ReoPro for CVA’s

The University of Iowa is recruiting patients for participation “in a large multinational study testing Abciximab (ReoPro) in patients with acute ischemic stroke.”

Here’s a bit more about the study, excerpted from a News-Medical.net article.

Unlike other investigational treatments to open blocked arteries in stroke beyond three hours, abciximab can be given into a vein in the arm and requires no additional invasive procedures. “Abciximab has been used for years by cardiologists to help keep diseased coronary arteries open,” explains Dr. Bernstein. “If this treatment proves safe and effective in acute stroke, it could be used in any emergency room throughout the country. This could fundamentally change the way we treat this common and devastating disease.”

Participants are potentially eligible for this trial if they can receive study drug or placebo within 6 hours of stroke onset, or if they wake up from sleep with a stroke and can receive study drug or placebo within three hours of waking up.

Surgical Tools Washed in Hydraulic Fluid

As reported on CNN.com

“Surgical Tools Washed in Hydraulic Fluid”

RALEIGH, North Carolina (AP) — About 3,800 patients at two hospitals run by Duke University Health System were operated on last year with instruments that were washed in hydraulic fluid instead of detergent, hospital regulators said.

Duke Health Raleigh and Durham Regional hospitals put patients in “immediate jeopardy” in November and December by not detecting the problem, despite complaints from medical staff about slick tools, according to a report by the Centers for Medicare & Medicaid Services.

The hospitals did not fix the problem for weeks, said the agency, which oversees patient care at hospitals that receive payments from federal insurance programs.

The mix-up apparently occurred when an elevator company drained hydraulic fluid into empty detergent barrels last summer. The detergent supplier later picked up the barrels and mistakenly redistributed them as washing fluid.

Duke Health officials assured patients in January that the likelihood of infection from the tools was “no more than the risk normally associated” with the procedures that the patients underwent.

However, dozens of patients who were exposed to the surgical instruments have reported lingering health concerns ranging from fatigue and joint pain to problems requiring hospitalization, the The (Raleigh) News & Observer reported Sunday.

At least 50 patients who developed complications have taken their concerns to lawyers, though no one has sued Duke or the hospitals. Two lawsuits have been filed against the elevator company and the detergent supplier.

Duke Health officials declined to comment further, citing possible lawsuits.

Helping Families Cope With Sudden or Unexpected Death

This is the text of a Medscape Webcast Video Editorial (you have to register, but it’s free)

“Helping Families Cope With Sudden or Unexpected Death”

Physicians often do save lives, and their work as a healer is retold within the narrative of that person’s life and by their family. What role then should the physician play when, instead, death comes?

Sudden, unexpected death can deeply wound the lives of those left behind. Families of decedents become a physician’s “extended patient” in desperate need of care. The manner in which death is communicated has an indelible effect on the future well-being of families. Research demonstrates significant, often permanent, coping and adjustment difficulties from poorly delivered death notification. This moment is a one-time only opportunity for physicians to treat a wound that’s responsive only to kind humanity.

What can you do?

Accept death as the predictable, ultimate outcome of every patient’s life story.

Expand the meaning of being a healthcare professional to include working with death.

Learn to heal through caring when a cure is no longer possible.

Comprehend the lasting effect you have on families during death notification.

Realize the potential to reduce litigation by unhappy families through sensitive communication at this troubled time.

Recognize the tangible lifesaving benefits of increasing organ and tissue donation through compassionate death notification of potential donor families.

Identify the death notification opportunity to increase autopsy rates.

Develop standards for death notification procedures in your institutions.

Establish mandatory death notification training within your institution to assure competency and proficiency of all residents and other personnel whose task it is to notify next of kin of a death.

Physicians can be a positive or a negative component of a family’s death story. Be the positive.