*SAFE INJECTION GLOBAL NETWORK* SIGNPOST *SAFE INJECTION GLOBAL NETWORK* Post00443 Cosmetic Injections + Abstracts + News 7 May 2008 CONTENTS 1. MMWR: Acute Renal Failure Associated with Cosmetic Soft-Tissue Filler Injections — North Carolina, 2007 2. Abstract: Complications after polymethylmethacrylate injections: report 3. Abstract: National incidence of percutaneous injury in Taiwan healthcare workers 4. Abstract: Sharps injuries and bloodborne pathogen exposures in home health care 5. Abstract: Do unsafe tetanus toxoid injections play a significant role in the transmission of HIV/AIDS? Evidence from seven African countries 6. Abstract: Social network-related risk factors for bloodborne virus infections among injection drug users receiving syringes through secondary exchange 7. Abstract: Cost of hospital-wide activities to improve patient safety and infection control: A multi-centre study in Japan 8. Abstract: Needlestick and sharps injuries among nursing students: an emerging occupational risk 9. Abstract: Biologic risk due to accident in academic personnel 10. Abstract: Needlestick injuries in a major teaching hospital: the worthwhile effect of hospital-wide replacement of conventional hollow- bore needles 11. Abstract: Needlestick injuries among nurses of Fars province, Iran 12. Abstract: Patient Pain and Tissue Trauma During Syringe Procedures: A Randomized Controlled Trial13. Abstract: The changing role of infection prevention practice as documented by the Certification Board of Infection Control and Epidemiology practice analysis survey 14. Abstract: A practical guide to venepuncture and blood sampling 15. Abstract: Prevalence of hepatitis C virus infection in hemodialysis patients 16. Abstract: Protection provided by clothing and textiles against potential hazards in the operating theatre 17. Abstract: Syringe disposal bins: the outcomes of a free trial for city traders in an inner-city municipality Australia 18. Abstract: Prevalence and predictors of injecting-related injury and disease among clients of Australia's needle and syringe programs 19. No Abstract: Evaluation of a novel 'needlecatcher' surgical instrument designed to reduce the incidence of needle stick injuries from suture needles during skin suturing 20. No Abstract: Nosocomial acquisition of the hepatitis C virus 21. No Abstract: 2008 National Patient Safety Goals... Communication is Key to Infection Control with Equipment 22. No Abstract: Cytomegalovirus mononucleosis after percutaneous injury in a Thai medical student 23. No Abstract: Call for ban on unsafe needles after inquest into nurse's death 24. News - India: Vaccine deaths: Lab gets clean chit - Russia: Russia Should Increase HIV Prevention Efforts Targeted at IDUs, UNAIDS Executive Director Piot Says - China: China's drug safety agency accuses US of shoddy investigation into tainted heparin - Canada: Spring can bring health risks in form of used syringes - USA: Health Department Releases Findings On Dr. Stokes' Patients - Canada: Expert: Safe injection site improves 'public order' - Focus on the World Blood Processing Supplies and Equipment Markets - Indonesia: Health ministry: 11,868 Indonesians infected with AIDS virus - The HIV epidemic in Eastern Europe and Central Asia examined at EECAAC II - USA: Second Doctor Told to Stop Practicing - USA: Judge Temporarily Bans Desai - USA: Infection Experts' Report Reveals the CDC'S Deadly Mistakes - India: Recycled syringes in valley market endanger lives - USA: Charges focus on contaminated needle: Former lab official in Angier accused - Kyrgyzstan: Breastfeeding Babies Infected with HIV in Kyrgyz Hospitals Pass Virus to Their Mothers This edition of SIGNpost is located at: http://uqconnect.net/signfiles/Archives/SIGN-POST00443.txt and is printer friendly. 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Subscribe or un-subscribe by email to: sign@uq.net.au, sign@who.int More information follows at the end of this SIGNpost! __________________________________________________________________________ __________________________________________________________________________ * Visit the WHO injection safety website and the SIGN Alliance Secretariat at: http://www.who.int/injection_safety/en/ Download the latest injection safety Best Practices review at: http://www.uqconnect.net/signfiles/Files/BestPracticesJul2003.pdf Use the Toolbox at: http://www.who.int/injection_safety/toolbox/en/ Get SIGN files on the web at: http://www.uqconnect.net/signfiles/Files/ SIGNpost archives: http://www.uqconnect.net/signfiles/Archives/?M=D __________________________________________________________________________ _____________________________________*____________________________________ 1. MMWR: Acute Renal Failure Associated with Cosmetic Soft-Tissue Filler Injections — North Carolina, 2007 Crossposted from the CDC Morbidity and Mortality Weekly Report (MMWR) with thanks. View the complete article (html) http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5717a1.htm Download the complete article (PDF): http://www.cdc.gov/mmwr/PDF/wk/mm5717.pdf __________________________________________________________________________ Morbidity and Mortality Weekly Report May 2, 2008 / Vol. 57 / No. 17 www.cdc.gov/mmwr Acute Renal Failure Associated with Cosmetic Soft-Tissue Filler Injections — North Carolina, 2007 Soft-tissue fillers are substances injected to augment or enhance the appearance of lips, breasts, buttocks, or other soft tissues. Previous reports have linked the administration of soft-tissue fillers, usually liquid silicone, by unlicensed practitioners to severe adverse events, including death (1–9). On December 27, 2007, the North Carolina Division of Public Health (NCDPH) was notified of three cases of renal failure occurring among women who had received cosmetic soft-tissue filler injections at a facility in North Carolina (facility A). This report summarizes the clinical findings for these cases and describes the subsequent public health investigation. All injections were administered by a practitioner with no medical training or supervision (practitioner A). Investigators were not able to identify the substances injected. Although records indicated that the injections contained liquid silicone, this substance has not been associated previously with renal failure. These findings underscore the risks posed by cosmetic injections administered by unlicensed practitioners. Public health officials should be alert for adverse events associated with these injections and take all necessary actions to prevent additional injuries. __________________________________________________________________________ _____________________________________*____________________________________ 2. Abstract: Complications after polymethylmethacrylate injections: report of 32 cases __________________________________________________________________________ Plast Reconstr Surg. 2008 May;121(5):1811-20. Complications after polymethylmethacrylate injections: report of 32 cases. Salles AG, Lotierzo PH, Gemperli R, Besteiro JM, Ishida LC, Gimenez RP, Menezes J, Ferreira MC. Division of Plastic Surgery, Faculty of Medicine, University of São Paulo, Brazil. agsalles@uol.com.br BACKGROUND: During the past 15 years, polymethylmethacrylate has been used as a synthetic permanent filler for soft-tissue augmentation. METHODS: This article reports 32 cases of complications seen at Hospital das Clínicas, Faculty of Medicine, University of São Paulo, for procedures performed elsewhere. RESULTS: The average age of the patients was 43.6 years (range, 22 to 70 years). Twenty-five patients were women. Sixteen injection procedures were performed by certified plastic surgeons, nine by dermatologists, two by urologists, and one by a nonphysician. Complications were classified into five groups according to main presentation as follows: tissue necrosis (five cases), an acute complication that can be related to technical mistakes but that can also be dependent on patient factors or caused by local infection; granuloma (10 cases), which usually presents as a subacute complication 6 to 12 months after the procedure; chronic inflammatory reactions (10 cases), which usually occur years later and can be related to a triggering event, such as another operation or infection in the area that was injected (these reactions are immunogenic in origin and may have cyclic periods of activation and remission); chronic inflammatory reaction in the lips (six cases), which may be present with severe symptoms, especially with lymphedema, because of mobility of the lip; and infections (one case), which are rare but possible complications after filling procedures. CONCLUSIONS: Polymethylmethacrylate filler complications, despite being rare, are often permanent and difficult or even impossible to treat. Safety guidelines should be observed when considering use of polymethylmethacrylate for augmentation. __________________________________________________________________________ _____________________________________*____________________________________ 3. Abstract: National incidence of percutaneous injury in Taiwan healthcare workers __________________________________________________________________________ Res Nurs Health. 2008 Apr;31(2):172-9. National incidence of percutaneous injury in Taiwan healthcare workers. Shiao JS, Lin MS, Shih TS, Jagger J, Chen CJ. Department of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan. We established a standardized surveillance system using the Chinese Exposure Prevention Information Network to estimate the frequency of percutaneous injuries (PCIs) in Taiwanese healthcare workers (HCWs). Fourteen hospitals employing 8,132 HCWs participated and a total of 583 PCIs were reported. The annual number was estimated to be 8,058 PCIs per hospital size, 8,100 per HCWs, and 8,286 per inpatient-day; indicating similar estimates using different denominators. The estimated annual frequency of pathogen-specific PCIs was 1,168 for hepatitis B, 1,263 for hepatitis C, and 59 for HIV. This study documents the annual incidence of PCI among HCWs showing important potential exposure to viral hepatitis and HIV in Taiwan. __________________________________________________________________________ _____________________________________*____________________________________ 4. Abstract: Sharps injuries and bloodborne pathogen exposures in home health care __________________________________________________________________________ AAOHN J. 2008 Jan;56(1):15-29; quiz 31-2. Sharps injuries and bloodborne pathogen exposures in home health care. Chalupka SM, Markkanen P, Galligan C, Quinn M. Department of Nursing, School of Health and Environment, University of Massachusetts Lowell, USA. Home health care is one of the fastest growing industries in the United States. Approximately 20,000 provider agencies deliver home health care services to 7.6 million individuals with acute illness, long-term health conditions, permanent disability, or terminal illness. The home health care setting poses many challenges that likely increase the risk of sharps injuries. Home health nurses face unique challenges in preventing and reporting sharps injuries in the home. This article examines the nature of and risk factors for sharps injuries in the home health care setting, the scope of the problem, the legislative and regulatory framework relevant to sharps injuries, and the role of occupational health nurses in promoting a culture of safety to prevent sharps injuries and bloodborne pathogen exposures. __________________________________________________________________________ _____________________________________*____________________________________ 5. Abstract: Do unsafe tetanus toxoid injections play a significant role in the transmission of HIV/AIDS? Evidence from seven African countries __________________________________________________________________________ Sex Transm Infect. 2008 Apr;84(2):122-5. Epub 2008 Jan 11. Do unsafe tetanus toxoid injections play a significant role in the transmission of HIV/AIDS? Evidence from seven African countries. de Walque D. Development Research Group, The World Bank, 1818 H Street, NW Washington, DC 20433, USA. ddewalque@worldbank.org OBJECTIVES: Although sexual transmission is generally considered to be the main factor driving the HIV/AIDS epidemic in Africa, recent studies have claimed that iatrogenic transmission should be considered as an important source of HIV infection. In particular, receipt of tetanus toxoid injections during pregnancy has been reported to be associated with HIV infection in Kenya. The objective of this paper is to assess the robustness of this association among women in nationally representative HIV surveys in seven African countries. METHODS: The association between prophylactic tetanus toxoid injections during pregnancy and HIV infection was analysed, using individual-level data from women who gave birth in the past five years. These data are from the nationally representative Demographic and Health Surveys, which included HIV testing in seven African countries: Burkina Faso 2003 (N = 2424), Cameroon 2004 (N = 2600), Ethiopia 2005 (N = 2886), Ghana 2003 (N = 2560), Kenya 2003 (N = 1617), Lesotho 2004 (N = 1278) and Senegal 2005 (N = 2126). RESULTS: Once the odds ratios (OR) were adjusted for five-year age groups and for ethnic, urban and regional indicators, the association between prophylactic tetanus toxoid injections during pregnancy and HIV infection was never statistically significant in any of the seven countries. Only in Cameroon was there an association between previous tetanus toxoid injection and HIV positivity but it became weaker (OR 1.53, 95% CI 0.91 to 2.57) once urban location and ethnic group were adjusted for. CONCLUSIONS: Although the risk of HIV infection through unsafe injections and healthcare should not be ignored and should be reduced, it does not seem that there is, at present and in the seven countries studied, strong evidence supporting the claim that unsafe tetanus toxoid injections are a major factor driving the HIV epidemic. __________________________________________________________________________ _____________________________________*____________________________________ 6. Abstract: Social network-related risk factors for bloodborne virus infections among injection drug users receiving syringes through secondary exchange __________________________________________________________________________ J Urban Health. 2008 Jan;85(1):77-89. Epub 2007 Nov 24. Social network-related risk factors for bloodborne virus infections among injection drug users receiving syringes through secondary exchange. De P, Cox J, Boivin JF, Platt RW, Jolly AM. Department of Epidemiology and Biostatistics, McGill University, 1020 Pine Avenue West, Montreal, H3A 1A2, QC, Canada. Prithwish.De@mail.mcgill.ca Secondary syringe exchange (SSE) refers to the exchange of sterile syringes between injection drug users (IDUs). To date there has been limited examination of SSE in relation to the social networks of IDUs. This study aimed to identify characteristics of drug injecting networks associated with the receipt of syringes through SSE. Active IDUs were recruited from syringe exchange and methadone treatment programs in Montreal, Canada, between April 2004 and January 2005. Information on each participant and on their drug-injecting networks was elicited using a structured, interviewer-administered questionnaire. Subjects' network characteristics were examined in relation to SSE using regression models with generalized estimating equations. Of 218 participants, 126 were SSE recipients with 186 IDUs in their injecting networks. The 92 non- recipients reported 188 network IDUs. Networks of SSE recipients and non- recipients were similar with regard to network size and demographics of network members. In multivariate analyses adjusted for age and gender, SSE recipients were more likely than non- recipients to self-report being HIV- positive (OR=3.56 [1.54-8.23]); require or provide help with injecting (OR=3.74 [2.01-6.95]); have a social network member who is a sexual partner (OR=1.90 [1.11-3.24]), who currently attends a syringe exchange or methadone program (OR=2.33 [1.16-4.70]), injects daily (OR=1.77 [1.11-2.84]), and shares syringes with the subject (OR=2.24 [1.13-4.46]). SSE is associated with several injection-related risk factors that could be used to help focus public health interventions for risk reduction. Since SSE offers an opportunity for the dissemination of important prevention messages, SSE-based networks should be used to improve public health interventions. This approach can optimize the benefits of SSE while minimizing the potential risks associated with the practice of secondary exchange. __________________________________________________________________________ _____________________________________*____________________________________ 7. Abstract: Cost of hospital-wide activities to improve patient safety and infection control: A multi-centre study in Japan __________________________________________________________________________ Health Policy. 2008 Apr 2 [Epub ahead of print] Cost of hospital-wide activities to improve patient safety and infection control: A multi-centre study in Japan. Fukuda H, Imanaka Y, Hayashida K. Department of Healthcare Economics and Quality Management, School of Public Health, Kyoto University Graduate School of Medicine, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan; Research Fellow of the Japan Society for the Promotion of Science, Japan. OBJECTIVE: The aim of this study was to assess the financial costs to hospitals for the implementation of hospital-wide patient safety and infection control programs. METHODS: We conducted questionnaire surveys and structured interviews in seven acute-care teaching hospitals with an established reputation for their efforts towards improving patient safety. We defined the scope of patient safety activities by use of an incremental activity measure between 1999 and 2004. Hospital-wide incremental manpower, material, and financial resources to implement patient safety programs were measured. RESULTS: The total incremental activities were 19,414-78,540 person-hours per year. The estimated incremental costs of activities for patient safety and infection control were calculated as US$ 1.100-2.335 million per year, equivalent to the employment of 17-40 full- time healthcare staff. The ratio of estimated costs to total medical revenue ranged from 0.55% to 2.57%. Smaller hospitals tend to shoulder a higher burden compared to larger hospitals. CONCLUSIONS: Our study provides a framework for measuring hospital-wide activities for patient safety. Study findings suggest that the total amount of resources is so great that cost-effective and evidence-based health policy is needed to assure the sustainability of hospital safety programs. __________________________________________________________________________ _____________________________________*____________________________________ 8. Abstract: Needlestick and sharps injuries among nursing students: an emerging occupational risk __________________________________________________________________________ G Ital Med Lav Ergon. 2007 Jul-Sep;29(3 Suppl):631-2. [Needlestick and sharps injuries among nursing students: an emerging occupational risk] [Article in Italian] Massaro T, Cavone D, Orlando G, Rubino M, Ciciriello M, Musti EM. Università degli Studi di Bari, Dipartimento Medicina Interna e Medicina Pubblica, Sezione Medicina del Lavoro Ramazzini, Bari. The biohazard represents a major occupational risk among workers in the health sector, this risk is not only exclusive for healthcare workers but involve also nursing students. The study reports data of a survey on injuries from accidental puncture in a group of 223 students of the third year of Nursing of Bari University. The 18% of students say they have suffered over the past 12 months an accidental puncture with sharp instruments. The cutting device most frequently involved is the needle from the syringe and insulin. The most at risk are the recovered and disposal of the needle. The biohazard in training is further compounded by factors such as lack of experience and skill manuals consolidated combined with a non perception of the risk. In the obligation of protection, training and information to students of Nursing, the University must implement programs aimed at both knowledge of the risks to which they are exposed, as well as security procedures to contain an emerging risk, which one of injury from sharp instruments, which are exposed young students not yet in employment. __________________________________________________________________________ _____________________________________*____________________________________ 9. Abstract: Biologic risk due to accident in academic personnel __________________________________________________________________________ G Ital Med Lav Ergon. 2007 Jul-Sep;29(3 Suppl):761-2. [Biologic risk due to accident in academic personnel] [Article in Italian] Davanzo E, Bruno A, Beggio M, Frasson C, Morandin M, Giraldo M, Borella- Venturini M, Trevisan A. Dipartimento di Medicina Ambientale e Sanità Pubblica, Università di Padova, Via Giustiniani 2, 35128 Padova. elisabettadavanzo@libero.it Needlestick injuries since 2004 to 2006 were evaluated in University healthcare workers that reported an accident by point, sharp or mucosal contamination. During this period, 497 accidents with instruments contamined with biological fluids were reported. The injuries were most frequent between 9 a.m. and 1 p.m. (233 accidents). There is no difference during the week (excluding Saturday and Sunday), whereas February, May, June, and July were the months at risk. The most of accidents were during the first four hours of the job. They were identified 423 known sources and compliance with follow-up was evaluated. Only 26.3% of subjects injured with known hepatitis B source, 32.3% with known HIV source, and 40% with known HCV source completed follow-up. Fortunately, no seroconversion was observed. The lack of compliance with the follow-up, also if the source is known, needs to stimulate healthcare workers to subject to the protocols and to follow the standard procedure to prevent the needlestick injuries. __________________________________________________________________________ _____________________________________*____________________________________ 10. Abstract: Needlestick injuries in a major teaching hospital: the worthwhile effect of hospital-wide replacement of conventional hollow- bore needles __________________________________________________________________________ Am J Infect Control. 2008 Apr;36(3):180-6. Needlestick injuries in a major teaching hospital: the worthwhile effect of hospital-wide replacement of conventional hollow-bore needles. Whitby M, McLaws ML, Slater K. Center for Healthcare Related Infection Surveillance and Prevention, Princess Alexandra Hospital, Brisbane, QLD, Australia. whitbym@health.qld.gov.au BACKGROUND: Needlestick injury (NSI) with hollow-bore needles remains a significant risk of bloodborne virus acquisition in health care workers. The impact on NSI rates after substantial replacement of conventional hollow-bore needles with the simultaneous introduction of safety- engineered devices (SEDs) including retractable syringes, needle-free intravenous (IV) systems, and safety winged butterfly needles was examined in an 800-bed Australian university hospital. METHODS: NSIs were prospectively monitored for 2 years (2005-2006) after the introduction of SEDs and compared with prospectively collected preintervention NSI data (2000-2004). RESULTS: Preintervention hollow-bore NSI rates over 10 years persisted at a constant rate between 3.01 and 3.77 per 100 full-time equivalent employees (FTE) (P = .31). Rates for 2005 (1.93; 95% CI: 1.48-2.47 per 100 FTE) and 2006 (1.50; 95% CI: 1.11-1.97 per 100 FTE) were significantly lower than the average rate for the preintervention years (3.39; 95% CI: 2.7-4.24 per 100 FTE, P = .00004). This represents a fall of 49% (43.1%-55.7%) in hollow-bore NSI, contributed to by the virtual elimination of NSI related to accessing IV lines. More importantly, high- risk injuries were also reduced 57% by retractable syringe use with an overall budgetary increase of approximately US $90,000 per annum. CONCLUSION: Introduction of SEDs results in an impressive fall in NSI with minimal cost outlay. __________________________________________________________________________ _____________________________________*____________________________________ 11. Abstract: Needlestick injuries among nurses of Fars province, Iran __________________________________________________________________________ Ann Epidemiol. 2007 Dec;17(12):988-92. Epub 2007 Oct 17. Needlestick injuries among nurses of Fars province, Iran. Askarian M, Shaghaghian S, McLaws ML. Department of Community Medicine, Shiraz University of Medical Sciences, The University of New South Wales, Sydney, Australia. askariam@sums.ac.ir PURPOSE: A prevalence survey was performed to estimate the magnitude and predictors for needlestick injury (NSI) in nurses of Fars province hospitals. METHODS: Questionnaires were distributed in 52 hospitals to a stratified random sample of 2,118 (46.3%) nurses between April and September 2005 to collect self-reported NSI in the past 12- months. RESULTS: Of the 1,555 nurses who returned a completed questionnaire, 49.6% (95% confidence interval [95 CI] 47.1%-52.1%) recalled at least one sharps injury, of which 52.6% were classified as NSI. Just over one fourth (26.3%; 95 CI 24.1%-28.6%, 409/1,555) of respondents sustained at least one NSI, 75.6% (95 CI 71.1%-79.6%) recalled having sustained between 1 and 4 injuries in the past 12-months, of which 72.2% involved a hollow-bore needle and 95.1% of injuries involved fingers. Predictors of NSI included being a registered nurse (odds ratio [OR] 1.6, 95% CI 1.1-2.3) or midwife (OR 2.4, 95% CI 1.4-3.9) compared with nurse managers, being employed in a hospital located in other cities smaller than Shiraz (OR 1.4, 95% CI 1.1-1.8). Nurses who reported a previous contaminated NSI were less likely to sustain a further injury (OR 0.3, 95% CI 0.2-0.4). CONCLUSION: The prevalence of NSI in Iranian nurses is high, with the majority of injured staff having sustained up to 4 NSIs in a 12-month period. Nearly all NSIs were high-risk injuries involving a hollow-bore needle. Providing nursing staff with safety-engineered devices, including retractable syringes when hollow-bore needles are to be used, will be an important step toward reducing our NSI epidemic. __________________________________________________________________________ _____________________________________*____________________________________ 12. Abstract: Patient Pain and Tissue Trauma During Syringe Procedures: A Randomized Controlled Trial __________________________________________________________________________ J Rheumatol. 2008 Apr 15 [Epub ahead of print] Patient Pain and Tissue Trauma During Syringe Procedures: A Randomized Controlled Trial. Moorjani GR, Michael AA, Peisajovich A, Park KS, Sibbitt WL Jr, Bankhurst AD. From the Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA. OBJECTIVE: To investigate the relationship of needle control to tissue trauma and hemorrhage during syringe procedures. METHODS: Forty-seven subjects with a palpable knee effusion underwent needle and syringe aspiration. Subjects were randomized to the conventional syringe or a safety technology, the reciprocating procedure device (RPD). This trial was registered at clinicaltrials.gov. Pain was measured with the Visual Analog Pain Scale (VAPS). Cell count, crystal examination, culture, and aspirated fluid volume were determined. Red blood cell (RBC) counts were used to measure blood in aspirated fluid. RESULTS: Patient pain during the syringe procedure significantly predicted blood (RBC) in aspirated fluid (r = 0. 53, p = 0.001). When compared to the conventional syringe, the RPD safety device reduced blood in aspirated fluid by 66.7% (RBC, 10(3)/ml: RPD 8.9 +/- 11.4; syringe 26.7 +/- 90.2; p 0.01), reduced patient pain by 73.9% (VAPS: RPD 1.68 +/- 2.34; syringe 6.44 +/- 2.86; p < 0.01), and improved fluid aspirate yield by 132% (aspirate volume: RPD 20.9 +/- 19.7 ml; syringe 9.00 +/- 6.58 ml; p < 0.01). CONCLUSION: Inadequate control of needle and syringe during physician- performed syringe procedures is an important cause of trauma to patient tissues resulting in hemorrhage, increased patient pain, and decreased aspirate yield. The RPD -- a safety device that improves needle control and decreases needle trauma to tissues -- reduces hemorrhage and improves the safety, outcome, and aspirate yield of physician-performed syringe procedures. __________________________________________________________________________ _____________________________________*____________________________________ 13. Abstract: The changing role of infection prevention practice as documented by the Certification Board of Infection Control and Epidemiology practice analysis survey __________________________________________________________________________ Am J Infect Control. 2008 May;36(4):241-9. The changing role of infection prevention practice as documented by the Certification Board of Infection Control and Epidemiology practice analysis survey. Curchoe R, Fabrey L, LeBlanc M. Unity Health System, Rochester, NY 14626, USA. rcurchoe@unityhealth.org BACKGROUND: The Certification Board of Infection Control and Epidemiology (CBIC) appointed an advisory committee to conduct a practice analysis (PA) of infection prevention and control professionals to identify current practices in place. The PA was also used to determine the need for an advanced practice examination. Results of the PA would assist in the development of a revised certification examination. METHODS: Nine thousand five hundred ninety (9590) e-mail surveys were distributed to infection control professionals (ICPs) in the United States and Canada as well as to a subsample of ICPs in Saudi Arabia. Decision rules and criteria were applied to each identified task in the PA. RESULTS: A total of 1304 responses were available for analysis, representing a response rate of approximately 21.8%. The majority of the respondents was certified in infection control, had a background as a registered nurse, worked in a community hospital, and had from 2 to 6 years experience, a notable change from the 2001 survey. Six major categories with 147 tasks were identified. Based on the 2005 PA results, research tasks were combined with education, which is consistent with the 2001 PA findings. CONCLUSION: The PA reflects current changes in the practice of infection prevention/control and epidemiology in the United States and Canada. The need for a separate advanced practice examination was not indicated from the survey results. The test specifications accepted for adoption by the CBIC will be used to build all examination forms for the certification program. __________________________________________________________________________ _____________________________________*____________________________________ 14. Abstract: A practical guide to venepuncture and blood sampling __________________________________________________________________________ Nurs Stand. 2008 Mar 26-Apr 1;22(29):29-36. A practical guide to venepuncture and blood sampling. Scales K. Imperial College Healthcare NHS Trust, Charing Cross Hospital, London. katie.scales@imperial.nhs.uk This article provides an overview of the knowledge and skills required for peripheral venepuncture, including anatomy and physiology, psychological issues, consent, vein selection, infection control, venepuncture technique, sharps disposal and the prevention and management of complications. A period of supervision and assessment of competency is required to consolidate this theoretical knowledge, and practitioners should comply with the policies and procedures of their organisation. __________________________________________________________________________ _____________________________________*____________________________________ 15. Abstract: Prevalence of hepatitis C virus infection in hemodialysis patients __________________________________________________________________________ Saudi J Kidney Dis Transpl. 2008 May-Jun;19(3):475-8. Prevalence of hepatitis C virus infection in hemodialysis patients. Taziki O, Espahbodi F. Department of Nephrology, Imam Khomeini Hospital, Mazandaran University, Sari, Iran. btaziki@yahoo.com. The prevalence of hepatitis C virus (HCV) infection in hemodialysis patients (HD) has decreased significantly during the past decade in most HD units. To evaluate the cause(s) of this reduction, we studied the HCV antibodies measurements in 1006 HD patients in the Province of Mazandaran, Iran, from January 2001 to December 2006. In December 2001, the prevalence of antibody to HCV was 18%, whereas by December 2006, it decreased to12%. Causes implicated in the reduction of prevalence of HCV infection in HD patients include a low percentage of new anti-HCV+ patients, a decrease in the conversion rate in HD patients, and more strict infection control measures in the dialysis units. __________________________________________________________________________ _____________________________________*____________________________________ 16. Abstract: Protection provided by clothing and textiles against potential hazards in the operating theatre __________________________________________________________________________ Int J Occup Saf Ergon. 2008;14(1):107-15. Protection provided by clothing and textiles against potential hazards in the operating theatre. Laing RM. Clothing and Textile Sciences, University of Otago, Dunedin, New Zealand. raechel.laing@otago.ac.nz The typical hospital and operating theatre present multiple potential hazards to both workers and patients, and protection against some of these is provided through use of various forms of clothing and textiles. While many standards exist for determining the performance of fabrics, most tests are conducted under laboratory conditions and against a single hazard. This paper provides an overview of selected developments in the principal properties of fabrics and garments for use in these workplaces, identifies the key standards, and suggests topics for further investigation. __________________________________________________________________________ _____________________________________*____________________________________ 17. Abstract: Syringe disposal bins: the outcomes of a free trial for city traders in an inner-city municipality Australia __________________________________________________________________________ Subst Use Misuse. 2008;43(1):139-53. Syringe disposal bins: the outcomes of a free trial for city traders in an inner-city municipality Australia. Devaney M, Berends L. Centre for Harm Reduction, Burnet Institute, Melbourne, VIC 3001, Australia. madonnad@burnet.edu.au Community responses toward discarded syringes have the potential to threaten the sustainability of harm reduction interventions. Many retailers in the central business district of Melbourne, Australia, have expressed concern about drug use and the associated discarded syringes. The Melbourne City Council has responded to these concerns through a variety of strategies. One such strategy was a 6-month free trial of syringe bins for businesses (2003-2004). The MCC commissioned an external evaluation of the trial. Eighteen business representatives and six key informants undertook semistructured interviews to monitor issues arising throughout the trial. Syringe disposal bins are a useful option for facilitating appropriate syringe disposal; 11 of the 13 businesses that participated in the trial continued with the maintenance of the syringe disposal bins beyond the free trial period. __________________________________________________________________________ _____________________________________*____________________________________ 18. Abstract: Prevalence and predictors of injecting-related injury and disease among clients of Australia's needle and syringe programs __________________________________________________________________________ Aust N Z J Public Health. 2008 Feb;32(1):34-7. Prevalence and predictors of injecting-related injury and disease among clients of Australia's needle and syringe programs. Topp L, Iversen J, Conroy A, Salmon AM, Maher L; Collaboration of Australian NSPs. Viral Hepatitis Epidemiology and Prevention Program, National Centre in HIV Epidemiology and Clinical Research, Faculty of Medicine, University of New South Wales, Darlinghurst, New South Wales. LTopp@nchecr.unsw.edu.au OBJECTIVE: To identify lifetime prevalence and predictors of self-reported injecting-related injuries and diseases (IRID) and/or injecting-related problems (IRP) among a national cross-sectional sample of injecting drug users. METHODS: 1,961 clients of 45 needle and syringe programs (NSPs) who participated in the 2006 Australian NSP Survey self-completed an item regarding lifetime experience of eight separate IRIDs and IRPs. RESULTS: Sixty-nine per cent of participants reported a history of IRID/IRP, with a mean of 1.9 injuries/problems (range 0-8). Lifetime prevalence of specific injuries/problems ranged from problems finding a vein (43%) to endocarditis (4%). Factors independently associated with IRID/IRP included bisexual identity; daily or more frequent injecting; injection of pharmaceutical preparations; female gender; longer injecting history; and hepatitis C antibody-positive serostatus. CONCLUSIONS: Consistent with existing literature, results suggest that vascular injury and localised infections are common among IDUs; and that treatment-seeking is often delayed until serious complications arise. IMPLICATIONS: Findings support the imperative for co-ordinated and timely treatment and prevention activities to reduce the severity and burden of these prevalent injecting outcomes. __________________________________________________________________________ _____________________________________*____________________________________ 19. No Abstract: Evaluation of a novel 'needlecatcher' surgical instrument designed to reduce the incidence of needle stick injuries from suture needles during skin suturing __________________________________________________________________________ Br J Dermatol. 2008 Mar;158(3):649-51. Epub 2008 Jan 17. Evaluation of a novel 'needlecatcher' surgical instrument designed to reduce the incidence of needle stick injuries from suture needles during skin suturing. Mckenna DJ, McGlennon S, McCallum M, Dolan OM. __________________________________________________________________________ _____________________________________*____________________________________ 20. No Abstract: Nosocomial acquisition of the hepatitis C virus __________________________________________________________________________ J Hepatol. 2008 Mar 31 [Epub ahead of print] Nosocomial acquisition of the hepatitis C virus. Forns X, Sánchez-Tapias JM, Bruguera M. Liver Unit, Hospital Clinic, ICMD, Ciberehd, IDIBAPS, Barcelona, Spain. __________________________________________________________________________ _____________________________________*____________________________________ 21. No Abstract: 2008 National Patient Safety Goals... Communication is Key to Infection Control with Equipment __________________________________________________________________________ Hall A. 2008 National Patient Safety Goals... Communication is Key to Infection Control with Equipment. Biomed Instrum Technol. 2008 Mar-Apr;42(2):140-1. No abstract available. __________________________________________________________________________ _____________________________________*____________________________________ 22. No Abstract: Cytomegalovirus mononucleosis after percutaneous injury in a Thai medical student __________________________________________________________________________ Am J Infect Control. 2008 Apr;36(3):228-9. Cytomegalovirus mononucleosis after percutaneous injury in a Thai medical student. Apisarnthanarak A, Mundy LM __________________________________________________________________________ _____________________________________*____________________________________ 23. No Abstract: Call for ban on unsafe needles after inquest into nurse's death __________________________________________________________________________ Nurs Stand. 2008 Feb 20-26;22(24):9. Call for ban on unsafe needles after inquest into nurse's death. Parish C. __________________________________________________________________________ _____________________________________*____________________________________ 24. News - India: Vaccine deaths: Lab gets clean chit - Russia: Russia Should Increase HIV Prevention Efforts Targeted at IDUs, UNAIDS Executive Director Piot Says - China: China's drug safety agency accuses US of shoddy investigation into tainted heparin - Canada: Spring can bring health risks in form of used syringes - USA: Health Department Releases Findings On Dr. Stokes' Patients - Canada: Expert: Safe injection site improves 'public order' - Focus on the World Blood Processing Supplies and Equipment Markets - Indonesia: Health ministry: 11,868 Indonesians infected with AIDS virus - The HIV epidemic in Eastern Europe and Central Asia examined at EECAAC II - USA: Second Doctor Told to Stop Practicing - USA: Judge Temporarily Bans Desai - USA: Infection Experts' Report Reveals the CDC'S Deadly Mistakes - India: Recycled syringes in valley market endanger lives - USA: Charges focus on contaminated needle: Former lab official in Angier accused - Kyrgyzstan: Breastfeeding Babies Infected with HIV in Kyrgyz Hospitals Pass Virus to Their Mothers Selected news items reprinted under the fair use doctrine of international copyright law: http://www4.law.cornell.edu/uscode/17/107.html __________________________________________________________________________ India: Vaccine deaths: Lab gets clean chit Kounteya Sinha and Pushpa Narayan,TNN,Times of India - India (06.05.08) NEW DELHI: Tests conducted by the Central Drug Laboratory (Kasauli) have given a clean chit to the measles vaccine which killed four 10-month-old babies in Tamil Nadu's Thiruvallur district on April 23. The Union health ministry had sent 20 vaccine samples for testing to CDL Kasauli. They were picked up from the fatal site in Tiruvallur and those lying with Human Biologicals Institute (Hyderabad) — the vaccine makers. Even though an official report from CDL Kasauli is yet to reach the ministry, two important initial tests — the abnormal toxicity test and the vaccine sterility test — have found the vaccine safe. The children had died within minutes of being administered the anti- measles vaccine at two medical camps in TN. The abnormal toxicity test, which saw the vaccine being injected into animals (five mice and two guinea pigs) did not kill them. In fact, the animals showed good health and weight gain confirming against toxicity of the vaccines. Scientists conducting the vaccine sterility test, to look for bacteria and fungal contamination, found “no contamination or presence of external pathogens in the vaccine which can cause untoward effects on humans”. These findings come days after TOI first reported that toxic shock syndrome (TSS) most likely killed the four children. The health ministry's five-member expert group, headed by additional director general Shiv Lal, said in its report that clinical and epidemiological investigations of the deaths revealed that all four children died of TSS, which usually occurs when the vaccine is contaminated. The committee, however, said the conclusion would have to be corroborated with the findings of CDL Kasauli. The seven-page report was prepared by Lal along with Safdarjung Hospital's R N Salhan, advisor to the drug controller general Charanjeet Sokhey, NIV Pune's Nitin Wadekar and joint director of NICD Uma Chawla. It was submitted to director general of health services (DGHS) R K Srivastava and health secretary Naresh Dayal on Monday. According to Lal, all four children died within 15 minutes of being vaccinated. The children became unconscious, with drooping head and frothy mouth. Their eyeballs were rolling and the death occurred suddenly. The final report from CDL Kasauli would reach the ministry in 10 days. Copyright © 2008 Times Internet Limited. .......................................................................... __________________________________________________________________________ Russia: Russia Should Increase HIV Prevention Efforts Targeted at IDUs, UNAIDS Executive Director Piot Says Kaisernetwork.org (06.05.08) Russia should increase efforts to address HIV/AIDS among injection drug users to slow the spread of the disease, UNAIDS Executive Director Peter Piot said on Saturday during a conference on HIV/AIDS in the former Soviet Union, Reuters reports. According to Reuters, the former Soviet Union has the third-highest number of people living with HIV/AIDS worldwide. IDUs account for about 80% of people living with HIV/AIDS in the region, and about one-third of IDUs in Uzbekistan are HIV-positive, Reuters reports. The region has "ploughed millions of dollars" into HIV prevention and treatment programs, and the number of new annual HIV cases decreased from 210,000 in 2001 to 150,000 in 2007. However, there has been a 150% increase since 2001 in the number of people living with the virus in the region to about 1.6 million. Russia has not invested in methadone clinics or needle-exchange programs to help slow the spread of HIV among IDUs, according to Reuters. In addition, HIV-associated stigma is still widespread in the country. Piot said that the "big difference" between HIV epidemics in the former Soviet Union and other regions is that injection drug use is "so widespread" in former Soviet countries "compared to other countries in the world." Piot added that although the region is "on the right path, the right trajectory," it "is at a critical point," and "some difficult decisions have to be made." At the conference, Piot also noted an increase in the number of women living with HIV/AIDS who are not IDUs or commercial sex workers -- a group previously considered less vulnerable to HIV. Women accounted for about 40% of new cases in Russia and Ukraine in 2007, nearly double the percentage in 2000, Piot said. "The question for me is: Is this the beginning of the generalization of HIV, is HIV getting out of the classic high-risk groups?" Piot asked (Kilner, Reuters, 5/3). .......................................................................... Russia Not Prepared To Implement Drug-Substitution Programs, Health Official Says In related news, Gennady Onishchenko, Russia's chief public health officer, on Monday said that the country is "not ready" to implement some HIV-prevention measures related to drug use. According to Onishchenko, regulations are not sufficient enough for some initiatives, such as methadone replacement therapy for heroin users, to run properly. He added that he is "not convinced" about the efficacy of substitution therapy, which is illegal in Russia under current regulations. Even if such programs were effective, the clinics would "turn into shops for drugs" because of inadequate law enforcement, Onishchenko said. However, Craig McClure, executive director of the International AIDS Society, said that there is much scientific evidence that supports the effectiveness of substitution programs. He added that such programs "could have a dramatic impact if implemented properly." In addition, Michel Kazatchkine -- executive director of the Global Fund To Fight AIDS, Tuberculosis and Malaria -- said that substitution therapy is a serious matter and should not become a political issue. "You have countries that are moving in the right direction ... and others that do not move," he said, adding, "Russia is like an isolated island. Where [injection] drug use drives over 60% of the epidemic, you cannot afford not to have a comprehensive approach." Some advocates also said that Onishchenko's comments reflect the attitudes of the Russian government and overall population. According to Kazatchkine, few members of the country's national legislature or dominant political party support substitution programs. He added that the Moscow government is conservative in its methods of addressing HIV/AIDS. "There is a basic lack of political support," Kazatchkine said. In addition, there is widespread stigma and discrimination against IDUs, according to Onishchenko. However, some advocates and officials say there has been some progress in Russia. Myths about HIV/AIDS are being addressed through measures such as television advertisements, McClure said. In addition, Russia has pledged about 9.3 billion rubles, or $392 million, for HIV/AIDS efforts in 2009 -- more than 20 times the amount spent in 2005. "The money is enough," Kazatchkine said, adding that the "question is whether the money is spent on the right things" (Nowak, AP/Google.com, 5/5). .......................................................................... __________________________________________________________________________ China: China's drug safety agency accuses US of shoddy investigation into tainted heparin The Associated Press, International Herald Tribune - France (06.05.08) BEIJING: China's drug safety agency accused the United States on Tuesday of stonewalling Beijing's investigation into a blood thinner linked to 81 deaths by refusing to provide details on victims and specifics about the later stages of drug production. Two Chinese experts who attended a conference on the drug, heparin, in suburban Washington, D.C., last month said the U.S. determined a contaminant was likely to blame without considering other possible factors. "We need to find the real reason," said Jin Shaohong, a member of the drug evaluation committee of China's Food and Drug Administration. "We need to resolve this in a scientific matter, not just by blaming a contaminant. I think it is too early to say that." Besides the deaths, hundreds of patients have suffered severe allergic reactions to large doses of heparin, which is commonly used in dialysis and other treatments. The U.S. Food and Drug Administration said it suspects the problems stem from a contaminant the agency discovered in supplies of raw heparin coming from China ? a compound derived from animal cartilage that so closely mimics heparin that routine purity tests can't detect it. The FDA did not immediately respond to China's concerns. Officials at Baxter International, the maker of heparin, said the company respectfully disagrees with China's position. "We've cooperated with all parties involved in the heparin situation and we will seek to understand any concerns to the contrary," said Erin Gardiner, a company spokeswoman. But the Chinese experts said U.S. officials and Baxter International refused to give them information to probe the possibility that drug interactions, patients' medical histories or safety issues after the raw material left China may have played a role. "At the conference, I asked and said, 'Can you tell me about some of these patients? Like among the 81, how many had kidney disease? ... How many had heart problems, or other problems like disease involving blood vessels in the brain?'" said Li Xuewang, a professor at Peking Union Medical College. "The response was there was no information, it could not be provided. It had to take several months of analysis before they could give it to us," he said, without specifying which officials had refused his request. Members of the Chinese delegation also visited the Baxter plant in Cherry Hill, New Jersey, where the finished drug is made, but were said they were denied details of how specific batches of the medicine were produced last fall. Baxter International told the visitors that samples from the batches in question had either been taken away by the FDA or destroyed, Jin said. "It is a such a big event and the case has not been closed yet, but they were all gone. It was no way to investigate further. I was so furious," he said. Gardiner said Baxter had agreed to provide Chinese officials with contaminated heparin samples when they visited the company's plant in New Jersey two weeks ago. At first, the company had to make sure it had enough samples to spare, but it has since confirmed that it would provide the samples, Gardiner said. China has said that the contaminant, over-sulfated chondroitin, may not be responsible because some patients received the tainted heparin but did not get sick. Meanwhile, other patients received dosages that did not contain the contaminant but still became ill, officials said. "Apart from the United States and Germany, more than 10 other countries using heparin products containing heparin-like substances (over-sulfated chondroitin) have not reported any cases of adverse reactions," Jin said. The investigation into the tainted heparin comes as China has been working hard to improve the safety of its exports after widespread allegations that many of its products ? from toys to fish ? are shoddy or dangerous. Raw heparin is derived from pig intestines, often processed by small, unregistered workshops in China. The raw ingredient for Baxter's heparin came from Wisconsin-based Scientific Protein Laboratories, which in turn owns a Chinese factory ? Changzhou SPL ? and buys additional raw heparin from other Chinese suppliers. Last month, the U.S. FDA warned Changzhou SPL the company does not have adequate systems for ensuring the raw materials it uses are safe and that any impurities are removed. The FDA noted as many as 12 companies in China are involved in the supply chain for heparin. Agency officials don't know at what point the contaminant was introduced. The heparin has been recalled by Baxter International and the FDA has blocked further imports from the Chinese company. .......................................................................... __________________________________________________________________________ Canada: Spring can bring health risks in form of used syringes Belleville Intelligencer - Belleville,Ontario,Canada (06.05.08) Spring brings green grass and flowers but it can also uncover some unwanted items, including used syringes, warns the health unit. The needles can carry HIV and hepatitis B and C viruses and can be left behind by intravenous drug users. "Children can come across a used needle in a park or other public place," said Bill Sherlock, a program manager with the Hastings and Prince Edward Counties Health Unit. "Teach your children what a syringe looks like and advise them never to touch one and to let an adult know if they see one." Being jabbed by a syringe is called a "needle-stick injury" and should be treated as a medical emergency, he said. Property owners have the legal responsibility for removing used syringes but they can get assistance from the health unit or police, Sherlock said. The health unit can provide a 'sharps' container to those who need one. The health unit said the people should follow certain steps if they come across a used needle: - Do not touch the needle. - If you do not have a sharps container, call for help at the local police department or the health unit at 613-966-5500. If the call is made before or after health unit business hours, follow the prompts and call the after-hours number. - Do not pick up the needle with your hands - use tongs or pliers instead. - Never put a needle into the garbage or recycling. If you are stuck by a needle: - Allow the wound to bleed freely. - Wash thoroughly with soap and warm water. - Disinfect the wound (for example, with an alcohol swab). - Cover the wound with a bandage. - Seek immediate medical attention at an emergency department. You may need testing and post-exposure medication. .......................................................................... __________________________________________________________________________ USA: Health Department Releases Findings On Dr. Stokes' Patients WWMT - Kalamazoo,MI,USA (02.05.08) GRAND RAPIDS (Newschannel 3) - Thousands of patients of a Grand Rapids- based dermatologist are breathing a sigh of relief, after finding out they most likely aren't at risk for suffering the consequences of needle reuse. Those thousands of people were patients of Dr. Robert Stokes. In November, health investigators broke the news that Stokes may have put thousands of patients at risk of contracting Hepatitis B, C or HIV, because he used the same needle for more than one patient. The Michigan Department of Community Health released its findings Friday, which are based on samples taken from 776 people who got tested at the free clinics set up by the health department. Of those tested, six tested positive for Hepatitis C, but investigators can't say for sure when those patients contracted the infection. None of the patients tested positive for either Hepatitis B or HIV. The samples only represent a fraction of the patients who received letters from the health department, and it's likely many of Stokes's other patients chose to be tested with their private doctors. Those results are not included in the findings. ......................................................................... __________________________________________________________________________ Canada: Expert: Safe injection site improves 'public order' CTV.ca News Staff CTV.ca - Canada (05.05.08) Vancouver's safe-injection site has not lowered or increased crime in the area, but has slightly reduced public drug use and saved taxpayers' money in health costs, according to a new report. Professor Neil Boyd, a criminologist at Vancouver's Simon Fraser University, said on Monday that Insite, the five-year-old safe-injection site, has not had a negative impact on its community. "We looked at crime rates in the area surrounding Insite, and we talked to business operators, we talked to service providers, to police, to residents in the surrounding vicinity. We found, overwhelmingly, people had very positive sentiments," he told CTV News. "Not only that, crime rates were quite unaffected by the implementation of Insite...In fact, we found some improvements in public order with respect to decreased injection debris, decreased injections around the site and those findings simply corroborated other research that had been carried out prior to our study." Boyd was commissioned last year by the federal government to study Insite's impact on crime rates in Vancouver's downtown east side. His research also showed: For every $1 spent on Insite, up to $4 of taxpayers' money is saved; The risk of contracting hepatitis C or HIV decreases as needle sharing is curbed; The use of detoxification services increases as Insite users are encouraged to seek treatment and counselling; and, Lives have been saved as Insite staff have been able to intervene during overdose events. Insite, believed to be North America's only supervised injection site, opened in 2003. It allows people to inject illegal drugs, including heroin and cocaine, under a nurse's supervision. It was able to open after it was granted a federal exemption from Canada's drug laws, which runs out at the end of June. More than 25 studies, published in some of the leading medical journals, have shown that it keeps health-care and law-enforcement budgets down while minimizing harm to addicts. "I don't think there's much doubt anymore," Boyd said. "We have to move to close this chapter and give Insite a long-standing exemption." Health Minister Tony Clement is expected to decide whether or not to extend Insite's exemption near the June 30 deadline. "I would urge Tony Clement to look carefully at the evidence, and I think if he does, he'll come to the conclusion that this isn't about enabling drug users. This is about helping a disadvantaged, very compromised population," Boyd said. Liberal public safety critic Ujjal Dosanjh said the government should not base its decision on ideological grounds, but on science and expert opinion. "The government should stop thinking and acting politically, and start acting responsibly for health reasons," he told CTV's Mike Duffy Live. "Insite has been studied to death -- literally. They should move on." Clement has said he wants more information about Insite before deciding whether to grant the program more government funding. "We're the government that actually wants more research ... because we want to make sure that this decision is the right decision for Canada, the right decision for addicts, the right decision for the community in Vancouver,'' he told the House of Commons Monday. Winnipeg MP Steven Fletcher, secretary to the health minister, has said the government will not base its decision purely on science, because the science is conflicting. He said Clement will have to consider the "realities of the situation." .......................................................................... __________________________________________________________________________ Focus on the World Blood Processing Supplies and Equipment Markets Market Wire (press release) - USA (05.05.08) LONDON, UNITED KINGDOM--(Marketwire - May 5, 2008) - Reportlinker.com announces that a new market research report related to the Medical devices industry is available in its catalogue. World Blood Processing Supplies and Equipment Markets This report analyzes the worldwide markets for Blood Processing Supplies and Equipment in Millions of US$. The major product segments analyzed are Blood Administration Sets, Blood Bank Freezers, Blood Bank Refrigerators, Blood Cell Processors, Blood Cell Washer Bags, Blood Collection Needles, Blood Collection & Micro Collector, Blood Collection Tube Adapter, Blood Donor Sets, Blood Filters, Blood Grouping Analyzers, Blood Lancets, Blood Sample Mailers, Blood Sampling Kits, Blood Tube Mixes, Blood Warming Coils/Pouches, Cleaning Solutions, Donor Blood (Blood Bank) Mix, Blood Grouping Reagents, Coagulation Reagents, Hematology Reagents, Hematology Stains, Control Plasmas, Hematocrit Centrifuges, Microscopic Slides, Sedimentation Tubes, Slide Stainers, Specimen Labels, Test Tube Racks, and Vials. The report provides separate comprehensive analytics for the US, Canada, Japan, Europe, Asia-Pacific, Latin America, and Rest of World. Annual forecasts are provided for each region for the period of 2000 through 2015. The report profiles 118 companies including many many key and niche players worldwide such as Fenwal Inc., Beckman Coulter, Inc., Becton, Dickinson and Company, Fresenius Kabi AG, Gambro BCT Inc., Haemonetics Corp, Immucor Inc., Pall Corporation, and Terumo Corporation. Market data and analytics are derived from primary and secondary research. Company profiles are mostly extracted from URL research and reported select online sources. Contents are at: http://www.marketwire.com/mw/release.do?id=852230 .......................................................................... __________________________________________________________________________ Indonesia: Health ministry: 11,868 Indonesians infected with AIDS virus Antara - Antara,Indonesia (03.05.08) Solo, Central Java (ANTARA News) - Up to March 2008, the total number Indonesians known to have been infected with the AIDS virus was 11,868, according to health ministry data. However, the real number of HIV patients in the country could be much higher than that recorded by the health ministry, Tjandra Yoga, the ministry`s director of infectious disease control, said here on Saturday when speaking in a symposium on "Fight TB-HIV/AIDS". Meanwhile, the number of those infected with HIV was estimated at 193,000 people, he said. If the government did not deal with the spread of HIV/AIDS, the number of HIV/AIDS patients could increase to around one million, he said. "The trend of HID/AIDS patients in Indonesia continues to increase," he said. In addition to unprotected sexual intercourse, most of the HIV/AIDS transmissions were caused by unsterilized needle and syringe exchanges among drugs users, he said. Copyright © 2008 .......................................................................... __________________________________________________________________________ The HIV epidemic in Eastern Europe and Central Asia examined at EECAAC II News-Medical.Net http://www.news-medical.net/?id=38011 (02.05.08) Starting tomorrow, the second Eastern Europe and Central Asia AIDS Conference (EECAAC II), the largest AIDS-focused event to date in the region, will bring together a wide range of private and public groups at a critical time in the fight against AIDS. EECAAC II is a collaborative effort hosted by the Federal Service on Surveillance Protection of Consumer Rights and Wellbeing of the Russian Federation, UNAIDS, the International AIDS Society and the Global Fund to Fight AIDS, Tuberculosis and Malaria. The conference will take place at the Moscow World Trade Center and will focus on "Accelerating Access to HIV Prevention, Treatment and Care for All." Improving the response to the HIV epidemic is necessary to ensure the wellbeing of future generations of young people throughout the region. Given the scale of the problem, a collective, multi-sectoral effort is required. Conference co-chair, Dr. G.G. Onishchenko stated, "Bringing together a broad range of professionals from governments, non-governmental organizations, science, medicine, and communities of people living with HIV is critical to ensuring a strong and sustained response. The Russian Federation is pleased to be able to host this meeting as a sign of its continuing strong commitment to combating AIDS in Russia, in the region, and globally." For three days, conference participants will review regional achievements, share results and focus on addressing the challenge of reducing the impact of the epidemic in the region. "Eastern Europe and Central Asia is at a critical turning point in the epidemic. There are strong indications of growing leadership and partnership among governments, civil society and communities," said Peter Piot, Executive Director of UNAIDS. "However HIV-related stigma and discrimination continues to hamper HIV prevention efforts in the region and renewed political action is needed if real progress is to be achieved." The HIV Epidemic in Eastern Europe and Central Asia: At a Crossroad Over the last decade, efforts to fight and treat HIV and AIDS have started to have a positive impact. According to the AIDS Epidemic Update Report released in December 2007 by UNAIDS and the World Health Organization, the estimated number of new HIV infections in the region fell from 230,000 in 2001 to 150,000 in 2007. But while the pace of the epidemic has slowed compared to 2000, the number of people living with HIV throughout the region continues to grow. Also, annual numbers of HIV diagnoses newly reported in 2006-2007 show an increase compared to previous years in Ukraine, the Russian Federation, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, the Republic of Moldova, Tajikistan and Uzbekistan. "Knowing the epidemic and better understanding the most vulnerable and affected populations will be the key to better targeting interventions, increasing effectiveness and sustaining existing momentum," said Michel Kazatchkine, the executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria. "We have a strong and growing momentum behind the response. However, we face new challenges as many countries transition programs from external to national funding." Civil society organizations have played a critical role throughout the region in reaching those most affected by HIV and accelerating access to and the effectiveness of prevention and treatment programs. Governments have also increased their support. For example, for 2006-2008, the Russian Federation provided $24 million to civil society organizations working in the area of HIV in addition to more than $800 million directed to other prevention, treatment and care programs and established the Governmental commission on HIV/AIDS, which includes civil society representatives and people living with HIV. In Ukraine, the president established a new National Coordination Council on HIV/AIDS, TB and Drug Addiction, which he personally chairs and civil society has been working in close collaboration with government to scale up access to voluntary counseling and testing. In Armenia harm reduction programs for injecting drug users have been implemented in partnership with civil society and now cover 60 percent of the targeted population and in Kazakhstan the National Program on Fighting the AIDS epidemic has been effective in providing antiretroviral therapy to 60 percent of those in need. "The International AIDS Society welcomes the strong commitment of the governments across Eastern Europe and Central Asia to tackling HIV," said Craig McClure, Executive Director, International AIDS Society. "Throughout the region many countries are in a state of economic and social transition. The evidence clearly shows that these conditions can increase vulnerability to HIV and it is therefore timely for governments to step up their commitment to the AIDS response." The conference will examine how current momentum can be sustained in the context of an expected decline in external funding, as well as the effects that this may have on the efforts of governments and NGOs, who have pioneered many life-saving initiatives, often with the help of external funding. The Changing Face of HIV in the Region EECAAC II will also explore three current trends in the epidemic's spread that have significant and new implications for the region: The feminization of the epidemic: the epidemic is affecting a greater number of women. In 2006, women accounted for about 40 percent of reported new cases. Young people are bearing the brunt of the epidemic: in a region already facing demographic challenges, more than 75 percent of people living with HIV in the region are under the age of 30. Increasing heterosexual transmission: 37 percent of reported new cases are a result of unprotected heterosexual intercourse. The issues, ideas and solutions discussed during EECAAC II will help to improve the joint regional response to the epidemic and inform and contribute to other major AIDS conferences in 2008, including the United Nations General Assembly High Level Meeting on AIDS in New York in June and the XVII International AIDS Conference in Mexico City in August. http://www.eecaac.org/ .......................................................................... __________________________________________________________________________ USA: Second Doctor Told to Stop Practicing Brian Haynes, Las Vegas Review-Journal (01.05.08) District Judge James Bixler on Wednesday signed a temporary restraining order prohibiting the practice of medicine by a second doctor linked to the state's clinic-based hepatitis C outbreak. The order bans Dr. Eladio Carrera, a co-owner of the now-closed Endoscopy Center of Southern Nevada, from practicing medicine while he is under investigation by the State Board of Medical Examiners. Last Friday, the board filed formal malpractice complaints against Carrera and Dr. Dipak Desai over their alleged roles in the outbreak. Seven cases of hepatitis C have been traced to the ECSN clinic at 700 Shadow Lane, and an eighth has been linked to the Desert Shadow Endoscopy Center at 4275 Burnham Ave. Investigators say the infections occurred when nurse anesthetists improperly reused syringes and contaminated anesthesia vials. District Judge David Wall issued an order Tuesday banning Desai from practicing medicine. Preliminary injunction hearings have been scheduled for Desai on May 8 and Carrerra on May 12. The case prompted the Southern Nevada Health District to warn 40,000 clinic patients of possible exposure to blood-borne diseases. .......................................................................... __________________________________________________________________________ USA: Judge Temporarily Bans Desai David Kihara, Las Vegas Review-Journal (30.04.08) District Court Judge David Wall on Tuesday signed a temporary restraining order prohibiting a doctor linked to the recent clinic-based hepatitis C outbreak from practicing medicine. On Monday, state Attorney General Catherine Cortez Masto sought the order against Dr. Dipak Desai on behalf of the Nevada State Board of Medical Examiners, which cited the need to "protect the public from further harm." Wall will decide on May 8 whether to issue a preliminary injunction against Desai, whose Endoscopy Center of Southern Nevada is at the center of the outbreak. Under an informal deal between Desai and Dr. Javaid Anwar, the board's president, Desai agreed to stop practicing medicine; however, he retained his license and could potentially practice in other states. Masto's separate request for a temporary restraining order against Eladio Carrera, a co-owner with Desai and two other physicians of the Shadow Lane endoscopy center, was pending Tuesday before Judge James Bixler. ......................................................................... __________________________________________________________________________ USA: Infection Experts' Report Reveals the CDC'S Deadly Mistakes Committee to Reduce Infection Deaths, Earthtimes - London,UK (14.04.08) NEW YORK, April 14 /PRNewswire-USNewswire/ -- On Wednesday, April 16th the House Committee on Government Oversight and Reform will hold a hearing on whether the federal government is doing enough to prevent hospital infections. The answer is no. "The Centers for Disease Control and Prevention consistently understate the size of the problem, and their lax guidelines give hospitals an excuse to do too little," says Betsy McCaughey, Ph.D., Chairman of the national Committee to Reduce Infection Deaths. (http://www.hospitalinfection.org/) How many hospital infections? "The CDC claims that 1.7 million people contract infections in U.S. hospitals each year. The truth is many times that number. The proof is in the data," explains McCaughey. 2.4% of all patients have MRSA (methicillin-resistant Staphylococcus aureus) hospital infections. That means 880,000 victims a year from one superbug! Furthermore, MRSA infections account for only 8% of hospital infections. "Imagine the numbers from bacteria of all kinds," says McCaughey. These new facts discredit the CDC's official number. "It's an irresponsible guesstimate based on a sliver of data from 2002. You can't responsibly deal with a health threat based on six-year-old data," McCaughey contends. The CDC is failing to set high standards for cleaning and screening - the two methods required to stop the rapid spread of germs from patient to patient. CDC fails to set cleanliness standards. Hospitals used to routinely test equipment and surfaces for bacterial contamination. The CDC (and the American Hospital Association) advised them to stop, saying it wasn't necessary. The infection toll proves that advice was wrong. Numerous studies link hospital acquired infections to unclean surfaces and equipment. Testing surfaces is so simple and inexpensive that it's used routinely in the food processing industry. "How can it be more important to test for bacteria in a hot dog factory than in an operating room?" asks McCaughey. CDC fails to call on all hospitals to screen for MRSA. Screening is necessary because patients who unknowingly carry the germ on their body shed it in particles on every surface. With screening, hospitals can identify the MRSA positive patients, and take steps to prevent the germ from spreading. Congress and seven state legislatures are considering making screening mandatory. Illinois, New Jersey, and Pennsylvania acted in 2007. Why is legislation needed? Because the CDC has failed to recommend that all hospitals screen. "It is common for government regulators to become soft on the industry they are supposed to regulate. A coziness develops. CDC administrators should spend less time with hospital executives and more time listening to grieving families," says McCaughey. Committee to Reduce Infection Deaths Copyright © 2008 PR Newswire. .......................................................................... __________________________________________________________________________ India: Recycled syringes in valley market endanger lives Tariq Ali Mir, GreaterKashmir.com - Srinagar,Jammu and Kashmir,India (12.04.08) Srinagar, April 12: Amid the government acting as mute spectator, many unscrupulous syringe manufacturing companies are playing with the lives of hundreds of innocent people by recycling the used syringes, highly placed sources in the Government Medical College Srinagar told Greater Kashmir. “Almost 80 percent of syringes on sale in medical outlets in the valley are clinically unsafe.” Many non-local labourers collect the used syringes and sell them to agents who then wash and pack them. “There is a good demand for these used syringes here,” a non-local labourer said. “The rates for these used syringes range from Rs 3 to Rs 4.” Most of labourers, especially the women could be seen collecting the syringes in the hospital and dispensary premises. Professor of pathology, at GMC Srinagar, Dr Nazir Mushtaq told Greater Kashmir that many of the cases of hepatitis-C were caused by using disposed syringes. “Government has provided automatic machines which destroy used syringes,” he said. “Strict guidelines, both in the government as well as private hospitals, nursing homes, have to be followed.” Dr Salim Khan of Social and Preventive Medicine (SPM) department, GMC Srinagar said that 70 to 80 per cent of the syringes used were unsafe. “Even some doctors prescribe injections where they could prescribe capsules and tablets,” he said. Quoting a survey, he said, that a person in valley used injections 5-6 times in a year on average. Dr Javaid Ahmad, in charge Syringe destroy Cell, GMC Srinagar said, our department has installed auto-destroyer in almost every hospital in the valley. “The employees seldom use these machines.” More than 2500 employees of the health departments were trained about the usage of this machine. “If the trend continues like this, it could prove a disaster in coming times,” he added. “The license of the doctors and the medical practitioners, who encourage the usage of disposed syringes, should be cancelled,” Tahir Muhammad, a social activist said. According to a report of the world health organization (WHO) more than 3 billion plastic syringes are used by people in India. While the syringe manufacturing companies have a capacity of 1.5 billion only. The report says that the deficit is net by many companies repacking the used syringes. .......................................................................... __________________________________________________________________________ USA: Charges focus on contaminated needle: Former lab official in Angier accused Titan Barksdale, News & Observer - Raleigh,NC,USA (10.04.08) FAYETTEVILLE - A former lab director in Angier will have to stand trial on charges linking him to contaminated syringes that made patients severely ill, a federal judge said Wednesday. Ravindra Kumar Sharma, a former quality control director at AM2PAT Inc, waived a hearing in a Fayetteville courtroom to review the charges against him. He will remain in federal custody while awaiting trial. According to court documents, Sharma is accused of approving the shipment of the contaminated syringes, purposely failing to conduct the proper tests meant to ensure that they were safe. "Sharma consistently falsified or directed others to falsify testing and production records of [syringes]," federal investigator Paul Pierce said in a criminal complaint. Sharma was arrested Friday and charged with introducing adulterated and misbranded drug devices with the intent to defraud. Rosemary Godwin, an assistant federal public defender representing Sharma, declined to comment. A spokeswoman at the defender's office was not available Wednesday afternoon. In December 2007, the Food and Drug Administration issued a release saying that the syringes, which were distributed nationwide, were contaminated with bacteria and that AM2PAT had issued a recall. The FDA warned that the bacteria found in some syringes "could present a serious adverse health consequence that could lead to life-threatening injuries or death." The FDA inspected the Angier site of AM2PAT and determined employees there "failed to have adequate controls to ensure necessary sterility of its pre-filled syringes," the release says. Despite the recall, several patients claim they were hospitalized with illnesses caused by the syringes. Lawsuits against AM2PAT, which closed its Angier site, are pending in Illinois. The Associated Press has reported that about 40 people got sick in Illinois and Texas -- including 20 outpatients from Rush University Medical Center in Chicago. The syringes typically contained blood thinner to prevent clots in the intravenous lines, a federal agent said in a criminal complaint against Sharma. They were used in hospitals and by outpatients. Studies performed by the Centers for Disease Control and Prevention linked the syringes to more than 100 illnesses and five deaths, Pierce said in the complaint. An unidentified employee said that Sharma never tested any syringes, though he was responsible for it, according to the complaint. The syringes were labeled as sterile and shipped. When a testing device broke in the lab, the employee said that Sharma told her to "just record a value," the complaint said. The testing device was broken between September 2006 and March 2007. Employees recorded false dates of the tests after authorization from an AM2PAT executive, the complaint said. AM2PAT Inc. is based in Illinois and focuses on manufacturing medical devices. The company had been in good standing, according to records filed with the Office of the Secretary of State for Illinois. The secretary's records list the company's president as Dushyant Patel. Telephone calls to a number listed for him in Illinois were not accepted. Sharma's next court appearance has not been scheduled. .......................................................................... __________________________________________________________________________ Kyrgyzstan: Breastfeeding Babies Infected with HIV in Kyrgyz Hospitals Pass Virus to Their Mothers Leila Saralayeva, Associated Press (09.04.08) In a dramatic rise from previous figures, Kyrgyz health officials said Wednesday a total of 72 children were infected with HIV at two hospitals in the country's southern region, along with 16 mothers. Earlier tallies had put the numbers at 41 children and six mothers. Health Minister Marat Mambetov said Tuesday that the infections, which began in the summer of 2006, had been contained. Investigators believe the children's infections stem from tainted blood and the multiple use of needles at hospitals in Osh and Nookat. Last month, charges were filed against 14 medical personnel accused of negligence in administering injections and blood transfusions. In some cases, the mothers were likely infected while breastfeeding their infants, said Uchkun Karimov, the prosecutor overseeing the case. While infection through nursing from child to mother is unusual, it is possible, AIDS experts say. The HIV-positive children are receiving antiretroviral treatment, though the infected mothers are not. Erkin Bakiyev, deputy director of the national AIDS center, said the mothers are not entitled to the drugs if they are in the first clinical stages of infection. Many in this impoverished Central Asian nation cannot afford to buy the drugs themselves. "These women are having huge financial difficulties," said Fatima Koshokova, director of the nongovernmental group Rainbow, which provides free legal assistance to people living with HIV/AIDS. "The husbands of many of these women leave when they learn the diagnosis, and these women are left alone with their grief," said Fatima Khabibullina, a Rainbow lawyer. Many do not qualify for welfare since they are legally married. Their HIV-infected children are entitled to 840 soms (US $23) monthly, a pittance even for Kyrgyzstan. __________________________________________________________________________ _____________________________________*____________________________________ __________________________________________________________________________ * SAFETY OF INJECTIONS brief yourself at: www.injectionsafety.org More information on the prevention of injection-associated infections can be obtained on the WHO web site at http://www.who.int/inf-fs/en/fact231.html and in French at http://www.who.int/inf-fs/fr/am231.html , on the web site of SIGN at www.injectionsafety.org and at the SIGN Secretariat, the Department of Essential Health Technologies, WHO, Avenue Appia 20, CH-1211 Geneva 27, Switzerland. Telephone: +41 22 791 3680, Facsimile: +41 22 791 4836, E- mail: sign@who.int _____________________________________*____________________________________ __________________________________________________________________________ SIGN meets annually to aid collaboration and synergy among SIGN network participants worldwide. The SIGN 2007 annual meeting was held 23 - 25 October in Geneva Switzerland. The final report of the November 2005 meeting is available for download from the SIGN website. The file is 773 KB and is in Adobe Acrobat format. http://www.who.int/entity/injection_safety/Final-SIGNHanoiReport7Feb06.pdf Many SIGN files can be opened in Acrobat Reader. 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