vendredi 31 octobre 2014

6 Mass. Hospitals Collaborate On Ebola Response Plan

6 Mass. Hospitals Collaborate On Ebola Response Plan

An entrance to Beth Israel Deaconess Medical Center in Boston. The hospital is one of six in the state that have formed a collaborative system to handle Ebola patients. (Steven Senne/AP)


An entrance to Beth Israel Deaconess Medical Center in Boston. The hospital is one of six in the state that have formed a collaborative system to handle Ebola patients. (Steven Senne/AP)


Six Massachusetts hospitals have formed a collaborative system to handle Ebola patients, even though there have been no Ebola cases in the state and public health officials say the risk is “extremely low.”


The Department of Public Health announced Friday that Baystate Medical Center in Springfield as well Beth Israel Deaconess Medical Center, Boston Medical Center, Brigham and Women’s Hospital, Massachusetts General Hospital and Tufts Medical Center in Boston would accept transfers from other hospitals in Massachusetts based on existing referral relationships and capacity.


Commissioner Cheryl Bartlett says the collaboration “shows that Massachusetts health care providers are well prepared” and that the plan will help ease pressure on the few hospitals nationwide that have already treated Ebola patients.



Each of the state’s hospitals and their emergency departments are able to screen, identify and isolate suspected cases, and will coordinate with the state on risk assessment and transfers as needed.


Paul Biddinger, the medical director of emergency preparedness at Partners HealthCare, says Brigham and Women’s Hospital and Mass General are well prepared for the event of an Ebola patient.


“Hundreds of people at each hospital have spent incalculable hours in the necessary planning, training and practice efforts needed to respond to the challenges posed by this disease,” Biddinger said.


With reporting from the WBUR newsroom and the Associated Press. This post will be updated with additional reporting by WBUR’s Martha Bebinger.


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Why Not Scratch That Itch? Study Says Serotonin Is The Reason

Why Not Scratch That Itch? Study Says Serotonin Is The Reason

(Sarahluv via Compfight)


(Sarahluv via Compfight)


By Nicole Tay

CommonHealth intern


One thing I’ve learned about living in Boston is that the mosquitoes here are vicious. They fly around almost silently, and by the time you notice them, it’s too late; they’ve already made a snack of you.


In one particular case, I was driving home from work and noticed I had an unwelcome passenger. The commute turned into an anxiety-ridden nightmare: lots of swatting while driving and many awkward attempts to lure her out the window. This would not end well, I knew. Sure enough, when I got home, I had bites everywhere. (Apparently, Boston mosquitoes can bite you through tights?!)


The itching comes next. Everyone knows not to scratch bites and itches, but few of us have the superhuman self-discipline to resist the urge. I had even deluded myself into pseudo-scientifically justifying my scratching: “If scratching relieves itchiness, it’s obviously due to some beneficial neuronal pathway, right?”


Wrong. New research from Washington University School of Medicine in St. Louis says otherwise: Scratching can relieve itch by creating minor pain. But when the body responds to pain signals, that response actually can make itching worse.


In essence, when we scratch, the resulting pain interferes with the itchiness and the brain releases serotonin to quell that pain. The serotonin then binds to certain receptors on certain neurons that stimulate the itchy sensation. From the press release:



As part of the study, the researchers bred a strain of mice that lacked the genes to make serotonin. When those genetically engineered mice were injected with a substance that normally makes the skin itch, the mice didn’t scratch as much as their normal littermates. But when the genetically altered mice were injected with serotonin, they scratched as mice would be expected to in response to compounds designed to induce itching.



[To identify the specific serotonin receptor, senior investigator Zhou-Feng] Chen’s team injected mice with a substance that causes itching. They also gave the mice compounds that activated various serotonin receptors on nerve cells. Ultimately, they learned that the receptor known as 5HT1A was the key to activating the itch-specific GRPR neurons in the spinal cord.


To prove they had the correct receptor, Chen’s team also treated mice with a compound that blocked the 5HT1A receptor, and those mice scratched much less.


“We always have wondered why this vicious itch-pain cycle occurs,” Chen said. “Our findings suggest that the events happen in this order. First, you scratch, and that causes a sensation of pain. Then you make more serotonin to control the pain. But serotonin does more than only inhibit pain. Our new finding shows that it also makes itch worse by activating GRPR neurons through 5HT1A receptors.”



So if there’s a lesson to be learned here, it’s that your brain and natural biological reactions aren’t always correct — at least when it comes to itchiness.


NHS Employers: We will continue to fight for better pay

NHS Employers: We will continue to fight for better pay

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Cumbria mental health review will report on trust suicides

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BREAKING: Ministers take first steps to imposing contract deal on doctors

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HSJ Live 31.10.2014: Ministers take first steps to imposing a contract deal on doctors

HSJ Live 31.10.2014: Ministers take first steps to imposing a contract deal on doctors

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Against Odds, Menino Fought Successfully To Merge 2 City Hospitals

Against Odds, Menino Fought Successfully To Merge 2 City Hospitals

At rear left is Boston Mayor Thomas Menino, pictured standing near, Sen. Edward M. Kennedy, D-Mass., shakes hands with nurse Janet Killarney while visiting the Boston Medical Center in 2004. (Charles Krupa/AP)


At rear left is Boston Mayor Thomas Menino, pictured standing near, Sen. Edward M. Kennedy, D-Mass., shakes hands with nurse Janet Killarney while visiting the Boston Medical Center in 2004. (Charles Krupa/AP)


In 1996, it took all of Boston Mayor Thomas Menino’s political muscle to pull off what some consider a managerial miracle. Despite intense union opposition, a reluctant city council and concerns about health care costs, Menino fought successfully for the merger of two city hospitals that had been founded in the mid-19th century.



Today, Boston Medical Center stands as an enduring legacy to Menino’s efforts to serve the health needs of the city’s neediest citizens.


On Thursday a steady stream of ambulances, people in wheelchairs and children pushed in strollers entered and left the Menino Pavillion on the Boston Medical Center campus.


“Me and all my children go here. It’s a great hospital,” said Jasmine Vigo, who was leaving the Menino Center with her infant son.


“He was wheezing. I wanted to make sure it wasn’t like a viral infection or something like that. He didn’t,” she said.


Vigo said she had all four of her children in the Menino building.


The eight-story brick building, bearing the former mayor’s name, contains clinics for adults and obstetrics. Its emergency room is the busiest in the Northeast. Meanwhile, its pediatric clinic provides health care to 30,000 kids a year — and that’s just at this one building on the sprawling Boston Medical Center campus.



The building wasn’t always bustling that way. Dr. Ravin Davidoff recalled his impressions when he did his residency here 33 years ago.


“As I looked at this place, [I thought] ‘this has to be the most depressing place I’ve been.’ It was a really old, archaic place, [that is] Boston City Hospital [in] 1981,” he said.


Today, Davidoff is chief medical officer at Boston Medical Center. He credits then-Mayor Menino in 1996 for bringing about the merger of Boston Medical Hospital, which served the city’s poor, and Boston University Medical Center Hospital, which served to train physicians.


“We had two separate hospitals and most people felt it was impossible those two would ever come together,” Davidoff said. “Mayor Menino, through shear will and commitment to people and the place, would make that happen.


“He really wouldn’t take ‘no’ for an answer,” Davidoff recalled.


Menino’s mantra for the medical center was, “exceptional care without exception.” Half of the patients it serves are low-income patients, three times more than any other hospital in the city.


President and CEO of Boston Medical Center Kate Walsh recalled her job interview with the mayor.


“He had a number of questions, wanting to make sure I knew why Boston Medical Center was here and who we served and wanted to make sure frankly, I think, I was going to work as hard as he did every day,” she said.


Walsh says the Menino Pavillion is at the heart of Boston Medical Center.


Further senior leadership changes at Medway

Further senior leadership changes at Medway

WORKFORCE: A member of University Hospitals Birmingham Foundation Trust’s senior leadership team has taken a permanent post at Medway Foundation Trust in one of several changes to the troubled trust’s management.

Morbidly obese patients face restrictions under NEW Devon cost cutting plan

Morbidly obese patients face restrictions under NEW Devon cost cutting plan

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Majority of HR managers would support imposing a contract on doctors

Majority of HR managers would support imposing a contract on doctors

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Hunt: NHS has 'responsibility' to help councils

Hunt: NHS has 'responsibility' to help councils

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Unions announce second strike

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New optimal screening threshold for gestational diabetes in twin pregnancies: Ideal 1-hour 50-g glucose challenge test cutoff ≥135 mg/dl

A common complication, gestational diabetes affects approximately 6-7% of pregnant women. Currently, screening is done in two steps to help identify patients most at risk; however, the suggested levels for additional testing were based on singleton pregnancy data. Now investigators have analyzed data from twin pregnancies and have determined that the optimal first step cutoff for additional screening appears to be a blood sugar level equal to or greater than 135 mg/dL for women carrying twins.

New optimal screening threshold for gestational diabetes in twin pregnancies: Ideal 1-hour 50-g glucose challenge test cutoff ≥135 mg/dl

Take a walk in the sun to ease time change woes, sleep expert says

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Take a walk in the sun to ease time change woes, sleep expert says

Heart's own immune cells can help it heal

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Fetal alcohol spectrum disorders prevalence in U.S. revealed by study

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Fetal alcohol spectrum disorders prevalence in U.S. revealed by study

Hygienic funerals, better protection for health workers offer best chance to stop Ebola

Hygienic funeral practices, case isolation, contact tracing with quarantines, and better protection for health care workers are the keys to stopping the Ebola epidemic that continues to expand in West Africa, researchers said in a new report. They said broad implementation of aggressive measures they recommend could lead to its control in Liberia, the focal point, by mid-March.

Hygienic funerals, better protection for health workers offer best chance to stop Ebola

Genetic factors behind surviving or dying from Ebola shown in mouse study

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Genetic factors behind surviving or dying from Ebola shown in mouse study

High-intensity sound waves may aid regenerative medicine

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High-intensity sound waves may aid regenerative medicine

What do American babies eat? A lot depends on Mom's socioeconomic background

Dietary patterns of babies vary according to the racial, ethnic and educational backgrounds of their mothers, pediatrics researchers have found. For example, babies whose diet included more breastfeeding and solid foods that adhere to infant guidelines from international and pediatric organizations were associated with higher household income -- generally above $60,000 per year -- and mothers with higher educational levels ranging from some college to post-graduate education.

What do American babies eat? A lot depends on Mom's socioeconomic background