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BARE NEWS: What You Need to Know!

BARE NEWS: What You Need to Know!

Greg Laukhuf ND, RN,CRN, RN-BC, NE-BC
Senior Editor

Ebola Vaccine Development Race Between the USA and China

Hackett, D. (2018).  Ebola Vaccine Development Race Between the USA and China. Precision Vaccinations.
The Ebola Hemorrhagic Fever (EHF) African outbreak in 2013–2016 was the fi to impact rural and urban areas simultaneously according to the Centers for Disease Control and Prevention (CDC). The outbreak evolved into a pandemic with 28,000 people infected and 11,000 fatalities. It was spread through inhalation, ingestion and or skin breaks when an uninfected person encounters infected blood or body fluids. 
During 2018 review of the Ebola recovery projects by the US Government Accountability Office the (GAO) found that the US needs to do more to prepare for future Ebola outbreaks. One of these projects is working with Merck on a new Ebola vaccine.
The Chinese vaccine has advantages. It incorporates a freeze-drying technique known as lyophilization, which allows the vaccine to be stored at 4°C (39°F) for a long time, and to remain stable at 37°C (99°F) for about three weeks. The two Merck vaccines must be stored at -70°C (-94°F) or below and are stable for only one week at 4°C (39°F). The Chinese vaccine could logistically be more suitable for the African region.

Health insurers push patients away from hospitals

Greene, J. (2018). Crain’s Detroit Business. Health insurers push patients away from hospitals.
Health insurers are creating programs to encourage patients to move away from hospitals to lower-priced outpatient providers or in-home services. This is in a move to reduce health care costs.
The insurers are requiring pre-authorization for hospital services and want patients to use low cost providers or home infusion services. This is changing how hospitals do business. Hospitals have taken notice that health insurers are directing patients away from inpatient settings and have begun to cut costs or invest more in outpatient care. Moody’s Investors Service said in a recent report that hospitals that don’t adapt could get squeezed out of the care continuum as insurers grow and direct more care to lower-cost settings.
Some systems like Ascension Health Michigan, one of the state’s largest nonprofit systems, and investor-owned Detroit Medical Center have laid off employees as inpatient volumes have declined. Ascension is selling 141 hospitals nationally and while seeking to boost outpatient and telemedicine services.

What is the impact of blood sampling from peripheral IV catheters?

IVTEAM. (March 31, 2018). What is the impact of blood sampling from peripheral IV catheters?  Intravenous Literature.
Blood draws for laboratory analyses are one of the most common experiences for hospitalized patients. When performed by venipuncture, they are often associated with pain and anxiety. Most hospitals avoid phlebotomy from peripheral IV catheters due to sample hemolysis, sample dilution by fluids,  IV dislodgement   or infiltration, and increased rates of phlebitis.
In a recent study, 81% of blood collection attempts were successful through a PIV. Results suggest that use of a PIV based blood collection was a reliable and valid approach and was superior to routine phlebotomy in self-reported responses from patients (Mulloy et al; 2018).
Reference:
Mulloy, D.F., Lee, S.M., Gregas, M., Hoffman, K.E. and Ashley, S.W. (2018) Effect of peripheral IV based blood collection on catheter dwell time, blood collection, and patient response. Applied Nursing Research. 40, p.76-79. doi: 10.1016/j. apnr.2017.12.006

Medtronic studies device aimed at lowering high blood pressure

Carlson, J. (April 9, 2018). Medtronic studies device aimed at lowering high blood pressure. Star Tribune.
Hypertension increases heart attack and stroke risks costing $500 billion in annual costs worldwide. Medtronic is launching the first placebo-controlled study of a medical device treatment intended to lower a person’s blood pressure without medication. The therapy is called “renal denervation,” and it involves inserting a catheter into the artery that feeds the kidneys to burn away some nerves driving overactive nervous impulses and cause high blood pressure.
Cleveland clinic- led study shows leadless pacemaker patients experience less complications
Pancetti, A. (2018). Cleveland clinic- led study shows leadless pacemaker patients experience less complications. Eurekalert.
One million pacemakers are implanted annually to regulate a patient’s heartbeat. Patients with leadless pacemakers’ experience have fewer problems than those receiving traditional pacemakers in a recent Cleveland Clinic research study released in the journal Heart Rhythm.
Conventional pacemakers are placed under the skin with wires, or leads, stretching from the shoulder vein and attaching to the heart. Leadless pacemakers do not need wires. The self-contained devices, smaller than a traditional pacemaker, are placed directly in the heart. The study found that leadless pacemakers eliminated lead and pocket complications and
infection. Complications among traditional pacemaker recipients included lead complications, pocket complications and infection.
“The data from this study is encouraging, and we expect complications from leadless pacemakers to continue to decline as the technology improves and physicians gain experience implanting these devices,” said Daniel Cantillon, M.D., research director for Cardiac Electrophysiology and Pacing at Cleveland Clinic. “While this research shows benefit for leadless pacing, we must keep in mind that the field is still too young to compare the long-term results of this technology, the implications of which will not be fully understood for at least another decade.”

7-T mercury release

Selmi, Y. and Adisen, M. (2018). Radiology Society North America.
MR imaging at 7-tesla magnet strength may release toxic mercury from amalgam dental fillings, according to a recent study in the Journal Radiology. The result was not present in 1.5-tesla magnets used in the clinical setting according to researchers.
The amount of mercury escaping silver fillings   in patients scanned with a 7-tesla MRI system exceeded levels set by the World Health Organization (WHO). (Radiology, June 26, 2018).”In our study, we found very high values of mercury after ultrahigh-field MRI,” said study author Selmi Yılmaz, PhD. “This is possibly caused by phase change in amalgam material or by formation of microcircuits, which leads to electrochemical corrosion, induced by the magnetic field.” “In a completely hardened amalgam, approximately 48 hours after placing on teeth, mercury becomes attached to the chemical structure, and the surface of the fi
is covered with an oxide film  layer,” Yılmaz explained. “Therefore, any mercury leakage is minimal.”
Studies have shown that mercury can escape from amalgam fillings, with approximately 40% of it traveling into saliva and entering the gastrointestinal system, where some 10% of the mercury is absorbed. In the meantime, approximately 60% is released as mercury vapor and is either inhaled, enters the lungs, or is exhaled.
An unusual medical training tool got its start as a childish pran
Foley, K. (July 13, 2018). An unusual medical training tool got its start as a childish prank. Quartz.
It’s marketed to pranksters as a “power-packed, super-concentrated liquid” that smells of “hints of dead animal and fresh poo”. Allen Wittman was still in high school when he invented the foul spray that would later become known as “Liquid Ass.” He tested it by dumping it onto a radiator during a basketball game.
This stinky spray has found a life in medical training by helping providers learn to maintain their calm and professionalism around foul human odors. Researchers, hospitals, armed forces and medical programs are increasingly ordering the liquid. The smell so realistically mimics the human colon, it’s the perfect training tool to teach medical responders how to maintain focus and professional manner amid a horrific smell.

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