â€śDoâ€™s and Donâ€™tsâ€ť of procedure masks and N95 respirators
To help educate healthcare professionals on how to properly wear respiratory
personal protective equipment (PPE), the Association for Professionals in
Infection Control and Epidemiology (APIC) has created two new fliers that
outline key points on use of N95 respirators and procedure masks in
The Doâ€™s and Donâ€™ts for wearing procedure masks in non-surgical healthcare
settings and the Doâ€™s and Donâ€™ts for wearing N95 respirators in non-surgical
healthcare settings are free, downloadable fact sheets that present quick
tips for wearing and safely removing this PPE, helping healthcare
professionals prevent the spread of infection by avoiding common mistakes.
The fliers were developed by APICâ€™s Communications Committee with input from
the American Nurses Association (ANA), the Association of Occupational
Health Professionals in Healthcare (AOHP), and the Association of
PeriOperative Registered Nurses (AORN).
Healthcare professionals often care for patients with infectious diseases
that are spread by droplets or particles in the air and therefore frequently
require respiratory protection. Data from the Respiratory Evaluation for
Acute Care Hospitals (REACH) studies conducted during the 2009 H1N1 pandemic
revealed the need for continued education and training about respiratory PPE
among healthcare professionals.
Download the new fliers on the â€śDoâ€™s and Donâ€™tsâ€ť for wearing N95 respirators
and procedure masks as well as other education materials for healthcare
professionals from APICâ€™s Infection Prevention and You website:
New target in
sepsis: The host response
As antibiotic resistance rises worldwide, researchers have been exploring
novel ways to treat severe sepsis, with one group having discovered
host-protective molecules that potentially could be harnessed to eradicate
bacteria quickly and in a nonbactericidal manner.
Researchers from Harvard University's Center for Experimental Therapeutics
and Reperfusion Injury reported that bioactive lipid molecules referred to
as 13-series resolvins (RvTs) hastened the resolution of inflammation and
increased survival from Escherichia coli infections in a mouse model.
Twelve hours after the administration of four RvTs to infected mice, the
treatment "afforded dose-dependent protection against hypothermia, limited
further neutrophil recruitment to sites of inflammation, and increased
bacterial phagocytosis by peritoneal leukocytes ... without exerting
bactericidal or bacteriostatic actions," reported Charles N. Serhan, PhD,
and colleagues in Nature Medicine.
Sepsis remains a prominent clinical challenge, with more than 750,000 cases
occurring each year in the U.S. and up to 30% mortality, according to Craig
R. Lee, PharmD, PhD, of the University of North Carolina at Chapel Hill, and
Darryl C. Zeldin, MD, of the National Institute of Environmental Health in
Research Triangle Park, NC. Thus far, efforts to identify new treatments
that could block activation of the excessive inflammatory response in sepsis
such as corticosteroids and nonsteroidal anti-inflammatory drugs have been
Serhan and colleagues have been analyzing the factors that participate in
the regulation of acute inflammation, and previously identified specialized
pro-resolving mediators that appear between 4 and 12 hours after the
initiation of infection. However, the mediators that control the very
earliest phase of the inflammatory response and the subsequent crucial
clearance of the phagocytosed bacteria had not previously been recognized.
Accordingly, they conducted a series of experiments looking for the earliest
mediators that accomplish these tasks, focusing on neutrophils, which are
the first responders to the vascular endothelium at the site of infection.
These experiments revealed the presence of RvTs in the first 4 hours of
infection in mice, and also in the peripheral blood of sepsis patients.
They then observed the effects of these molecules on human leukocytes, and
found dose-dependent increases in E. coliphagocytosis in macrophages,
as well as enhanced efferocytosis (from the Latin efferro, to take away,
carry to the grave, bury) of neutrophils undergoing apoptosis, which is a
crucial component of the resolution of inflammation.
They further reported that the synthesis of RvTs was a two-step neutrophil-endothelial
interaction process, in which docosapentaenoic acid undergoes metabolism by
COX-2 present in the endothelium, and the resulting compound
13-hydroxydocosapentaenoic acid is metabolized to RvTs.
They then noted that the administration of statins has been shown to be
beneficial in sepsis and is protective in a murine model of bacterial
infection. Pointing out that atorvastatin regulates endothelial COX-2, they
questioned whether the statin might influence the synthesis of RvTs.
So they incubated cultures of the neutrophil-endothelium cellular mix with
atorvastatin and injected this into mice before E. coli infection, and found
an increase in RvT biosynthesis along with rapid infection resolution and
Serhan's group also considered whether the use of RvTs plus atorvastatin
might enhance recovery from infections, and found that mice given the
combination had longer survival than those given the statin alone,
suggesting that lower doses of atorvastatin might be sufficient during
infection, thereby lessening the likelihood of the adverse events that can
occur at high doses.
They concluded, "Given the extensive size of the vascular-endothelial system
in humans and the abundance of neutrophils within the circulation, formation
of RvTs during early stages of self-resolving acute inflammation and their
regulation by atorvastatin could provide a molecular basis for the
development of new treatment strategies for infectious inflammation."
Visit MedPage Today for the study.
Elite Guidewire and wireClip Torquer Guidewire by Boston Scientific
Boston Scientific Corp is recalling RotaWire 'Elite' core wires because they
may crack and separate from the rest of the Rotablator Rotational
Atheroctomy System and cause serious injury such as tamponade (blood in the
sac around the heart causing decreased heart function), myocardial
infarction (heart attack), and migration of wire fragments elsewhere in the
The company has received three reports of this issue occurring, including
one patient death following medical intervention to remove the broken wire.
Other interventions have included purposefully blocking off (occluding) the
affected artery, placing stents into the affected artery, and emergency
The use of affected product may cause serious adverse health consequences,
The RotaWire Elite Guidewire and wireClip Torquer Guidewire are components
of the Rotablator Rotational Atherectomy System. The device is used to open
narrowed arteries and improve blood flow to the heart by cutting plaque from
the artery wall (atherectomy).
Boston Scientific sent an Urgent Medical Device Recall Removal - Immediate
Action Required letter to customers beginning October 9, 2015. The letter
listed the following instructions: Stop distributing and using these devices
immediately and return all affected products to Boston Scientific.
Read the FDA MedWatch safety alert.
is possible thanks to synapse discovery
According to scientists, a new discovery of a synapse protein may soon lead
to Alzheimerâ€™s disease being a thing of the past.
It has recently become common knowledge that the links between brain cells
are obliterated during the onset of Alzheimerâ€™s disease. UNSW Australia
scientists lead the team of researchers who discovered this fact.
This has paved the way for a range of cures on a hypothetical level. The
vanishing of synapses is the first stage of Alzheimerâ€™s. These synapses
connect various neurons in the human brain. They are a necessity for
learning purposes and the formation of memory. In fact, all brain functions
are dependent on these synapses.
â€śOne of the first signs of Alzheimerâ€™s disease is the loss of synapses â€“ the
structures that connect neurons in the brain,â€ť says study leader, Dr.
Vladimir Sytnyk, of the UNSW School of Biotechnology and Biomolecular
â€śSynapses are required for all brain functions, and particularly for
learning and forming memories. In Alzheimerâ€™s disease, this loss of synapses
occurs very early on, when people still only have mild cognitive impairment,
and long before the nerve cells themselves die.
â€śWe have identified a new molecular mechanism which directly contributes to
this synapse loss â€“ a discovery we hope could eventually lead to earlier
diagnosis of the disease and new treatments.â€ť
In the earlier stages of Alzheimerâ€™s, the victims only have a little bit of
cognitive damage. It is a long and painful journey from this relatively
benign stage to the devastating period when all nerve cells simply die off.
A novel molecular mechanism has been found whereby the synapses get wiped
out in the first place. It is hoped that this discovery will help in finding
a suitable cure for the dreaded malady. Care is better than cure and so an
earlier diagnosis is of the essence. And suitable therapeutic steps may be
instituted that will work on a regular basis.
A protein termed neural cell adhesion molecule 2 (NCAM2) was thoroughly
studied by the experts. This protein is said to help in the formation of
synapses. It facilitates the various connections in the brain.
Thus it could prove very useful in the fight against Alzheimerâ€™s.
Post-mortem brain samples from people with Alzheimerâ€™s proved that levels of
NCAM2 were low in the hippocampus.
Furthermore, this protein is broken up by another protein which is called
beta-amyloid. Beta-amyloid is a major part of the plaques that accumulate in
the brains of Alzheimerâ€™s patients.
â€śOur research shows the loss of synapses is linked to the loss of NCAM2 as a
result of the toxic effects of beta-amyloid,â€ť says Dr Sytnyk. â€śIt opens up a
new avenue for research on possible treatments that can prevent the
destruction of NCAM2 in the brain.â€ť
The wearing away of synapses is due to the obliteration of NCAM2 and this in
turn is due to the derangements wrought by the protein known as beta-amyloid.
The avenues opened up for future research will explore the prevention of
This is the only direction that holds promise so far. And it just might be
the sole means of ending the disease in the times which are yet to come.
Alzheimerâ€™s often begins in the ripe years of most senior citizens.
And it progresses steadily to reduce the afflicted personâ€™s memory till all
functions necessary for a responsible life are gone. The final stage leads
to certain death. It is a degenerative disease of modern civilization and
requires new solutions rather than the tried and tested therapeutic methods
he studyâ€™s first author is Dr. Iryna Leshchynsâ€™ka of the UNSW School of
Biotechnology and Biomolecular Sciences and the team includes researchers
from Neuroscience Research Australia and the Dementia Research Unit of the
UNSW School of Medical Sciences.
Visit i4u News for the report.
gene editing could lead to groundbreaking cures
Thanks to the controversial new technology known as CRISPR, scientists are
beginning to make headway in understanding and potentially curing some of
the world's most intractable diseases.
Sickle-cell anemia, HIV, schizophrenia and autism -- essentially, anything
involving bad DNA is now fair game. The latest example, from a study
published earlier this month in the journal Molecular Therapy,
focuses on Facioscapulohumeral muscular dystrophy, or FSHD, which is one of
the most common forms of muscular dystrophy. The genetic disease causes the
muscle fibers in the face, shoulders and upper arms to weaken over time --
and there is no known cure.
Enter CRISPR. This new gene-editing technique allows researchers to easily
change, delete or replace genes in any plant or animal, including people.
Picture the precision and ease of the find-and-replace function on a word
document -- thatâ€™s how easy it now is to change the human genome. As an
article in the MIT Technology Review put it last year, â€śThis means
they can rewrite the human genome at will.â€ť Or, as one bioethicist told The
Huffington Post last week, comparing what CRISPR can do to earlier attempts
at genetic manipulation, â€śWe used to have a butter knife, now weâ€™ve got a
Biomedical researchers all over the world are now wondering how the
technology might change their approach to all sorts of diseases. About a
year ago, a team of FSHD researchers, led by Peter Jones at the University
of Massachusetts Medical School, decided to give CRISPR a try. They already
had a pretty good idea which of the thousands of genes in the human genome
caused the disease, but until CRISPR came along therapeutic avenues were
The acronym CRISPR, which stands for (take a deep breath) â€śclusters of
regularly interspaced short palindromic repeats,â€ť refers to both a technique
and an actual thing, which is a macromolecular complex. The complex consists
of a mix of two different types of biological material, protein and RNA. The
RNA seeks out and binds to the targeted gene, like a hunting dog chasing
down a fox, and the protein goes to work on it -- the hunter firing a shot.
The implications of this are pretty huge. The research could pave the way
for other valuable studies, according to Charis Himeda, the lead author on
the study. â€śI think progress for any disease is really progress for all
diseases, because a lot of these therapies and technologies are going to
turn out to be broadly applicable,â€ť she said.
Himedaâ€™s use of CRISPR may be less risky than some of the other potential
therapies. Replacing bad genes, as other scientists have done, involves
cutting away pieces of DNA. To simply stop them from making stuff, as the U.
Mass team has done, is less likely to cause the genes any permanent damage.
But that doesnâ€™t mean the technique is risk-free. Himeda points out that
while they achieved a 50 percent reduction in expression of the FSHD disease
gene, we still donâ€™t know what the effects are on all the other genes in a
Thereâ€™s a bigger ethical question at play here, too. Many people think itâ€™s
simply a bad idea to meddle with the human genome, no matter what technique
you use or how good your intentions are. The fact that CRISPR is so easy to
use makes it especially frightening. What happens if it ends up in the wrong
Visit the Huffington Post for the story.
announces agreement to provide institutional security to Yankee Alliance
Green Security and Yankee Alliance have entered into an agreement
designating Green Security as the preferred provider of vendor and
contractor credentialing and background investigation services to Yankee
Allianceâ€™s 12,600 plus healthcare members across the country. This
relationship will leverage Green Securityâ€™s advanced onsite technologies to
help these members control, manage and monitor vendor and contractor access
across their facility.
Craig Shoukimas, Vice President of Contracting at Yankee Alliance,
commented, â€śWe have been looking for an advanced security solution to fix
the current, unacceptable screening practices. We found that Green Security
is an organization that is uniquely familiar with credentialing and
background investigation for healthcare organizations of all sizes. As such,
Green Security is well positioned to ensure that the risk of outsider
presence does not expose our members, and their patients, to dangerous
situations. In our efforts to create the most protected and safe environment
for healthcare services, this is a big win.â€ť
Green Security President Shawn Fitzgibbons explains: â€śWhile staff at
hospitals are carefully screened, the hospital remains is a high-risk
environment where vendor, contractor and visitor access is less controlled,
leaving the hospital vulnerable to security threats and ultimately liability
and safety concerns. We have listened to the concerns at hospitals about
this and developed a novel solution to help hospitals easily take back
control of vendor and visitor presence in the hospital.â€ť
For more information visit www.yankeealliance.com.
Doctors' use of
computers during appointments leaves patients less satisfied
Doctors who entered data into computerized health records during patients'
appointments did less positive communicating, and patients rated their care
excellent less often, in a recent study.
â€śMany clinicians worry that electronic health records keep them from
connecting with their patients,â€ť said Dr. Neda Ratanawongsa of the
University of California, San Francisco, who co-authored the research
But doctors who used the computer more also spent more time correcting or
disagreeing with patients, she told Reuters Health by email.
The researchers used data from encounters between 47 patients and 39 doctors
at a public hospital between 2011 and 2013. The patients had type 2
diabetes, rheumatoid arthritis or congestive heart failure, and sometimes
more than one of those chronic conditions. All spoke English or Spanish.
Researchers interviewed them by phone before their appointment, videotaped
the appointment, and interviewed the patients again after their visit.
Using the tapes, the researchers rated how much each physician used the
computer during the appointment on a scale from one to 12. The electronic
health records could be used to review test results, track healthcare
maintenance, prescribe medications and refer patients to specialists.
In the post-appointment interview the patients rated the quality of their
care over the past six months.
About half of the 25 encounters with high computer use were rated as
â€śexcellent careâ€ť by the patients, compared to more than 80 percent of the 19
encounters with low computer use, as reported in JAMA Internal Medicine.
Doctors who spent more time using the computer spent less time making eye
contact with patients and tended to engage in more â€śnegative rapport
building,â€ť correcting patients about their medical history or drugs theyâ€™ve
taken based on information in the electronic record.
â€śJust under half of my patients have limited health literacy and about half
speak a language other than English,â€ť Ratanawongsa said. â€śThe computer helps
me know about their health and their healthcare.â€ť
â€śThe hard part is figuring out how to help care teams access and add to this
information AND still stay present with patients in the room,â€ť she said.
Electronic health records â€śneed to be more usable so clinicians with varying
computer proficiency can use them without struggling and diverting focus
from patients,â€ť Ratanawongsa said.
Visit Reuters for the article.