Hospital sterilization: How problems slip through
Bernstein, M.D., of the University of Manitoba here, and colleagues. The researchers found that ulcerative colitis, the inflammatory bowel disease that affects only the large intestine, strikes an average of 194 of every 100,000 Canadians, with 11.8 new cases per 100,000 each year. Crohn’s disease, which affects the large and small intestines, is even more common in Canada and affects about 234 per 100,000 people, with an incidence of 13.4 per 100,000 each year. By comparison, ulcerative colitis prevalence is 58 to 157 per 100,000 in Northern Europe and about 167 per 100,000 for an area of Minnesota. Crohn’s disease prevalence ranges from 27 to 48 per 100,000 in Northern Europe to 144 per 100,000 in an area of Minnesota. Some Third World nations and areas in tropical latitudes have still lower rates. Although the reasons for these differences remain unclear, the hygiene hypothesis may help explain the distribution in Canada, said Richard Fedorak, M.D., of the University of Alberta in Edmonton, a co-author. “If you live in an environment that’s too clean or too sterile as a child your intestines are not exposed to bacteria of the same types and numbers you would be exposed to in a tropical area,” he said. which is especially true for Canada because much of the country has cold winters with little bacterial activity in the soil. Then if the genetic triggers are present, “your intestine is not able to tolerate bacteria as you get older and starts to destroy itself,” he added. Supporting this speculation, the researchers discovered differences among provinces: Nova Scotia in the Maritimes consistently had the highest rates of ulcerative colitis (19.2 incidence and 247.9 prevalence per 100,000) and Crohn’s disease (20.2 incidence and 318.5 per 100,000), Following closely is Alberta, with ulcerative colitis incidence of 11.0 and prevalence of 185.0 per 100,000 and Crohn’s disease incidence of 16.5 and prevalence of 283.0 per 100,000, and Manitoba had likewise high rates of ulcerative colitis (15.4 incidence and 248.6 prevalence per 100,000) and Crohn’s disease (15.4 incidence and 271.4 prevalence per 100,000); Whereas British Columbia, on the west coast, consistently had much lower rates of both ulcerative colitis (9.9 incidence and 162.1 prevalence per 100,000) and Crohn’s disease (8.8 incidence and 160.7 prevalence per 100,000). British Columbia proved to be an outlier, particularly for Crohn’s disease perhaps because of its milder winters, more precipitation, and “because its population ethnic make-up is somewhat different from the rest of Canada,” the researchers wrote. Much of British Columbia’s immigration in the past 20 years has been from Asia, they said. “Asians are known to have less [inflammatory bowel disease] than Caucasians,” perhaps because of genetics, less sterile conditions during childhood, or other environmental factors. Males and females generally had similar rates of ulcerative colitis though significantly more females had Crohn’s disease (1.31 ratio, 95% CI 1.23-1.40). Notably, though, the prevalence of Crohn’s disease was significantly greater in boys than girls (prevalence 49.6 versus 43.8 per 100,000, P=0.0001).
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Atlanta-Based EndoChoice Approved To Market Full-Spectrum Endoscopy System In Canada
The hospital says in this case, it wasn’t following the manufacturer’s specific guidelines for this specialized endoscope. “Endoscopes are particularly complex and difficult to clean because they’ve got very long, very narrow channels,” said infection prevention and control expert Dr. Mary Vearncombe. “It’s very difficult to make sure that those channels are flushed and disinfected properly in between uses, just because their diameter is so very narrow.” Dr. Armstong said the late discovery highlights a need to regularly review whether the team in charge of cleaning endoscopesis doing it properly. Common procedure He says the issue is analogous to the deadly E. coli contamination of the water supply in Walkerton, Ont. in 2000. In that case,procedures were in place to ensure safe drinking water, but checks weren’t done to ensure the processes were followed. “One knows what needs to be done to produce a safe water supply, but if the appropriate checks are put into place but they are not monitored and verified, then it’s possible to assume that everything’sOK and the processes are being followed without actually documenting that its actually done on a daily basis or a weekly basis,” said Armstrong,a McMaster University associate professor and consultant gastroenterologist at Hamilton Health Sciences. Every year, about 1.6 million endoscopic procedures are performed in Canada, a figure representing about five per cent of the population. Despite how common the procedure has become, hospitalstend totrack incidents of improper endoscope cleaning that result in patient harm on an ad-hoc basis, says Armstrong. Thatmeans the public only learns of problems when the media covers large-scale events disclosed by the hospital.
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The Fuse endoscopy system is comprised of colonoscopes and gastroscopes with multiple imagers enabling doctors to see more of the GI tract for diagnosis and treatment. Standard, forward-viewing endoscopy systems have a single imager so clinicians are switching to the Fuse system in an effort to improve the quality of their procedures. The Health Canada license means its Fuse system will be the first endoscopy equipment available with expanded viewing capabilities to reach Canadian patients, the company said. Endoscopes are thin flexible tubes with imaging capabilities that doctors use to view the upper and lower GI tracts of their patients. The news from Health Canada enables EndoChoice to begin delivering Fuse endoscopy systems to their gastroenterology specialist customers throughout Canada . “We intend to gain market clearance in several more countries in the near future,” said Mark Gilreath, Founder and CEO at EndoChoice. “While 2013 has been an exciting year for our company, the introduction of Fuse into Canada and other markets will enable us to make 2014 even more dynamic as we bring this game-changing technology to more clinicians.” EndoChoice is a medtech company focused on the manufacturing and commercialization of platform technologies including devices, diagnostics, infection control and endoscopic imaging for specialists treating a wide range of gastrointestinal diseases. EndoChoice leverages its direct sales organization to serve more than 2,000 customers in the United States and works with 34 distribution partners world-wide. The Company was founded in 2008 and has rapidly developed a proprietary product portfolio.
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