Monday, May 6, 2013

'Nightmare' Bacteria Spreading in U.S. Hospitals, Nursing Homes: CDC

For bleeding attacks, longer-term outcome may

By Steven Reinberg

HealthDay Reporter

TUESDAY, March 5 (HealthDay News) -- A "nightmare" bacteria that is resistant to powerful antibiotics and kills half of those it infects has surfaced in nearly 200 U.S. hospitals and nursing homes, federal health officials reported Tuesday.

The U.S. Centers for Disease Control and Prevention said 4 percent of U.S. hospitals and 18 percent of nursing homes had treated at least one patient with the bacteria, called Carbapenem-Resistant Enterobacteriaceae (CRE), within the first six months of 2012.

"CRE are nightmare bacteria. Our strongest antibiotics don't work and patients are left with potentially untreatable infections," CDC Director Dr. Thomas Frieden said in a news release. "Doctors, hospital leaders and public health [officials] must work together now to implement the CDC's 'detect and protect' strategy and stop these infections from spreading."

"The good news," Frieden added at an afternoon teleconference, "is we now have an opportunity to prevent its further spread." But, he continued, "We only have a limited window of opportunity to stop this infection from spreading to the community and spreading to more organisms."

CRE are in a family of more than 70 bacteria called enterobacteriaceae, including Klebsiella pneumoniae and E. coli, that normally live in the digestive system.

In recent years, some of these bacteria have become resistant to last-resort antibiotics known as carbapenems.

Although CRE bacteria are not yet found nationwide, they have increased fourfold within the United States in the past decade, with most cases reported in the Northeast.

Health officials said they're concerned about the rapid spread of the bacteria, which can endanger the lives of patients and healthy people. For example, in the last 10 years, the CDC tracked one CRE from one health-care facility to similar facilities in 42 states.

One type of CRE, a resistant form of Klebsiella pneumoniae, has increased sevenfold in the past decade, according to the CDC's March 5 Vital Signs report.

"To see bacteria that are resistant is worrisome, because this group of bacteria are very common," said Dr. Marc Siegel, clinical associate professor of medicine at NYU Langone Medical Center in New York City.

Most CRE infections to date have been in patients who had prolonged stays in hospitals, long-term facilities and nursing homes, the report said.

The bacteria kill up to half the patients whose bloodstream gets infected and are easily spread from patient to patient on the hands of health-care workers, the CDC said.

Moreover, CRE bacteria can transfer their antibiotic resistance to other bacteria of the same type.

This problem is the result of the overuse of antibiotics, Siegel said. "The more you use an antibiotic, the more resistance is going to emerge," he said. "This is an indictment of the overuse of this class of antibiotic."


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New Pap Guidelines May Miss Aggressive Cancer in Young Women: Study

Title: New Pap Guidelines May Miss Aggressive Cancer in Young Women: Study
Category: Health News
Created: 3/7/2013 6:36:00 PM
Last Editorial Review: 3/8/2013 12:00:00 AM

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Eye-Tracking Tool Might Quickly Spot Stroke

A bright pink glow showed the precise pathway a

By Amanda Gardner

HealthDay Reporter

TUESDAY, March 5 (HealthDay News) -- The key to correctly diagnosing when a case of dizziness is just vertigo or a life-threatening stroke may be surprisingly simple: a pair of goggles that measures eye movement at the bedside in as little as one minute, a new study contends.

"This is the first study demonstrating that we can accurately discriminate strokes and non-strokes using this device," said Dr. David Newman-Toker, lead author of a paper on the technique that is published in the April issue of the journal Stroke.

Some 100,000 strokes are misdiagnosed as something else each year in the United States, resulting in 20,000 to 30,000 deaths or severe physical and speech impairments, the researchers said.

As with heart attacks, the key to treating stroke and potentially saving a person's life is speed. Magnetic resonance imaging (MRI), the current gold standard for assessing stroke, can take up to six hours to complete and costs $1,200, said Newman-Toker, who is an associate professor of neurology and otolaryngology at Johns Hopkins Hospital in Baltimore.

Sometimes people don't even get as far as an MRI, and may be sent home with a first "mini stroke" that is followed by a devastating second stroke, he added.

The new study findings come with some significant caveats, however.

For one thing, the study was a small one, involving only 12 patients.

"It is impossible for a small study to prove 100 percent accuracy," said Dr. Daniel Labovitz, director of the Stern Stroke Center at Montefiore Medical Center in New York City, who was not involved with the study. About 4 percent of dizziness cases in the emergency room are caused by stroke.

The other caveat is that the device is not yet approved in the United States for diagnosing stroke. The U.S. Food and Drug Administration only recently gave it approval for use in assessing balance. It has been available in Europe for that purpose for about a year.

The device -- known as a video-oculography machine -- is a modification of a "head impulse test," which is used regularly for people with chronic dizziness and other inner ear-balance disorders.

"There are 500 otolaryngologists and 4 million dizzy patients in the U.S. alone," Newman-Toker said. "We [otolaryngologists] can't see everybody and [emergency room physicians] can't easily be trained to develop expertise in eye movement interpretation."

"Now we have a device that can do it for them," he added.

The test is simple to perform: Wearing a pair of goggles hooked up to a webcam and special software, the patient is asked to focus on one spot on the wall while the doctor moves the patient's head from side to side.


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Cholesterol Levels May Vary By Season

Title: Cholesterol Levels May Vary By Season
Category: Health News
Created: 3/7/2013 12:36:00 PM
Last Editorial Review: 3/8/2013 12:00:00 AM

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Sunday, May 5, 2013

Brain Scans May Explain Thinking, Memory Problems in Some MS Patients

Study found more damaged white matter in brains

By Denise Mann

HealthDay Reporter

WEDNESDAY, March 6 (HealthDay News) -- Besides problems with gait and vision, people who have multiple sclerosis often complain they have trouble remembering things, and now new research may explain why.

According to a small study from the Netherlands, people with MS who report memory and thinking problems have more extensive damage to the white matter in their brains than their counterparts with MS who don't report such problems.

Up to 70 percent of all people with MS will experience a mental decline at some point, said study author Hanneke Hulst at the VU University Medical Center, in Amsterdam. And the new research "confirmed that cognitive symptoms in MS have a biological basis," Hulst said.

The findings were published online March 6 in Neurology.

MS is an autoimmune disease that occurs when the body attacks myelin, a fatty substance that insulates the nerve fibers of the central nervous system. The brain's white matter is surrounded by myelin. Symptoms range in severity and may include problems with gait, balance, vision, memory and thinking abilities.

To get a better picture of what was going on in the brains of people with MS, Hulst and colleagues used a new type of brain scan called diffusion tensor imaging along with traditional MRI scans on 20 people with MS-related thinking problems, 35 people with MS whose thinking ability was not affected by the disease and 30 people without MS.

More damage appeared in the brain's white matter of people with MS who reported memory and thinking impairments than in those who had MS but no such complaints about mental declines: 76 percent vs. 49 percent, respectively. This was especially apparent in areas of the brain charged with memory, attention and concentration, the researchers said.

"Imaging can now be used to capture a wider spectrum of changes in the brains of people with MS, and will therefore help determine more accurately whether new treatments are helping with all aspects of the disease, including cognitive [mental] impairment," Hulst said. "Unfortunately, at the moment there are no treatments available to prevent or cure cognitive problems in MS."

Dr. Steven Mandel, a neurologist at Lenox Hill Hospital in New York City, said the new study validates some of the complaints he hears from people with MS. "The test is not ready for prime time, but in the future, it can help us sort out how impaired these individuals are in regard to everyday life and daily living." It may also serve as a marker to assess whether a treatment is making a difference, he said.

Dr. Fred Lublin, director of the Corinne Goldsmith Dickinson Center for Multiple Sclerosis at Mount Sinai Medical Center in New York City, said that memory and thinking problems are common in people with MS, but they are usually subtle.

"People with MS are more aware of [these problems] than are the people around them," Lublin said. Still, he added, "this is an important finding that helps us better understand how cognitive impairment occurs and therefore can be a marker for treatments in the future."

More information

Learn more about how MS affects memory and concentration at the National Multiple Sclerosis Society.


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Health Tip: Do I Need a Cardiac Stress Test?

Title: Health Tip: Do I Need a Cardiac Stress Test?
Category: Health News
Created: 3/8/2013 8:35:00 AM
Last Editorial Review: 3/8/2013 12:00:00 AM

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Health Tip: Teach Kids In-Line Skating Safety

Title: Health Tip: Teach Kids In-Line Skating Safety
Category: Health News
Created: 3/8/2013 8:35:00 AM
Last Editorial Review: 3/8/2013 12:00:00 AM

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