hospitals are getting much better in managing this than they have in the past," said Richard Clarke, CEO of Healthcare Financial Management Association, whose members include hospitals and managed care organizations.
Something as simple as hand-washing often can reduce the problem.
"Sometimes doctors are the most difficult people to convince to do this," said Clarke. "The challenge here is that patients sometimes come in with infections which then spread in the hospital."
The stimulus bill signed by Obama earlier this year includes $50 million for reducing health care-associated infections.
Other areas of waste identified in the PricewaterhouseCoopers report included up to $493 billion related to risky behavior such as smoking, obesity and alcohol abuse, $21 billion in staffing turnover, $4 billion in prescriptions written on paper, and $1 billion in the over-prescribing of antibiotics.
By Parija B. Kavilanz, CNNMoney.com

13-year-old girl dies of swine flu in Pune, toll reaches 8

Swine flu claimed yet another life of a 13-year-old girl here on Tuesday, raising the total number of victims across the country to eight.
Shruti Gawade, a student of Ahilyadevi school, became the sixth victim of the H1N1 virus in the state. Five of them died in Pune itself. Shruti, a resident of Narayan Peth area, had been kept on ventilator since August 7 when she was brought here after being referred from a private hospital in critical condition, said Dr Pandurang Pawar, Medical Superintendent of Sasoon hospital. In Chennai, two persons including a four-year-old boy fell prey to the deadly virus on Monday.
(economictimes.indiatimes.com)

Good Pharmacy Practice urged

HCM CITY — The Ministry of Health encourages pharmaceutical companies to set up drugstore chains adopting Good Pharmacy Practice (GPP) standards, a health official said.

Deputy Health Minister Cao Minh Quang called it one of four main targets for Viet Nam’s drug retail system by 2010.

Drug companies should invest in building more facilities and researching into new drugs to improve the quality of their products and achieve the GPP standards the ministry set out in January 2007, he said.

Initially, they should be willing to accept a dip in profits since they have to invest large sums of money to set up pharmacies meeting GPP standards, he warned.

They would also face difficulties in acquiring market share since they would only sell drugs on doctors’ prescriptions and compete with non-GPP rivals, he said.

But they would benefit when non-GPP drugstores are forced to close down in 2010, he said.

Besides, he pointed out that the ministry has issued a slew of incentives for companies setting up GPP-standard chains.

These include buying drugs from foreigners and overseas Vietnamese who bring them into Viet Nam and from foreign-invested enterprises, importing and exporting drugs directly, and selling medicines to national health programmes and health insurance.

Already 15 pharmaceutical companies based in Ha Noi, HCM City, Can Tho, and Da Nang, including My Chau, V-Phano, Saphaco, and Eco, have registered to set up the GPP-standard chains.

With the Vietnamese pharmaceuticals market being very promising and attracting foreign investment, these chains would make profits very soon, Quang predicted.

He said 444 of the country’s 9,066 pharmacies meet GPP standards, including 140 attached to hospitals.

In HCM City, the number is 200 out of 3,356.

People buy medicines at a pharmacy in HCM City. The Ministry of Health is encouraging pharmaceutical companies to adopt Good Pharmacy Practice standards. — VNA/VNS Photo The Anh

Pham Khanh Phong Lan, deputy head of the HCM City Department of Health, said the city has its own policies to encourage drugstores to adopt GPP standards.

The department plans to organise free training courses for pharmacists and publicise drugstores that adopt GPP standards.

It will work with the Department of Finance to work out tax breaks for GPP-standard drugstores as well as companies that set up such chains and encourage foreign drug companies to supply to them.

The department would frequently check GPP drugstores to ensure they maintain the standards, she said. — VNS

By vietnamnews

Flu drugs 'unhelpful' in children

Tamiflu is the antiviral being used in the UK

Research has cast doubt on the policy of giving antiviral drugs to children for swine flu.

Work in the British Medical Journal shows Tamiflu and Relenza rarely prevent complications in children with seasonal flu, yet carry side effects.

Although they did not test this in the current swine flu pandemic, the authors say these drugs are unlikely to help children who catch the H1N1 virus.

The government stuck by its policy of offering antivirals to anyone infected.

The Department of Health said a "safety-first approach" of offering antivirals to everyone remains a sensible and responsible way forward, but promised to keep the policy under review.

There were an estimated 30,000 new cases of swine flu in England in the last week, a drop compared with the 110,000 cases the week before.

A decreased incidence has also been seen in Scotland and Wales in the past week.

The total of swine flu-related deaths in England and Scotland stands at 41.

Antivirals are the mainstay of treatment at the moment until a vaccine becomes available, which is expected in September.

The drugs are designed to ensure that symptoms are mild and reduce the chance of an infected person giving the illness to someone else.

The UK has moved beyond the stage of containing swine flu into the "treatment phase", which means that Tamiflu is only being offered to people who have swine flu and not usually to their contacts.

No effect

While the latest study shows that antivirals can shorten the duration of normal seasonal flu in children by up to a day and a half, it also shows that they have little or no effect on asthma flare-ups, ear infections or the likelihood of children needing antibiotics.

But the drugs can cause unpleasant side effects, such as vomiting with Tamiflu.

There is also the risk that widespread use of the drugs will mean the flu virus will develop resistance to them.

For most children aged between 1 and 12, the risks associated with taking the drugs may well outweigh any benefits, say the researchers.

Their work also reveals the effectiveness of using antivirals to contain the spread of flu.

They found that 13 people need to be treated to prevent one additional case, meaning antivirals reduce transmission by 8%.

The University of Oxford team, led by Dr Matthew Thompson, carried out a review of four trials on the treatment of seasonal flu in 1,766 children and three trials involving the use of antiviral to limit the spread of seasonal flu in 863 children.

Dr Thompson said: "Our research is finding for most children these antiviral drugs are probably not going to have much of an effect."

Co-researcher Dr Carl Henegan, a GP and expert from the John Radcliffe Hospital in Oxford, said the current policy of giving Tamiflu for mild illness was an "inappropriate strategy".

He said: "The downside of the harms outweigh the one-day reduction in symptomatic benefits."

Flu expert Professor Hugh Pennington said the findings were not surprising and underlined what was already known about Tamiflu.

"Tamiflu has a place but it's not a wonder cure."

A Department of Health spokesman said: "Whilst there is doubt about how swine flu affects children, we believe a safety-first approach of offering antivirals to everyone remains a sensible and responsible way forward.

"However, we will keep this policy under review as we learn more about the virus and its effects.

"The BMJ research is correct to say that many people with swine flu only get mild symptoms, and they may find bed rest and over-the-counter flu remedies work for them.

"But for those who experience severe symptoms, the best scientific advice tells us that Tamiflu should still be taken as soon as possible - and to suggest otherwise is potentially dangerous. If people are in any doubt about whether to take Tamiflu, they should contact their GP."

Liberal Democrat Shadow Health Secretary, Norman Lamb said called for an urgent review of the policy.

The BBC.