Simple measures cut infections caught in hospitals

CHICAGO (AP) — Preventing surgery-linked infections is a major concern for hospitals and it turns out some simple measures can make a big difference.

A project at seven big hospitals reduced infections after colorectal surgeries by nearly one-third. It prevented an estimated 135 infections, saving almost $4 million, the Joint Commission hospital regulating group and the American College of Surgeons announced Wednesday. The two groups directed the 2 1/2-year project.

Solutions included having patients shower with special germ-fighting soap before surgery, and having surgery teams change gowns, gloves and instruments during operations to prevent spreading germs picked up during the procedures.

Some hospitals used special wound-protecting devices on surgery openings to keep intestine germs from reaching the skin.

The average rate of infections linked with colorectal operations at the seven hospitals dropped from about 16 percent of patients during a 10-month phase when hospitals started adopting changes to almost 11 percent once all the changes had been made.

Hospital stays for patients who got infections dropped from an average of 15 days to 13 days, which helped cut costs.

"The improvements translate into safer patient care," said Dr. Mark Chassin, president of the Joint Commission. "Now it's our job to spread these effective interventions to all hospitals."

Almost 2 million health care-related infections occur each year nationwide; more than 90,000 of these are fatal.

Besides wanting to keep patients healthy, hospitals have a monetary incentive to prevent these infections. Medicare cuts payments to hospitals that have lots of certain health care-related infections, and those cuts are expected to increase under the new health care law.

The project involved surgeries for cancer and other colorectal problems. Infections linked with colorectal surgery are particularly common because intestinal tract bacteria are so abundant.

To succeed at reducing infection rates requires hospitals to commit to changing habits, "to really look in the mirror and identify these things," said Dr. Clifford Ko of the American College of Surgeons.

The hospitals involved were Cedars-Sinai Medical Center in Los Angeles; Cleveland Clinic in Ohio; Mayo Clinic-Rochester Methodist Hospital in Rochester, Minn.; North Shore-Long Island Jewish Health System in Great Neck, NY; Northwestern Memorial Hospital in Chicago; OSF Saint Francis Medical Center in Peoria, Ill.; and Stanford Hospital & Clinics in Palo Alto, Calif.

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Online:

Joint Commission: http://www.jointcommission.org

American College of Surgeons: http://www.facs.org

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

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Wall Street cuts gains on "fiscal cliff" worry

NEW YORK (Reuters) - A young model was either insane, or a calculating, quick-thinking murderer who feigned mental illness when he killed and castrated his lover, a prominent Portuguese journalist, in their New York hotel room last year, a jury heard on Wednesday. No one disputes that Renato Seabra, 22, killed Carlos Castro, 65, in January 2011. Seabra pleaded not guilty by reason of insanity to a charge of second degree murder, and his trial reached closing arguments at Manhattan criminal court. ...
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Bombings Are Said to Kill Dozens Near Syria’s Capital


Francisco Leong/Agence France-Presse — Getty Images


Rebels celebrated on top of a downed Syrian jet in Daret Azzeh, 20 miles west of Aleppo, on Wednesday.







DUBAI, United Arab Emirates — Syrian state media said on Wednesday that 34 people and possibly many more had died in twin car bombings in a suburb populated by minorities only a few miles from the center of Damascus, the capital, as the civil war swirls from north to south claiming ever higher casualties. One estimate by the government’s opponents put the death toll at 47.




There were also reports from witnesses in Turkey and anti-government activists in Syria that for the second successive day insurgents had shot down a government aircraft in the north of the country, offering further evidence that the rebels are seeking a major shift by challenging the government’s dominance of the skies. It was not immediately clear how the aircraft, apparently a plane, had been brought down.


Video posted on the Internet by rebels showed wreckage with fires still burning around it. The aircraft appeared to show a tail assembly clearly visible jutting in the debris. Such videos are difficult to verify, particularly in light of the restrictions facing reporters in Syria. However, the episode on Wednesday seemed to be confirmed by other witnesses.


“We watched a Syrian plane being shot down as it was flying low to drop bombs,” said Ugur Cuneydioglu, who said he observed the incident from a Turkish border village in southern Hatay Province. “It slowly went down in flames before it hit the ground. It was quite a scene,” Mr. Cuneydioglu said.


Video posted by insurgents on the Internet showed a man in aviator coveralls being carried away. It was not clear if the man was alive but the video said he had been treated in a makeshift hospital. A voice off-camera says: “This is the pilot who was shelling residents’ houses.”


The aircraft was said to have been brought down while it was attacking the town of Daret Azzeh, 20 miles west of Aleppo and close to the Turkish border. The town was the scene of a mass killing last June, when the government and the rebels blamed one another for the deaths and mutilation of 25 people. The video posted online said the plane had been brought down by “the free men of Daret Azzeh soldiers of God brigade.”


On Tuesday, Syrian rebels said they shot down a military helicopter with a surface-to-air missile outside Aleppo and they uploaded video that appeared to confirm that rebels have put their growing stock of heat-seeking missiles to effective use.


In recent months, rebels have used mainly machine guns to shoot down several Syrian Air Force helicopters and fixed-wing attack jets. In Tuesday’s case, the thick smoke trailing the projectile, combined with the elevation of the aircraft, strongly suggested that the helicopter was hit by a missile.


Rebels hailed the event as the culmination of their long pursuit of effective antiaircraft weapons, though it was not clear if the downing on Tuesday was an isolated tactical success or heralded a new phase in the war that would present a meaningful challenge to the Syrian government’s air supremacy. In Damascus, the official SANA news agency said the explosions in Jaramana outside the city at around 7 a.m. were the work of “terrorists,” the word used by the authorities to denote rebel forces seeking the overthrow of President Bashar al-Assad. Photographs on the SANA Web site showed wreckage and flames in what looked like a narrow alleyway with cars covered in chunks of debris from damaged buildings. The agency said the bombings were in the main square of Jaramana, which news reports said is largely populated by members of the Christian and Druse minorities. Residents said the neighborhood is home to many families who have fled other parts of Syria because of the conflict and to some Palestinian families. The blasts caused “huge material damage to the residential buildings and shops,” SANA said.


The photographs on the Web site showed shattered windows at the Abou Samra coffee house and gurneys laden with injured clogging what seemed to be a hospital corridor.


SANA said two bombings in other neighborhoods caused minor damage. Activists reported that there were four explosions and said they were all “huge.”


Footage broadcast on Syria’s private Addounia channel and state television showed damage scarring gray, six-story apartment houses above tangles of wrecked cars as ambulances arrived to transport the wounded and rescuers playing fire hoses on the damage. The camera panned over bloodstained sidewalks.


The blasts seemed initially at least to shift the focus of the fighting from the north, where insurgents have claimed string of tactical breakthroughs in recent days, to areas ringing Damascus.


In the north in recent days, the insurgents also claimed to have seized air bases and a hydroelectric dam, apparently seeking both to expand their communications lines and to counter the government’s supremacy in the air.


The death toll from Wednesday’s bombings was not immediately confirmed. An activist group, the British-based Syrian Observatory for Human Rights, initially said that 29 people had died but revised the figure later to 47, of whom 38 had been identified. Of the 120 injured, the rebel group said, 23 people were in a serious condition, meaning that the tally could climb higher.


The explosions reflected the dramatic shift since Syria’s uprising began in March 2011 as a peaceful protest centered on the southern town of Daraa. It has since spread across the land in a full-blown civil war pitting government forces against a rebel army of Army defectors, disaffected civilians and what the authorities say are foreign jihadists.


Hala Droubi reported from Dubai, United Arab Emirates, and Alan Cowell from Paris. Sebnem Arsu contributed reporting from Istanbul, and Hania Mourtada from Beirut, Lebanon.



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Christina Aguilera Faces Major Blow on The Voice






The Voice










11/28/2012 at 10:30 AM EST







Dez Duron and Christina Aguilera (inset)


Tyler Golden/NBC (2)


Monday night on The Voice, the coaches were confident, but some of the contestants were seeing green.

After Amanda Brown and Trevin Hunte opened with Lady Gaga's "Marry the Night," the first save was revealed. An ecstatic Cassadee Pope from Team Blake celebrated her win, before Cee Lo Green treated viewers to another surprise – a duet with Kermit the Frog to the signature Muppet tune, "Bein' Green."

Voters also rescued Team Adam's Amanda Brown. After reveling in her victory, Melanie Martinez, Nicholas David, Terry McDermott and Bryan Keith joined her for a rendition of Plain White T's "Rhythm of Love."

Then Team Adam's Melanie Martinez got the good news she was safe for another night, followed by Cassadee Pope and Dez Duron's singing Rihanna's "Hate That I Love You." Team Cee Lo's Nicholas David then found out that he still has a spot on the show.

But with room for only two more singers, Team Cee Lo's Cody Belew said goodbye to The Voice, along with Team Christina's last remaining member, Dez Duron.

"You will always be on Team Xtina, and I will always support you," Aguilera told him.

Trevin Hunte and Terry McDermott rounded out the top six, which means they'll be performing again on Monday's show.

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CDC: HIV spread high in young gay males

NEW YORK (AP) — Health officials say 1 in 5 new HIV infections occur in a tiny segment of the population — young men who are gay or bisexual.

The government on Tuesday released new numbers that spotlight how the spread of the AIDS virus is heavily concentrated in young males who have sex with other males. Only about a quarter of new infections in the 13-to-24 age group are from injecting drugs or heterosexual sex.

The Centers for Disease Control and Prevention said blacks represented more than half of new infections in youths. The estimates are based on 2010 figures.

Overall, new U.S. HIV infections have held steady at around 50,000 annually. About 12,000 are in teens and young adults, and most youth with HIV haven't been tested.

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Online:

CDC report: http://www.cdc.gov/vitalsigns

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Wall Street pares losses after Boehner comments

'Tis the season of giving, and a grocery-store owner is doing just that. Joe Lueken, who owns and manages two grocery stores in Bemidji, Minnesota, and one in Wahpeton, North Dakota, is retiring at age 70. Instead of selling his stores to the highest bidder, though, he will transfer ownership to the stores' 400 or [...]
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Protesters Gather Again in Cairo Streets to Denounce Morsi





CAIRO — Thousands flowed into the streets of the capital Tuesday afternoon for a day of protest against President Mohamed Morsi’s attempt to assert broad new powers for the duration of the country’s political transition, dismissing his efforts just the night before to reaffirm his deference to Egyptian law and courts.




By early Tuesday afternoon in Cairo, a dense crowd of hundreds had gathered outside the headquarters of a trade group for lawyers, and thousands more had filed in around a small tent city in Tahrir Square. In an echo of the chants against Hosni Mubarak, then the Egyptian president, almost two years ago, they shouted, “Leave, leave!” and “Bring down the regime!” They also denounced the spiritual leader of the Muslim Brotherhood, the Islamist group allied with Mr. Morsi.


A few blocks away, in a square near the American Embassy and the Interior Ministry headquarters, groups of young men resumed a running battle that began nine days ago, throwing rocks and tear gas canisters at riot police officers. Although those clashes grew out of anger over the deaths of dozens of protesters in similar clashes one year ago, many of the combatants have happily adopted the banner of protest against Mr. Morsi as well.


Egyptian television had captured the growing polarization of the country on Monday in split-screen coverage of two simultaneous funerals, each for a teenage boy killed in clashes set off by disputes over the new president’s powers. Thousands of supporters of Mr. Morsi and his allies in the Muslim Brotherhood marched through the streets of the Nile Delta city of Damanhour to bury a 15-year-old killed outside a Brotherhood office during an attack by protesters, and in Tahrir Square in Cairo, thousands gathered to bury a 16-year-old killed in clashes with riot police officers and to chant slogans blaming Mr. Morsi for his death. “Morsi killed him,” the boy’s father said in a video statement circulated over the Internet.


“Now blood has been spilled by political factions, so this is not going to go away,” said Rabab el-Mahdi, a professor at the American University in Cairo and a left-leaning activist, adding that these were the first deaths rival factions had blamed on each other and not on the security forces of the Mubarak government since the uprising began last year. Still larger crowds were expected in the evening, as marchers from around the city headed for the square. Many schools and other businesses had closed in anticipation of bedlam, and on Monday, the Brotherhood called off a rival demonstration in support of the president, saying it wanted to avoid violence.


Egypt’s Supreme Judicial Council met again on Tuesday to consider its response to the president, and the leader of Al Azhar, a center of Sunni Muslim learning that is regarded as the pre-eminent moral authority here, met with groups of political leaders in an attempt to resolve the battle over the president’s decree and the deadlock in the constitutional assembly, which is trying to draw up a new constitution.


But even as Mr. Morsi met with top judges Monday night in an effort to resolve the crisis, a coalition of opposition leaders held a news conference to declare that preserving the role of the courts was only the first step in a broader campaign against what Abdel Haleem Qandeil, a liberal intellectual, called “the miserable failure of the rule of the Muslim Brothers.” Mr. Morsi “unilaterally broke the contract with the people,” he declared. “We have to be ready to stand up to this group, protest to protest, square to square, and to confront the bullying.”


Mr. Morsi’s attempt to remove the last check on his power over the political transition had brought the country’s fractious opposition groups together for the first time in a united front against the Brotherhood. But the show of unity papered over deep divisions between groups and even within them, said Ms. Mahdi of the American University.


“This is not a united front, and I am inside it,” she said. “Every single political group in the country is now divided over this — is this decree revolutionary justice or building a new dictatorship? Should we align ourselves with folool” — the colloquial term for the remnants of the old political elite — “or should we be revolutionary purists? Is it a conflict between the Muslim Brotherhood and the pro-Mubarak judiciary, or is this the beginning of a fascist regime in the making?”


Mayy El Sheikh contributed reporting.



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Kourtney Kardashian Hits the Beach with Daughter Penelope















11/27/2012 at 10:30 AM EST







Kourtney Kardashian and daughter Penelope


INF


It's scarf weather for Penelope Disick, even on the sunny beaches of Miami!

Kourtney Kardashian hit the sand Monday in Bal Harbour, Fla., just north of Miami Beach, with her 4-month-old daughter dolled up in a colorful printed headscarf – keeping the tot warm from the cool ocean breeze and fashionable for the reality-TV cameras.

Kourtney's partner, Scott Disick, and their son Mason, who will be 3 next month, were also on hand, with Disick sporting a mysterious monogrammed eyepatch – though there's been no report of him suffering an injury.

Kardashian, 33, and Disick, 29, welcomed Penelope Scotland back on July 8, saying they were "overjoyed to welcome our precious angel."

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Bounce houses a party hit but kids' injuries soar

CHICAGO (AP) — They may be a big hit at kids' birthday parties, but inflatable bounce houses can be dangerous, with the number of injuries soaring in recent years, a nationwide study found.

Kids often crowd into bounce houses, and jumping up and down can send other children flying into the air, too.

The numbers suggest 30 U.S. children a day are treated in emergency rooms for broken bones, sprains, cuts and concussions from bounce house accidents. Most involve children falling inside or out of the inflated playthings, and many children get hurt when they collide with other bouncing kids.

The number of children aged 17 and younger who got emergency-room treatment for bounce house injuries has climbed along with the popularity of bounce houses — from fewer than 1,000 in 1995 to nearly 11,000 in 2010. That's a 15-fold increase, and a doubling just since 2008.

"I was surprised by the number, especially by the rapid increase in the number of injuries," said lead author Dr. Gary Smith, director of the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio.

Amusement parks and fairs have bounce houses, and the playthings can also be rented or purchased for home use.

Smith and colleagues analyzed national surveillance data on ER treatment for nonfatal injuries linked with bounce houses, maintained by the U.S. Consumer Product Safety Commission. Their study was published online Monday in the journal Pediatrics.

Only about 3 percent of children were hospitalized, mostly for broken bones.

More than one-third of the injuries were in children aged 5 and younger. The safety commission recommends against letting children younger than 6 use full-size trampolines, and Smith said barring kids that young from even smaller, home-use bounce houses would make sense.

"There is no evidence that the size or location of an inflatable bouncer affects the injury risk," he said.

Other recommendations, often listed in manufacturers' instruction pamphlets, include not overloading bounce houses with too many kids and not allowing young children to bounce with much older, heavier kids or adults, said Laura Woodburn, a spokeswoman for the National Association of Amusement Ride Safety Officials.

The study didn't include deaths, but some accidents are fatal. Separate data from the product safety commission show four bounce house deaths from 2003 to 2007, all involving children striking their heads on a hard surface.

Several nonfatal accidents occurred last year when bounce houses collapsed or were lifted by high winds.

A group that issues voluntary industry standards says bounce houses should be supervised by trained operators and recommends that bouncers be prohibited from doing flips and purposefully colliding with others, the study authors noted.

Bounce house injuries are similar to those linked with trampolines, and the American Academy of Pediatrics has recommended against using trampolines at home. Policymakers should consider whether bounce houses warrant similar precautions, the authors said.

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Online:

Pediatrics: http://www.pediatrics.org

Trade group: http://www.naarso.com

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

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Market opens down on "fiscal cliff" caution

NEW YORK (Reuters) - Stocks opened slightly lower on as worry over the threat to the economy posed by the "fiscal cliff" offset optimism from a deal to ease Greece's debt burden.


The Dow Jones industrial average <.dji> dropped 33.02 points, or 0.25 percent, to 12,934.35. The Standard & Poor's 500 Index <.spx> shed 2.58 points, or 0.18 percent, to 1,403.71. The Nasdaq Composite Index <.ixic> lost 4.07 points, or 0.14 percent, to 2,972.71.


(Reporting by Chuck Mikolajczak; Editing by Kenneth Barry)


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