20 Days until Inauguration - Improvements in Medical Care should be applied nationally.

Decontamination Reduces Death in Intensive Care Unit (click title to entry - thank you)

Antibiotic decontamination of digestive tract or oropharynx beneficial

Publish date: Jan 1, 2009

THURSDAY, Jan. 1 (HealthDay News) -- Decontaminating the digestive tract or the oropharynx with antibiotics to avoid infection reduces the likelihood of death in critically ill patients in the intensive care unit (ICU), according to an article in the Jan. 1 issue of the New England Journal of Medicine.
A.M.G.A. de Smet, M.D., from University Medical Center Utrecht in the Netherlands, and colleagues assigned 5,939 ICU patients to selective digestive tract decontamination (SDD, topical or intravenous administration of four antibiotics), selective oropharyngeal decontamination (SOD, oropharyngeal administration of the same antibiotics), or standard care. A cluster randomization design was used, where all patients received all three regimens in random order over the course of six months.
At day 28, the investigators found that crude mortality was 27.5 percent for the standard care group, 26.6 percent for the SOD group and 26.9 percent for the SDD group. Using a model that took age, sex, Acute Physiology and Chronic Health Evaluation score, intubation status, and medical specialty into account, the likelihood of death was significantly lower for both the SOD group (odds ratio 0.86) and SDD group (odds ratio 0.83) compared with the standard care group, the researchers report.
"These data show an absolute reduction in mortality of 3.5 and 2.9 percentage points (corresponding to relative reductions of 13 percent and 11 percent) at day 28 with SDD and SOD, respectively, among patients admitted to Dutch ICUs," de Smet and colleagues conclude. "Considering the importance of antibiotic resistance in ICUs, the SOD regimen seems preferable to the SDD regimen because it does not include widespread systemic prophylaxis with cephalosporins and involves a lower volume of topical antibiotics, thus minimizing the risk of selection for and development of antibiotic resistance in the long term."
Several of the study authors report financial relationships with the pharmaceutical industry.

Oh, really? NO !!!!!!

He hasn't got a strong case, if a case at all. The appointment by the Governor of a qualified candidate proves that decisions can and are made to benefit the people of Illinois.

This needs to stop, it's harassment and the new Senator-Select needs to be seated.


Prosecutor seeks extension for indicting Blagojevich (click here)
U.S. Atty. Patrick Fitzgerald says more time is needed because of the complexity of the corruption case against the Illinois governor, who was arrested on a criminal complaint.
By John Chase 9:46 AM PST, December 31, 2008
The U.S. attorney's office in Chicago today asked a federal judge for an extra three months to formally indict Gov. Rod Blagojevich and his former chief of staff.The move by U.S. Atty. Patrick Fitzgerald's office was expected because the deadline for handing up an indictment had been set for Jan. 7. The extension would give prosecutors until April 7....

Triaging the Humanitarian Crisis in Gaza

According to Gordon Brown there is a dire circumstance with the people of Gaza. I am confident the concerns with Israel stem from 'replenishing the Hamas fighting force.' In other words, while everyone involved, including the Ministries in Israel, knows the issues within Gaza, what reassurances does Israel have that will prevent 'rearming' of Hamas and escalation of the circumstances. Gordon Brown needs to effectively work with the UN to stop the civilian losses, but, also realize their are people in Israel still receiving rocket fire and in places that reach nearly to Tel Aviv.

"Doctors Without Borders"
December 30, 2008
Gaza: First Wounded Patients Receive Treatment (click here)
Four days after air attacks against the Gaza Strip began hospitals are already overwhelmed by an influx of wounded patients. Two Doctors Without Borders/Médecins Sans Frontières (MSF) teams have begun treating them and an initial MSF truckload of medical supplies and drugs entered the Gaza Strip today.
A two-person MSF team, composed of a doctor and a nurse, are providing support to the hospital in Shifa, Gaza’s referral hospital, to triage the wounded and refer patients to the MSF clinic in Gaza City, thus easing the hospital’s workload. The facility is already overwhelmed by the influx of wounded patients. A second team – including a doctor, three nurses, and a physical therapist—has treated approximately a dozen wounded patients at that clinic. Twenty more are already scheduled for tomorrow.
Tomorrow, a third MSF teams hopes to reopen MSF’s second pediatric clinic in Beit Lahia, northern Gaza Strip, to treat pediatric emergencies and help relieve some of the burden at Kemal Edwan hospital, which is also crowded with wounded patients.
A fourth team is planned for our Khan Yunis clinic in the southern Gaza Strip, if security conditions allow, to relieve the Al Nasser hospital (Khan Yunis) and the Al Najar hospital (Rafah).
An initial MSF truck carrying medical supplies and drugs managed to enter the Gaza Strip today. These items will allow us to re-stock our emergency inventories and supply hospital facilities in the Gaza Strip, which lack drugs and materiel. This truck contains medical kits for treating several hundred wounded and burned patients, as well as mattresses and logistical supplies.
For now, only MSF national staff are working in the Gaza Strip, but MSF is trying to strengthen its teams with international staff.

From the article at the title to this entry - thank you.

..."It is vital that moderation must now prevail - there's a humanitarian crisis."
He said he had spoken on the telephone to the prime minister of Israel, Ehud Olmert, and received assurances that humanitarian aid would be able to get through and help casualties in Gaza.
Mr Brown said: "We have now set aside $10m of aid so that will happen....

The casualties in Gaza also include soldiers of Hamas that will take advantage of humanitarian efforts to 'patch their wounds' enough to return to battle. The people within the hospital systems will be used as field hospitals and the supplies that are supposed to go to the people will be distributed among the soldiers first.

The people of Gaza believe in Hamas and that is an issue for Israel. The Israeli soldier is 'at risk' with increased cooperation regarding humanitarian efforts. Israel needs reassurances and they also need clear communication with their forces to know where aid agencies are working. If we recall, the UN suffered tragedy in Southern Lebanon when Hezbollah were lobbying rockets to Israel due to poor communication. We don't need disaffected efforts that escalates the confrontation or causes injury and death to aid workers or journalists reporting on the efforts and the delivery of the supplies and their ultimate use.

I agree whole-heartedly the circumstances of the civilians are very poor, but, the support of Hamas by these same people have brought them to this juncture. While The West has a conscience regarding the elderly, women and children of Gaza as Palestinians with a right to a quality of life; their own government and propensity for that government does not.

It is profound tragedy that exists in Gaza. While the citizens are the ultimate victims of any failed policy, the 'peace' that everyone seeks chronically has been out of reach while the 'citizen' of Gaza have 'leaned' toward a preference to destroy Israel rather than recognize it and begin an economic relationship. The citizens of Gaza have been unable to discern their best outcome with Israel and Hebrews. They aren't interested in compassion, they are interested in war and place their children in the middle of that philosophy.

There needs to be effective policy based human rights for Gaza, but, it has to be Hamas that changes their methodology of leadership and government, not Israel. Other areas of Palestine are successful. They don't these problems. Hamas chronically volates human rights as using their civilians as human shields and 'bargaining chips' in hopes of a bigger game.

When that is addressed there will be 'a peace' between Israel and Palestine.

She's suing now? Why? She is a lobbyist with 'interests' and she is only attempting to defend those interests now?

"...The story examined Ms Iseman's relationship with the senator a decade ago and it was seized on by Mr McCain's supporters as evidence of media bias. Despite denials by both, it was viewed by the public as a story about a romantic affair, the suit alleges.
The New York Times said it stood by the story. "We continue to bel-ieve it to be true and accurate, and that we will prevail. It was an important piece that raised questions about a presidential contender and the perception he had been engaged in conflicts of interest."
The article was criticised by the newspaper's ombudsman. "If you cannot provide readers with some independent evidence, I think it is wrong to report the suppositions or concerns of anonymous aides about whether the boss is getting into the wrong bed," wrote Clark Hoyt in February...."

The Republicans make a huge issue of morality and the public had a right to know any details, especially coming from aides that would have first hand contact. The anonymous informers aren't really anonymous, now are they. The NYT knows who they are and IF there are falsehoods in any of their reporting they can be held responsible.

There seems to be a lot of disguntled aides within the RNC. This. Palin. A lot. One has to wonder why there exists such problems when they all should be enthusiastically 'pulling' for their nominee.

Perhaps the truth is that the 'grassroots' of the RNC are as oppressed as the rest of the country and sincerely believe their party is lost and floundering. The RNC grassroots did not elect a President. The don't believe in the performance of their elected President and Vice and are sincerely unhappy.

I don't consider Ms. Iseman's interest in her clients effective if she can't speak out to defend herself and hence them. A full vetting of the facts should have been made available from her and she could have insisted the NYT publish same in a front page article. She was ineffective in her capacity.

Now, it seems very opportunist to sue in an attempt to claim damages. How much of the damage was actually done by her for her lack of assertion when the article first appeared?

The RNC is in reckage and the Democrats are along for the ride in fear of political 'fallout' for their next elections.

Basically, the political 'stability' of the USA is questionably intact after a decade of an RNC that prided themselves in winning elections by using 'wedge issues.' The Democrats need to 'resource' the USA Constitution and legislated laws of the country for a stable way forward, otherwise, the Republicans might even look competent.

They are lucky to be alive. Israel controls the waters off Gaza. They have to, otherwise it would raise the risk to other cities.

They don't get my sympathy. It is one thing to attempt a mission that will actually help the people of Gaza by finding 'escort' to their shores with 'permission' from the Isreali Navy and it is another thing to try to DEFY the Security Forces of Israel at a time of conflict.

What were they thinking? They thought cameras and popular faces were going to get them a 'pass' through troubled waters? Not a chance. They should have known that the Israeli Navy would consider them a threat.

Darn shame. They 'risked everything' to what end?


A crowd on a dock in Tyre, Lebanon, welcomed the vessel SS Dignity as it arrived yesterday. The boat carried peace activists and medical supplies. (Mohammed Zaatari/Associated Press)

By Zeina Karam
Associated Press
December 31, 2008
...The vessel, called SS Dignity, was greeted by a small, cheering crowd as it pulled into the southern Lebanese port of Tyre with damage near the prow. Its aid trip was foiled as Israel wages a major bombardment of Gaza that has killed more than 360 people since Saturday....
...The boat's British captain, Denis Healey, said the Israeli action occurred "without any warning or any provocation." Organizers said the boat was in international waters - 90 miles off the coast of Gaza - when it was intercepted....

The Israeli Navy doesn't need to communicate to any boat (ie: "USS Cole") they preceive as a threat. There was 'provocation' by the simple fact the boat was 'on course' to the Gaza coast. The Israeli Navy does not need any reason, other than 'defense' to justify their actions.

The government of Israel needs to 'change their approach' to communicating with the media. They are 'used to developing' a propaganda strategy when in fact they simply need to state the facts.

Their actions in this move to 'stop missiles from Gaza' is justified and the response is not too strong. There are dead in Gaza. There are demands for hospital care in Gaza, but, the measures used by Israel to date have not stopped the rockets over the Gaza border. There could be far more devastation than already exists. Israeli intelligence is very good. They know where the targets are and seek 'precision strikes.' Israel is attempting to limit casualities while defending their own people and cities.

I think the criticism of these measures by Israel is wrong and needs to stop. Egypt and Jordan are at work with all the authorities involved and there is no inappropriate aggression anywhere else in Palestinian territories. This is an isolated circumstance with Gaza and Hamas and it is very unfortunate, but, it must continue to end. The 'end' can be defined as the ceasation of rockets over the Gaza border and disarmament of Hamas.

There is no doubt this issue resulted from failed policy between Hamas and Israel.