Find Me A Cure

WHAT kills more than five times as many Americans as AIDS? Hospital infections, which account for an estimated 100,000 deaths every year.Yet the Centers for Disease Control and Prevention, which are calling for voluntary blood testing of all patients to stem the spread of AIDS, have chosen not to recommend a test that is essential to stop the spread of another killer sweeping through our nation’s hospitals:

M.R.S.A., or methicillin-resistant Staphylococcus aureus. The C.D.C. guidelines to prevent
hospital infections, released last month, conspicuously omit universal testing of patients
for M.R.S.A.

That’s unfortunate. Research shows that the only way to prevent M.R.S.A. infections is to
identify which patients bring the bacteria into the hospital. The M.R.S.A. test costs no
more than the H.I.V. test and is less invasive, a simple nasal or skin swab.
Staph bacteria are the most prevalent infection-causing germs in most hospitals, and
increasingly these infections cannot be cured with ordinary antibiotics. Sixty percent of
staph infections are now drug resistant (that is, M.R.S.A.), up from 2 percent in 1974.
Some people carry M.R.S.A. germs in their noses or on their skin without realizing it. The
bacteria do not cause infection unless they get inside the body — usually via a catheter, a
ventilator, or an incision or other open wound. Once admitted to a hospital, these patients shed the germs on bedrails, wheelchairs, stethoscopes and other surfaces, where M.R.S.A. can live for many hours.

Doctors and other caregivers who lean over an M.R.S.A.-positive patient often pick up the germ on their hands, gloves or lab coats and carry it along to their next patient.

The blood-pressure cuffs that nurses wrap around patients’ bare arms frequently carry live bacteria, including M.R.S.A. In a recent study at a French teaching hospital, 77 percent of blood-pressure cuffs wheeled from room to room were contaminated. Another study linked contaminated blood-pressure cuffs to several infected infants in the nursery at the
University of Iowa hospital.

Among developed nations, the United States has one of the worst records of curbing
drug-resistant infections, according to the Sentry Antimicrobial Surveillance Program, an
international effort to monitor drug-resistant germs. In this country, M.R.S.A. hospital
infections increased 32-fold from 1976 to 2003, according to the C.D.C.

In the 1980s, Denmark, Finland and the Netherlands faced similarly soaring rates of
M.R.S.A., but nearly eradicated it. How? By screening patients and requiring health care
workers treating patients with M.R.S.A. to wear gowns and gloves and use dedicated equipment to prevent the spread. The Dutch called their strategy “search and destroy.”

A growing number of hospitals in the United States have proved that such precautions work here, too. Recently, a pilot program using screening at Presbyterian University Hospital, in Pittsburgh, reduced M.R.S.A. infections by 90 percent. At a Yale-affiliated hospital in New Haven, screening reduced M.R.S.A. infections in intensive care by two-thirds.

And a recently completed nine-year study at the Brigham and Women’s Hospital, in Boston, found that screening led to a 75 percent drop in M.R.S.A. bloodstream infections among intensive-care patients and a 67 percent decline throughout the hospital. Earlier efforts to stop these infections by installing many more dispensers of hand cleanser and conducting a yearlong educational campaign on hand hygiene had no effect.

Some public health advocates recommend screening only “high-risk” patients — those who recently have been hospitalized, live in nursing homes or have kidney disease. Partial
screening is somewhat effective, but universal screening prevents the most infections.
Can hospitals afford to screen for M.R.S.A.? They cannot afford not to. Infections wipe out hospital profits. When a patient develops an infection and has to spend many additional
weeks hospitalized, Medicare does not pay for most of that additional care.

Treating hospital infections costs an estimated $30.5 billion a year in the United States.
Prevention, on the other hand, is inexpensive and requires no capital outlays. A pilot
program at the University of Pittsburgh found that screening tests, gowns and other
precautions cost only $35,000 a year, and saved more than $800,000 a year in infection
costs. A review of similar cost analyses, published in The Lancet in September, concluded
that M.R.S.A. screening increases hospital profits — as it saves lives.

Yet, for a decade, the C.D.C. has rebuffed calls for screening, most recently from a
committee of the Society for Healthcare Epidemiologists of America. C.D.C. officials claim
that more research is needed to prove the benefits of screening. More research cannot hurt, but we know enough already to move ahead.

Some hospitals are leading the way, including Evanston Northwestern, in Illinois; the
Veterans Affairs medical centers; New England Baptist Hospital, in Boston; and Johns Hopkins Hospital, in Baltimore.

The C.D.C.’s lax guidelines give many other hospitals an excuse to do too little. Every year of delay costs thousands of lives and billions of dollars.

Source:The New York Times

WASHINGTON: The chance that infidelity will intrude on a romantic relationship may be written in the couple’s genes, a study has found. The results suggest a DNA test could tell a man the rough chances his female partner will cheat on him, though it wouldn’t necessarily work the opposite way. Researchers focused on a set of genes that past studies have implicated in a link between sexual attraction and genetic similarity. The cluster of genes is termed the major histocompatibility complex, or MHC.

The researchers studied 48 male-female couples who were either dating “exclusively” or married or living together. As the proportion of MHC genes the couple shared increased, “women’s sexual responsivity to their partners decreased, their number of outside] sexual partners increased, and their attraction to men other than their primary partners increased,” the researchers wrote in a paper describing their findings.

Two quantities were almost equal on average, according to Christine Garver-Apgar, the study’ author: the fraction of MHC genes shared, and the woman’s number of extra partners. In other words, if the man and woman had half the genes in common, the woman would have on average nearly half a lover on the side. But these tendencies were found only for women; men’s attraction and likelihood of cheating appeared unrelated to the genes, they wrote.

This may also explain past studies suggesting that humans and animals prefer mates with dissimilar MHC genes, according to scientists. Such a preference might help assure that offspring have a wide range of immunity genes in the holster, giving them an edge over pathogens.

Infidelity touches about half of all couples, married or not, according to infidelity researcher Shirley Glass. Last year, scientists also found one in 25 dads may be raising another man’s child.

Source :The Times Of India