Categories
Cardiovascular
Diagnostics
Endocrinology
Health Insurance
Medical Devices
Mental Health
Nutrition
Oncology
Public Health
Sexual Health
Popular Articles
Cellulite Treatment

National Pharmacy Association Project To Improve NHS Commissioning, UK
The NPA is working with LPCs and PCTs to develop a process for assuring the quality of commissioning of community pharmacy services. The aim of the project is to increase constructive dialogue between contractors and commissioners, increase the level of local investment in pharmacy services and improve PCT performance right the way around the commissioning cycle.
generic viagra online
Study Shows Decreased Risk Of Death From Opportunistic Infections With Earlier Antiretroviral Treatment
HIV-positive people with opportunistic infections who receive earlier antiretroviral treatment lower their risk of death compared with people who delay treatment, according to a new study conducted by the Stanford University School of Medicine and published in PLoS One, the San Jose Mercury News reports. The findings could lead to changes in recommendations for antiretroviral treatment protocol, specifically for patients diagnosed with HIV at an advanced stage, the Mercury News reports. The study included 262 HIV-positive participants at 39 health care sites across the U.S., and 20 participants in South Africa. During the yearlong study, the researchers found that among the participants who were treated promptly after developing an opportunistic infection, 14% died or developed another infection. The researchers also found that 24% of participants who deferred treatment for an average of 45 days died or had a decrease in health outcomes. According to the Mercury News, the question of when to start HIV-positive people on antiretroviral treatment remains unclear because of issues such as the high cost of medicines, side effects, and drug interactions or resistance. Andrew Zolopa, head of Stanford University School of Medicine"s division of infectious diseases and lead investigator of the study, said that physicians often treat HIV-positive people for an "acute crisis, then follow up later with treatment for HIV." He continues, "But that answer is wrong. The study shows very clearly that there is no safety downside to doing this -- and the benefit is quite substantial, reducing death by 50%." "Even in San Francisco, one of the first epicenters of HIV in the United States, we still find that many people present late in the course of their illness with an opportunistic infection," Mitch Katz, director of San Francisco"s Department of Health who was not involved in the study, said. He added, "This study shows that it is lifesaving to treat those persons with antiretroviral drugs while they are still in the hospital." Katz said that the results could lead to changes in HIV/AIDS practices worldwide. The International AIDS Society, CDC and the British AIDS Society have developed guidelines recommending that early antiretroviral treatment be considered in patients with opportunistic infections, Zolopa said. In addition, NIH is considering an international study to examine earlier initiation of antiretroviral treatment involving more than 9,000 people from both developed and developing countries (Krieger, San Jose Mercury News, 5/15).
News of the day
Senate Democrats Meet With White House Adviser To Craft Response To Republican Criticism On Health Reform
Senate Democrats on Wednesday worked with senior White House adviser David Axelrod to craft a health care message focused on affordability and choice, the AP/Contra Costa Times reports (Werner, AP/Contra Costa Times, 5/13). The meeting followed the release of a memo last week by Republican strategist Frank Luntz outlining how to criticize Democratic plans for health reform (Budoff Brown/McGrane, Politico, 5/13). Senate Majority Whip Richard Durbin (D-Ill.) said Luntz"s memo was "an interesting catalyst for us" (AP/Contra Costa Times, 5/13).Axelrod presented Democrats with polling data about what U.S. residents are seeking from a health care overhaul and discussed better word choices, such as "shared responsibility" rather than "mandates" for coverage requirements. According to CongressDaily, the meeting centered Democrats on a coordinated message that the U.S. health care system must be affordable and accessible and should be patient-focused (Edney/Condon, CongressDaily, 5/13). Sen. Evan Bayh (D-Ind.) said that many Democrats felt "unease that we did not have a strategy" to answer the attacks coming from Republicans (Pear, New York Times, 5/14). Senate Finance Committee Chair Max Baucus (D-Mont.) said, "Everybody in the room had been a little nervous that, "Gee, Democrats don"t have their act together"" (CongressDaily, 5/13). However, Bayh said that "Axelrod came to reassure us that they do have a strategy" (New York Times, 5/14). Durbin said, "This is an effort to coordinate our message so we present a health care reform effort the American people trust" (Armstrong, CQ Today, 5/13). According to Durbin, Axelrod emphasized that Democrats should continue with the campaign theme that the goal of an overhaul is to "fix what"s broken in the system and preserve what"s good" (Young, The Hill, 5/13).Sen. Charles Schumer (D-N.Y.) said, "We believe the public shares our views. But we don"t want to be overwhelmed by either res, messaging or boots on the ground." He added, "We won"t make the mistake of 1993-94." According to the New York Times, a plan developed by the administration of former President Clinton "collapsed" in the face of Republican criticism (New York Times, 5/14).
Cardiovascular

Ambulance Phone Triage System Misses More Than 50% Of Stroke Patients

[Is ambulance telephone triage using advanced medical priority despatch protocols able to identify patients with acute stroke correctly? Emerg Med J 2009; 26: 442-5] The ambulance phone triage system misses more than 50 per cent of people who have had a stroke, reveals research published in Emergency Medicine Journal. The triage system relies on computer software (Advanced Medical Priority Dispatch Software, or AMPDS) to code the level of emergency from the verbal description of symptoms provided by the caller to prioritise the ambulance response. AMPDS contains several stroke related questions, and people who are unconscious are automatically graded as Category A, which merits an 8 minute ambulance response. Stroke patients who are still conscious warrant a 19 minute response (Category B). There are around 110,000 cases of stroke each year in the UK. Stroke is the third most common cause of death and the leading cause of severe disability. An ambulance is called to around half of people who have had a stroke, and the evidence shows that prompt treatment can significantly reduce the risk of major disability and death. The authors compared the software based clinical coding with the clinical diagnosis made by a doctor for all patients admitted by ambulance from one regional service to the emergency department of one major hospital in southern England. During the six month study period, almost 5000 patients were admitted by ambulance, 126 of whom were subsequently diagnosed by a doctor as having had a stroke. But use of AMPDS only picked up 60 patients who had had a stroke; the remaining 66 were given another diagnosis. Fewer than one in four stroke patients were given a Category A ambulance response, and 3% were given a Category C response (60 minute response). The system also coded 62 other patients as having had a stroke, when they had other problems. AMPDS was developed to help call takers, most of whom have no medical training, and only up to 21 hours of dispatcher training, to prioritise symptoms accurately. Since 2002, all UK ambulance services have used some decision based tool, and most use AMPDS. This system is also widely used throughout the rest of Europe and America. "This first link in the chain of survival needs strengthening in order provide prompt and timely emergency care for these patients," conclude the authors, calling for the Category B response for conscious stroke patients to be upgraded to Category A. British Medical Journal


Add your comment:
Name:
Site address: http://
Your message:
Enter today\\\\'s date, 2 digits
(spam protection):

© Copyright 2009