Saline better than soap for wound cleaning in open fractures

By Gene Emery

NEW YORK (Reuters Health) - Researchers have uncovered a dirty little secret for cleaning open wound fractures - soap isn't as good as saline. Neither are the costly machines that deliver the solution at high pressure.

A new study found that the risk of reoperation to treat a wound infection or to promote wound or bone healing increased 32% when soap was used instead of regular saline (P=0.01).

Many countries lack assistive devices for elderly

By Shereen Lehman

NEW YORK (Reuters Health) - Governments in low- and middle-income countries do give some thought to access for devices that assist disabled elderly, a recent study suggests, but more attention is needed.

The study, reported online September 11 in BMJ Innovations, looked at the availability of assistive technologies ranging from wheelchairs, canes, prosthetics, spectacles, low vision aids, and hearing aids, to communication boards, household robots and assistive mobile and computer technology.

Snoring, apnea linked to diabetes risk in older adults

By Madeline Kennedy

NEW YORK (Reuters Health) - Sleep-disordered breathing may nearly double the risk of type 2 diabetes for older patients, researchers say.

"Recent evidence suggests that diabetes patients have a higher prevalence of sleep disturbances than the general population," lead author Dr. Linn Beate Strand told Reuters Health by email. "However, less is known about whether symptoms of sleep-disordered breathing increase the risk of developing type 2 diabetes later, especially in older adults."

C. difficile-associated megacolon incidence, mortality rising in the US

By Larry Hand

NEW YORK (Reuters Health) - Health care professionals should be highly suspicious of megacolon in Clostridium difficile-infected patients and have a low threshold for transferring infected patients to intensive care units, Veterans Affairs researchers warn.

"The incidence of Clostridium difficile-associated megacolon has nearly tripled and mortality has nearly doubled over the past decade," Dr. SreyRam Kuy from the Overton Brooks VA Medical Center in Shreveport, Louisiana, told Reuters Health by email.

Unwelcome news about Medicare's rising drug plan costs

By Mark Miller

CHICAGO (Reuters) - Seniors have received some unpleasant news in their mailboxes in recent weeks: premiums for many Medicare prescription drug insurance plans will rise at double-digit rates next year.

Premiums for the ten most popular Medicare Part D prescription drug plans (PDPs) will rise an average of 8% next year - the fastest clip in five years, according to Avalere Health, a consulting and research firm. And five of the top plans will boost their average premiums anywhere from 16% to 26%.

Discussing life expectancy gives advanced cancer patients realistic view

By Kathryn Doyle

NEW YORK (Reuters Health) - When doctors discuss prognosis with advanced cancer patients, those patients have more realistic views of their life expectancy and don't seem to experience a decrease in emotional wellbeing, according to a new study.

"That the vast majority of cancer patients who are dying say that they want to know their prognosis seems surprisingly courageous," senior author Dr. Holly G. Prigerson of Weill Cornell Medical College in New York City told Reuters Health by email.

Flu vaccine helps reduce flu-associated pneumonia

By Kathryn Doyle

NEW YORK (Reuters Health) - In a study of patients with pneumonia, those whose pneumonia was related to the flu were more likely to have skipped the flu vaccine, compared to patients with pneumonia from other causes.

"We knew that influenza vaccines could prevent fever and respiratory symptoms associated with influenza infections, but whether influenza vaccines could prevent pneumonia . . . was unclear," Dr. Carlos G. Grijalva, of the Vanderbilt University School of Medicine in Nashville, Tennessee, told Reuters Health by email.

Spironolactone best add-on in resistant hypertension

By David Douglas

NEW YORK (Reuters Health) - Add-on spironolactone is superior to bisoprolol and to doxazosin in helping control resistant hypertension, according to a new UK trial.

"Spironolactone, a treatment that has been around for 50 years, is by far the most effective treatment for resistant hypertension," lead author Dr. Bryan Williams of University College London told Reuters Health by email. "These results should influence hypertension treatment guidelines world-wide."

Complex patients more likely to switch from Medicare Advantage

By Andrew M. Seaman

NEW YORK (Reuters Health) - Medicare Advantage plans might not be meeting the needs of patients requiring the costliest and most complex levels of care, a new study suggests.

Between 2010 and 2011, such patients were more likely to switch from Medicare Advantage plans to traditional Medicare, rather than vice versa, researchers found.

California governor signs bill legalizing physician-assisted suicide

By Sharon Bernstein

SACRAMENTO, Calif. (Reuters) - Physician-assisted suicide will become legal in California under a bill signed into law on Monday by Democratic Governor Jerry Brown.

The law, based on a similar measure in Oregon, allows doctors to prescribe medication to end a patient's life if two doctors agree the person has only six months to live and is mentally competent.