The Waiting Room – Documentary To be Aired on PBS Next Year

From the blog item A Lens on Health

I was fortunate enough to attend a screening last week of The Waiting Room, a unique lens on public health and our current health system.

The screening was part of the Center for Health, Media and Policy’s ongoing Health in Film & New Media Series series; it was was one of the best films I have seen about health, about people, about hopes and dreams in the inner city.

Director Peter Nicks conducted interviews with dozens of patients and staff in the Emergency Department of Highland Hospital in Oakland, CA. He gathers a rather sobering portrait of safety net health care and those that would fall through the cracks without it. Overworked and sometimes exhausted doctors and nurses care for anyone that needs it in this understaffed and overcrowded ED.

The hospital’s waiting room holds dozens of stories. The ones that patients want tell to the intake nurse, to the doctors, to the camera, to the stranger sitting next to them. The waiting room is a place of last resort for the Hell’s Angel, the newly unemployed executive, the drug addict, the displaced blue collar worker, who wait for care and hope to be treated as more than just a number……

Read the entire blog item by  a health care journalist (name is not on her blog,even her bio)

Bird flu science too scary to publish, some say

Some biosecurity experts are concerned new research could be used as a blueprint by nefarious forces and are arguing against publication of the work. (CBC)

 

From the 19th November 2011 CBC (Canadian Broadcast Corp) news item

(via a Linked In item by Sandeep Pulim M.D.,Sr. Medical Editor at M3-USA, who is also on Twitter)

 

New bird flu research that shows that the dangerous virus can mutate to become easily transmissible among ferrets — and perhaps humans — has embroiled the scientific community in a difficult debate.

Some biosecurity experts are concerned the research could be used as a blueprint by nefarious forces and are arguing against publication of the work.

But others, especially influenza scientists, are countering that the flu world needs to know the possible paths the H5N1 virus could take to become one that can spread easily among people so laboratories can be on the lookout for those changes in nature….

…

2 papers already published

The body does not have the power to bar publication, but it is unclear whether a scientific journal would feel comfortable publishing an article if the group says it should not be placed in the public domain.

It’s also not clear whether the funders of the research — in this case, the U.S. National Institutes of Health — would permit publication if the government’s biosecurity advisers objected to publication of an article.

The controversy relates to several papers, two of which have recently been published and another which is in the publication pipeline.

That latter paper is the one garnering the most concern.

The senior author, virologist Ron Fouchier of Erasmus Medical Centre in Rotterdam, the Netherlands, won’t talk about the work other than to confirm it is under review by the National Security Advisory Board on Biosecurity.

But Fouchier electrified the flu world in September when he gave an outline of the work at a major influenza conference in Malta.

He told the gathering that in trying to find out whether H5N1 could acquire the ability to spread easily among people, he came up with a virus that spread among ferrets as easily as seasonal flu viruses, according to a report on the meeting in Scientific American.

Scientists caught in Catch-22

Ferrets are considered the best animal model for human infection with influenza. It is feared that a virus that could spread easily among the animals would spread easily among people as well.

H5N1 currently does not transmit easily to people or among people. To date there have been 570 confirmed cases of H5N1 infection in 15 countries and 335 of those people have died.

The other two recently published studies, one by scientists from the U.S. Centers for Disease Control and another by scientists at St. Jude’s Children’s Hospital in Memphis, Tenn., both involved engineering viruses with some genes from H5N1 viruses. Both papers were published without being referred to the biosecurity advisory board.

Flu scientists may feel like they are caught in a Catch-22 situation. For years they’ve faced demands from governments anxious to know whether H5N1 could become a human flu virus and what it would take for that to happen.

 

 

 

Related articles

• Bird flu science too scary to publish, some say (talesfromthelou.wordpress.com)
• Debate rages over new bird flu research; some argue it’s not safe to publish (thestar.com)
• Bird Flu Experiment Rattles Bioterrorism Experts (npr.org)
• Bird Flu Experiment Rattles Bioterrorism Experts (npr.org)
• NIH grantees rebut theory that seasonal flu strains originate in tropical regions (jflahiff.wordpress.com)
• Five easy mutations to make bird flu a lethal pandemic (newscientist.com)
• Flu cases up 50% (premierlinedirect.co.uk)
• Where did the bird flu come from (wiki.answers.com)

Targeted antibacterial proteins may offer antibiotic alternative

Targeted antibacterial proteins may offer antibiotic alternative.(Company press release )

New publication demonstrates ability of Avidocin™ proteins to prevent and treat E. coli O157 diarrhea in animal study

SOUTH SAN FRANCISCO, CA — A novel antibacterial protein targeted against E. coli O157:H7 may offer a way to prevent or treat serious food-borne bacterial infections, as demonstrated in a study published in the December issue of Antimicrobial Agents and Chemotherapy. Results in an animal model of E. coli infection showed that the orally administered protein, developed by AvidBiotics, Inc., could prevent or treat E. coli O157:H7-induced diarrhea and intestinal inflammation when administered either on a preventative basis or after the onset of diarrhea. Moreover, animals treated with the protein also carried and shed fewer of the E. coli O157:H7 bacteria in their feces.

“E. coli O157:H7 contamination of foods like ground meats or produce is a well-publicized public health problem, with life-threatening infection outbreaks reported around the world in recent years,” said Dean Scholl, Ph.D., lead author of the publication. “Antibiotics are contraindicated for patients infected with enterohemorrhagic E. coli (EHEC) strains like O157:H7, because many of those drugs induce the bacteria to produce and release harmful toxins. Anti-diarrheal medications also do not benefit infected patients, as they cause the bacteria to be retained in the intestines, leading to greater toxin exposure. Thus the successful development of treatments that can prevent infection or limit symptoms and disease duration and the possible further spread of harmful bacteria without increasing toxin release could benefit both individual patients and affected communities.”

The study published by Dr. Scholl and his collaborators at AvidBiotics and Brigham and Women’s Hospital/Harvard Medical School assessed AvidBiotics’ anti-E. coli O157 protein, termed an Avidocin™ protein, in a rabbit model of infection and reported that:

• The Avidocin protein remained active within the treated animals’ intestinal tract for at least 24 hours post administration.
• When given shortly after the animals were infected with E. coli O157:H7 but before they developed active disease, the Avidocin protein inhibited bacterial colonization and/or the symptoms of infection. Animals that received the highest dose of protein studied did not develop diarrhea at any time during the experiment. In contrast, animals given buffer alone developed typical diarrhea within 1-2 days after infection, which worsened by the 3rd day of the study.
• Analyses of colon tissue showed less severe intestinal inflammation in Avidocin protein-treated animals compared to controls. Avidocin protein administration also greatly reduced the number of E. coli O157:H7 recovered from the intestine and the stool of treated animals.
• When the anti-E. coli O157:H7 Avidocin protein was administered to infected animals already exhibiting disease symptoms, the existing diarrhea began to resolve in treated animals compared to animals treated with placebo. This reduction in diarrhea persisted until the experiment was terminated, 9 days post infection, at which time the feces of the treated animals appeared closer to feces from uninfected animals than the still largely liquid stool of the control animals. Thus, even after the onset of diarrhea in E. coliO157:H7-infected animals, administration of the anti-E. coli O157:H7 Avidocin protein could still mitigate the effects of infection.

“These findings suggest that an Avidocin protein targeted against E. coli O157:H7 offers promise for both the prevention and treatment of infection by this important enteric pathogen,” concluded Dr. Scholl. “Moreover, this agent provides several significant advantages over conventional antibiotics, including a lack of drug-induced shiga toxin production and unintended collateral damage to normal intestinal bacterial populations. Additionally those rare variants of E. coli O157:H7 that emerge resistant to the anti-E. coli O157:H7 Avidocin protein are likely to have compromised virulence, or disease-causing properties.”

About the Avidocin™ Protein Platform

AvidBiotics genetically engineers Avidocin proteins from R-type pyocins, antibacterial proteins produced by some Pseudomonas aeruginosa strains. These proteins specifically kill bacteria by binding to the bacterial cell and punching a hole in the cell envelope, causing membrane depolarization and ultimately cell death. AvidBiotics has previously demonstrated that Avidocin proteins can be engineered to recognize and kill in a highly targeted and specific manner a variety of bacteria, including E. coli, Salmonella, Shigella, Clostridium difficile, andYersinia pestis (the bacterium that causes plague), thus serving as a platform for the production of numerous highly specific antibacterial agents.

AvidBiotics is also currently developing Avidocin proteins against Acinetobacter, a bacterium associated with serious, often broadly antibiotic-resistant infections in Intensive Care Units and those incurred by U.S. military deployed in Iraq and Afghanistan. In addition to the human health care uses of the Avidocin™ technology, AvidBiotics is collaborating with food safety and hygiene company EcoLab to develop antibacterial proteins for use against E. coli O157:H7 in meat processing.

###

About AvidBiotics

AvidBiotics is a developer of novel, non-antibody proteins as targeted therapeutics against bacteria, viral infections and cancers. The scaffolds of AvidBiotics’ proteins exhibit functional potency, e.g. killing, exceeding that of antibodies. AvidBiotics has two proprietary product platforms. The first is this new class of tailorable, targeted bactericidal agents for use in the treatment or prevention of specific bacterial infections. The second specifically flags virus-infected or cancerous cells for enhanced destruction by the Natural Killer and T cells of the potent innate immunity system. AvidBiotics focuses on human therapeutic applications of its technologies, both on its own and in partnership with governmental agencies and research institutions, while taking advantage of further near-term collaborative opportunities offered by specific applications of its products and technology platforms in areas such as food safety, biodefense and animal husbandry. For more information on AvidBiotics, please visit the company’s web site at http://www.avidbiotics.com.

Related articles

• Targeted antibacterial proteins may offer antibiotic alternative (eurekalert.org)
• St. Louis E.coli O157:H7 Outbreak Update – 23 Infected (thechefstableblog.com)
• E.coli O157:H7 infections in five Organic Pastures raw milk customers (thebovine.wordpress.com)
• E. Coli Linked To NC State Fair Livestock Building (thechefstableblog.com)
• Bagged salad recalled over E. coli fears (msnbc.msn.com)
• No Antibiotics For Future Infections? Possible If Nothing Is Done Today (jflahiff.wordpress.com)

Protecting patients from medical apology programs

Protecting patients from medical apology programs

by GABRIEL H. TENINBAUM in the 20 November edition of KevidMD.com

To deal with the aftermath of medical errors, an increasing number of providers are encouraging injured patients to participate in “medical apology programs.” The idea, proponents say, is for patients to meet with facility representatives to learn what happened and why.  It gives the patient a chance to ask questions and it gives providers a chance to apologize, and as appropriate, offer compensation.  These programs are promoted as humanitarian, and, at least in terms of providing an emotional outlet for patients, they are.

 

The evidence also suggests that they are about something else: money.  Every aspect of how they operate – from who risk managers involve, to what those involved are told to say – suggests a key goal is to dissuade patients from seeking compensation by creating an emotional connection with them. …

Related articles

• We’re Only Human, Even Our Doctors and Nurses (hcfama.org)
• Patient Safety Must Be Improved (medicalnewstoday.com)
• In Touch With Patients (1 Letter) (nytimes.com)
• Medical Error Prompts Doctor to Push for Safety Measures (prweb.com)
• Health IT May Be Cause Of Patient Errors (baravaida.wordpress.com)
• How much physician guidance do patients want with medical decisions? (kevinmd.com)