Tuesday, August 31, 2010

Today's Science Times

Every Tuesday brings the Science Times section of the New York Times. This morning, there are two articles of interest for our readers:

  • There's an article on bedbugs which explains the reasons why they have become so common in recent years.
  • There's an essay on isolation by Abigail Zuger, an infectious diseases physician, which focuses on the human dimensions of a practice that can be rather cruel to patients. She writes of an elderly woman placed in isolation for C. difficile who sobbed continuously: "Increasingly, modern medicine forces us to specialize in the invisible. Here we had invisible germs with an inviolable mandate, and an all too visible patient pleading with us to ignore it. It was quite a struggle to try to see the one, to try not to see the other."

2 comments:

  1. Thanks, Mike, for pointing out Abigail Zuger's excellent essay. Readers should click on the "contact precautions" label below your post to re-read some of our prior posts about the hassles and harms of isolation.

    We desperately need to move toward practices that prevent contact transmission without singling patients out for this harmful intervention. Such practices include hand hygiene adherence rates close to 100%, adopting use of the bare-below-the-elbows approaches Mike has been advocating for years, and (hopefully) the future adoption of antimicrobial fabrics and surfaces that resist colonization.

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  2. Good piece, Mike (and Dan)
    It is interesting that a practice that is dramatically apparent and intrustive to healthcare workers and patients in the hospital has little data behind benefits or costs.
    Some of the lack of concern for the unintended consequences probably is based on published studies having little power and serious methodological flaws. In preliminary analysis at the University of Maryland (presented by Hannah Day at the CDC Decennial)hospital wide we found depression to be approximately 25% more common in isolated patients after adjusting for other factors. We hope to soon complete a few projects addressing the potential costs of isolation.
    It is good to see IC practices being questioned in the hope of improving overall quality of hospital care.

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