One of the things that I personally don't like about basic blogging software is the way good articles can slip down out of sight, forcing the visitor to search through month by month to see what else has been covered on a blog. While reading a techy advice blog, I found they suggested an idea that I'd been considering myself - a greatest hits list. This would be a summary of earlier articles that had proved popular over the last year, giving visitors an easy way to catch up on what they'd missed.
So here are our most viewed articles, with normalised viewing figures instead of the actual views - that means I've given the most viewed one 100%, and compared the others with that article's views. It was going to be a Top Five list, but three articles were very close in the number of views, to I made it a Top Seven instead.
Portable dialysis machine Dec 2009 - 100%
This topic in general seems to have quite a few web pages devoted to different designs, but this particular design seemed to crop up quite often in Google.
Implantable Artificial Kidney - coming soon Sept 2010 - 84%
Although this is a recent article, it has grabbed second place due to the huge amount of interest such a device has created and how useful it would be. Let's hope its future is as bright as its developers hope.
Vitamin E helps fight muscle cramps during dialysis Nov 2009 - 78%
With around 20% of patients suffering from cramp during dialysis, this article attracted a fair bit of attention.
Fresenius gets another warning Oct 2010 - 66%
Their claimed failure to deal properly with problem items already out in the field generated some bad publicity for this well-known supplier.
Drug hope for Polycystic Kidney Disease Sufferers Sept 2010 - 57%
I suppose any good news about a new drug showing hope automatically attracts attention.
Location, location, location July 2010 - 56%
This article showed that where you lived had a big effect on how well you were treated. There were two such articles in short succession (one about the US and the other about the UK), and the link shows both of them.
Baxter Recalls Peritoneal Dialysis Solutions Dec 2010 - 55%
Another big supplier has problems with its products. For such a recent article to feature in the top seven shows that patients are trying to keep up to date on these product recall stories.
So if you've missed them, give these articles a read.
Monday, 3 January 2011
Saturday, 18 December 2010
Baxter Recalls Peritoneal Dialysis Solutions
This only applies to European supplies, according to an update.
A Reuters article reported the following news, on 17 December 2010.
Baxter has recalled the following products, due to the potential presence of endotoxins - Dianeal, Extraneal and Nutrineal. According to a spokesperson of the European Medicines Agency "Although the number of batches affected is likely to be low, the agency's Committee for Medicinal Products for Human Use has concluded that current stocks should be replaced, because it is not possible to identify which bags are affected."
There is a risk that patients who receive solutions containing endotoxins may develop aseptic peritonitis. The toxins are thought to have been caused by bateria settling on microscopic cracks in two tanks used in the production of these solutions, at their Irish factory in Castlebar.
A Reuters article reported the following news, on 17 December 2010.
Baxter has recalled the following products, due to the potential presence of endotoxins - Dianeal, Extraneal and Nutrineal. According to a spokesperson of the European Medicines Agency "Although the number of batches affected is likely to be low, the agency's Committee for Medicinal Products for Human Use has concluded that current stocks should be replaced, because it is not possible to identify which bags are affected."
There is a risk that patients who receive solutions containing endotoxins may develop aseptic peritonitis. The toxins are thought to have been caused by bateria settling on microscopic cracks in two tanks used in the production of these solutions, at their Irish factory in Castlebar.
Friday, 3 December 2010
Cost Comparison of Peritoneal Dialysis Versus Hemodialysis
Looking through some old links I'd collected, I came across a research paper from 2009. It makes interesting reading.
The article covers a cost comparison study looking at patients who started on dialysis between January 1st 2004 and December 31st 2006. It examined 463 patients, and paired up those on peritoneal dialysis with those in equivalent health on hemodialysis - it's important is such studies to match equivalent patients, to remove other variables from any differences found.
Because in the United States most dialysis patients have their costs paid by the Medicare ESRD system, there was a lot of data available for analysis by the researchers, who examined the use and cost of healthcare services during a 12-month period.
On a per-patient basis, those initiating dialysis with HD averaged 20 more outpatient visits over 12 months compared with matched patients in the PD group. The HD patients also had nominally more ED visits (mean [95% CI], 3.3 [2.1-5.0] vs 2.3 [1.3-3.5] for PD; P = .28). Over the 12-month period of follow-up, more HD patients were hospitalized (80% vs 50% for PD, P <.01).
The median (IQR) total per-patient healthcare costs were $43,510 higher among HD patients than among PD patients over 12 months ($173,507 [$98,706-$335,719] vs $129,997 [$73,212-$207,578], P = .03). Many of the cost differences between hemodialysis patients and peritoneal dialysis patients were quite spectacular. Such as the median (IQR) per-patient inpatient costs were $39,851 ($6089-$140,125) for HD patients versus $651 ($0-$40,591) for PD patients (P <.01). Read that again. You didn't imagine it. Read it again!
So given these costs, you might wonder a bit about the following statistic:
PD was the initial dialysis modality for only about 12% of patients in the study. In prior research, 7% to 27% of patients with ESRD in the United States have been reported to initiate dialysis with PD.
And yet peritoneal dialysis is significantly less expensive! And PD patients are much less likely to be hospitalised.
It makes you wonder if someone is suggesting to doctors that hemodialysis is a better choice, perhaps encouraging them to send patients to an HD clinic.
The article covers a cost comparison study looking at patients who started on dialysis between January 1st 2004 and December 31st 2006. It examined 463 patients, and paired up those on peritoneal dialysis with those in equivalent health on hemodialysis - it's important is such studies to match equivalent patients, to remove other variables from any differences found.
Because in the United States most dialysis patients have their costs paid by the Medicare ESRD system, there was a lot of data available for analysis by the researchers, who examined the use and cost of healthcare services during a 12-month period.
On a per-patient basis, those initiating dialysis with HD averaged 20 more outpatient visits over 12 months compared with matched patients in the PD group. The HD patients also had nominally more ED visits (mean [95% CI], 3.3 [2.1-5.0] vs 2.3 [1.3-3.5] for PD; P = .28). Over the 12-month period of follow-up, more HD patients were hospitalized (80% vs 50% for PD, P <.01).
The median (IQR) total per-patient healthcare costs were $43,510 higher among HD patients than among PD patients over 12 months ($173,507 [$98,706-$335,719] vs $129,997 [$73,212-$207,578], P = .03). Many of the cost differences between hemodialysis patients and peritoneal dialysis patients were quite spectacular. Such as the median (IQR) per-patient inpatient costs were $39,851 ($6089-$140,125) for HD patients versus $651 ($0-$40,591) for PD patients (P <.01). Read that again. You didn't imagine it. Read it again!
So given these costs, you might wonder a bit about the following statistic:
PD was the initial dialysis modality for only about 12% of patients in the study. In prior research, 7% to 27% of patients with ESRD in the United States have been reported to initiate dialysis with PD.
And yet peritoneal dialysis is significantly less expensive! And PD patients are much less likely to be hospitalised.
It makes you wonder if someone is suggesting to doctors that hemodialysis is a better choice, perhaps encouraging them to send patients to an HD clinic.
Wednesday, 17 November 2010
Deliberately Damage Kidneys to Improve Your Health!
Well, I bet just like me, your first thoughts were What!!!
Among other things, your kidneys help control blood pressure, and a new medical procedure aims to knock out this control system, to lower your blood pressure substantially.
I just saw this reported on the BBC News tonight, but you can also read about it in Lancet, the world famous medical journal.
The research, by Australian medical scientists, selectively severs nerves to the kidney that have an vital role in controlling blood pressure. This is done via a catheter inserted into the groin which feeds a thin wire up next to the nerves in question. The wire is given a short burst of radio waves and the energy knocks out some of the nerves in the arteries of the kidneys. So they no longer signal to raise blood pressure.
The technique is suggested as useful where patients have trouble remembering to take normal blood pressure controlling medication, or where the medication has little effect, and it proved to be very successful as six months after treatment, 84% of those treated had a lower blood pressure. Okay, not a back to normal blood pressure, but a better level than before treatment anyway, thus lowering their risk of future strokes and heart attacks.
Among other things, your kidneys help control blood pressure, and a new medical procedure aims to knock out this control system, to lower your blood pressure substantially.
I just saw this reported on the BBC News tonight, but you can also read about it in Lancet, the world famous medical journal.
The research, by Australian medical scientists, selectively severs nerves to the kidney that have an vital role in controlling blood pressure. This is done via a catheter inserted into the groin which feeds a thin wire up next to the nerves in question. The wire is given a short burst of radio waves and the energy knocks out some of the nerves in the arteries of the kidneys. So they no longer signal to raise blood pressure.
The technique is suggested as useful where patients have trouble remembering to take normal blood pressure controlling medication, or where the medication has little effect, and it proved to be very successful as six months after treatment, 84% of those treated had a lower blood pressure. Okay, not a back to normal blood pressure, but a better level than before treatment anyway, thus lowering their risk of future strokes and heart attacks.
Friday, 12 November 2010
Health Problems in Dialysis Clinics?
A research report produced by ProPublica, which has been discussed on many news sites, suggests that there are some serious health issues attached to dialysis - not that dialysis itself is bad for you, but the clinic you receive treatment at may be very bad for you.
To quote from the report
"Nearly 40 years after Congress created a unique entitlement for patients with kidney failure, U.S. death rates and per-patient costs are among the world's highest while the biggest for-profit providers flourish."
ProPublica examined thousands of clinic inspection reports and interviewed many patients and others involved in dialysis, and came to a shocking conclusion - at clinics all over America, it is quite common for patients to receive their live-giving treatment in unsanitary conditions, where lapses in the quality of care can endanger their life. In a health care clinic!
The report describes some pretty scary events that have occurred, including some which have lead to the patient's death, and claims that medical care supervision is minimal in some clinics. That care is often administered by young under-qualified technicians. That staff to patient ratios are not prescribed by the authorities. That some clinics (note that it says some, not most) are run like a factory systems, with technicians stretched to their limits by monitoring too many patients simultaneously.
According to the report, the clinic inspections that they examined revealed that almost half of those checked were described as filthy or unsafe, and many exposed patients to hepatitis, staph, tuberculosis and HIV. Prescription errors were common.
And remember, in America, Medicare funds these clinics, and running clinics is big business. According to the report, the government's payment policies for dialysis have created financial incentives that, in some ways, have worked against better patient care, while enabling for-profit corporations to dominate the business.
But if you come from a poor background in the US and have kidney failure, where can you go for treatment? To a Medicare funded clinic. It's highly unlikely that the less well-off will get private care for their dialysis.
Italy has one of the lowest mortality rates for dialysis care -- about one in nine patients dies each year, compared with one in five in the US! And yet Italy spends about one third less on patients than the Medicare system, according to the report.
Italy has doctors and nurses present at all stages of treatment, not technicians whose general medical knowledge will, by definition, be more limited. Fistulas are used in preference to catheters - catheters can be used immediately they are inserted, but are more prone to infection and clotting than fistulas, which must be allowed to "settle in" before being used.
Overall the report paints a pretty poor picture of health care at some clinics, and advocates reform in the way dialysis patients are treated. The obvious answers include (but are not limited to) having better staffing ratios, with doctors and nurses present to check patients, not just technicians.
It's not as if there's much of a choice in having dialysis or saying no thanks, not today.
You just don't expect to be at risk by saying yes to treatment!
To quote from the report
"Nearly 40 years after Congress created a unique entitlement for patients with kidney failure, U.S. death rates and per-patient costs are among the world's highest while the biggest for-profit providers flourish."
ProPublica examined thousands of clinic inspection reports and interviewed many patients and others involved in dialysis, and came to a shocking conclusion - at clinics all over America, it is quite common for patients to receive their live-giving treatment in unsanitary conditions, where lapses in the quality of care can endanger their life. In a health care clinic!
The report describes some pretty scary events that have occurred, including some which have lead to the patient's death, and claims that medical care supervision is minimal in some clinics. That care is often administered by young under-qualified technicians. That staff to patient ratios are not prescribed by the authorities. That some clinics (note that it says some, not most) are run like a factory systems, with technicians stretched to their limits by monitoring too many patients simultaneously.
According to the report, the clinic inspections that they examined revealed that almost half of those checked were described as filthy or unsafe, and many exposed patients to hepatitis, staph, tuberculosis and HIV. Prescription errors were common.
And remember, in America, Medicare funds these clinics, and running clinics is big business. According to the report, the government's payment policies for dialysis have created financial incentives that, in some ways, have worked against better patient care, while enabling for-profit corporations to dominate the business.
But if you come from a poor background in the US and have kidney failure, where can you go for treatment? To a Medicare funded clinic. It's highly unlikely that the less well-off will get private care for their dialysis.
Italy has one of the lowest mortality rates for dialysis care -- about one in nine patients dies each year, compared with one in five in the US! And yet Italy spends about one third less on patients than the Medicare system, according to the report.
Italy has doctors and nurses present at all stages of treatment, not technicians whose general medical knowledge will, by definition, be more limited. Fistulas are used in preference to catheters - catheters can be used immediately they are inserted, but are more prone to infection and clotting than fistulas, which must be allowed to "settle in" before being used.
Overall the report paints a pretty poor picture of health care at some clinics, and advocates reform in the way dialysis patients are treated. The obvious answers include (but are not limited to) having better staffing ratios, with doctors and nurses present to check patients, not just technicians.
It's not as if there's much of a choice in having dialysis or saying no thanks, not today.
You just don't expect to be at risk by saying yes to treatment!
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