Monday, May 07, 2007
I'm not really dead, just have not posted here in quite a while, due to uncontrollable circumstances keeping me from medical care for a number of months.
Or, as the Monty Python skit said:
"I'm not dead yet!"
Hmmm.... Then again,wasn't that followed by people saying "Well, he will be soon. He's very ill." and "You'll be stone dead in a moment?" Perhaps not the cheeriest of movies to reference...
Thursday, July 27, 2006
The Hindu News Update Service:
Patients with history of cancer at increased risk for acquiring and dying from sepsis
Hospitalized patients with a history of cancer are at a ten-fold increased risk of acquiring and subsequently dying from sepsis, a severe immune response to an infection, compared to hospitalized patients without cancer, according to research by investigators at the Emory University School of Medicine.
This press release issued by Eurekalert says that in addition, the risk for sepsis among male patients was found to be 30 percent greater than for female patients. The results are reported in the June issue of Chest, the peer-reviewed journal of the American College of Chest Physicians (ACCP). The study utilized data from 1979 to 2001 from the National Hospital Discharge Survey (NHDS) and the Surveillance, Epidemiology, and End Results (SEER) databases. The NHDS database from the years 1979 to 2001 included 854 million hospitalizations, of which 76.7 million involved a co-existing diagnosis of malignancy, and nearly 11 million involved sepsis.
That's a pretty significant size population.
Sepsis occurred in 2.3 percent of all the cancer patients, or 1.7 million patients. According to the study, during the 23-year study period, the number of sepsis cases in patients with cancer increased from 24,150 in 1979 to 87,160 in 2001, representing an increase of 261 percent during the study period.
That's also a scary percent of increase.
Of the sepsis patients with a history of cancer, gastrointrestinalmalignancies were most common at 24.4 percent, followed by lung (20 percent), lymphoma (14.1 percent), prostate (9.3 percent), and breast cancers (8.8 percent). Patients with pancreatic cancer were found to have the highest incidence of sepsis, even greater than for leukemia."
The culprit is the immune system. "Sepsis occurs when the intended protective and reparative immune response becomes exaggerated and causes problems throughout the body, such as acute renal failure and lung failure."
In the study, Emory investigators conclude that cancer is a strong independent predictor of mortality from sepsis due to compromised immune systems. The use of chemotherapy, radiation, or other immune modulating therapy employed to combat the underlying malignancy are some of the reasons for patients' increased susceptibility to sepsis.
"There is very little data on how sepsis affects cancer patients, although physicians generally feel that cancer patients are more susceptible to sepsis because the normal immune system is altered, either because of the cancer itself or because of chemotherapy. Based on the data in this paper, we now know that cancer is clearly one of those conditions that increases the risk for sepsis--in this case by 10 times."
Again, some scary numbers.
Dr. Martin also says that other findings from the research are important for physicians who take care of either cancer patients or sepsis patients. Care of sepsis patients requires antibiotics, usually prescribed based upon the suspected source of infection. For cancer patients, the source of sepsis is highly related to the type of cancer.
Lung cancer patients, for instance, are more likely to get respiratory infections as a cause of sepsis, while patients with prostate cancer are more likely to develop urinary infections and patients with gastro-intestinal malignancies are more likely to develop abdominal sepsis.
"This is potentially useful for physicians in both preventing infections that may cause sepsis, and in treating cancer patients who present with sepsis," Dr. Martin explained.
Not very cheerful news for those of us with a cancer diagnosis, is it?
The study also reveals that sepsis incidence rates are higher among cancer patients than among patients with other conditions commonly considered to increase the risk of sepsis.
Out of 100,000 cancer patients in the U.S., for example 1,075 developed sepsis, compared to 1,051 per 100,000 patients with HIV/AIDS or 701 per 100,000 patients with diabetes.
Sepsis patients with cancer overall had a 55 percent greater risk of dying than sepsis patients without cancer, and after adjusting for other factors that may influence the risk of dying (such as the type of infection or severity of illness), sepsis patients with cancer were twice as likely to die compared to sepsis patients without cancer.
"There is a striking increase in the risk of dying with sepsis that appears to be directly attributable to the diagnosis of cancer," Dr. Martin says.
Sunday, July 23, 2006
ScienceDaily: Risk Of Ventilator-associated Pneumonia Cut Significantly:
"Researchers found that administering the topical antiseptic chlorhexidine to critically ill patients on mechanical ventilation greatly decreased their daily risk of acquiring deadly hospital-related ventilator-associated pneumonia. The results appeared in the second issue for June 2006 of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.
Mirelle Koeman, M.D., Ph.D., of the Department of Emergency Medicine and Infectious Diseases at the University Medical Center Utrecht in the Netherlands, and 13 associates used chlorhexidine as an oral decontaminant paste to treat 127 intubated ventilated patients. The investigators treated a separate group of 128 ventilated patients with a paste composed of chlorhexidine and the antibiotic colistin. A third group of 130 ventilated patients were given a placebo paste.
In comparison to the placebo, the chlorhexidine paste reduced the risk of ventilator-associated pneumonia by 65 percent and the chlorhexidine/colistin combination cut the risk by 55 percent."
"The interventions tested cost less than $100 per patient, making them extremely cost effective," said Dr. Koeman.
This makes it possible to save lives rather than kill patients with hospital-acquired infections.
Saturday, July 22, 2006
ScienceDaily: Vitamin A Deficiency Linked To Major Intestinal Surgery:
"All three patients, who were all over the age of 65, had had extensive intestinal surgery between 20 and 35 years earlier.
The operations included intestinal bypass, surgical removal of diseased tissue as a result of inflammatory bowel disease, and gallbladder removal.
All the patients were diagnosed with vitamin A deficiency, and this was in spite of them having taken vitamin supplements."
The article goes on to mention that night blindness is one of the most common symptoms of vitamin A deficiency! Many of us that ignore this symptom and have had significant abdominal surgery (ever) should look into their status regarding this lipid-soluable substance.
Wednesday, April 12, 2006
LiveScience.com tells us:
Cancer in dinosaurs and illnesses in other animals are being studied in a groundbreaking new program that combines medical school with the study of natural history.
Despite being millions of years removed from our time and our own species, illnesses in animals like the dinosaurs can shed light on the evolution of human disease, says Christopher Beard, curator and specialist in vertebrate paleontology at Carnegie Museum of Natural History in Pittsburgh.
Some diseases that afflict humans today, such as malaria, gout, and cancer, are truly ancient and were handed down to us from our distant ancestors. By studying the distribution of these diseases in other living and fossil organisms, we can gain insights into the nature of these diseases.
Four curators from the Carnegie Museum will be teaching seminars and utilizing the museum collection which includes a 150-million-year-old fossilized dinosaur bone complete with a tumor.
Finding such a growth doesn't surprise surgeon and University of Southern California professor, Michael Kennedy, who said, "Cancer is the most common cause of death in animals. It is not a uniquely human disease."