Date: 10/6/2008 12:08 AM
By LINDSEY TANNER
AP Medical Writer
CHICAGO (AP) _ More children have died from flu because they also had staph infections, according to a new government report that urges parents to have their kids get the flu shot.
The number of deaths wasn’t high — 73 during the 2006-07 flu season — but there was more than a fivefold increase in hard-to-treat complications. And preliminary figures indicate deaths rose again during this past winter’s flu season.
Public health officials say the numbers underscore the importance of a brand new recommendation that all children, from 6 months through 18 years, get routine flu shots. Before this year, shots were recommended for kids under 5 years.
More than half the children who died were between ages 5 and 17 and had been healthy until they got the flu.
Parents shouldn’t panic, “but it’s an important message to say even healthy children develop complications and die almost before anything much can be done for them,” said Dr. Gregory Poland, a Mayo Clinic infectious disease specialist. He was not involved in the federal study, but has worked with a federal vaccine advisory committee and has consulted for vaccine makers.
Flu season is just beginning, and this year’s vaccine should be widely available this month.
While few children die from the flu virus, it puts about 20,000 U.S. kids in the hospital each year.
Only 6 percent of the children studied who died had been fully vaccinated against the flu. Two doses are recommended each flu season for children ages 6 months to 8 years who have not been vaccinated previously; for older kids, just one dose a year is needed.
The study, appearing in the October edition of Pediatrics for release Monday, is based on an analysis of reported flu deaths from the 2004-05 through 2006-07 seasons. Flu deaths in children during those seasons totaled 47, 46 and 73, respectively.
The percentage of those who also had bacterial infections jumped from 6 percent to almost 36 percent. Most had staph infections, and 60 percent of those involved the dangerous MRSA bug, which is resistant to antibiotics.
More recent data suggest flu deaths among children have continued to rise, with 86 tallied for the 2007-08 season in a preliminary report last month, said Lyn Finelli, the study’s lead author, who is a researcher for the Centers for Disease Control and Prevention.
Preliminary information also suggests there has been no drop in fatal flu-staph cases in children, and those could still be on the rise too, she said.
Staph germs commonly live in the nose or skin without causing illness; more than one-fourth of U.S. children and adults carry them.
These bugs can become deadly when they get into the bloodstream, sometimes through wounds. The flu is thought to make people more susceptible to bacterial infections like staph, Finelli said.
Details on how children in the study died were not available, but some developed bacterial pneumonia, seizures and shock.
Finelli said parents should take children to the doctor when they have flu symptoms and signs of other complications. These could include extreme fatigue, no thirst, or in older children complaints about feeling very ill.
___
On the Net:
American Academy of Pediatrics: http://www.aap.org
CDC: http://www.cdc.gov
Copyright 2008 The Associated Press.
Doctors: No hamsters or exotic pets for young kids
Date: 10/6/2008 12:06 AM
By LINDSEY TANNER
AP Medical Writer
CHICAGO (AP) _ Warning: young children should not keep hedgehogs as pets — or hamsters, baby chicks, lizards and turtles, for that matter — because of risks for disease.
That’s according to the nation’s leading pediatricians’ group in a new report about dangers from exotic animals.
Besides evidence that they can carry dangerous and sometimes potentially deadly germs, exotic pets may be more prone than cats and dogs to bite, scratch or claw — putting children younger than 5 particularly at risk, the report says.
Young children are vulnerable because of developing immune systems plus they often put their hands in their mouths.
That means families with children younger than 5 should avoid owning “nontraditional” pets. Also, kids that young should avoid contact with these animals in petting zoos or other public places, according to the report from the American Academy of Pediatrics. The report appears in the October edition of the group’s medical journal, Pediatrics.
“Many parents clearly don’t understand the risks from various infections” these animals often carry, said Dr. Larry Pickering, the report’s lead author and an infectious disease specialist at the federal Centers for Disease Control and Prevention.
For example, about 11 percent of salmonella illnesses in children are thought to stem from contact with lizards, turtles and other reptiles, Pickering said. Hamsters also can carry this germ, which can cause severe diarrhea, fever and stomach cramps.
Salmonella also has been found in baby chicks, and young children can get it by kissing or touching the animals and then putting their hands in their mouths, he said.
Study co-author Dr. Joseph Bocchini said he recently treated an infant who got salmonella from the family’s pet iguana, which was allowed to roam freely in the home. The child was hospitalized for four weeks but has recovered, said Bocchini, head of the academy’s infectious diseases committee and pediatrics chairman at Louisiana State University in Shreveport.
Hedgehogs can be dangerous because their quills can penetrate skin and have been known to spread a bacteria germ that can cause fever, stomach pain and a rash, the report said.
With supervision and precautions like hand-washing, contact between children and animals “is a good thing,” Bocchini said. But families should wait until children are older before bringing home an exotic pet, he said.
Those who already have these pets should contact their veterinarians about specific risks and possible new homes for the animals, he said.
Data cited in the study indicate that about 4 million U.S. households have pet reptiles. According to the American Veterinary Medical Association, all kinds of exotic pets are on the rise, although generally fewer than 2 percent of households own them.
The veterinarian group’s Mike Dutton, a Weare, N.H., exotic animal specialist, said the recommendations send an important message to parents who sometimes buy exotic pets on an impulse, “then they ask questions, sometimes many months later.”
But a spokesman for the International Hedgehog Association said there’s no reason to single out hedgehogs or other exotic pets.
“Our recommendation is that no animal should be a pet for kids 5 and under,” said Z.G. Standing Bear. He runs a rescue operation near Pikes Peak, Colo., for abandoned hedgehogs, which became fad pets about 10 years ago.
Copyright 2008 The Associated Press.
By LINDSEY TANNER
AP Medical Writer
CHICAGO (AP) _ Warning: young children should not keep hedgehogs as pets — or hamsters, baby chicks, lizards and turtles, for that matter — because of risks for disease.
That’s according to the nation’s leading pediatricians’ group in a new report about dangers from exotic animals.
Besides evidence that they can carry dangerous and sometimes potentially deadly germs, exotic pets may be more prone than cats and dogs to bite, scratch or claw — putting children younger than 5 particularly at risk, the report says.
Young children are vulnerable because of developing immune systems plus they often put their hands in their mouths.
That means families with children younger than 5 should avoid owning “nontraditional” pets. Also, kids that young should avoid contact with these animals in petting zoos or other public places, according to the report from the American Academy of Pediatrics. The report appears in the October edition of the group’s medical journal, Pediatrics.
“Many parents clearly don’t understand the risks from various infections” these animals often carry, said Dr. Larry Pickering, the report’s lead author and an infectious disease specialist at the federal Centers for Disease Control and Prevention.
For example, about 11 percent of salmonella illnesses in children are thought to stem from contact with lizards, turtles and other reptiles, Pickering said. Hamsters also can carry this germ, which can cause severe diarrhea, fever and stomach cramps.
Salmonella also has been found in baby chicks, and young children can get it by kissing or touching the animals and then putting their hands in their mouths, he said.
Study co-author Dr. Joseph Bocchini said he recently treated an infant who got salmonella from the family’s pet iguana, which was allowed to roam freely in the home. The child was hospitalized for four weeks but has recovered, said Bocchini, head of the academy’s infectious diseases committee and pediatrics chairman at Louisiana State University in Shreveport.
Hedgehogs can be dangerous because their quills can penetrate skin and have been known to spread a bacteria germ that can cause fever, stomach pain and a rash, the report said.
With supervision and precautions like hand-washing, contact between children and animals “is a good thing,” Bocchini said. But families should wait until children are older before bringing home an exotic pet, he said.
Those who already have these pets should contact their veterinarians about specific risks and possible new homes for the animals, he said.
Data cited in the study indicate that about 4 million U.S. households have pet reptiles. According to the American Veterinary Medical Association, all kinds of exotic pets are on the rise, although generally fewer than 2 percent of households own them.
The veterinarian group’s Mike Dutton, a Weare, N.H., exotic animal specialist, said the recommendations send an important message to parents who sometimes buy exotic pets on an impulse, “then they ask questions, sometimes many months later.”
But a spokesman for the International Hedgehog Association said there’s no reason to single out hedgehogs or other exotic pets.
“Our recommendation is that no animal should be a pet for kids 5 and under,” said Z.G. Standing Bear. He runs a rescue operation near Pikes Peak, Colo., for abandoned hedgehogs, which became fad pets about 10 years ago.
Copyright 2008 The Associated Press.
EPA won’t limit toxic chemical in drinking water
Date: 10/3/2008 5:28 PM
By ERICA WERNER
Associated Press Writer
WASHINGTON (AP) _ Federal regulators said Friday they don’t plan to try to rid drinking water supplies of a toxic rocket fuel ingredient that’s been found in 35 states.
The Environmental Protection Agency will take public comment for 30 days before finalizing its decision not to regulate the contaminant, perchlorate, in drinking water. The Associated Press and other news outlets reported the agency’s plans last month based on internal EPA documents.
The announcement Friday provoked outrage from Democratic lawmakers and a lawsuit threat from environmental groups. Particularly widespread in California and Texas, perchlorate has been found to interfere with thyroid function and pose developmental health risks, particularly for babies and fetuses.
“EPA’s decision has industry’s fingerprints all over it. Weapons makers will benefit at the expense of millions of Americans,” said Earthjustice attorney George Torgun. He said Earthjustice would argue in court that perchlorate does qualify for regulation under the Safe Drinking Water Act.
The decision on perchlorate has been pending for years as the Pentagon tussled with EPA over the issue.
The Defense Department used perchlorate for decades in testing missiles and rockets, and most perchlorate contamination is the result of defense and aerospace activities, congressional investigators said last year.
The Pentagon could face liability if EPA set a national drinking water standard that forced water agencies around the country to undertake costly clean-up efforts. But Pentagon officials have insisted they did not seek to influence EPA’s decision.
States have already moved ahead with their own drinking water standards, with California setting a limit of 6 parts per billion and Massachusetts setting it at 2 parts per billion.
EPA said in a press release Friday that it had determined that in more than 99 percent of public drinking water systems, perchlorate was not at levels of public health concern. Under the Safe Drinking Water Act, “the agency determined there is not a ‘meaningful opportunity for health risk reduction’ through a national drinking water regulation.”
___
On the Net:
Government Accountability Report with map of 35 states found to have perchlorate:
http://www.gao.gov/new.items/d05462.pdf
Copyright 2008 The Associated Press.
By ERICA WERNER
Associated Press Writer
WASHINGTON (AP) _ Federal regulators said Friday they don’t plan to try to rid drinking water supplies of a toxic rocket fuel ingredient that’s been found in 35 states.
The Environmental Protection Agency will take public comment for 30 days before finalizing its decision not to regulate the contaminant, perchlorate, in drinking water. The Associated Press and other news outlets reported the agency’s plans last month based on internal EPA documents.
The announcement Friday provoked outrage from Democratic lawmakers and a lawsuit threat from environmental groups. Particularly widespread in California and Texas, perchlorate has been found to interfere with thyroid function and pose developmental health risks, particularly for babies and fetuses.
“EPA’s decision has industry’s fingerprints all over it. Weapons makers will benefit at the expense of millions of Americans,” said Earthjustice attorney George Torgun. He said Earthjustice would argue in court that perchlorate does qualify for regulation under the Safe Drinking Water Act.
The decision on perchlorate has been pending for years as the Pentagon tussled with EPA over the issue.
The Defense Department used perchlorate for decades in testing missiles and rockets, and most perchlorate contamination is the result of defense and aerospace activities, congressional investigators said last year.
The Pentagon could face liability if EPA set a national drinking water standard that forced water agencies around the country to undertake costly clean-up efforts. But Pentagon officials have insisted they did not seek to influence EPA’s decision.
States have already moved ahead with their own drinking water standards, with California setting a limit of 6 parts per billion and Massachusetts setting it at 2 parts per billion.
EPA said in a press release Friday that it had determined that in more than 99 percent of public drinking water systems, perchlorate was not at levels of public health concern. Under the Safe Drinking Water Act, “the agency determined there is not a ‘meaningful opportunity for health risk reduction’ through a national drinking water regulation.”
___
On the Net:
Government Accountability Report with map of 35 states found to have perchlorate:
http://www.gao.gov/new.items/d05462.pdf
Copyright 2008 The Associated Press.
ABC’s ‘Private Practice’ explores bioethics
Date: 9/30/2008 10:26 AM
By SANDY COHEN
AP Entertainment Writer
LOS ANGELES (AP) _ On a massive sound stage at Hollywood’s Raleigh Studios, a woman is dying of ovarian cancer. One doctor wants to treat her traditionally, by removing her uterus and ovaries. Another wants the patient to participate in a clinical trail that might preserve her ability to have children, but could have serious side effects.
On a different day, an obstetrician is conflicted about whether to deliver a premature baby she believes was conceived solely because the umbilical-cord blood could save the family’s older, dying child. Another doctor struggles to do what’s right when his teenage patient — who has HIV but doesn’t know it — confides that he plans to have sex for the first time.
Bioethical questions like these come up weekly on ABC’s “Private Practice,” the “Grey’s Anatomy” spin-off that begins its second season Wednesday.
“We’re telling stories … that will provide a lot of moral debate among our doctors and maybe debate at home when you watch,” said series creator Shonda Rhimes.
The issues they face cause plenty of drama for the doctors at the Oceanside Wellness Group, where Kate Walsh’s character, Addison Montgomery, came to work after leaving “Grey’s” Seattle Grace Hospital.
“They’re all viable conflicts … grounded in these medical stories,” Walsh said. “It’s topical but not so procedural that it’s not a Shonda Rhimes show. You still have all the great dialogue and characters and stories and romance.”
Like “Grey’s Anatomy,” ”Private Practice” features an ensemble cast of doctors whose personal lives are often far messier than their professional ones. They have affairs with one another and struggle with love as they overcome tough medical challenges and the financial realities of keeping their medical co-op alive.
The bioethical issues raised are based on real medical cases and community concerns, said researcher and writer Elizabeth Klaviter.
“We look at the things that have ourselves and our family members and friends buzzing — the issues that people are talking about in terms of right or wrong and the laws, ethics and social morays that are put on us in terms of how we conduct ourselves,” said Klaviter, who also researches cases for “Grey’s Anatomy.”
“Doctors disagree,” she said. “We’re looking for cases where there are different courses of action or treatment.”
This season, the doctors at Oceanside Wellness will have to decide what rights prostitutes have to medical care and whether to treat a sex offender at their child-friendly practice. They also engage in an abortion debate that surprised actor Tim Daly, who plays Dr. Pete Wilder.
“I never thought we’d be doing something like that on Disney,” which owns ABC, he said. “It was just these characters discussing their opinions and they didn’t agree and they were passionate about it, just like in the real world.”
Daly and his castmates credit Rhimes and the show’s writers for using the forum of a prime-time drama to inspire viewers to consider current bioethical issues.
“If you can make anybody think in this day and age, and entertain them at the same time, that’s a dream come true,” said KaDee Strickland, who plays Dr. Charlotte King, a physician at a rival hospital.
Making bioethics a theme of the show is “seductive,” Walsh said, because it deepens the characters while raising important issues for viewers to ponder. Though she said it was a risk for her to leave “Grey’s,” she feels she landed in a good place.
“It was a risk but it wasn’t like sex-without-a-condom risk. It was an offer I couldn’t refuse,” she said. “I’m hugely grateful that it did really well last fall… It’s really a testament to Shonda and her gift for being able to tap into the culture and the big collective consciousness of what people really relate to.”
History proves that viewers respond to medical shows: “We may never end up in a courtroom or never end up arrested, but sooner or later everybody’s going to come through the doors of a doctor’s office,” Rhimes said. Exploring bioethics adds a new dimension to the already-beloved genre.
“It’s something more and more doctors are facing these days,” Rhimes said. “It’s just a very different way of looking at medicine that I don’t think we normally think about — the ethics of what you’re doing.”
ABC is owned by The Walt Disney Co.
Copyright 2008 The Associated Press.
By SANDY COHEN
AP Entertainment Writer
LOS ANGELES (AP) _ On a massive sound stage at Hollywood’s Raleigh Studios, a woman is dying of ovarian cancer. One doctor wants to treat her traditionally, by removing her uterus and ovaries. Another wants the patient to participate in a clinical trail that might preserve her ability to have children, but could have serious side effects.
On a different day, an obstetrician is conflicted about whether to deliver a premature baby she believes was conceived solely because the umbilical-cord blood could save the family’s older, dying child. Another doctor struggles to do what’s right when his teenage patient — who has HIV but doesn’t know it — confides that he plans to have sex for the first time.
Bioethical questions like these come up weekly on ABC’s “Private Practice,” the “Grey’s Anatomy” spin-off that begins its second season Wednesday.
“We’re telling stories … that will provide a lot of moral debate among our doctors and maybe debate at home when you watch,” said series creator Shonda Rhimes.
The issues they face cause plenty of drama for the doctors at the Oceanside Wellness Group, where Kate Walsh’s character, Addison Montgomery, came to work after leaving “Grey’s” Seattle Grace Hospital.
“They’re all viable conflicts … grounded in these medical stories,” Walsh said. “It’s topical but not so procedural that it’s not a Shonda Rhimes show. You still have all the great dialogue and characters and stories and romance.”
Like “Grey’s Anatomy,” ”Private Practice” features an ensemble cast of doctors whose personal lives are often far messier than their professional ones. They have affairs with one another and struggle with love as they overcome tough medical challenges and the financial realities of keeping their medical co-op alive.
The bioethical issues raised are based on real medical cases and community concerns, said researcher and writer Elizabeth Klaviter.
“We look at the things that have ourselves and our family members and friends buzzing — the issues that people are talking about in terms of right or wrong and the laws, ethics and social morays that are put on us in terms of how we conduct ourselves,” said Klaviter, who also researches cases for “Grey’s Anatomy.”
“Doctors disagree,” she said. “We’re looking for cases where there are different courses of action or treatment.”
This season, the doctors at Oceanside Wellness will have to decide what rights prostitutes have to medical care and whether to treat a sex offender at their child-friendly practice. They also engage in an abortion debate that surprised actor Tim Daly, who plays Dr. Pete Wilder.
“I never thought we’d be doing something like that on Disney,” which owns ABC, he said. “It was just these characters discussing their opinions and they didn’t agree and they were passionate about it, just like in the real world.”
Daly and his castmates credit Rhimes and the show’s writers for using the forum of a prime-time drama to inspire viewers to consider current bioethical issues.
“If you can make anybody think in this day and age, and entertain them at the same time, that’s a dream come true,” said KaDee Strickland, who plays Dr. Charlotte King, a physician at a rival hospital.
Making bioethics a theme of the show is “seductive,” Walsh said, because it deepens the characters while raising important issues for viewers to ponder. Though she said it was a risk for her to leave “Grey’s,” she feels she landed in a good place.
“It was a risk but it wasn’t like sex-without-a-condom risk. It was an offer I couldn’t refuse,” she said. “I’m hugely grateful that it did really well last fall… It’s really a testament to Shonda and her gift for being able to tap into the culture and the big collective consciousness of what people really relate to.”
History proves that viewers respond to medical shows: “We may never end up in a courtroom or never end up arrested, but sooner or later everybody’s going to come through the doors of a doctor’s office,” Rhimes said. Exploring bioethics adds a new dimension to the already-beloved genre.
“It’s something more and more doctors are facing these days,” Rhimes said. “It’s just a very different way of looking at medicine that I don’t think we normally think about — the ethics of what you’re doing.”
ABC is owned by The Walt Disney Co.
Copyright 2008 The Associated Press.
Baby deaths shock Turkey
Date: 9/26/2008 8:01 AM
By SUZAN FRASER
Associated Press Writer
ANKARA, Turkey (AP) _ Outside the Zekai Tahir Burak maternity hospital stands a bronze statue of a mother nursing a baby with an inscription from the Prophet Mohammed: “Paradise lies at the feet of the mother.”
In July, the Ankara facility became the scene of any parent’s hell: A total of 27 newborns died here within two weeks, most of them from infection.
Now Turkey is reeling from a similar tragedy at another hospital, this time in the western city of Izmir, where 13 premature babies died last weekend within 24 hours, apparently from tainted IV treatment.
The deaths at two of the nation’s most modern maternity hospitals go to the heart of Turkey’s uncertain status as a country energetically seeking to modernize in its bid to join the European Union — but held back by problems associated with the developing world.
The scandals have exposed a shortfall in the number of specialized neonatal units dealing with premature and high-risk babies as well as a shortage of qualified staff in a country of 70 million.
Most hospitals lack specialized premature birth units, and high-risk or premature babies are often transferred to larger hospitals in cities such Istanbul, Ankara or Izmir. The transfer and high concentration of newborns in the same place increases the risk of infections, experts say.
“There just isn’t the facility that allows a premature baby to survive in the hospital that it was born in,” said Bedriye Yorgun, who heads the Ankara-based Health and Social Services Workers’ Union, which advocates improved health services. “When the babies are transferred, there is a higher chance of exposure to infection and of spreading an infection.”
The government has acknowledged a shortage and has said it plans to increase the number of neonatal wards nationwide from the current 156 to 200 by 2010. It has also admitted to a shortage of more than 400 specialized doctors and thousands of nurses.
After the first deaths at the capital’s Zekai Tahir Burak maternity hospital, a team of government-appointed doctors said a staff shortage had increased the risk of infection.
Dr. Fahri Ovali, one of the doctors, told reporters: “There were four high-risk babies for every nurse.”
The Izmir tragedy caused a renewed explosion of outrage in this country where children are cherished and people will often stop to show affection to other people’s kids.
“Such shame does not exist elsewhere in the world,” read a headline in Bugun newspaper. “13 mothers’ arms left empty,” said Aksam newspaper.
A preliminary investigation concluded that the infants died of a bacterial infection spread by IV treatment. Further investigation is under way to see how the bacteria got mixed with the intravenous solution used to treat the infants at Izmir’s Tepecik hospital. The bodies of three of the babies, who were buried immediately after their deaths, were exhumed to help with the investigation.
Izmir health department head Mehmet Ozkan said the hospital believed the babies were not neglected. After the 13 deaths, the unit was placed under quarantine and no new babies have been admitted.
Some of the families have filed complaints against the hospital accusing its directors of negligence. A local prosecutor has also launched a criminal investigation into the deaths, while the main opposition party has called for a parliamentary debate on the deaths.
A chief obstetrician at Etlik Zubeyde Hanim hospital said a government decree forcing hospitals not to turn away any patients was to blame.
“If there are no spare incubators and you are forced to admit more and more babies, what do you do? You have to put two babies into the same incubator, which increases the possibility of infections,” he said. He spoke on condition of anonymity because of the sensitivity of the issue and because as a state-employee, he is not authorized to speak to journalists.
Yorgun, who heads the health workers’ union agreed.
“The government is telling the people that no one will be turned away from hospitals, but it is not creating the conditions to allow doctors to treat everyone,” she said.
Copyright 2008 The Associated Press.
By SUZAN FRASER
Associated Press Writer
ANKARA, Turkey (AP) _ Outside the Zekai Tahir Burak maternity hospital stands a bronze statue of a mother nursing a baby with an inscription from the Prophet Mohammed: “Paradise lies at the feet of the mother.”
In July, the Ankara facility became the scene of any parent’s hell: A total of 27 newborns died here within two weeks, most of them from infection.
Now Turkey is reeling from a similar tragedy at another hospital, this time in the western city of Izmir, where 13 premature babies died last weekend within 24 hours, apparently from tainted IV treatment.
The deaths at two of the nation’s most modern maternity hospitals go to the heart of Turkey’s uncertain status as a country energetically seeking to modernize in its bid to join the European Union — but held back by problems associated with the developing world.
The scandals have exposed a shortfall in the number of specialized neonatal units dealing with premature and high-risk babies as well as a shortage of qualified staff in a country of 70 million.
Most hospitals lack specialized premature birth units, and high-risk or premature babies are often transferred to larger hospitals in cities such Istanbul, Ankara or Izmir. The transfer and high concentration of newborns in the same place increases the risk of infections, experts say.
“There just isn’t the facility that allows a premature baby to survive in the hospital that it was born in,” said Bedriye Yorgun, who heads the Ankara-based Health and Social Services Workers’ Union, which advocates improved health services. “When the babies are transferred, there is a higher chance of exposure to infection and of spreading an infection.”
The government has acknowledged a shortage and has said it plans to increase the number of neonatal wards nationwide from the current 156 to 200 by 2010. It has also admitted to a shortage of more than 400 specialized doctors and thousands of nurses.
After the first deaths at the capital’s Zekai Tahir Burak maternity hospital, a team of government-appointed doctors said a staff shortage had increased the risk of infection.
Dr. Fahri Ovali, one of the doctors, told reporters: “There were four high-risk babies for every nurse.”
The Izmir tragedy caused a renewed explosion of outrage in this country where children are cherished and people will often stop to show affection to other people’s kids.
“Such shame does not exist elsewhere in the world,” read a headline in Bugun newspaper. “13 mothers’ arms left empty,” said Aksam newspaper.
A preliminary investigation concluded that the infants died of a bacterial infection spread by IV treatment. Further investigation is under way to see how the bacteria got mixed with the intravenous solution used to treat the infants at Izmir’s Tepecik hospital. The bodies of three of the babies, who were buried immediately after their deaths, were exhumed to help with the investigation.
Izmir health department head Mehmet Ozkan said the hospital believed the babies were not neglected. After the 13 deaths, the unit was placed under quarantine and no new babies have been admitted.
Some of the families have filed complaints against the hospital accusing its directors of negligence. A local prosecutor has also launched a criminal investigation into the deaths, while the main opposition party has called for a parliamentary debate on the deaths.
A chief obstetrician at Etlik Zubeyde Hanim hospital said a government decree forcing hospitals not to turn away any patients was to blame.
“If there are no spare incubators and you are forced to admit more and more babies, what do you do? You have to put two babies into the same incubator, which increases the possibility of infections,” he said. He spoke on condition of anonymity because of the sensitivity of the issue and because as a state-employee, he is not authorized to speak to journalists.
Yorgun, who heads the health workers’ union agreed.
“The government is telling the people that no one will be turned away from hospitals, but it is not creating the conditions to allow doctors to treat everyone,” she said.
Copyright 2008 The Associated Press.
More parents ponder cancer gene tests for kids
Date: 9/21/2008 5:48 PM
By MARILYNN MARCHIONE
AP Medical Writer
CHICAGO (AP) _ Women are going for breast cancer gene testing in record numbers, forcing more parents to face a tough question: Should we test the kids?
About 100,000 tests for breast cancer gene mutations were done last year, double the number in 2005. The trend may grow even more because of widening insurance coverage and a new law banning genetic discrimination.
Medical experts advise against such testing before age 25, saying that little can be done to prevent or screen for breast or ovarian cancer until then, so the knowledge would only cause needless worry.
However, new studies and interviews by The Associated Press show that many people who have BRCA gene mutations — and even more of their offspring — disagree. Cornell University freshman Jenna Stoller is one.
“I’m the kind of person that, like my mom, am more comfortable knowing something about myself than not knowing,” said Stoller, who tested positive earlier this year, shortly after her 18th birthday. Her mother made her wait five years after revealing her own positive test result, even though Jenna wanted to be tested at age 13.
“I remember thinking on my 17th birthday that I had another year to wait till I could make the decision for myself,” she said.
Research also shows there can be benefits to at least talking about testing and inherited cancer risks with teens. It led some to quit smoking, one study found. Others, like Stoller, were advised to limit alcohol and avoid birth control pills, which can raise the risk of breast cancer though they also lower the risk of ovarian cancer.
A decade after BRCA testing began, researchers are just starting to discover the many effects that someone’s positive test can have on other family members. A big issue is whether it is ethical or good to test minors.
“I’ve seen a fair number of parents in clinic who have really struggled with this question,” said Dr. Angela Bradbury, a breast cancer specialist at Fox Chase Cancer Center in Philadelphia who has led several studies on the topic.
Myriad Genetics Inc., based in Salt Lake City, sells the only BRCA gene test, which costs up to $3,000.
Men can also carry a BRCA mutation, and if either parent does, a child has a 50-50 chance of inheriting it. The mutations are most common in people of eastern European Jewish descent.
Women with a faulty gene have a three to seven times greater risk of developing breast cancer and a higher risk of ovarian cancer. Men have more risk of prostate, pancreatic and other types of cancer.
To lower risk, women can consider anti-estrogen drugs or having their breasts or ovaries removed. But these drastic measures are not advised for very young women. Even mammograms are not advised till age 25, because cancer is rare before then.
So the American Society of Clinical Oncology and other groups say that when the risk of childhood cancer is low and nothing can be done to lower it, children should not be given gene tests.
“The rule is, do no harm — test only if you can offer something that will help,” said Mary-Claire King, the University of Washington scientist who in 1990 discovered the first breast cancer predisposition gene, BRCA-1.
“The life of a young girl is complicated enough already. There is nothing about it that needs to change” if she carries one of these genes, King said.
But some parents are testing girls before they even have breasts, let alone cancer risk. One woman had her 4-year-old daughter tested, said Sue Friedman, executive director of FORCE: Facing Our Risk of Cancer Empowered, a Tampa-based support group for people with BRCA genes.
Another woman tested two very young children several years ago at Baptist Health South Florida in Miami.
“We wanted to know — it’s as simple as that,” she said. “Kids are born with all kinds of defects that parents have to make decisions about. I just think this is one of those things,” said the woman, who spoke on condition of anonymity because of privacy concerns for her children.
Rae Wruble, a nurse and genetics adviser at Baptist Health, said this woman was the only one in more than 900 she has counseled who chose to test very young children. Wruble said she always tells patients that cancer groups recommend against testing minors and why. But she admitted: “If I had young children, I would have tested them because that’s just the kind of person I am — I would want to know.”
Most parents do not peek inside their child’s gene toolbox, Friedman said. “It does deny the actual patient informed consent.”
“I feel very strongly that people should not test their children, but children should make their own decision,” said Jill Stoller, a New Jersey pediatrician who is the mother of Jenna, the Cornell student.
Jenna had hours of counseling before doctors agreed that for her, testing was the right choice. However, Jennifer Scalia Wilbur, a counselor at Women and Infants Hospital in Providence, R.I., told of a 19-year-old who had testing without counseling and now wants to remove her breasts and not have children.
“It was extremely distressing” to talk with her now and try to correct her overly dire outlook, she said.
At a meeting of the oncology society in June, Bradbury reported on a survey she did of 163 adult BRCA gene carriers in the Chicago area. About half supported testing minors in some or all circumstances. A previous survey she led of 53 gene carriers and 22 of their offspring (ages 18 to 25) found about the same degree of support. Most sons and daughters favored testing minors.
Another of her studies, recently published in the American Journal of Medical Genetics, explored how sons and daughters ages 18 to 25 were affected by learning that a parent had tested positive.
Some effects were good — five of the seven smokers said they were motivated to quit.
Most said the knowledge had no big negative effect, but six of the 22 said they felt frightened or disturbed.
“I was shocked, scared. I wondered if I was going to get the gene and realized I could pass it to my (future) kids. I would feel like it was my fault if they got cancer,” one daughter said in the survey.
Two sons said the knowledge might change their plans to have children. Five daughters and two sons had already gone for gene testing, and nearly all of the rest said they planned to be tested.
Wanting to test minors can be a knee-jerk response that changes after counseling. Tammy LeVasseur of North Attleboro, Mass., at first thought she wanted all three of her daughters to be tested after she learned of her own positive result in July.
She later decided to encourage testing for her two oldest daughters, ages 26 and 28, who had already finished having children, but not for Jessica, who just turned 17.
“I want to wait until I’m in my 20s,” Jessica LeVasseur said. “They wouldn’t do anything about it. There’s no reason to worry now. I’d rather just be able to finish my teenage years without worrying about that.”
___
On the Net:
National Cancer Institute: http://www.cancer.gov/cancertopics/factsheet/risk/brca
FORCE support group: http://www.facingourrisk.org/index.php
Copyright 2008 The Associated Press.
By MARILYNN MARCHIONE
AP Medical Writer
CHICAGO (AP) _ Women are going for breast cancer gene testing in record numbers, forcing more parents to face a tough question: Should we test the kids?
About 100,000 tests for breast cancer gene mutations were done last year, double the number in 2005. The trend may grow even more because of widening insurance coverage and a new law banning genetic discrimination.
Medical experts advise against such testing before age 25, saying that little can be done to prevent or screen for breast or ovarian cancer until then, so the knowledge would only cause needless worry.
However, new studies and interviews by The Associated Press show that many people who have BRCA gene mutations — and even more of their offspring — disagree. Cornell University freshman Jenna Stoller is one.
“I’m the kind of person that, like my mom, am more comfortable knowing something about myself than not knowing,” said Stoller, who tested positive earlier this year, shortly after her 18th birthday. Her mother made her wait five years after revealing her own positive test result, even though Jenna wanted to be tested at age 13.
“I remember thinking on my 17th birthday that I had another year to wait till I could make the decision for myself,” she said.
Research also shows there can be benefits to at least talking about testing and inherited cancer risks with teens. It led some to quit smoking, one study found. Others, like Stoller, were advised to limit alcohol and avoid birth control pills, which can raise the risk of breast cancer though they also lower the risk of ovarian cancer.
A decade after BRCA testing began, researchers are just starting to discover the many effects that someone’s positive test can have on other family members. A big issue is whether it is ethical or good to test minors.
“I’ve seen a fair number of parents in clinic who have really struggled with this question,” said Dr. Angela Bradbury, a breast cancer specialist at Fox Chase Cancer Center in Philadelphia who has led several studies on the topic.
Myriad Genetics Inc., based in Salt Lake City, sells the only BRCA gene test, which costs up to $3,000.
Men can also carry a BRCA mutation, and if either parent does, a child has a 50-50 chance of inheriting it. The mutations are most common in people of eastern European Jewish descent.
Women with a faulty gene have a three to seven times greater risk of developing breast cancer and a higher risk of ovarian cancer. Men have more risk of prostate, pancreatic and other types of cancer.
To lower risk, women can consider anti-estrogen drugs or having their breasts or ovaries removed. But these drastic measures are not advised for very young women. Even mammograms are not advised till age 25, because cancer is rare before then.
So the American Society of Clinical Oncology and other groups say that when the risk of childhood cancer is low and nothing can be done to lower it, children should not be given gene tests.
“The rule is, do no harm — test only if you can offer something that will help,” said Mary-Claire King, the University of Washington scientist who in 1990 discovered the first breast cancer predisposition gene, BRCA-1.
“The life of a young girl is complicated enough already. There is nothing about it that needs to change” if she carries one of these genes, King said.
But some parents are testing girls before they even have breasts, let alone cancer risk. One woman had her 4-year-old daughter tested, said Sue Friedman, executive director of FORCE: Facing Our Risk of Cancer Empowered, a Tampa-based support group for people with BRCA genes.
Another woman tested two very young children several years ago at Baptist Health South Florida in Miami.
“We wanted to know — it’s as simple as that,” she said. “Kids are born with all kinds of defects that parents have to make decisions about. I just think this is one of those things,” said the woman, who spoke on condition of anonymity because of privacy concerns for her children.
Rae Wruble, a nurse and genetics adviser at Baptist Health, said this woman was the only one in more than 900 she has counseled who chose to test very young children. Wruble said she always tells patients that cancer groups recommend against testing minors and why. But she admitted: “If I had young children, I would have tested them because that’s just the kind of person I am — I would want to know.”
Most parents do not peek inside their child’s gene toolbox, Friedman said. “It does deny the actual patient informed consent.”
“I feel very strongly that people should not test their children, but children should make their own decision,” said Jill Stoller, a New Jersey pediatrician who is the mother of Jenna, the Cornell student.
Jenna had hours of counseling before doctors agreed that for her, testing was the right choice. However, Jennifer Scalia Wilbur, a counselor at Women and Infants Hospital in Providence, R.I., told of a 19-year-old who had testing without counseling and now wants to remove her breasts and not have children.
“It was extremely distressing” to talk with her now and try to correct her overly dire outlook, she said.
At a meeting of the oncology society in June, Bradbury reported on a survey she did of 163 adult BRCA gene carriers in the Chicago area. About half supported testing minors in some or all circumstances. A previous survey she led of 53 gene carriers and 22 of their offspring (ages 18 to 25) found about the same degree of support. Most sons and daughters favored testing minors.
Another of her studies, recently published in the American Journal of Medical Genetics, explored how sons and daughters ages 18 to 25 were affected by learning that a parent had tested positive.
Some effects were good — five of the seven smokers said they were motivated to quit.
Most said the knowledge had no big negative effect, but six of the 22 said they felt frightened or disturbed.
“I was shocked, scared. I wondered if I was going to get the gene and realized I could pass it to my (future) kids. I would feel like it was my fault if they got cancer,” one daughter said in the survey.
Two sons said the knowledge might change their plans to have children. Five daughters and two sons had already gone for gene testing, and nearly all of the rest said they planned to be tested.
Wanting to test minors can be a knee-jerk response that changes after counseling. Tammy LeVasseur of North Attleboro, Mass., at first thought she wanted all three of her daughters to be tested after she learned of her own positive result in July.
She later decided to encourage testing for her two oldest daughters, ages 26 and 28, who had already finished having children, but not for Jessica, who just turned 17.
“I want to wait until I’m in my 20s,” Jessica LeVasseur said. “They wouldn’t do anything about it. There’s no reason to worry now. I’d rather just be able to finish my teenage years without worrying about that.”
___
On the Net:
National Cancer Institute: http://www.cancer.gov/cancertopics/factsheet/risk/brca
FORCE support group: http://www.facingourrisk.org/index.php
Copyright 2008 The Associated Press.
Doctors: infection led to Turkish newborn deaths
Date: 9/22/2008 2:18 PM
By SUZAN FRASER
Associated Press Writer
ANKARA, Turkey (AP) _ An infection spread by IV treatment led to the weekend deaths of 13 premature newborns at a hospital in western Turkey, a doctor investigating the deaths told the private Dogan news agency Monday.
The deaths drove the number of babies killed by infections in Turkey to at least 40 in three months.
In July, more than 27 newborns died of an infection at a hospital for high-risk births in the capital, Ankara. Government-appointed doctors investigating the deaths said a staff shortage had increased the risk of infection.
Recep Ozturk, a doctor at Istanbul’s Cerrahpasa University Hospital, said preliminary results indicated that IV-spread infection caused the latest deaths at Izmir’s Tepecik hospital Saturday and early Sunday, Dogan reported. Ozturk, who spoke on behalf of the group of doctors investigating the case, said the infection appeared to be spread by intravenous solution, Dogan reported.
A local prosecutor was investigating whether neglect may have been a factor.
Izmir health department head Mehmet Ozkan said the hospital believed the babies were not neglected. Tepecik hospital was caring for 41 newborns overnight Saturday. After the 13 deaths, the unit was placed under quarantine and no new babies have been admitted. The hospital has 30 incubators and can accommodate 45 infants.
The bodies of three babies buried over the weekend were being exhumed to help with the investigation, the state-run Anatolia news agency reported.
Hospitals in small towns in Turkey generally lack specialized premature birth units, and high-risk or premature babies are often taken to larger hospitals in cities such Istanbul, Ankara or Izmir.
Health workers unions say, however, that the larger hospitals are often understaffed or ill-equipped to care for large numbers of newborns.
“These unfortunate deaths are very saddening,” Prime Minister Recep Tayyip Erdogan said. “There may have been neglect, this will become clear after the investigation.”
“Premature births constitute a high risk, and this may have played a part, too,” he said.
Turkey’s infant mortality rate is relatively high, at 23.66 in 1,000 in 2005, compared with that of its EU-member neighbor Greece, where 3.8 newborns out of 1,000 died the same year, according to the Organization for Economic Co-operation and Development.
Copyright 2008 The Associated Press.
By SUZAN FRASER
Associated Press Writer
ANKARA, Turkey (AP) _ An infection spread by IV treatment led to the weekend deaths of 13 premature newborns at a hospital in western Turkey, a doctor investigating the deaths told the private Dogan news agency Monday.
The deaths drove the number of babies killed by infections in Turkey to at least 40 in three months.
In July, more than 27 newborns died of an infection at a hospital for high-risk births in the capital, Ankara. Government-appointed doctors investigating the deaths said a staff shortage had increased the risk of infection.
Recep Ozturk, a doctor at Istanbul’s Cerrahpasa University Hospital, said preliminary results indicated that IV-spread infection caused the latest deaths at Izmir’s Tepecik hospital Saturday and early Sunday, Dogan reported. Ozturk, who spoke on behalf of the group of doctors investigating the case, said the infection appeared to be spread by intravenous solution, Dogan reported.
A local prosecutor was investigating whether neglect may have been a factor.
Izmir health department head Mehmet Ozkan said the hospital believed the babies were not neglected. Tepecik hospital was caring for 41 newborns overnight Saturday. After the 13 deaths, the unit was placed under quarantine and no new babies have been admitted. The hospital has 30 incubators and can accommodate 45 infants.
The bodies of three babies buried over the weekend were being exhumed to help with the investigation, the state-run Anatolia news agency reported.
Hospitals in small towns in Turkey generally lack specialized premature birth units, and high-risk or premature babies are often taken to larger hospitals in cities such Istanbul, Ankara or Izmir.
Health workers unions say, however, that the larger hospitals are often understaffed or ill-equipped to care for large numbers of newborns.
“These unfortunate deaths are very saddening,” Prime Minister Recep Tayyip Erdogan said. “There may have been neglect, this will become clear after the investigation.”
“Premature births constitute a high risk, and this may have played a part, too,” he said.
Turkey’s infant mortality rate is relatively high, at 23.66 in 1,000 in 2005, compared with that of its EU-member neighbor Greece, where 3.8 newborns out of 1,000 died the same year, according to the Organization for Economic Co-operation and Development.
Copyright 2008 The Associated Press.
Turkey investigates hospital deaths of 27 babies
Date: 8/4/2008 1:09 PM
By SUZAN FRASER
Associated Press Writer
ANKARA, Turkey (AP) _ Turkey’s Health Ministry launched an investigation Monday into the deaths of more than two dozen newborn babies at a hospital in Ankara.
The Zekai Tahir Burak hospital has acknowledged that 27 babies died there in the past two weeks, but said most had died from complications related to premature delivery.
Most of the 26,000 babies born each year or admitted to Zekai Tahir Burak are premature, as the hospital handles high-risk births. The hospital could not immediately say how many babies were delivered in the two week period involving the 27 deaths.
Turkey’s infant mortality rate in 2005 was 23.6 in 1,000, relatively high compared with neighboring Greece, where 3.8 in 1,000 newborns died the same year, according to the Organization for Economic Co-operation and Development.
But a health workers union said 27 recent deaths in two weeks at the state-run hospital in Ankara was too high, and blamed poor sanitary conditions and negligence.
Health Minister Recep Akdag ordered an inquiry into the deaths, and the ministry set up a team of investigators to look into practices at the hospital, which has one of the busiest maternity wards in the capital. The hospital says it has capacity for 122 newborns at a time, but often has up to 180.
The ministry said the results of the investigation would be made public.
“The necessary measures will be taken if anyone is found to be at fault,” it said in a statement.
Over the weekend, Dr. Ugur Dilmen, who heads the hospital’s newborn unit, said the babies’ deaths were the result of birth defects, heart failure, hernia, hypertension and stillbirth.
The hospital said tests had ruled out infection as a possible cause.
“None of the deaths were caused by a hospital infection,” chief physician Leyla Mollamahmutoglu said.
The Health and Social Services Workers union, however, questioned the hospital’s sanitary conditions. Union chief Kemal Yilmaz said Monday that visitors entered the newborn unit with plastic booties over shoes, but no masks.
Yilmaz also suggested the hospital was understaffed and overcrowded, with up to three newborns placed in one incubator.
He demanded the hospital answer questions about how many babies each nurse is responsible for, and whether any of the babies who died had been given antibiotics, among other queries.
Copyright 2008 The Associated Press.
By SUZAN FRASER
Associated Press Writer
ANKARA, Turkey (AP) _ Turkey’s Health Ministry launched an investigation Monday into the deaths of more than two dozen newborn babies at a hospital in Ankara.
The Zekai Tahir Burak hospital has acknowledged that 27 babies died there in the past two weeks, but said most had died from complications related to premature delivery.
Most of the 26,000 babies born each year or admitted to Zekai Tahir Burak are premature, as the hospital handles high-risk births. The hospital could not immediately say how many babies were delivered in the two week period involving the 27 deaths.
Turkey’s infant mortality rate in 2005 was 23.6 in 1,000, relatively high compared with neighboring Greece, where 3.8 in 1,000 newborns died the same year, according to the Organization for Economic Co-operation and Development.
But a health workers union said 27 recent deaths in two weeks at the state-run hospital in Ankara was too high, and blamed poor sanitary conditions and negligence.
Health Minister Recep Akdag ordered an inquiry into the deaths, and the ministry set up a team of investigators to look into practices at the hospital, which has one of the busiest maternity wards in the capital. The hospital says it has capacity for 122 newborns at a time, but often has up to 180.
The ministry said the results of the investigation would be made public.
“The necessary measures will be taken if anyone is found to be at fault,” it said in a statement.
Over the weekend, Dr. Ugur Dilmen, who heads the hospital’s newborn unit, said the babies’ deaths were the result of birth defects, heart failure, hernia, hypertension and stillbirth.
The hospital said tests had ruled out infection as a possible cause.
“None of the deaths were caused by a hospital infection,” chief physician Leyla Mollamahmutoglu said.
The Health and Social Services Workers union, however, questioned the hospital’s sanitary conditions. Union chief Kemal Yilmaz said Monday that visitors entered the newborn unit with plastic booties over shoes, but no masks.
Yilmaz also suggested the hospital was understaffed and overcrowded, with up to three newborns placed in one incubator.
He demanded the hospital answer questions about how many babies each nurse is responsible for, and whether any of the babies who died had been given antibiotics, among other queries.
Copyright 2008 The Associated Press.
Pre-pregnancy diabetes tied to more birth defects
Date: 7/30/2008 12:01 AM
BC-MED–
By MIKE STOBBE
AP Medical Writer
ATLANTA (AP) _ Diabetic women who get pregnant are three to four times more likely to have a child with birth defects than other women, according to new government research.
The study is the largest of its kind, and provides the most detailed information to date on types of birth defects that befall the infants of diabetic mothers, including heart defects, missing kidneys and spine deformities.
The study lists nearly 40 types of birth defects found to be significantly more common in the infants of diabetic mothers than in those who weren’t diabetic or who were diagnosed with diabetes after they became pregnant.
The study’s list of diabetes-associated birth defects is surprising — it’s much longer than was previously understood, said Janis Biermann, senior vice president for education and health promotion at the March of Dimes.
“It adds more information about the specific types of birth defects associated with pregestational diabetes and gestational diabetes,” said Biermann, who was not involved in the research.
Researchers from the Centers for Disease Control and Prevention led the study, which is being published in the American Journal of Obstetrics and Gynecology. CDC officials released the study Wednesday.
Birth defects affect one in 33 babies born in the United States, and cause about one in five infant deaths. The cause of most birth defects isn’t known but some risk factors include obesity, alcohol, smoking and infections.
Doctors have known for decades about the threat diabetes poses to pregnancies. Past research has focused on dangers to the infant by the extra amounts of glucose — sugar — circulating in the womb of a diabetic mother. Studies with rats and mice clearly show excess sugar harms fetal tissue development, said Dr. E. Albert Reece, a study co-author, who directs birth defects research at the University of Maryland School of Medicine.
The new study draws from the birth records between 1997 and 2003 at hospitals in 10 states — Arkansas, California, Georgia, Iowa, Massachusetts, New Jersey, New York, North Carolina, Texas and Utah.
The study focused on the 13,000 births involving a major birth defect, and compared them to nearly 5,000 randomly selected healthy births from the same locations.
Mothers were asked if they had been diagnosed with diabetes before or during their pregnancy. The researchers said those who were diagnosed while pregnant either had a temporary, pregnancy-induced condition called gestational diabetes or had diabetes that had gone undiagnosed until they were pregnant.
The study found that there was no diabetes involved in 93 percent of the birth defects.
About 2 percent of the children with single birth defects were born to mothers who had diabetes before they became pregnant. About 5 percent of the infants with multiple defects were born to mothers with that condition. In healthy births, the percentage of mothers who were diabetic before pregnancy was much lower.
The study also showed a wide range of birth defects that included malformation of the heart, spine, limbs and gastrointestinal tract.
“Diabetes is not discriminating” in which birth defects it’s linked to, said Dr. Adolfo Correa, a CDC epidemiologist who was the study’s lead author.
___
On the Net:
CDC: http://www.cdc.gov/ncbddd/bd/facts.htm
Copyright 2008 The Associated Press.
BC-MED–
By MIKE STOBBE
AP Medical Writer
ATLANTA (AP) _ Diabetic women who get pregnant are three to four times more likely to have a child with birth defects than other women, according to new government research.
The study is the largest of its kind, and provides the most detailed information to date on types of birth defects that befall the infants of diabetic mothers, including heart defects, missing kidneys and spine deformities.
The study lists nearly 40 types of birth defects found to be significantly more common in the infants of diabetic mothers than in those who weren’t diabetic or who were diagnosed with diabetes after they became pregnant.
The study’s list of diabetes-associated birth defects is surprising — it’s much longer than was previously understood, said Janis Biermann, senior vice president for education and health promotion at the March of Dimes.
“It adds more information about the specific types of birth defects associated with pregestational diabetes and gestational diabetes,” said Biermann, who was not involved in the research.
Researchers from the Centers for Disease Control and Prevention led the study, which is being published in the American Journal of Obstetrics and Gynecology. CDC officials released the study Wednesday.
Birth defects affect one in 33 babies born in the United States, and cause about one in five infant deaths. The cause of most birth defects isn’t known but some risk factors include obesity, alcohol, smoking and infections.
Doctors have known for decades about the threat diabetes poses to pregnancies. Past research has focused on dangers to the infant by the extra amounts of glucose — sugar — circulating in the womb of a diabetic mother. Studies with rats and mice clearly show excess sugar harms fetal tissue development, said Dr. E. Albert Reece, a study co-author, who directs birth defects research at the University of Maryland School of Medicine.
The new study draws from the birth records between 1997 and 2003 at hospitals in 10 states — Arkansas, California, Georgia, Iowa, Massachusetts, New Jersey, New York, North Carolina, Texas and Utah.
The study focused on the 13,000 births involving a major birth defect, and compared them to nearly 5,000 randomly selected healthy births from the same locations.
Mothers were asked if they had been diagnosed with diabetes before or during their pregnancy. The researchers said those who were diagnosed while pregnant either had a temporary, pregnancy-induced condition called gestational diabetes or had diabetes that had gone undiagnosed until they were pregnant.
The study found that there was no diabetes involved in 93 percent of the birth defects.
About 2 percent of the children with single birth defects were born to mothers who had diabetes before they became pregnant. About 5 percent of the infants with multiple defects were born to mothers with that condition. In healthy births, the percentage of mothers who were diabetic before pregnancy was much lower.
The study also showed a wide range of birth defects that included malformation of the heart, spine, limbs and gastrointestinal tract.
“Diabetes is not discriminating” in which birth defects it’s linked to, said Dr. Adolfo Correa, a CDC epidemiologist who was the study’s lead author.
___
On the Net:
CDC: http://www.cdc.gov/ncbddd/bd/facts.htm
Copyright 2008 The Associated Press.
Rapid rise seen in fatal medication errors at home
Date: 07/28/2008 04:04 PM
By CARLA K. JOHNSON
Associated Press Writer
CHICAGO (AP) _ Deaths from medication mistakes at home, like actor Heath Ledger’s accidental overdose, rose dramatically during the past two decades, an analysis of U.S. death certificates finds.
The authors blame soaring home use of prescription painkillers and other potent drugs, which 25 years ago were given mainly inside hospitals.
“The amount of medical supervision is going down and the amount of responsibility put on the patient’s shoulders is going up,” said lead author David P. Phillips of the University of California, San Diego.
The findings, based on nearly 50 million U.S. death certificates, are published in Monday’s Archives of Internal Medicine. Of those, more than 224,000 involved fatal medication errors, including overdoses and mixing prescription drugs with alcohol or street drugs.
Deaths from medication mistakes at home increased from 1,132 deaths in 1983 to 12,426 in 2004. Adjusted for population growth, that amounts to an increase of more than 700 percent during that time.
In contrast, there was only a 5 percent increase in fatal medication errors away from home, including hospitals, and not involving alcohol or street drugs.
Abuse of prescription drugs plays a role, but it’s unclear how much. Valid prescriptions taken in error, especially narcotics such as methadone and oxycodone, account for a growing number of deaths, said experts who reviewed the study.
The increases coincided with changing attitudes about painkillers among doctors who now regard pain management as a key to healing. Multiple prescription drugs taken at once — like the sleeping pills, painkillers and anxiety drugs that killed “Dark Knight” star Ledger — also play a part, experts said.
“When we see overdoses, we’re seeing many more mixed drug overdoses,” said Dr. Jeffrey Jentzen, president of the National Association of Medical Examiners and director of autopsies at the University of Michigan in Ann Arbor. Jentzen said autopsies are much more likely to include toxicology tests today than 25 years ago, which would contribute to finding more fatal medication errors as cause of death.
But Phillips said there were no significant increases in other poisonings like suicidal overdoses or homicides, so more testing doesn’t explain the huge increase. The analysis excluded suicides, homicides and deaths related to side effects.
The increase was steepest in death rates from mixing medicine with alcohol or street drugs at home; that death rate climbed from 0.04 per 100,000 people in 1983 to 1.29 per 100,000 people in 2004.
Many patients ignore the risk of mixing alcohol with prescriptions, said Cynthia Kuhn of Duke University Medical Center, who was not involved in the study.
“They think, ‘Oh, one drink won’t hurt.’ Then they have three or four,” Kuhn said.
The increase in deaths was highest among baby boomers, people in their 40s and 50s.
“We’re sort of drug happy,” said boomer Dr. J. Lyle Bootman, the University of Arizona’s pharmacy dean, who was not involved in the research. “We have this general attitude that drugs can fix everything.”
People share prescriptions at an alarming rate, Bootman said. One recent study found 23 percent of people say they have loaned their prescription medicine to someone else and 27 percent say they have borrowed someone else’s prescription drugs.
Kenneth Kolosh, a statistics expert at the National Safety Council, praised the study but said improved attention to coding location on death certificates may account, in part, for the huge increases the researchers found.
Phillips countered that home deaths from any cause increased relatively little during the time period, so better coding doesn’t explain the change.
Michael R. Cohen, president of the Institute for Safe Medication Practices, said more states should require pharmacists to teach patients about dangerous drugs and insurers should pay pharmacists to do so.
___
On the Net:
Archives of Internal Medicine: http://www.archinternmed.com
Copyright 2008 The Associated Press.
By CARLA K. JOHNSON
Associated Press Writer
CHICAGO (AP) _ Deaths from medication mistakes at home, like actor Heath Ledger’s accidental overdose, rose dramatically during the past two decades, an analysis of U.S. death certificates finds.
The authors blame soaring home use of prescription painkillers and other potent drugs, which 25 years ago were given mainly inside hospitals.
“The amount of medical supervision is going down and the amount of responsibility put on the patient’s shoulders is going up,” said lead author David P. Phillips of the University of California, San Diego.
The findings, based on nearly 50 million U.S. death certificates, are published in Monday’s Archives of Internal Medicine. Of those, more than 224,000 involved fatal medication errors, including overdoses and mixing prescription drugs with alcohol or street drugs.
Deaths from medication mistakes at home increased from 1,132 deaths in 1983 to 12,426 in 2004. Adjusted for population growth, that amounts to an increase of more than 700 percent during that time.
In contrast, there was only a 5 percent increase in fatal medication errors away from home, including hospitals, and not involving alcohol or street drugs.
Abuse of prescription drugs plays a role, but it’s unclear how much. Valid prescriptions taken in error, especially narcotics such as methadone and oxycodone, account for a growing number of deaths, said experts who reviewed the study.
The increases coincided with changing attitudes about painkillers among doctors who now regard pain management as a key to healing. Multiple prescription drugs taken at once — like the sleeping pills, painkillers and anxiety drugs that killed “Dark Knight” star Ledger — also play a part, experts said.
“When we see overdoses, we’re seeing many more mixed drug overdoses,” said Dr. Jeffrey Jentzen, president of the National Association of Medical Examiners and director of autopsies at the University of Michigan in Ann Arbor. Jentzen said autopsies are much more likely to include toxicology tests today than 25 years ago, which would contribute to finding more fatal medication errors as cause of death.
But Phillips said there were no significant increases in other poisonings like suicidal overdoses or homicides, so more testing doesn’t explain the huge increase. The analysis excluded suicides, homicides and deaths related to side effects.
The increase was steepest in death rates from mixing medicine with alcohol or street drugs at home; that death rate climbed from 0.04 per 100,000 people in 1983 to 1.29 per 100,000 people in 2004.
Many patients ignore the risk of mixing alcohol with prescriptions, said Cynthia Kuhn of Duke University Medical Center, who was not involved in the study.
“They think, ‘Oh, one drink won’t hurt.’ Then they have three or four,” Kuhn said.
The increase in deaths was highest among baby boomers, people in their 40s and 50s.
“We’re sort of drug happy,” said boomer Dr. J. Lyle Bootman, the University of Arizona’s pharmacy dean, who was not involved in the research. “We have this general attitude that drugs can fix everything.”
People share prescriptions at an alarming rate, Bootman said. One recent study found 23 percent of people say they have loaned their prescription medicine to someone else and 27 percent say they have borrowed someone else’s prescription drugs.
Kenneth Kolosh, a statistics expert at the National Safety Council, praised the study but said improved attention to coding location on death certificates may account, in part, for the huge increases the researchers found.
Phillips countered that home deaths from any cause increased relatively little during the time period, so better coding doesn’t explain the change.
Michael R. Cohen, president of the Institute for Safe Medication Practices, said more states should require pharmacists to teach patients about dangerous drugs and insurers should pay pharmacists to do so.
___
On the Net:
Archives of Internal Medicine: http://www.archinternmed.com
Copyright 2008 The Associated Press.
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