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Test For Strep Bacteria In Pregnant Women Misses More Cases Than Expected, Study Shows
A federal recommendation that all pregnant women undergo testing for Group B strep bacteria has helped increase the number of screenings but also has produced a high level of false negatives, according to a study published Thursday in the New England Journal of Medicine, the AP/Newark Star-Ledger reports. Group B strep is a common bacteria in the intestines or lower genital tract. Although it poses no harm to most adults, during delivery it can be spread to infants, who can develop blood infections, pneumonia, meningitis, mental retardation, hearing and vision loss, or death. Problems occur in fewer than one in 3,000 births, but the Centers for Disease Control and Prevention in 2002 issued a recommendation that all pregnant women be tested because of the potential for serious complications. The study is the first research to examine the screening program. The researchers examined data on Group B strep cases in 10 states, finding that 250 infants out of nearly 7,700 were born with the infection. They compared the results with a similar study that was conducted before the CDC recommendations were in place, finding that the screening rate rose from 48% to 85% of pregnant women. The study also found that infant infections from Group B strep declined by 27%.Researchers predicted there would be between 44 and 86 false negatives in full-term infants, based on data from previous studies. However, their results showed about 60% of infected infants -- 116 cases -- were born to women who had tested negative for Group B strep. Researchers noted that the timing of a Group B test might play a role because the infection can come quickly, and tests could have been performed before the bacteria appeared. CDC recommends that pregnant women be screened between 35 and 37 weeks" gestation. CDC researcher Stephanie Schrag, who co-authored the study, said, "Maybe it was a true negative test, and the mother later became colonized" with the bacteria before delivery (Stobbe, AP/Newark Star-Ledger, 6/17).
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Addictive 'Spice Gold' Causes Withdrawal Syndrome
A clinical report from Dresden supports the impression that "Spice Gold" is strongly addictive. In the current edition of Deutsches Arzteblatt International (Dtsch Arzteblatt Int 2009: 106[27]: 464-7), Ulrich S. Zimmermann, from Dresden Technical University, and his colleagues describe a young man who developed physical withdrawal symptoms after regular consumption of this designer drug, accompanied by a dependence syndrome.
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European Paediatric Influenza Analysis (EPIA) Group Formed To Quantify The Burden Of Seasonal Influenza In Children In Europe
The Netherlands Institute for Health Services Research (NIVEL) and SDI, a U.S. private-sector healthcare information company, announced the formation of the European Paediatric Influenza Analysis (EPIA) group, created to generate data needed to inform the decision process about paediatric influenza vaccination policy in individual European countries. Researchers from Denmark, England, Finland, Italy, the Netherlands, Scotland, Spain and Wales are participating; it is hoped that other countries will also join. EPIA was formed to address knowledge gaps highlighted in a recent European Centre for Disease Prevention and Control (ECDC) report that concluded that a key barrier to decision-making about paediatric flu vaccines is the lack of high-quality, European-specific data on disease burden, especially for young children. It is estimated by ECDC that at least 40,000 people die each year from influenza in the European Union (EU). EPIA will present the initial results from their research project at the 27th annual meeting of the European Society for Paediatric Infectious Diseases (ESPID) in June.
Medical Devices

Outcomes Improved By Early Mobilization Of Patients In ICU

Aside from the obvious and immediate health problems that patients undergoing mechanical ventilation face, those who recover often do so with profound loss of strength and mobility that can impair their daily functioning and even lead to increased risk of morbidity and mortality down the line. Now research shows that functional status may be restored earlier to ICU patients by performing daily interruptions in sedation paired with mobilization and exercise, as led by physical and occupational therapists. The study results were announced on May 17 at the 105th International Conference of the American Thoracic Society in San Diego. "Weakness and loss of functional independence - the inability to transfer from bed, walk and execute typical daily self-care activities, such as cleaning and dressing oneself - are commonly experienced among patients discharged from the intensive care unit," said William Schweickert, M.D., assistant professor of medicine in the Pulmonary, Allergy, and Critical Care Division at the University of Pennsylvania Medical Center. "This can result in major disability and protracted rehabilitation and may be accelerated or exacerbated by prolonged periods of immobility, especially among patients who undergo mechanical ventilation and sedation." "Because ICU-acquired weakness is associated with such poor outcomes and potentially exacerbated by deep sedation and immobility, we wanted to see whether mobilization begun in the earliest days of respiratory failure would improve patient function at hospital discharge and reduce delirium," he continued. Dr. Schweickert and colleagues conducted a randomized trial of 100 patients who were undergoing sedation and mechanical ventilation in the ICU. They compared patients who underwent a protocol of daily mobilization in conjunction with sedative interruption with those who underwent sedative interruption alone and therapy services as ordered by their primary care team. They found that patients who underwent the mobilization protocol were more frequently able to get out of bed, stand and occasionally walk with assistance during mechanical ventilation. The physical regimens prescribed by the primary care team, on the other hand, often began only after mechanical ventilation was no longer needed, potentially leading to a longer loss of functional status and a longer recovery time. The degree of functional loss in the control arm was substantial - only one third of patients left the hospital able to function independently. In contrast, nearly 60 percent of the early mobilization patients had achieved independence. "Overall, patients in the mobilization group were nearly twice as likely to regain their functional independence at hospital discharge and experienced less delirium than did their counterparts who did not receive the intervention," said Dr. Schweickert. "The benefits of pairing mobilization and sedative interruption from the inception of critical illnesses are substantial, but the improvements in function are not easily recognizable until about two weeks," observed Dr, Schweickert, adding that "starting these therapies early can be difficult in the context of ongoing critical illness, yet the data highlights that it can be done safely. We still need to test how this intervention and its findings translate into longer-term survival and better quality of life." Keely Savoie American Thoracic Society


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