Quote:People who donate a kidney to a sick friend or relative live at least as long as others in the general population and may live somewhat longer because they tend to take better care of themselves after the procedure.

"We have intuitively felt this way, and hoped that this operation is safe, but this is the first time that we have been able to demonstrate it in a national representation of live donors," said Dr. Dorry L. Segev of the Johns Hopkins School of Medicine, lead author of the report in the Journal of the American Medical Assn.

Live-donor transplants have become increasingly common in recent years because of the large number of people who need kidneys and the limited availability of cadaver organs.

There are 83,754 Americans waiting for a kidney transplant, 80% of the number of people waiting for any organ, according to the United Network for Organ Sharing, which helps allocate organs. In 2008, there were 5,968 living-donor kidney transplants.

Several small studies have suggested that donation is safe, but the low rate of risk has made accurate estimates difficult. To surmount that problem, Segev and his colleagues studied the 80,347 Americans who donated kidneys between April 1, 1994, and March 31, 2009. The team compared them with 9,364 participants in a large government survey the third National Health and Nutrition Examination Survey who met the criteria for kidney donation.

There were 25 deaths in the first 90 days after surgery among the donors, for a rate of 3.1 deaths per 10,000 subjects, compared with a rate of 0.4 per 10,000 in the control group. That suggests the procedure "has always been profoundly safe," Segev said.

Death rates in the first 90 days were slightly higher for men than for women and for blacks than for whites. The highest risk, 36.7 deaths per 10,000 donors, occurred among donors who had high blood pressure.

From the survey forms used in the study, it is not clear if the hypertension was controlled or uncontrolled, Segev said. But it "would probably be wise for hypertensive patients considering donation to be treated through a carefully maintained protocol," he added.

The results "confirm that this is a safe operation," he said. "But it also gives us more specific numbers that we can give patients who are considering doing this. This is a very personal decision with no medical benefit for the donor, so it requires very careful consideration of what the risks are."

Quote:In a world first, scientists in Australia announced they had extracted DNA from the fossilised eggshells of extinct birds, including iconic giants such as the moa and elephant bird.

The achievement marks a major step towards drafting the genome of birds wiped out by human greed, although the scientists warn this does not mean an extinct species should or even can be resurrected in the style of Jurassic Park.

The team, led by Michael Bunce of Murdoch University in Perth, Western Australia, say they isolated DNA from desiccated inner membranes in fossil eggshells, found in 13 locations in Australia, Madagascar and New Zealand.

Ancient genetic material was coaxed from the eggshell of the moa (Dinornis), a flightless cousin to the ostrich that reached up to four metres (13 feet) in height and was hunted to extinction by New Zealand's Maori by the late 18th century.
DNA was also extracted from the elephant bird (Aepyornis), like the moa and ostrich a species of ratite, said the study, published in the Proceedings of the Royal Society B.
Growing up to three metres (10 feet) high, the bird was wiped out by European colonisation of Madagascar by 1700.

Other successes were reported using eggshells from an Australian owl and a New Zealand duck of unknown date. The oldest egg sample was from an emu (Dromaius novaehollandiae), some 19,000 years old.
But the team were unable to get DNA from far older samples in Australia, estimated at 50,000 years old, from an extinct megafaunal bird called Genyornis.
The technique entails reducing the shell to powder, extracting the DNA with lab chemicals and then amplifying it using polymerase chain reaction, or PCR a standard tool used by forensic scientists, for instance, in getting the famous "genetic fingerprint."

Bunce said the team extracted in each case only a tiny amount of DNA just 250 base pairs, the "rungs" on the ladder-like genetic code, and this is less than a fraction of one percent of the bird's genome.
"The point was proof of principle, to show that it can be done," he said in a phone interview with AFP.
"We didn't go out to get very long pieces of DNA. That's obviously the next step."
Bunce said the exploit would give palaeontologists a new window into creatures of the past.

Quote:Dr. Peter J. Pronovost, 45, is medical director of the Quality and Safety Research Group at Johns Hopkins Hospital in Baltimore, which means he leads that institution’s quest for safer ways to care for its patients. He also travels the country, advising hospitals on innovative safety measures. The Hudson Street Press has just released his book, “Safe Patients, Smart Hospitals: How One Doctor’s Checklist Can Help Us Change Health Care from the Inside Out,”

Q. WHAT GOT YOU STARTED ON YOUR CRUSADE FOR HOSPITAL SAFETY?

A. My father died at age 50 of cancer. He had lymphoma. But he was diagnosed with leukemia. When I was a first-year medical student here at Johns Hopkins, I took him to one of our experts for a second opinion. The specialist said, “If you would have come earlier, you would have been eligible for a bone marrow transplant, but the cancer is too advanced now.” The word “error” was never spoken. But it was crystal clear. I was devastated. I was angry at the clinicians and myself. I kept thinking, “Medicine has to do better than this.”

A few years later, when I was a physician and after I’d done an additional Ph.D. on hospital safety, I met Sorrel King, whose 18-month-old daughter, Josie, had died at Hopkins from infection and dehydration after a catheter insertion.

The mother and the nurses had recognized that the little girl was in trouble. But some of the doctors charged with her care wouldn’t listen. So you had a child die of dehydration, a third world disease, at one of the best hospitals in the world. Many people here were quite anguished about it. And the soul-searching that followed made it possible for me to do new safety research and push for changes.

Q. What exactly was wrong here?

A. As at many hospitals, we had dysfunctional teamwork because of an exceedingly hierarchal culture. When confrontations occurred, the problem was rarely framed in terms of what was best for the patient. It was: “I’m right. I’m more senior than you. Don’t tell me what to do.” With the thing that Josie King died from — an infection after a catheter insertion, our rates were sky high: about 11 per 1,000, which, at the time, put us in the worst 10 percent in the country.

Catheters are inserted into the veins near the heart before major surgery, in the I.C.U., for chemotherapy and for dialysis. The C.D.C. estimates that 31,000 people a year die from bloodstream infections contracted at hospitals this way. So I thought, “This can be stopped. Hospital infections aren’t like a disease there’s no cure for.” I thought, “Let’s try a checklist that standardizes what clinicians do before catheterization.” It seemed to me that if you looked for the most important safety measures and found some way to make them routine, it could change the picture.The checklist we developed was simple: wash your hands, clean your skin with chlorhexidine, try to avoid placing catheters in the groin, if you can, cover the patient and yourself while inserting the catheter, keep a sterile field, and ask yourself every day if the benefits of catheterization exceed the risks.

Q. WASH YOUR HANDS? DON’T DOCTORS AUTOMATICALLY DO THAT?

A. National estimates are that we wash our hands 30 to 40 percent of the time. Hospitals working on improving their safety records are up to 70 percent. Still, that means that 30 percent of the time, people are not doing it.

At Hopkins, we tested the checklist idea in the surgical intensive care unit. It helped, though you still needed to do more to lower the infection rate. You needed to make sure that supplies — disinfectant, drapery, catheters — were near and handy. We observed that these items were stored in eight different places within the hospital, and that was why, in emergencies, people often skipped steps. So we gathered all the necessary materials and placed them together on an accessible cart. We assigned someone to be in charge of the cart and to always make sure it was stocked. We also instituted independent safeguards to make certain that the checklist was followed.

We said: “Doctors, we know you’re busy and sometimes forget to wash your hands. So nurses, you are to make sure the doctors do it. And if they don’t, you are empowered to stop takeoff on a procedure.”

Q. HOW DID THAT FLY?

A. You would have thought I started World War III! The nurses said it wasn’t their job to monitor doctors; the doctors said no nurse was going to stop takeoff. I said: “Doctors, we know we’re not perfect, and we can forget important safety measures. And nurses, how could you permit a doctor to start if they haven’t washed their hands?” I told the nurses they could page me day or night, and I’d support them. Well, in four years’ time, we’ve gotten infection rates down to almost zero in the I.C.U.

We then took this to 100 intensive care units at 70 hospitals in Michigan. We measured their infection rates, implemented the checklist, worked to get a more cooperative culture so that nurses could speak up. And again, we got it down to a near zero. We’ve been encouraging hospitals around the country to set up similar checklist systems.

Q. IN YOUR BOOK, YOU MAINTAIN THAT HOSPITALS CAN REDUCE THEIR ERROR RATES BY EMPOWERING THEIR NURSES. WHY?

A. Because in every hospital in America, patients die because of hierarchy. The way doctors are trained, the experiential domain is seen as threatening and unimportant. Yet, a nurse or a family member may be with a patient for 12 hours in a day, while a doctor might only pop in for five minutes.

When I began working on this, I looked at the liability claims of events that could have killed a patient or that did, at several hospitals — including Hopkins. I asked, “In how many of these sentinel events did someone know something was wrong and didn’t speak up, or spoke up and wasn’t heard?”

Even I, a doctor, I’ve experienced this. Once, during a surgery, I was administering anesthesia and I could see the patient was developing the classic signs of a life threatening allergic reaction. I said to the surgeon, “I think this is a latex allergy, please go change your gloves.” “It’s not!” he insisted, refusing. So I said, “Help me understand how you’re seeing this. If I’m wrong, all I am is wrong. But if you’re wrong, you’ll kill the patient.” All communication broke down. I couldn’t let the patient die because the surgeon and I weren’t connecting.

So I asked the scrub nurse to phone the dean of the medical school, who I knew would back me up. As she was about to call, the surgeon cursed me and finally pulled off the latex gloves.

Q. WHAT CAN CONSUMERS DO TO PROTECT THEMSELVES AGAINST HOSPITAL ERRORS?

A. I’d say that a patient should ask, “What is the hospital’s infection rate?” And if that number is high or the hospital says they don’t know it, you should run. In any case, you should also ask if they use a checklist system.

Quote:Enter the SYSKID ('Systems biology towards novel chronic kidney disease diagnosis and treatment') project, which is determined to resolve these issues.

CKD is a serious disease that adversely affects a patient's well-being by triggering end-stage renal disease, cardiovascular complications and bone metabolism disorders. The SYSKID project partners say they will identify the molecular and cellular mechanisms responsible for the disease's development, and will combine this information with clinical risk factors, which in turn will shed light on the biomarkers of this disease.

The researchers note that the biomarkers will give the team the information they need to conduct preclinical studies into new treatment methods to stop the progression of CKD. The team will also obtain the materials required to develop and evaluate tools for early-stage diagnosis, and to monitor prognosis and therapy.

SYSKID brings together 25 leading research groups from Austria, Belgium, Denmark, France, Germany, Hungary, Ireland, Israel, Italy, the Netherlands, Poland, Spain, Switzerland, the UK and the US.

Quote:The rare spirits that went under the gavel at a recent online auction in New Zealand weren't aged brandies or hard-to-find liqueurs.

Instead, two glass vials purportedly containing the ghosts of two dead people sold for $2,830 New Zealand dollars ($1,983) at an auction that ended Monday night.

The "ghosts" were put up for bidding by Avie Woodbury from the southern city of Christchurch. She said they were captured in her house and stored in glass vials with stoppers and dipped in holy water, which she says "dulls the spirits' energy."

She said they were the spirits of an old man who lived in the house during the 1920s, and a powerful, disruptive little girl who turned up after a session with a spirit-calling Ouija board. Since an exorcism at the property last July led to their capture, there has been no further spooky activity in the house, she said.

The auction attracted more than 214,000 page views and dozens of questions before the winning bid, Trademe auction site spokesman Paul Ford said Tuesday. The name of the winning bidder was not released.

Woodbury said that once an "exorcist's fee" has been deducted, the proceeds of the spirit sale will go to the animal welfare group the Society for the Prevention of Cruelty to Animals.

Quote:The sole purpose of the parathyroid glands is to control calcium within the blood in a very tight range between 8.8 and 10.2. In doing so, parathyroids also control how much calcium is in the bones, and therefore, how strong and dense the bones are. Although the parathyroid glands are located next to (and sometimes inside) the thyroid gland, they have no related function.

The thyroid gland regulates the body’s metabolism and has no effect on calcium levels while parathyroid glands regulate calcium levels and have no effect on metabolism. Calcium is the element that allows the normal conduction of electrical currents along nerves--its how our nervous system works and how one nerve 'talks' to the next. Our entire brain works by fluxes of calcium into and out of the nerve cells. Calcium is also the primary element which causes muscles to contract.

Knowing these two major functions of calcium helps explain why people can get a tingling sensation in their fingers or cramps in the muscles of their hands when calcium levels drop below normal. A sudden drop in the calcium level (like after a successful parathyroid operation where the patient doesn't take their calcium pills for the first few days after the surgery) can cause patients to feel "foggy", "weird" or "confused like my brain isn't working correctly".

The brain DEMANDS a normal steady-state calcium level, so any change in the amount of calcium can cause the brain to feel un-loved and the patient to feel bad. Likewise, too much parathyroid hormone causes too high a calcium level--and this can make a person feel run down, cause them to sleep poorly, make them more irritable than usual, and even cause a decrease in memory.

In fact, the most common symptoms for patients with parathyroid disease are related to the brain, and include depression and lack of energy! After removal of a bad parathyroid gland, most people will feel dramatically better. Some say its like "someone turned the lights on". Most people don't feel good when their calcium level is above 10, and the vast majority of people will feel pretty darn tired and run-down when their calcium level is above 10.5.

NORMAL PARATHYROID ACTIVITY

Although the four parathyroid glands are quite small, they have a very rich blood supply. This suits them well since they are required to monitor the calcium level in the blood 24 hours a day. As the blood filters through the parathyroid glands, they detect the amount of calcium present in the blood and react by making more or less parathyroid hormone (PTH).

When the calcium level in the blood is too low, the cells of the parathyroids sense it and make more parathyroid hormone. Once the parathyroid hormone is released into the blood, it circulates to act in a number of places to increase the amount of calcium in the blood (like removing calcium from bones). When the calcium level in the blood is too high, the cells of the parathyroids make less parathyroid hormone (or stop making it altogether), thereby allowing calcium levels to decrease. This feed-back mechanism runs constantly, thereby maintaining calcium (and parathyroid hormone) in a very narrow "normal" range. In a normal person with normal parathyroid glands, their parathyroid glands will turn on and off dozens of times per day...in an attempt to keep the calcium level in the normal range so our brain and muscles function properly.

Those of us with normal parathyroid function will have calcium levels that are constant... with almost zero variability. For instance, if your calcium level is 9.6 this week and you have normal parathyroid glands, your calcium will be between 9.4 and 9.8 every time you measure it for most of your life. Contrast this with somebody that has a bad parathyroid gland. The bad parathyroid gland has lost it's regulatory system and these patients have calcium levels that bounce around from high to low, never the same number twice: up - down, up - down, up, up, down, up, up, down. The control system is lost in parathyroid tumors. This is hyperparathyroidism.

HOW DOES PARATHYROID HORMONE INCREASE BLOOD
CALCIUM ?

Like all endocrine glands, parathyroids make a hormone (a small protein capable of causing distant cells in the body to react in a specific manner). Parathyroid hormone (PTH) has a very powerful influence on the cells of the bones which causes them to release their calcium into the bloodstream. Calcium is the main structural component of bones which give them their rigidity.

the principle purpose of the bones is to provide a storage system for calcium--so our brain will never be without calcium. Under the presence of parathyroid hormone, bones will give up their calcium in an attempt to increase the blood level of calcium. Under normal conditions, this process is very highly tuned and the amount of calcium in our bones remains at a normal high level. Under the presence of too much parathyroid hormone, however, the bones will continue to release their calcium into the blood at a rate which is too high resulting in bones which have too little calcium. This condition is called osteopenia and osteoporosis and is illustrated in the bone segment on the top which has larger "pores" and less bone mass.

When bones are exposed to high levels of parathyroid hormone for several years they become brittle and much more prone to fractures. Another way in which the parathyroid hormone acts to increase blood levels of calcium is through its influence on the intestines. Under the presence of parathyroid hormone the lining of the intestine becomes more efficient at absorbing calcium normally found in our diet

Quote:A new device could help speed up an evacuation.

Entrepreneur Clifford Adkins invented the med sled in his basement.

"Well, we started with a hunting product actually," Adkins said.

The U.S. military requested them to remove injured troops from the streets of Baghdad. Then, 600 hospitals followed with orders of their own.

Some schools signed up for the sleds.

Because there's no carrying involved, a smaller person can pull a bigger person. It can also be dragged where ceiling tiles or bricks may litter the ground.

School staff members are now undergoing online and hands-on training.

High school teacher Morgan Burkes is grateful for sled.

"If ever something were to happen, it's a great asset to have something like that, to ensure that everyone gets out safely," Burkes said.

The sleds are also moving into nursing homes, corporations, federal buildings and even the funeral industry.

Quote:Men who work outdoors, enabling their bodies to create vitamins through exposure to sunlight, have a reduced risk of kidney cancer, researchers said today.

However, the study, published by the American Cancer Society, found that the reduced risk only applied to men – there was no drop in renal cancer among the women studied who worked outdoors.

The researchers, from the National Cancer Institute in the US, said the study of 2,500 workers in central Europe supported emerging evidence that the prevalence of a number of cancers, including breast, ovarian and colorectal cancer, was lower when people were exposed to ultraviolet light.

They said vitamin D, a known anti-carcinogenic, was carried by the body to the liver and on to the kidneys, and recommended further research.

"Scientific evidence suggests that vitamin D, which is generally made in the body after exposure to the sunlight, may help prevent a number of diseases including cancer," the research author, Sara Karami, said.

"In our study, we used job titles to estimate sunlight exposure at work. We observed that men with high estimated levels of sunlight exposure had a lower risk of kidney cancer than men who had lower estimated sunlight exposure at work."

Scientists have monitored an increase in renal cell carcinoma (RCC), the main form of kidney cancer, in the US and globally over the past 20 years.

A reduction in vitamin D – probably caused by many more people having sedentary lifestyles and indoor jobs – is believed to be likely to be a contributory factor.

The researchers studied more than 2,500 workers of Caucasian descent in Russia, Romania, Poland and the Czech Republic, splitting them into three groups according to exposure to daylight in their jobs.

A significant fall of up to 38% in the risk of RCC was found with increasing occupational UV exposure among men.

In northernmost regions, that increased to a 73% drop – but after finding no similar decrease in risk for women, Karami said: "We do not have an explanation for the apparent differences in risk between men and women."

"Biological or behavioural differences between men and women may play a role. For example, hormonal differences may influence the body's response to sunlight exposure, and men may be prone to working outdoors while shirtless."

Although some foods contain vitamin D, the majority of people receive up to 90% of the chemical through exposure to ultraviolet light.

Farm workers and those who receive strong UV light reflected from the sea were in the highest category. Those in high sunlight jobs were assumed to receive double the intensity of sunlight to those in low exposure jobs.

Despite the findings, the researchers warned against ignoring the "well-documented risks" of skin cancer resulting from excess exposure to the sun.

"There are no public health recommendations from this study. Men and women should continue to consult their health care providers regarding the appropriate amount of sun exposure, weighing the well-documented risks between sun exposure and skin cancer risk," Karami added.

Healthy Caucasians can generate a full dose of vitamin D with 10-20 minutes exposure to strong sunlight on unprotected skin. After that, photo-degradation ensures no higher levels are created.

The anti-carcinogenic properties of vitamin D include the prevention of tumour cell replication.

Quote:March 8, 2010-The Canadian Food Inspection Agency says it is tracing where a potentially tainted food additive was distributed in Canada and what products it was used in.

It's also assessing whether those products pose a health risk, though the agency says on its website that the risks related to this contamination "are considered to be very low."

The discovery of salmonella in processing equipment at a Las Vegas plant has sparked a recall of food products in Canada and the United States that contain a popular flavour enhancer.

Hydrolyzed vegetable protein is used in many processed foods, including soups, sauces, stews, dips and dressings.

Two types of veggie dip - T. Marzetti-brand Spinach and Southwest Ranch - and potato chips sold under the Hawaiian Kettle banner have been recalled in Canada. The list of recalled products in the United States is much longer.

The U.S. Food and Drug Administration has said it could potentially result in one of the largest food recalls in North America.

"We don't want to prejudge the investigation. We'll see what it bears out," said Tim O'Connor, a spokesperson with the Canadian Food Inspection Agency.

"And if any products are identified which pose a risk to consumers, a recall notice will be issued.

"There is concern in that this is a product used in a wide variety of products," O'Connor added. "The question becomes how much of this basic ingredient has been used in products, which are in Canada. And the investigation of that continues."

The agency also will look at which products were heat-treated after the ingredient was added and which weren't, O'Connor said. "And therefore, which pose a risk to consumers and then what is that level of risk?"

The ingredient is often added to processed foods, which are prepared using processes that kill salmonella, the agency noted. Many foods that contain the additive also are cooked by consumers in ways that would destroy the bacteria.

However, the agency said some ready-to-eat foods can be made in ways that wouldn't kill salmonella and might pose a risk to consumers if the recalled ingredient were used.

Basic Food Flavors Inc. of Las Vegas has recalled all the paste and powder hydrolyzed vegetable protein that it has produced since Sept. 17, 2009.

The Canadian Food Inspection Agency couldn't say yesterday how much of the potentially contaminated flavour enhancer was sent to Canada. It also didn't add any new products to the recall list.

Agency staff will talk to the companies that bought the flavour enhancer, said food safety recall specialist Davendra Sharma. Staff go through "the whole supply chain" to find out when, where and how much of the product was distributed, he said.

They also look at who received it and what they did with it. "Was it used to make some product where it was all cooked?" Sharma asked. "Then the bacteria would have been all killed. That's not a risk."

A risk assessment with Health Canada will determine whether a product requires any action, he said.

As for when the agency will know the complete picture in Canada, Sharma said: "It could take some time."

Quote:March is National Kidney Health Month in Canada and a perfect opportunity for British Columbians to learn more about the risks of kidney disease and the benefits of early diagnosis.

Approximately one in thirty British Columbians has some level of kidney disease, and many of these individuals are not aware that they suffer from kidney disease because there are no early symptoms.

“By increasing awareness of the risk factors for kidney disease, we hope more British Columbians will take action to protect their health,” said Health Services Minister Kevin Falcon. “Healthy lifestyle choices play an important role in kidney health and if kidney disease is identified early, it can often be managed through diet, medication and lifestyle adjustments, which can postpone and sometimes even prevent the need for dialysis.”

People living with kidney disease often do not know they are affected until their kidneys actually begin to fail. At that point their only treatment options are dialysis or a kidney transplant.

Early diagnosis and treatment for kidney disease can significantly delay and even prevent kidney failure and the need for dialysis. Reducing the chances of developing kidney disease starts with understanding the risk factors. These include:

• Having diabetes, high blood pressure or heart disease.

• Having a family history of kidney disease.

• Belonging to specific high-risk ethnic groups (Aboriginal, Pacific Islanders, Asians or of African descent).

“Early detection of kidney disease is essential to optimizing health outcomes for patients,” said clinical nephrologist Dr. Adeera Levin, executive director of the BC Provincial Renal Agency, an agency of the Provincial Health Services Authority. “With proper treatment, many patients with early stage kidney disease can manage their condition without ever needing dialysis.”

During National Kidney Month, the Kidney Foundation of Canada, BC Branch, will be conducting its annual March Drive fundraising initiative.

“This year we’re expecting up to 8,000 volunteers to be involved in the campaign, knocking on doors across the province to raise money and promote better understanding of kidney health,” says Lorraine Gerrard, executive director of the Kidney Foundation of Canada, BC Branch.

March 11 is World Kidney Day 2010, an internationally observed day dedicated to increasing awareness of kidney disease and promoting the benefits of early diagnosis