Tag: hospitals

Categories : General InterestTags :

Wrangle Over GoFundMe For Family of Deceased Nurse

On By ModernMedia

The family of a pregnant nurse who died with COVID have yet to receive any money from a GoFundMe campaign that names them as beneficiaries.

Mary Agyapong, 28, died after giving birth in April 2020 at Luton and Dunstable Hospital, where she worked. At 35 weeks pregnant, she was admitted to hospital April 5 after having collapsed with breathing difficulties, but was discharged the same day, despite her misgivings. She was readmitted two days later with COVID symptoms. She gave birth to a daughter by Caesarean section and was then transferred to intensive care on April 8, where she died four days later.

On April 15, family friend Rhoda Asiedu set up a GoFundMe page to support “Mary’s husband, and the couple’s children… during this heavy and trying time”, and has raised more than £186 000 (R3 720 000). This money had been placed into a trust, according to her lawyers.

Ms Agyapong’s widower said he found it “surprising” he had not been involved.

Coroner Emma Whitting, at an inquest held last month, said that it was “unclear” how mother-of-two Ms Agyapong contracted COVID before her death. She then urged Prime Minister Boris Johnson to begin a public inquiry into the pandemic.

The funds raised were paid to Ms Asiedu’s legal team, Blue Trinity, who said it had been placed “on trust” for the education of Ms Agyapong’s children and that 80% would be released when they turned 21. The remaining 20% would be provided to Ms Agyapong’s widower Ernest Boateng for “maintenance and upkeep” of the children, but he had “failed to co-operate with the trustees to arrange a schedule of maintenance”.
Blue Trinity however has not responded to requests from the BBC or Mr Boateng’s legal team to see the trust documents.

“I just try to keep my head above the water,” said Mr Boateng, who is studying law. “I find it very surprising that we have not been asked or involved with this GoFundMe money – it’s beyond my understanding.”

GoFundMe stated that it was clear from the outset that the money would be placed in a trust, adding: “Our records show the wording of the page has not been changed since it launched on 15 April 2020.”

However, an archived snapshot of the webpage on 16 April found by the BBC made no reference to a trust at all. When fundraiser Ms Asiedu was contacted by the BBC, she directed media requests to her legal team.

Source: BBC News

Categories : General InterestTags :

Russian Doctors Perform Heart Surgery in Burning Hospital

On By ModernMedia

Russian doctors stayed behind in a burning hospital to complete open-heart surgery on a patient after a fire broke out on the roof while they were operating.

It took firefighters over two hours to put out the blaze in the city of Blagoveshchensk. Using fans to keep smoke out of the operating room where a group of eight doctors and nurses was working on the patient, they also ran a power cable in to keep it supplied with electricity.

The heart bypass operation was finished in two hours before removing the patient to another site, the emergencies ministry said.

“There’s nothing else we could do. We had to save the person. We did everything at the highest level,” surgeon Valentin Filatov was quoted as saying by REN TV. 

According to the ministry, when the fire broke out on the roof,  128 people were immediately evacuated from the hospital, which is extremely old. There were no reported injuries.

“The clinic was built more than a century ago, in 1907, and the fire spread like lightning through the wooden ceilings of the roof,” the ministry said. The fire was believed to have been started by a short circuit. The hospital is the only one in the region with a specialist cardiological unit.

“A bow to the medics and firefighters,” said the local regional governor, Vasiliy Orlov.

Source: Reuters

Categories : Diseases, Syndromes and ConditionsTags :

Premature Death Risk Doubled for Patients With Superbug on Their Skin

On By ModernMedia

Adults middle-aged or older who carry methicillin-resistant Staphylococcus aureus (MRSA) ‘superbug’ on their skin are twice as likely to die within the next decade as people who do not, according to a study by the University of Florida (UF).

“Very few people who carry MRSA know they have it, yet we have found a distinct link between people with undetected MRSA and premature death,” said lead author Arch Mainous, PhD, a professor in the department of health services research, management and policy at UF.

The findings suggest that routine screening for undetected MRSA may be warranted in older people to prevent deaths from infection.

A third of Americans carry Staphylococcus aureus, or staph, on their skin or in nasal passages, and of these about 1% carry MRSA, the notorious antibiotic resistant staph strain.

MRSA carriers may not even be aware that they carry the bacteria unless they develop an infection or are tested for it. A quarter of people who carry MRSA without an active infection, known as colonised MRSA for at least a year, eventually develop a MRSA infection.

“MRSA can be part of normal body flora, but it can lead to infection when immune systems are compromised, especially in people who are hospitalized, have underlying disease, or after antibiotic use,” said Prof Mainous, also vice chair for research in the UF College of Medicine’s department of community health and family medicine.

According to a 2017 Centers for Disease Control and Prevention report, 119 000 Americans experienced a staph bloodstream infection and nearly 20 000 died. Hospitalised patients with colonised MRSA may be particularly vulnerable to  infection in hospital or after discharge. Among carriers, wounds, surgical incisions and use of medical devices, such as catheters, may also lead to MRSA infection.

In this study, researchers analysed data from the 2001-2004 National Health and Nutrition Examination Survey, a nationally representative study combining survey questions with laboratory testing, which includes nasal swabs for detecting MRSA.

Adjusting for risk factors including gender and ethnicity, the researchers linked data on participants ages 40-85 with data from the National Death Index to track deaths over an 11-year period.

The mortality rate among participants without MRSA was about 18% compared with 36% among those with colonised MRSA. There was no increased mortality risk for those with non-MRSA staph bacteria on their skin.

Although some states and hospital systems require MRSA testing for patients before hospital admission, policies for testing and treatment of colonised MRSA, which may include antibiotics use, vary widely betweens hospitals, Prof Mainous said.

“Without a uniform strategy, we are missing an opportunity to help prevent deaths caused by MRSA,” he said. “Maybe we should know who is carrying MRSA.”

Source: Medical-News.Net

Journal information: Mainous, A. G., et al. (2021) Methicillin-Resistant Staphylococcus Aureus Colonization and Mortality Risk Among Community Adults Aged 40-85. Journal of the American Board of Family Medicine.

Categories : Cancer COVIDTags :

Despite COVID, Cancer Screenings in the US Picked Up

On By ModernMedia
Woman Receives Mammogram. An Asian female technician positions an African-American woman at an imaging machine to receive a mammogram. Creator: Rhoda Baer

In an encouraging sign, the RAND corporation reports that despite COVID, cancer screenings in the United States rebounded in the wake of the first wave.

There has been concern since the COVID pandemic was keeping people from going in for routine cancer screening, resulting in more undetected cancers to progress unchecked and an increase in cancer deaths. As some 600 000 Americans were expected to die of cancer in 2020, any impact on screening is a considerable health concern.

In a statement, Ryan McBain, PhD, of the RAND Corp. in Santa Monica, California, said: “These are the first findings to show that, despite real fears about the consequences of drop off in cancer screens, health facilities figured out how to pick this back up after the initial pandemic restrictions. Our study shows that health systems were able to recalibrate resources and protocols in a relatively short interval to deliver these important services.”

In Spain, cancer diagnoses were down 38% in the first half of 2020, according to one study. The pandemic’s impact on cancer screening that required in-person examinations, such as mammography and colonoscopy, were a particular concern, McBain and co-authors noted. Moreover, little was known about the magnitude of the decline in screening rates or longer-term trends in screen.

Using data on Castlight Health beneficiaries from January 15 to July 31, 2020, the researchers calculated weekly screening rates per 10 000 eligible beneficiaries. Before the declaration of national emergency in the US on March 13, screening mammography weekly rate was 87.8 per 10 000, falling to a low of 6.9 per 10 000 in April. Thereafter, screening rates began a steady recovery, to 88.2 per 10 000 at the end of July.

Over the same time period, weekly colonoscopy screenings fell from 15.1 to 0.9 per 10 000, before rebounding to a weekly median of 12.6 per 10 000 by July 31, 2020.

Multivariable regression analyses confirmed the significant declines in screening mammography and colonoscopy. A larger decline in colonoscopy was observed in high-income counties. Otherwise, the analyses showed no significant demographic variations.

Laura Makaroff, DO, of the American Cancer Society in Atlanta, said that the pandemic’s ultimate impact on cancer screening and cancer care is still largely unknown.

“We have seen similar data showing some rebound in cancer screening rates last summer and fall, but even those turnarounds show an approximate 30% decrease in cancer screening compared with pre-pandemic rates,” she said to MedPage Today in an email. “We also don’t yet know the full impact of the late fall and winter surges on disruptions in cancer screening and diagnosis.”

“The COVID-19 pandemic has had numerous consequences secondary to the disease itself, including reduced access to care for other illnesses,” Dr Makaroff added. “While these measures were necessary, delays in cancer screening, diagnosis, and treatment due to reduced healthcare access will likely result in a short-term drop in cancer diagnoses followed by increases in late-stage diagnoses and preventable cancer deaths.

“The full impact of the COVID-19 pandemic on cancer prevention and early detection will not be known until population-based nationwide data become available in the years to come,” she said.

Source: MedPage Today

Journal information: McBain RK, et al “Decline and rebound in routine cancer screening rates during the COVID-19 pandemic” J Intern Med 2021; DOI: 10.1007/s11606-021-06660-5.

Categories : Cancer PaediatricsTags :

Delaying Lumbar Puncture Cuts Relapse in Childhood Leukaemia

On By ModernMedia

Commencing chemotherapy several days before the first lumbar puncture for diagnosis and treatment of acute lymphoblastic leukaemia (ALL) may lower the risk of central nervous system (CNS) relapse in children, according to a study from St Jude Children’s Research Hospital and collaborators in China. 

“This study identified factors to help us predict and better manage the risk of CNS relapse that will be useful for treating ALL patients worldwide, in both resource-rich and resource-limited countries,” said corresponding author Ching-Hon Pui, MD, chair of the St. Jude Department of Oncology. Dr Pui pioneered paediatric ALL treatment that has achieved 94% long-term survival for St. Jude patients that did not receive brain irradiation.

Using an adapted paediatric protocol from St Jude Hospital, 7640 children and adolescents across 20 Chinese hospitals were enrolled in the trial. However, there was a great disparity across the hospital settings. For example, just three of the hospitals offered total intravenous anaesthesia for children undergoing spinal taps, while only two had flow cytometry for the diagnosis of leukaemia cells in cerebrospinal fluid.

The five-year overall survival rate was 91% for study patients, and the cancer-free survival rate was 80%, which is a dramatic improvement over previous clinical trials in China. But 1.9% of patients relapsed in the CNS alone, and in another 2.7% of patients the relapse involved the CNS. In comparison, a Canadian study reported a 6.6% rate for CNS-involved relapse in paediatric ALL patients followed over 10 years.

According to Dr Piu, in order to increase the survival rate of paediatric ALL patients requires identifying those at risk for CNS relapse, along with increasing their quality of life. Three factors reduced the risk of CNS relapse. First, commencing dexamethasone a few days before the spinal tap, prevents leukaemia cells entering the cerebrospinal fluid (CSF). Second, intravenous anaesthesia reduced bleeding risk during lumbar punctures, and improved  intrathecal therapy. Third, flow cytometry enables more accurate diagnosis of leukaemia cells in CSF, and reduced CNS relapse.

Source: Medical Xpress

Journal information: Jingyan Tang et al. Prognostic Factors for CNS Control in Children with Acute Lymphoblastic Leukemia Treated Without Cranial Irradiation, Blood (2021). DOI: 10.1182/blood.2020010438

Categories : GeneticsTags :

Whole Genome Sequencing Yields Diagnoses for Rare Diseases

On By ModernMedia

With the integration of whole genome sequencing in Swedish healthcare, some 1200 individuals with rare diseases have received a diagnosis, with novel disease genes discovered in the process.

“We’ve established a way of working where hospital and university collaborate on sequencing each patients’ entire genome in order to find genetic explanations for different diseases,” said first author Henrik Stranneheim, researcher at the Department of Molecular Medicine and Surgery, Karolinska Institutet. “This is an example of how precision medicine can be used to make diagnoses and tailor treatments to individual patients.”

The technology of large-scale whole genome sequencing to yield a person’s entire DNA, is not yet widely used in hospitals despite the technology becoming much more accessible over the last ten years. Whole genome sequencing has uncovered a great genetic variety among different populations, such as in South Africa, where a pilot study uncovered a high rate of novel variants in African populations.

Karolinska University Laboratory and the Clinical Genomics facility at SciLifeLab launched the Genomic Medicine Centre Karolinska-Rare Diseases (GMCK-RD) five years ago. Since then, the centre has sequenced the genomes of 3219 patients, which led to molecular diagnoses for 40% of them with rare diseases.

In addition to these, the researchers found pathogenic mutations in more than 750 genes and discovered 17 novel disease genes. 

“Clinical whole genome sequencing has had huge implications for the area of rare diseases,” explained corresponding author Anna Wedell, professor at the Department of Molecular Medicine and Surgery, Karolinska Institutet. “Used in the right way, targeted at each patient’s specific clinical situation, new groups of patients can receive the right diagnosis and treatment in a way that hasn’t been possible before.”

Whole genome sequencing is challenging in part due to having to manage and interpret the millions of variations that exist within each invidual’s genome. In order to overcome this difficulty, the centre came up with a model that directs the initial analysis to pathogenic variants in genes relevant for that patient’s clinical symptomsIn this way, doctors play an important role in choosing which genetic analyses to run first.
Should the first assessment fail, the analyses are then broadened to more gene panels, which has uncovered new disease genes.

“For us to succeed with precision medicine, a multidisciplinary collaboration between health care and academia is essential,” said second corresponding author Anna Lindstrand, professor at the Department of Molecular Medicine and Surgery, Karolinska Institutet and consultant at Karolinska University Hospital’s Department of Clinical Genetics. “Through these initiatives we combine clinical expertise with bioinformatic tools and together deliver accurate diagnoses and individualised treatments.”

Source: Medical Xpress

Journal information: “Integration of whole genome sequencing into a health care setting: High diagnostic rates across multiple clinical entities in 3219 rare disease patients,” Genome Medicine (2021). DOI: 10.1186/s13073-021-00855-5

Categories : HospitalsTags :

Optimised Scheduling Algorithm Cuts Delays for MRI Scans

On By ModernMedia

A team of researchers from Dartmouth Engineering and Philips have developed an optimised scheduling algorithm that significantly cuts the waiting time of patients for MRI at Lahey Hospital in Massachusetts, cutting overall associated costs by 23%.

“Excellence in service and positive patient experiences are a primary focus for the hospital. We continuously monitor various aspects of patient experiences and one key indicator is patient wait times,” said Christoph Wald, professor and chair, Department of Radiology, Lahey Hospital, Tufts University Medical School. With a goal of wanting to improve patient wait times, we worked with data science researchers at Philips and Dartmouth to help identify levers for improvement that might be achieved without impeding access.”

Exam waiting times can be stressful for patients, depending on the perceived value of the visit, and the associated costs of a delay to the patient.

Before the new algorithm, the average outpatient’s waiting time at the hospital was 54 minutes. The researchers found that the problem was a complicated scheduling system, which must cater to emergency room patients, inpatients, and outpatients; while other appointments are relatively inflexible, inpatient exams usually can be delayed if necessary.
“By analysing the patient data, we found that delays were prominent because the schedule was not optimal,” explained first author Yifei Sun, a Dartmouth Engineering PhD candidate. “This research uses optimisation and simulation tools to help the MRI centres of Lahey Hospital better plan their schedule to reduce overall cost, which includes patient waiting time.”

After identifying sources of delays, the researchers then created a mathematical model which optimised the length of each exam slot, and then worked in inpatient exams. Then they created an algorithm which cut down on the waiting time with its associated costs for outpatients, idle equipment time, employee overtime, and cancelled inpatient exams.

“This iterative improvement process did result in measurable improvements of patient wait times,” said Prof Wald. “The construction and use of a simulation model have been instrumental in educating the Lahey team about the benefits of dissecting workflow components to arrive at an optimised process outcome. We have extended this approach to identify bottlenecks in our interventional radiology workflow and to add additional capacity under the constraints of staffing schedules.”

The researchers believe that this solution may have great applicability, as the problem is common to mid-sized hospitals.

“We also provided suggestions for hospitals that don’t have optimisation tools or have different priorities, such as patient waiting times or idle machine times,” said Sun, who worked on the paper with her advisor Vikrant Vaze, the Stata Family Career Development Associate Professor of Engineering at Dartmouth.

Source: News-Medical.Net

Journal information: Sun, Y., et al. (2021) Stochastic programming for outpatient scheduling with flexible inpatient exam accommodation. Health Care Management Science. doi.org/10.1007/s10729-020-09527-z.

Categories : Hospitals Mental HealthTags :

Burnout is Highly Prevalent in Healthcare Workers in Cape Town

On By ModernMedia
Image by Free-Photos from Pixabay

Among Cape Town healthcare workers, burnout is highly prevalent, and worsened by the fear of infection, said City spokesperson Priya Reddy.

A year after the breakout of COVID in the Western Cape, the provincial department of health also reported significant levels of burnout among its health-care workers, especially in doctors, nurses and support staff.

Reddy said: “Burnout is highly prevalent as a result of exposure to trauma, loss, grief and compassion fatigue, and is exacerbated by the high levels of anxiety for fear of contracting the virus.”

However, she said: “The presence of Covid-19 has not diverted health-care workers from their primary responsibilities, thus the pandemic added additional levels of care and caution to the way they work and required a major adjustment.”

In response, the City has made available a number of employee assistance programmes (EAP) and wellness interventions to all employees, including City health-care workers and those supporting them in their different functions. The City is also providing workshops on burnout, compassion fatigue and resilience, and making proactive interventions to deal with stress and anxiety.

The provincial health department reported that between October and December last year, 2832 employees accessed the employee health and wellness programme. Work related problems, trauma, COVID related challenges, family challenges and relationships issues were the most common problems presented during this time.

In his review of the pandemic ‘s year in the province, provincial department of health head, Dr Keith Cloete said: “The department recognised the immense impact the pandemic has had on its staff and has initiated intentional healing and grieving sessions with our front-line workers and managers.”

“The department also recognised the need for staff to rest and recuperate, and in between the two waves we encouraged and granted staff to take leave so they can spend some time with family members,” Dr Cloete added.

SA Society of Psychiatrists (Sasop) board member Dr Renata Schoeman said: “Because people on the verge of burnout feel the need to keep going even though they are exhausted and in a state of relentless overwork, by the time they consult a health professional, burnout has often already become depression or anxiety disorder.”

She added: “Avoiding burnout is a classic case where prevention is better than cure, and lifestyle is the most effective preventative strategy. Improving your emotional and mental fitness, as well as physical fitness, helps to build resilience which means you can handle stress better and cope with setbacks.”

A survey of burnout in India found that 52.8% of respondents reported pandemic-related burnout, compared to 26.9% for work-related burnout. Burnout risk was increased by 1.64 for doctors and by 5 for support staff.

Source: IOL

Categories : COVID HospitalsTags :

Brazil’s Hospitals Are on The Brink of Collapse

On By ModernMedia

Health systems in most of Brazil’s largest cities are close to collapse because of COVID cases, its leading health institute Fiocruz warns.

More than 80% of intensive care unit beds are occupied in the capitals of 25 of Brazil’s 27 states, Fiocruz said.  The highly contagious variant that emerged in Brazil may have serious knock-on effects for the rest of the world, health experts have warned.

In a stark warning, Fiocruz epidemiologist Jesem Orellana told AFP news agency that  “Brazil is a threat to humanity.”

Brazil’s President Jair Bolsonaro had already provoked outrage among his citizens and rebukes from local leaders by telling people to “stop whining” about COVID. The country recorded 1972 COVID deaths on Tuesday, along with a surge to 70 000 cases — a 38% increase on last week’s figure. ICUs at 15 state capitals are at 90% capacity, said Fiocruz, and in two cities, Porto Alegre and Campo Grande, they had exceeded capacity.

“The fight against COVID was lost in 2020 and there is not the slightest chance of reversing this tragic circumstance in the first half of 2021,” Fiocruz’s Jesem Orellana said, as quoted by AFP.

“The best we can do is hope for the miracle of mass vaccination or a radical change in the management of the pandemic. Impunity in management seems to be the rule.”

Of the currently available vaccines, so far Pfizer’s has been confirmed to be effective in lab tests against a specially engineered version of the virus made to mimic the variant.

Source: BBC News

Categories : COVID General Interest UncategorizedTags :

Nurse Recounts His Year on the Frontlines

On By ModernMedia
Stethoscope. Photo by Robert Ruggiero on Unsplash

One year into the first case of COVID being detected in South Africa, one nurse recounts the hardships he and other healthcare workers have faced as they battled against the pandemic.

Lebohang Nkoana, a nurse on the frontline at Thelle Mogoerane Hospital in Vosloorus, Ekurhuleni, spoke to IOL of his experiences.

“When Covid-19 came, no one knew what to expect,” said Nkoana, who has been a nurse for eight years and is also a branch secretary for the Democratic Nurses Organisation of SA.

“It was devastating because we were already short-staffed. At first, we were resistant. We did not want to work with Covid-19 patients

“We were just using normal non-sterile gloves. Then we stopped working for two days as we did not want to risk our lives and also because we were not fully informed about the disease.”

Like many in the first days of the pandemic, he was forced to work without adequate PPE. Lack of regulation and price gouging had also worsened the PPE situation during the early days of the pandemic.

“There was no PPE, no increment, nothing. I had to use what I had at my disposal to protect myself and render a service.

“I went into a Covid ward to save lives, but in the process, exposed myself.”

Mr Koana contracted COVID during the course of his duty, and lost 19 of his colleagues to the disease, with little in the way of support for his trauma. He is also stigmatised in his community, as people assume that he has COVID. He also fears for his wife and two children.

“I am not scared for myself, because as a nurse, I took an oath. I am scared for my children. If I bring the virus home and it kills my wife, who will take care of our children?”

Source: IOL