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United States

Current Population – 278,058,881

Deaths from pharmaceuticals – 165,000 (Confirmed)

[from – more of the chart found below]

http://web.archive.org/web/20040620194830/www.honeri.org/ADR.html

**

(and from wikipedia entry found below – )

The terms iatrogenesis and iatrogenic artifact refer to adverse effects or complications caused by or resulting from medical treatment or advice. In addition to harmful consequences of actions by physicians, iatrogenesis can also refer to actions by other healthcare professionals, such as psychologists, therapists, pharmacists, nurses, dentists, and others.

http://en.wikipedia.org/wiki/Iatrogenesis

My Note –

What this means is that the American Medical Journals have a small percentage of the overall available statistics about deaths and injuries from their practitioners, hospitals, pharmaceuticals, medical errors and from medically prescribed pharmaceutical drug deaths hidden under the word – “iatrogenesis” and “iatrogenic artifact” and no telling where else.

– cricketdiane, 08-13-09

***

In the United States, it has been estimated that as many as one hospital patient in ten acquires a nosocomial infection, or 2 million patients a year. Estimates of the annual cost range from $4.5 billion to $11 billion and up. Nosocomial infections contributed to 88,000 deaths in the U.S. in 1995. One third of nosocomial infections are considered preventable. Ms. magazine reports that as many as 92 percent of deaths from hospital infections could be prevented. [3] The most common nosocomial infections are of the urinary tract, surgical site and various pneumonias [4]

http://en.wikipedia.org/wiki/Nosocomial

***

August 10, 2009

Hearst Newspapers Prints Results of a Groundbreaking Medical Malpractice Investigation

“Richard Flagg drowned in his own blood.
Stanley Stinnett choked on his own vomit.

Both were victims of the leading cause of accidental death in America—mistakes made in medical care.

Experts estimate that a staggering 98,000 people die from preventable medical errors each year. More Americans die each month of preventable medical injuries than died in the terrorist attacks of Sept. 11, 2001.”

So begins the most comprehensive and compelling national investigative series about medical malpractice that any news organization may ever have produced. The series, Dead by Mistake, was generated by ” a team of skilled and dedicated journalists from across Hearst newspapers and television stations,” in conjunction with “an entire class of graduate journalism students at Columbia University,” that “read thousands of pages of documents, disciplinary files, lawsuits, governmental, medical and other public and private reports.”

It appears prominently in a number of Hearst’s publications, but you can catch the entire collection of stories here. The site includes in-depth statistical analysis, victims’ stories, slide shows, video, state-by-state analysis of “adverse event” reporting policies, and much, much more. Suffice it to say, it is a phenomenal source of solid information and its release couldn’t be have been more timely as Congress and the Administration grapple with medical liability issues in the health care bill.

Hearst’s investigative series is literally so sprawling there’s no way we can do it justice here—but as the report makes clear, medical malpractice is a nationwide epidemic—one that effects patients of every state, age, and income level. In just the last ten years alone, some “2 million Americans have died needlessly of preventable medical mistakes.” And those numbers are on the rise.

Needless to say, any fair reading of this report makes it clear: the problem with medical malpractice isn’t lawsuits—it’s the amount of medical malpractice itself. And this is no time to further insulate negligent health care providers from liability (especially since limiting patients’ rights will barely make a dent in overall health care expenditures).

Ironically, one person who knew that well was the aforementioned Richard Flagg. Richard was not just a malpractice victim. He was a tireless advocate for patients’ rights. Before his eventual death due to medical malpractice, Richard traveled twice to Washington, D.C. with the Center for Justice & Democracy, struggling to breathe, to ensure that the legal rights of patients were not limited with “caps” and other so-called “tort reforms.” His and others’ powerful messages ensured that Congress and the Bush Administration did not take away patients’ rights that year. Let’s hope his death was not in vain this year.

http://www.thepoptort.com/2009/08/hearst-groundbreaking.html

***

[And from the wikipedia entry -]

Medical malpractice is professional negligence by act or omission by a health care provider in which care provided deviates from accepted standards of practice in the medical community and causes injury or death to the patient. Standards and regulations for medical malpractice vary by country and jurisdiction within countries.

A 2004 study of medical malpractice claims in the United States examining primary care malpractice found that though incidence of negligence in hospitals produced a greater proportion of severe outcomes, the total number of errors and deaths due to errors were greater for outpatient settings. No single medical condition was associated with more than five percent of all negligence claims, and one-third of all claims were the result of misdiagnosis.[6]

A recent study by Healthgrades found that an average of 195,000 hospital deaths in each of the years 2000, 2001 and 2002 in the U.S. were due to potentially preventable medical errors. Researchers examined 37 million patient records and applied the mortality and economic impact models developed by Dr. Chunliu Zhan and Dr. Marlene R. Miller in a study published in the Journal of the American Medical Association (JAMA) in October 2003. The Zhan and Miller study supported the Institute of Medicine’s (IOM) 1999 report conclusion, which found that medical errors caused up to 98,000 deaths annually and should be considered a national epidemic. 7

A 2006 follow-up to the 1999 Institute of Medicine study found that medication errors are among the most common medical mistakes, harming at least 1.5 million people every year. According to the study, 400,000 preventable drug-related injuries occur each year in hospitals, 800,000 in long-term care settings, and roughly 530,000 among Medicare recipients in outpatient clinics. The report stated that these are likely to be conservative estimates. In 2000 alone, the extra medical costs incurred by preventable drug related injuries approximated $887 million – and the study looked only at injuries sustained by Medicare recipients, a subset of clinic visitors. None of these figures take into account lost wages and productivity or other costs.[9]

http://en.wikipedia.org/wiki/Medical_malpractice

**

HOSPITAL-BORNE INFECTIONS CAN BE REDUCED.

HealthFacts | June 1, 2001|Napoli, Maryann |

Bloodstream infections acquired in the hospital cause 20,000 to 70,000 deaths each year in the U.S. This estimate was reported by Drs. R. P. Wenzel and M. B. Edmond of the University of Virginia in the March/April issue of the journal Emerging Infectious Diseases. Hospital-borne bloodstream infections were described as a leading cause of death in the U.S.

[etc.]

http://www.encyclopedia.com/doc/1G1-75286635.html

***

“A 2003 survey is all the more distressing because there seems to be no improvement in error reporting even with all the attention on this topic. Dr. Dorothea Wild surveyed medical residents at a community hospital in Connecticut. She found that only half of the residents were aware that the hospital had a medical error-reporting system, and the vast majority didn’t use it at all.”

[Excerpt from -]

http://www.ourcivilisation.com/medicine/usamed.htm

***

Iatrogenesis

From Wikipedia, the free encyclopedia

Ancient Greek painting in a vase, showing a physician (iatros) bleeding a patient.

The terms iatrogenesis and iatrogenic artifact refer to adverse effects or complications caused by or resulting from medical treatment or advice. In addition to harmful consequences of actions by physicians, iatrogenesis can also refer to actions by other healthcare professionals, such as psychologists, therapists, pharmacists, nurses, dentists, and others. Iatrogenesis is not restricted to conventional medicine and can also result from complementary and alternative medicine treatments.

Some iatrogenic artifacts are clearly defined and easily recognized, such as a complication following a surgical procedure. Some are less obvious and can require significant investigation to identify, such as complex drug interactions. And, some conditions have been described for which it is unknown, unproven or even controversial whether they be iatrogenic or not; this has been encountered particularly with regard to various psychological and chronic pain conditions. Research in these areas is ongoing.

Causes of iatrogenesis include medical error, negligence, and the adverse effects or interactions of prescription drugs. In the United States, from 120,000 to 225,000 deaths per year may be attributed in some part to iatrogenesis.[1]

http://en.wikipedia.org/wiki/Iatrogenesis

***

Also from the same entry above –

In other situations, actual negligence or faulty procedures are involved, such as when drug prescriptions are handwritten by the pharmacotherapist. It has been proven that poor handwriting can lead a pharmacist to dispense the wrong drug, worsening a patient’s condition.[citation needed]

[edit] Adverse effects

A very common iatrogenic effect is caused by drug interaction, i.e., when pharmacotherapists fail to check for all medications a patient is taking and prescribe new ones which interact agonistically or antagonistically (potentiate or decrease the intended therapeutic effect). Significant morbidity and mortality is caused because of this. Adverse reactions, such as allergic reactions to drugs, even when unexpected by pharmacotherapists, are also classified as iatrogenic.

The evolution of antibiotic resistance in bacteria is iatrogenic as well.Finland M (1979). “Emergence of antibiotic resistance in hospitals, 1935-1975”. Rev. Infect. Dis. 1 (1): 4–22. PMID 45521. Bacteria strains resistant to antibiotics have evolved in response to the overprescription of antibiotic drugs.

Certain drugs are toxic in their own right in therapeutic doses because of their mechanism of action. Alkylating antineoplastic agents, for example, cause DNA damage, which is more harmful to cancer cells than regular cells. However, alkylation causes severe side effects and is actually carcinogenic in its own right, potentially leading to the development of secondary tumors. Similarly arsenic-based medications like melarsoprol for trypanosomiasis cause arsenic poisoning.

Nosocomial infection

A related term is nosocomial, which refers to an iatrogenic illness due to or acquired during hospital care, such as an infection. Sometimes, hospital staff can be unwitting transmitters of nosocomial infections (in one of such instances, many hospitals have forbidden physicians to use long ties, because they transmitted bacteria from bed to bed when the doctor swept the tie over the patients when bending over them).[citation needed] The most common iatrogenic illness in this realm, however, are nosocomial infections caused by unclean or inadequately sterilized hypodermic needles, surgical instruments, and the use of ungloved hands to perform medical or dental procedures.[citation needed] For example, a number of hepatitis B and C infections caused by dentists and surgeons on their patients have been documented.[citation needed] One of the most horrid cases of massive death caused in recent times by iatrogenic infection has been reported on several bush hospitals in Zaire and Sudan, where the intensive reuse of poorly sterilized syringes and needles by nurses spread the Ebola virus, probably causing hundreds of deaths. [2]

Psychology

In psychology, iatrogenesis can occur due to misdiagnosis (including diagnosis with a false condition as was the case of hystero-epilepsy[3]). Conditions hypothesized to be partially or completely iatrogenic include bipolar disorder,[4] dissociative identity disorder,[5][3] fibromyalgia,[6] somatoform disorder,[7] chronic fatigue syndrome,[7] posttraumatic stress disorder,[8] substance abuse,[9] antisocial youths[10] and others[11] though research is equivocal for each condition. The degree of association of any particular condition with iatrogenesis is unclear and in some cases controversial. The over-diagnosis of psychological conditions is due to clinical dependence upon subjective criteria. The assignment of pathological nomenclature is rarely a benign process and can easily rise to the level of emotional iatrogenesis, especially when no alternatives outside of the diagnostic naming process have been considered.[citation needed]

Iatrogenic poverty

Medical treatment does not only have an effect on the mind and body of patients but also on their wallet. Meessen et al used the term “Iatrogenic Poverty” to describe impoverishment induced by medical care[12]. Impoverishment is described for households exposed to catastrophic health expenditure[13] or to hardship financing[14]. Every year, worldwide, over 100,000 households fall into poverty due to health care expenses. Especially in countries in economic transition, the willingness to pay for health care is increasing and the supply side does not stay behind and develops very fast. But, the regulatory and protective capacity in those countries is often lagging behind. Patients easily fall in a vicious circle of illness, ineffective therapies, consumption of savings, indebtedness, sale of productive assets and eventually poverty.

Incidence and importance

Iatrogenesis is a major phenomenon, and a severe risk to patients. A study carried out in 1981 more than one-third of illnesses of patients in a university hospital were iatrogenic, nearly one in ten were considered major, and in 2% of the patients, the iatrogenic disorder ended in death. Complications were most strongly associated with exposure to drugs and medications.[15] In another study, the main factors leading to problems were inadequate patient evaluation, lack of monitoring and follow-up, and failure to perform necessary tests.[16]

In the United State alone, recorded deaths per year (2000):

  • 12,000—unnecessary surgery
  • 7,000—medication errors in hospitals
  • 20,000—other errors in hospitals
  • 80,000—infections in hospitals
  • 106,000—non-error, negative effects of drugs

Based on these figures, 225,000 deaths per year constitutes the third leading cause of death in the United States, after deaths from heart disease and cancer. Also, there is a wide margin between these numbers of deaths and the next leading cause of death (cerebrovascular disease).

This totals 225,000 deaths per year from iatrogenic causes. In interpreting these numbers, note the following:

  • most data were derived from studies in hospitalized patients.
  • the estimates are for deaths only and do not include negative effects that are associated with disability or discomfort.
  • the estimates of death due to error are lower than those in the IOM report. If higher estimates are used, the deaths due to iatrogenic causes would range from 230,000 to 284,000.[17]

http://en.wikipedia.org/wiki/Iatrogenesis

***

In the United State alone, recorded deaths per year (2000):

  • 12,000—unnecessary surgery
  • 7,000—medication errors in hospitals
  • 20,000—other errors in hospitals
  • 80,000—infections in hospitals
  • 106,000—non-error, negative effects of drugs

Based on these figures, 225,000 deaths per year constitutes the third leading cause of death in the United States, after deaths from heart disease and cancer. Also, there is a wide margin between these numbers of deaths and the next leading cause of death (cerebrovascular disease).

[from above]

***

Is American Medicine Working?


At 14% of the Gross National Product, health care spending reached $1.6 trillion in 2003. (15) Considering this enormous expenditure, we should have the best medicine in the world. We should be reversing disease, preventing disease, and doing minimal harm. However, careful and objective review shows the opposite. Because of the extraordinary narrow context of medical technology through which contemporary medicine examines the human condition, we are completely missing the full picture.

Never before have the complete statistics on the multiple causes of iatrogenesis (adverse results from medical practices and adverse pharmaceutical reactions and deaths) been combined in one paper. Medical science amasses tens of thousands of papers annually—each one a tiny fragment of the whole picture.

The number of unnecessary medical and surgical procedures performed annually is 7.5 million. (3) The number of people exposed to unnecessary hospitalization annually is 8.9 million. (4) The total number of iatrogenic [induced inadvertently by a physician or surgeon or by medical treatment or diagnostic procedures] deaths is 783,936.

[From -]

The American Medical System
Is The Leading Cause Of Death And Injury In The United States

By Gary Null PhD, Carolyn Dean MD ND, Martin Feldman MD, Debora Rasio MD, Dorothy Smith PhD

A definitive review and close reading of medical peer-review journals, and government health statistics shows that American medicine frequently causes more harm than good.

The number of people having in-hospital, adverse drug reactions (ADR) to prescribed medicine is 2.2 million. (1)

Dr. Richard Besser, of the CDC , in 1995, said the number of unnecessary antibiotics prescribed annually for viral infections was 20 million. Dr. Besser, in 2003, now refers to tens of millions of unnecessary antibiotics. (2, 2a)

The number of unnecessary medical and surgical procedures performed annually is 7.5 million. (3) The number of people exposed to unnecessary hospitalization annually is 8.9 million. (4) The total number of iatrogenic [induced inadvertently by a physician or surgeon or by medical treatment or diagnostic procedures] deaths is 783,936.

http://www.ourcivilisation.com/medicine/usamed.htm

***

http://web.archive.org/web/20040620194830/www.honeri.org/ADR.html

A real-time calculation of the number of deaths per minute occurring around the world and in the United States from adverse pharmaceutical / drug reactions. This page includes a table chart of every country’s population and medically prescribed pharmaceutical / drug adverse reaction related deaths. (probably on the low side since fewer than 20% of those events are reported – my note)

PROJECTED GLOBAL DEATH RATE

0.11 people per second
6.61 people per minute
397 people per hour
9535 people per day
3480169 people per year

have been killed by ‘doctor-prescribed’ prescription drugs (Adverse Drug Reactions) since this page loaded. Most of these deaths would have been prevented if Natural Medicine was used.

The Death Rates for the countries listed (in descending order) have been extrapolated from a mean percentage of (0.0593%) of the population per annum. This is taken from the ADR Deaths in terms of the official statistics of the United States Journal of American Medicine as an example.

This table and counter brought to you by Dr. Anthony Rees ( H.O.N.E.R.I ) Should you have any new ADR Death statistics from peer reviewed literature or official published statistics for any countries listed, please feel free to email me with this information, so we can get this table to be as accurate as possible.

Country

Current Population

Adverse Drug Reaction Deaths Per Year.

Afghanistan

Population – 26,813,057

Deaths from pharmaceuticals – 15,900

Albania

Population – 3,510,484

Deaths from pharmaceuticals – 2,082

Algeria

Population – 31,736,053

Deaths from pharmaceuticals – 18,820

Andorra

Population – 67,627

Deaths from pharmaceuticals – 40

Angola

Population – 10,366,031

Deaths from pharmaceuticals – 6,147

Antigua and Barbuda

Population – 66,970

Deaths from pharmaceuticals – 40

Argentina

Population – 37,384,816

Deaths from pharmaceuticals – 22,170

Armenia

Population – 3,336,100

Deaths from pharmaceuticals – 1,978

Australia

Population – 19,357,594

Deaths from pharmaceuticals – 11,479

Austria

Population – 8,150,835

Deaths from pharmaceuticals – 4,833

Azerbaijan

Population – 7,771,092

Deaths from pharmaceuticals – 4,608

Bahamas The

Population – 297,852

Deaths from pharmaceuticals – 177

Bahrain

Population – 645,361

Deaths from pharmaceuticals – 383

Bangladesh

Population – 131,269,860

Deaths from pharmaceuticals – 77,843

Barbados

Population – 275,330

Deaths from pharmaceuticals – 163

Belarus

Population – 10,350,194

Deaths from pharmaceuticals – 6,138

Belgium

Population – 10,258,762

Deaths from pharmaceuticals – 6,083

Belize

Population – 256,062

Deaths from pharmaceuticals – 152

Benin

Population – 6,590,782

Deaths from pharmaceuticals – 3,908

Bhutan

Population – 2,049,412

Deaths from pharmaceuticals – 1,215

Bolivia

Population – 8,300,463

Deaths from pharmaceuticals – 4,922

Bosnia and Herzegovina

Population – 3,922,205

Deaths from pharmaceuticals – 2,326

Botswana

Population – 1,586,119

Deaths from pharmaceuticals – 940

Brazil

174,468,575

Deaths from pharmaceuticals – 103,459

Brunei

343,653

Deaths from pharmaceuticals – 204

Bulgaria

7,707,495

Deaths from pharmaceuticals – 4,570

Burkina Faso

12,272,289

Deaths from pharmaceuticals – 7,278

Burma

41,994,678

Deaths from pharmaceuticals – 24,903

Burundi

6,223,897

Deaths from pharmaceuticals – 3,691

Cambodia

12,491,501

Deaths from pharmaceuticals – 7,408

Cameroon

15,803,220

Deaths from pharmaceuticals – 9,371

Canada

31,592,805

Deaths from pharmaceuticals – 18,734

Cape Verde

405,163

Deaths from pharmaceuticals – 240

Central African Republic

3,576,884

Deaths from pharmaceuticals – 2,121

Chad

8,707,078

Deaths from pharmaceuticals – 5,163

Chile

15,328,467

Deaths from pharmaceuticals – 9,090

China

1,273,111,290

Deaths from pharmaceuticals – 754,954

Colombia

40,349,388

Deaths from pharmaceuticals – 23,927

Comoros

596,202

Deaths from pharmaceuticals – 353

Congo Democratic Republic

53,624,718

Deaths from pharmaceuticals – 31,799

Congo Republic of the Congo

2,894,336

Deaths from pharmaceuticals – 1,716

Costa Rica

3,773,057

Deaths from pharmaceuticals – 2,237

Cote d’Ivoire

16,393,221

Deaths from pharmaceuticals – 9,721

Croatia

4,334,142

Deaths from pharmaceuticals – 2,570

Cuba

11,184,023

Deaths from pharmaceuticals – 6,632

Cyprus

762,887

Deaths from pharmaceuticals – 452

Czech Republic

10,264,212

Deaths from pharmaceuticals – 6,087

Denmark

5,352,815

Deaths from pharmaceuticals – 3,174

Djibouti

460,700

Deaths from pharmaceuticals – 273

Dominica

70,786

Deaths from pharmaceuticals – 42

Dominican Republic

8,581,477

Deaths from pharmaceuticals – 5,089

Ecuador

13,183,978

Deaths from pharmaceuticals – 7,818

Egypt

69,536,644

Deaths from pharmaceuticals – 41,235

El Salvador

6,237,662

Deaths from pharmaceuticals – 3,699

Equatorial Guinea

486,060

Deaths from pharmaceuticals – 353

Eritrea

4,298,269

Deaths from pharmaceuticals – 2549

Estonia

1,423,316

Deaths from pharmaceuticals – 844

Ethiopia

65,891,874

Deaths from pharmaceuticals – 39,074

Fiji

844,330

Deaths from pharmaceuticals – 501

Finland

5,175,783

Deaths from pharmaceuticals – 3,069

France

59,551,227

Deaths from pharmaceuticals – 35,314

Gabon

1,221,175

Deaths from pharmaceuticals – 724

Gambia The

1,411,205

Deaths from pharmaceuticals – 837

Georgia

4,989,285

Deaths from pharmaceuticals – 2,959

Germany

83,029,536

Deaths from pharmaceuticals – 49,236

Ghana

19,894,014

Deaths from pharmaceuticals – 11,797

Greece

10,623,835

Deaths from pharmaceuticals – 6,300

Grenada

89,227

Deaths from pharmaceuticals – 55

Guatemala

12,974,361

Deaths from pharmaceuticals – 7,694

Guinea

7,613,870

Deaths from pharmaceuticals – 4,515

Guinea-Bissau

1,315,822

Deaths from pharmaceuticals – 780

Guyana

697,181

Deaths from pharmaceuticals – 413

Haiti

6,964,549

Deaths from pharmaceuticals – 4,130

Holy See (Vatican City)

890

Deaths from pharmaceuticals – 0,5

Honduras

6,406,052

Deaths from pharmaceuticals – 3,799

Hong Kong

7,210,505

Deaths from pharmaceuticals – 4,276

Hungary

10,106,017

Deaths from pharmaceuticals – 5,993

Iceland

277,906

Deaths from pharmaceuticals – 165

India

1,029,991,145

Deaths from pharmaceuticals – 610,784

Indonesia

228,437,870

Deaths from pharmaceuticals – 135,463

Iran

66,128,965

Deaths from pharmaceuticals – 39,214

Iraq

23,331,985

Deaths from pharmaceuticals – 13,836

Ireland

3,840,838

Deaths from pharmaceuticals – 2,278

Israel

59,38,093

Deaths from pharmaceuticals – 3,521

Italy

57,679,825

Deaths from pharmaceuticals – 34,204

Jamaica

2,665,636

Deaths from pharmaceuticals – 1,581

Japan

126,771,662

Deaths from pharmaceuticals – 75,175

Jordan

5,153,378

Deaths from pharmaceuticals – 3,056

Kazakhstan

16,731,303

Deaths from pharmaceuticals – 9,922

Kenya

30,765,916

Deaths from pharmaceuticals – 18,244

Kiribati

94,149

Deaths from pharmaceuticals – 56

Korea North

21,968,228

Deaths from pharmaceuticals – 13,027

Korea South

47,904,370

Deaths from pharmaceuticals – 28,407

Kuwait

2,041,961

Deaths from pharmaceuticals – 1,211

Kyrgyzstan

4,753,003

Deaths from pharmaceuticals – 2,818

Laos

5,635,967

Deaths from pharmaceuticals – 3,342

Latvia

2,385,231

Deaths from pharmaceuticals – 1,414

Lebanon

3,627,774

Deaths from pharmaceuticals – 2,151

Lesotho

2,177,,062

Deaths from pharmaceuticals – 1,291

Liberia

3,225,837

Deaths from pharmaceuticals – 1,913

Libya

5,240,599

Deaths from pharmaceuticals – 3,108

Liechtenstein

32,528

Deaths from pharmaceuticals – 19

Lithuania

3,610,535

Deaths from pharmaceuticals – 2,141

Luxembourg

442,972

Deaths from pharmaceuticals – 263

Macau

453,733

Deaths from pharmaceuticals – 269

Macedonia

2,046,209

Deaths from pharmaceuticals – 1,213

Madagascar

15,982,563

Deaths from pharmaceuticals – 9,478

Malawi

10,548,250

Deaths from pharmaceuticals – 6,255

Malaysia

22,229,040

Deaths from pharmaceuticals – 13,182

Maldives

310,764

Deaths from pharmaceuticals – 184

Mali

11,008,518

Deaths from pharmaceuticals – 6,528

Malta

394,583

Deaths from pharmaceuticals – 234

Marshall Islands

70,822

Deaths from pharmaceuticals – 42

Martinique

418,454

Deaths from pharmaceuticals – 248

Mauritania

2,747,312

Deaths from pharmaceuticals – 1,629

Mauritius

1,189,825

Deaths from pharmaceuticals – 705

Mexico

101,879,171

Deaths from pharmaceuticals – 60,414

Micronesia Federated

134,597

Deaths from pharmaceuticals – 80

Moldova

4,431,570

Deaths from pharmaceuticals – 2,628

Monaco

31,842

Deaths from pharmaceuticals – 19

Mongolia

2,654,999

Deaths from pharmaceuticals – 1,574

Morocco

30,645,305

Deaths from pharmaceuticals – 18,173

Mozambique

19371057

Deaths from pharmaceuticals – 11,487

Namibia

1,797,677

Deaths from pharmaceuticals – 1,066

Nauru

12,088

Deaths from pharmaceuticals – 7

Nepal

25,284,463

Deaths from pharmaceuticals – 14,994

Netherlands

15,981,472

Deaths from pharmaceuticals – 9,478

New Zealand

3,864,129

Deaths from pharmaceuticals – 2,291

Nicaragua

4,918,393

Deaths from pharmaceuticals – 2,917

Niger

10,355,156

Deaths from pharmaceuticals – 6,141

Nigeria

126,635,626

Deaths from pharmaceuticals – 75,095

Norway

4,503,440

Deaths from pharmaceuticals – 2,670

Oman

2,622,198

Deaths from pharmaceuticals – 1,554

Pakistan

144,616,639

Deaths from pharmaceuticals – 85,758

Palau

19,092

Deaths from pharmaceuticals – 11

Panama

2,845,647

Deaths from pharmaceuticals – 1,687

Papua New Guinea

5,049,055

Deaths from pharmaceuticals – 2,994

Paraguay

5,734,139

Deaths from pharmaceuticals – 3,400

Peru

27,483,864

Deaths from pharmaceuticals – 16,298

Philippines

82,841,518

Deaths from pharmaceuticals – 49,125

Poland

38,633,912

Deaths from pharmaceuticals – 22,910

Portugal

10,066,253

Deaths from pharmaceuticals – 5,970

Qatar

769,152

Deaths from pharmaceuticals – 456

Romania

22,364,022

Deaths from pharmaceuticals – 13,262

Russia

145,470,197

Deaths from pharmaceuticals – 86,264

Rwanda

7,312,756

Deaths from pharmaceuticals – 4,336

Saint Kitts and Nevis

38,756

Deaths from pharmaceuticals – 23

Saint Lucia

158,178

Deaths from pharmaceuticals – 94

Saint Vincent and Grenadines

115,942

Deaths from pharmaceuticals – 69

Samoa

179,058

Deaths from pharmaceuticals – 106

San Marino

27,336

Deaths from pharmaceuticals – 16

Sao Tome and Principe

165,034

Deaths from pharmaceuticals – 98

Saudi Arabia

22,757,092

Deaths from pharmaceuticals – 13,495

Senegal

10,284,929

Deaths from pharmaceuticals – 6,099

Seychelles

79,715

Deaths from pharmaceuticals – 47

Sierra Leone

5,426,618

Deaths from pharmaceuticals – 3,218

Singapore

4,300,419

Deaths from pharmaceuticals – 2,550

Slovakia

5,414,937

Deaths from pharmaceuticals – 3,211

Slovenia

1,930,132

Deaths from pharmaceuticals – 1,144

Solomon Islands

480,442

Deaths from pharmaceuticals – 285

Somalia

7,488,773

Deaths from pharmaceuticals – 4,441

South Africa

43,586,097

Deaths from pharmaceuticals – 25,847

Spain

40,037,995

Deaths from pharmaceuticals – 23,742

Sri Lanka

19408635

Deaths from pharmaceuticals – 11,509

Sudan

36,080,373

Deaths from pharmaceuticals – 21,396

Suriname

433,998

Deaths from pharmaceuticals – 257

Swaziland

1,104,343

Deaths from pharmaceuticals – 655

Sweden

8,875,053

Deaths from pharmaceuticals – 5,262

Switzerland

Population – 7,283,274

Deaths from pharmaceuticals – 4,319

Syria

Population – 16,728,808

Deaths from pharmaceuticals – 9920

Taiwan

Population – 22,370,461

Deaths from pharmaceuticals – 13266

Tajikistan

Population – 6,578,681

Deaths from pharmaceuticals – 3,901

Tanzania

Population – 36,232,074

Deaths from pharmaceuticals – 21,486

Thailand

61,797,751

Deaths from pharmaceuticals – 36,646

Togo

Population – 5,153,088

Deaths from pharmaceuticals – 3,056

Tonga

Population – 104,227

Deaths from pharmaceuticals – 62

Trinidad and Tobago

Population – 1,169,682

Deaths from pharmaceuticals – 694

Tunisia

Population – 9,705,102

Deaths from pharmaceuticals – 5,755

Turkey

Population – 66,493,970

Deaths from pharmaceuticals – 39,431

Turkmenistan

Population – 4,603,244

Deaths from pharmaceuticals – 2,730

Tuvalu

Population – 10,991

Deaths from pharmaceuticals – 6

Uganda

Population – 23,985,712

Deaths from pharmaceuticals – 14,223

Ukraine

Population – 48,760,474

Deaths from pharmaceuticals – 28,915

United Arab Emirates

Population – 2,407,460

Deaths from pharmaceuticals – 1,428

United Kingdom

Population – 59,647,790

Deaths from pharmaceuticals – 46,600 (Confirmed)

United States

Population – 278,058,881

Deaths from pharmaceuticals – 165,000 (Confirmed)

Uruguay

Population – 3,360,105

Deaths from pharmaceuticals – 1,992

Uzbekistan

Population – 25,155,064

Deaths from pharmaceuticals – 14,917

Vanuatu

Population – 192,910

Deaths from pharmaceuticals – 114

Venezuela

Population – 23,916,810

Deaths from pharmaceuticals – 14,183

Vietnam

Population – 79,939,014

Deaths from pharmaceuticals – 47,404

Yemen

Population – 18,078,035

Deaths from pharmaceuticals – 10,720

Yugoslavia

Population – 10,677,290

Deaths from pharmaceuticals – 6,332

Zambia

Population – 9,770,199

Deaths from pharmaceuticals – 5,794

Zimbabwe

Population – 1,1365,366

Deaths from pharmaceuticals – 6,740

**
3,480,169 TOTAL

Deaths from medically prescribed pharmaceuticals – Total 3,480,169

http://web.archive.org/web/20040620194830/www.honeri.org/ADR.html

***

Nosocomial infection

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Nosocomial infections are infections which are a result of treatment in a hospital or a healthcare service unit, but secondary to the patient’s original condition. Infections are considered nosocomial if they first appear 48 hours or more after hospital admission or within 30 days after discharge. Nosocomial comes from the Greek word nosokomeion (νοσοκομείον) meaning hospital (nosos = disease, komeo = to take care of). This type of infection is also known as a hospital-acquired infection (or more generically healthcare-associated infection).

Nosocomial infections are even more alarming in the 21st century. The main reasons are as follows:

  • Hospitals house large numbers of people who are sick and whose immune systems are often in a weakened state;
  • Increased use of outpatient treatment means that people who are in the hospital are sicker on average;
  • Medical staff move from patient to patient, providing a way for pathogens to spread;
  • Many medical procedures bypass the body’s natural protective barriers;
  • Sanitation protocol regarding uniforms, equipment sterilization, washing, and other preventative measures may be either unheeded by hospital staff or too lax to sufficiently isolate patients from infectious agents.
  • Patients are often prescribed antibiotics and other anti-microbial drugs to help treat illness; this may increase the selection pressure for the emergence of resistant strains.

Thorough hand washing and/or use of alcohol rubs by all medical personnel before and after each patient contact is one of the most effective ways to combat nosocomial infections[1]. More careful use of anti-microbial agents, such as antibiotics, is also considered vital.[2]

[edit] Epidemiology

In the United States, it has been estimated that as many as one hospital patient in ten acquires a nosocomial infection, or 2 million patients a year. Estimates of the annual cost range from $4.5 billion to $11 billion and up. Nosocomial infections contributed to 88,000 deaths in the U.S. in 1995. One third of nosocomial infections are considered preventable. Ms. magazine reports that as many as 92 percent of deaths from hospital infections could be prevented. [3] The most common nosocomial infections are of the urinary tract, surgical site and various pneumonias [4]

In France, prevalence was 6.87% in 2001[5] and 7.5% in 2006[6] (some patients were infected twice) :

An estimated 5% to 19% of hospitalized patients are infected, and up to 30% in intensive care units. The patients must stay in the hospital 4-5 additional days. About 9,000 people die with a nosocomial infection, but about 4,200 would have survived without this infection.

In Italy, in the 2000s, about 6.7 % of hospitalized patients were infected, i.e. between 450,000 and 700,000 patients, which caused between 4,500 and 7,000 deaths.[7]

In Switzerland, extrapolations assume about 70,000 hospitalised patients are affected by nosocomial infections (between 2 and 14% of hospitalized patients).[8]

[edit] Transmission

Microorganisms are transmitted in hospitals by several routes, and the same microorganism may be transmitted by more than one route. There are five main routes of transmission—contact, droplet, airborne, common vehicle, and vectorborne.

  • Contact transmission, the most important and frequent mode of transmission of nosocomial infections, is divided into two subgroups: direct-contact transmission and indirect-contact transmission.
    • Direct-contact transmission involves a direct body surface-to-body surface contact and physical transfer of microorganisms between a susceptible host and an infected or colonized person, such as occurs when a person turns a patient, gives a patient a bath, or performs other patient-care activities that require direct personal contact. Direct-contact transmission also can occur between two patients, with one serving as the source of the infectious microorganisms and the other as a susceptible host.
    • Indirect-contact transmission involves contact of a susceptible host with a contaminated intermediate object, usually inanimate, such as contaminated instruments, needles, or dressings, or contaminated gloves that are not changed between patients. Additionally, the improper use of saline flush syringes, vials, and bags have been implicated in disease transmission in the US, even when healthcare workers had access to gloves, disposable needles, intravenous devices, and flushes.[9]
  • Droplet transmission occurs when droplets are generated from the source person mainly during coughing, sneezing, and talking, and during the performance of certain procedures such as bronchoscopy. Transmission occurs when droplets containing germs from the infected person are propelled a short distance through the air and deposited on the host’s body.
  • Airborne transmission occurs by dissemination of either airborne droplet nuclei (small-particle residue {5 µm or smaller in size} of evaporated droplets containing microorganisms that remain suspended in the air for long periods of time) or dust particles containing the infectious agent. Microorganisms carried in this manner can be dispersed widely by air currents and may become inhaled by a susceptible host within the same room or over a longer distance from the source patient, depending on environmental factors; therefore, special air handling and ventilation are required to prevent airborne transmission. Microorganisms transmitted by airborne transmission include Legionella, Mycobacterium tuberculosis and the rubeola and varicella viruses.
  • Common vehicle transmission applies to microorganisms transmitted to the host by contaminated items such as food, water, medications, devices, and equipment.
  • Vector borne transmission occurs when vectors such as mosquitoes, flies, rats, and other vermin transmit microorganisms.

Predisposition to infection

Factors predisposing a patient to infection can broadly be divided into four areas:

  • People in hospitals are usually already in a poor state of health, impairing their defense against bacteria – advanced age or premature birth along with immunodeficiency (due to drugs, illness, or IR radiation) present a general risk, while other diseases can present specific risks – for instance chronic obstructive pulmonary disease can increase chances of respiratory tract infection.
  • Invasive devices, for instance intubation tubes, catheters, surgical drains and tracheostomy tubes all bypass the body’s natural lines of defence against pathogens and provide an easy route for infection. Patients already colonised on admission are instantly put at greater risk when they undergo an invasive procedure.
  • A patient’s treatment itself can leave them vulnerable to infection – immunosuppression and antacid treatment undermine the body’s defences, while antimicrobial therapy (removing competitive florabloodtransfusions have also been identified as risk factors. and only leaving resistant organisms) and recurrent

Prevention

Isolation

Isolation precautions are designed to prevent transmission of microorganisms by common routes in hospitals. Because agent and host factors are more difficult to control, interruption of transfer of microorganisms is directed primarily at transmission.

Handwashing and gloving

Handwashing frequently is called the single most important measure to reduce the risks of transmitting skin microorganisms from one person to another or from one site to another on the same patient. Washing hands as promptly and thoroughly as possible between patient contacts and after contact with blood, body fluids, secretions, excretions, and equipment or articles contaminated by them is an important component of infection control and isolation precautions.

Although handwashing may seem like a simple process, it is often performed incorrectly. Healthcare settings must continually remind practitioners and visitors on the proper procedure in washing their hands to comply with responsible handwashing. Simple programs such as Henry the Hand, and the use of handwashing signals can assist healthcare facilities in the prevention of nosocomial infections.

All visitors must follow the same procedures as hospital staff to adequately control the spread of infections. Visitors and healthcare personnel are equally to blame in transmitting infections. Moreover, multi-drug resistant infections can leave the hospital and become part of the community flora if we don’t take steps to stop this transmission.

In addition to handwashing, gloves play an important role in reducing the risks of transmission of microorganisms. Gloves are worn for three important reasons in hospitals. First, gloves are worn to provide a protective barrier and to prevent gross contamination of the hands when touching blood, body fluids, secretions, excretions, mucous membranes, and nonintact skin; the wearing of gloves in specified circumstances to reduce the risk of exposures to bloodborne pathogens is mandated by the OSHA Bloodborne Pathogens final rule. Second, gloves are worn to reduce the likelihood that microorganisms present on the hands of personnel will be transmitted to patients during invasive or other patient-care procedures that involve touching a patient’s mucous membranes and nonintact skin. Third, gloves are worn to reduce the likelihood that hands of personnel contaminated with microorganisms from a patient or a fomite can transmit these microorganisms to another patient. In this situation, gloves must be changed between patient contacts and hands should be washed after gloves are removed.

Wearing gloves does not replace the need for handwashing, because gloves may have small, non-apparent defects or may be torn during use, and hands can become contaminated during removal of gloves. Failure to change gloves between patient contacts is an infection control hazard.

Surface sanitation

Sanitizing surfaces is an often overlooked yet critical component of breaking the cycle of infection in health care environments. Modern sanitizing methods such as NAV-CO2 have been effective against gastroenteritis, MRSA, and influenza. Use of hydrogen peroxide vapor has been clinically proven to reduce infection rates and risk of acquisition. Hydrogen peroxide is effective against endospore forming bacteria, such as Clostridium difficile, where alcohol has been shown to be ineffective.[10]

Aprons

Wearing an apron during patient care reduces the risk of infection.[citation needed] The apron should either be disposable or be used only when caring for a specific patient.

Mitigation

The most effective technique of controlling nosocomial infection is to strategically implement QA / QC measures to the health care sectors and evidence-based management can be a feasible approach. For those VAP/HAP diseases (ventilator-associated pneumonia, hospital-acquired pneumonia), controlling and monitoring hospital indoor air quality needs to be on agenda in management [11] whereas for nosocomial rotavirus infection, a hand hygiene protocol has to be enforced.[12][13][14]

Known diseases

See also

References

  1. ^ McBryde ES, Bradley LC, Whitby M, McElwain DL (October 2004). “An investigation of contact transmission of methicillin-resistant Staphylococcus aureus”. J. Hosp. Infect. 58 (2): 104–8. doi:10.1016/j.jhin.2004.06.010. PMID 15474180.
  2. ^ Lautenbach E (2001). “Chapter 14. Impact of Changes in Antibiotic Use Practices on Nosocomial Infections and Antimicrobial Resistance—Clostridium difficile and Vancomycin-resistant Enterococcus (VRE)“. in Markowitz AJ. Making Health Care Safer: A Critical Analysis of Patient Safety Practices. Agency for Healthcare Research and Quality. http://www.ahrq.gov/clinic/ptsafety/chap14.htm.
  3. ^ Ricks, Delthia (Spring 2007). “Germ Warfare“. Ms. Magazine: 43–5. http://www.msmagazine.com/spring2007/germwarfare.asp.
  4. ^ Klevens RM, Edwards JR, Richards CL, et al. (2007). “Estimating health care-associated infections and deaths in U.S. hospitals, 2002”. Public Health Rep 122 (2): 160–6. PMID 17357358.
  5. ^ enquête nationale de prévalence 2001
  6. ^ Vasselle A (26 August 2006) (in French). Quelle est la prévalence de ces infections?. http://ecoetsante2010.free.fr/article.php3?id_article=525. Quelle est la prévalence de ces infections ?]
  7. ^ L’Italie scandalisée par “l’hôpital de l’horreur”, Éric Jozsef, Libération, January 17, 2007 (French)
  8. ^ Facts sheet – Swiss Hand Hygiene Campaign. (.doc)
  9. ^ Jain SK, Persaud D, Perl TM, et al. (July 2005). “Nosocomial malaria and saline flush“. Emerging Infect. Dis. 11 (7): 1097–9. PMID 16022788. http://www.cdc.gov/ncidod/EID/vol11no07/05-0092.htm.
  10. ^ Otter JA, French GL (January 2009). “Survival of nosocomial bacteria and spores on surfaces and inactivation by hydrogen peroxide vapor”. J. Clin. Microbiol. 47 (1): 205–7. doi:10.1128/JCM.02004-08. PMID 18971364.
  11. ^ Leung M, Chan AH (March 2006). “Control and management of hospital indoor air quality“. Med. Sci. Monit. 12 (3): SR17–23. PMID 16501436. http://www.medscimonit.com/fulltxt.php?ICID=447117.
  12. ^ Chan PC, Huang LM, Lin HC, et al. (April 2007). “Control of an outbreak of pandrug-resistant Acinetobacter baumannii colonization and infection in a neonatal intensive care unit”. Infect Control Hosp Epidemiol 28 (4): 423–9. doi:10.1086/513120. PMID 17385148.
  13. ^ Traub-Dargatz JL, Weese JS, Rousseau JD, Dunowska M, Morley PS, Dargatz DA (July 2006). “Pilot study to evaluate 3 hygiene protocols on the reduction of bacterial load on the hands of veterinary staff performing routine equine physical examinations“. Can. Vet. J. 47 (7): 671–6. PMID 16898109.
  14. ^ Katz JD (September 2004). “Hand washing and hand disinfection: more than your mother taught you”. Anesthesiol Clin North America 22 (3): 457–71, vi. doi:10.1016/j.atc.2004.04.002. PMID 15325713.

http://en.wikipedia.org/wiki/Nosocomial

***

In the United States, it has been estimated that as many as one hospital patient in ten acquires a nosocomial infection, or 2 million patients a year. Estimates of the annual cost range from $4.5 billion to $11 billion and up. Nosocomial infections contributed to 88,000 deaths in the U.S. in 1995. One third of nosocomial infections are considered preventable. Ms. magazine reports that as many as 92 percent of deaths from hospital infections could be prevented. [3] The most common nosocomial infections are of the urinary tract, surgical site and various pneumonias [4]

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