However, there was no decrease in stroke rates among blacks.

“It’s encouraging that, for the first time ever in our study area, there is a drop in the most common type of stroke,” said Dawn Kleindorfer, M.D., lead author of the study and assistant professor of neurology at the University of Cincinnati. “However, it’s very disappointing that the racial disparity seems to be getting worse.”

Investigators found that the age-adjusted annual rate of ischemic stroke (those caused by a blood clot) resulting in hospitalization changed between 1999 and 2005 from:
189 to 167 per 100,000 overall, an 11.6 percent drop;
180 to 154 per 100,000 among whites, a 14.4 percent reduction;
263 to 275 per 100,000 among blacks, a 4.6 percent rise, but not a significant change.

The patterns remained the same when out-of-hospital strokes were included. During the same period, researchers found no change in the rate of hemorrhagic strokes (those caused by bleeding).
The likelihood of dying after an ischemic stroke remained steady over time and was similar in whites and blacks, about 10 percent, according to the report.

Researchers used data from the Greater Cincinnati/Northern Kentucky Stroke Study, which gathered information on all first strokes occurring in a five-county area with 1.3 million people. The counties include urban, suburban and rural areas. It’s comparable to the nation in education, income and in the percentage of blacks (18 percent), but does not include a substantial proportion of persons of Hispanic ethnicity (less than 3 percent).

“When you look at national maps on mortality, you see many more stroke deaths in blacks,” Kleindorfer said. “According to our data, this occurs because blacks are far more likely to have a stroke to begin with, not because they are more likely to die once the stroke happens.”

The racial disparity could not be explained by differences in the occurrence and treatment of stroke risk factors. According to a telephone survey conducted in the study area, blacks were more likely than whites to have been diagnosed with risk factors such as high blood pressure and diabetes, but they were also more likely to be receiving treatment for these conditions.

“We’ve done a lot of work in the community to increase stroke awareness and encourage prevention, but the stroke rates are absolutely stable in blacks,” Kleindorfer said.

The investigators are collecting 2010 data in their ongoing phase of their epidemiology of stroke project.
Stroke is the third leading cause of death in the United States and a leading cause of major disability in adults.

Co-authors are Jane Khoury, Ph.D.; Charles J. Moomaw, Ph.D.; Kathleen Alwell, R.N.; Daniel Woo, M.D.; Matthew L. Flaherty, M.D.; Pooja Khatri, M.D.; Opeolu Adeoye, M.D.; Simona Ferioli, M.D.; Joseph P. Broderick, M.D.; and Brett M. Kissela, M.D. Individual author disclosures are on the manuscript.

Dutch scientists who carried out the study said the findings suggest that regular checking of vitamin B-12 levels during long-term metformin treatment should be “strongly considered” to try to prevent deficiency and its effects.

Vitamin B12 is essential to maintain healthy nerve cells and red blood cells. It is found in meat, dairy products, eggs, fish, shellfish and fortified breakfast cereals, and it also can be taken as a supplement.

Coen Stehouwer of Maastricht University Medical Center in the Netherlands, whose study was published in the British Medical Journal, said symptoms of B12 deficiency include fatigue, mental changes, anemia and nerve damage known as neuropathy.

All these symptoms can easily be misdiagnosed as being due to diabetes and its complications, or to aging, he said, but checking B12 levels could help doctors to assess the real cause and treat it if it was found to be B12 deficiency.

“Our data provide a strong case for routine assessment of vitamin B12 levels during long term treatment with metformin,” Stehouwer wrote.

An estimated 246 million people around the world have diabetes and rates are expected to rise along with the number of people who are overweight or obese. Most sufferers have type 2 diabetes, the kind linked with poor diet and lack of exercise.

Stehouwer’s team studied 390 patients with type 2 diabetes, giving metformin to 196 of them three times a day for more than four years, and a placebo, or dummy pill, to the other 194.

They found that people who had taken the metformin had a 19 percent reduction in their vitamin B12 levels compared with people who had taken a placebo, who had almost no B12 change.

The reduced levels of vitamin B12 in the metformin group also persisted and became more apparent over time, they said.

“Our study shows that it is reasonable to assume harm will eventually occur in some patients with metformin-induced low vitamin B12 levels,” Stehouwer wrote.

In a comment on the study, Josep Vidal-Alaball, a specialist in primary care and public health at Heath Park in Cardiff, Wales, said assessments should be carried out to see if giving patients advice on B12 in their diets would solve the problem.

“If it does not, a trial of screening for vitamin B-12 deficiency in patients taking metformin would be needed,” he wrote.

Nancy J. Sullivan, Ph.D., of the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases (NIAID), NIH, led the study team, which included collaborators from the U.S. Army Medical Research Institute for Infectious Diseases in Fort Detrick, Md., and the Centers for Disease Control and Prevention. Their findings appear May 20 in the open-access journal PLoS Pathogens. Currently, there are no specific treatments or vaccines available to control Ebola outbreaks.
Transmission electron micrograph of Ebola virus. Credit: CDC
Transmission electron micrograph of Ebola virus. Credit: CDC

“The important work by Dr. Sullivan and her colleagues shows that it is possible to generate immunity to newly identified species of Ebola virus with a vaccine originally designed to protect against a different species,” says NIAID Director Anthony S. Fauci, M.D. “This finding will guide future vaccine design and may open an avenue for developing a single vaccine that works against both known and emerging Ebola virus species.”

The experimental Ebola vaccine being developed at NIAID has two components, a prime and a boost. The prime consists of a DNA vaccine containing a small piece of genetic material encoding surface proteins from Zaire ebolavirus and Sudan ebolavirus. The boost consists of a weakened cold virus that delivers the Zaire ebolavirus surface protein.

Previously, Dr. Sullivan and her collaborators demonstrated that the prime-boost strategy produces a strong antibody response in monkeys. More importantly, the experimental vaccine induces a robust reaction by the cellular arm of the immune system. The cellular arm includes T cells, which help orchestrate the overall immune response.

“An ideal Ebola vaccine would stimulate broad immunity so that we wouldn’t have to scramble to create entirely new vaccines whenever new virus species are identified,” notes Dr. Sullivan.

However, developing one vaccine to protect against multiple Ebola virus species poses a challenge, she says. To the antibody-producing arm of the immune system, each species looks different. Neutralizing antibodies that recognize one Ebola species cannot readily recognize, or cross-neutralize, the others. T cells, in contrast, can cross-react, even when the target viruses share only small pieces in common.

After the emergence of Bundibugyo ebolavirus (BEBOV) in 2007, Dr. Sullivan’s team decided to revisit the prime-boost vaccine regimen to see if the cellular immunity generated would confer protection against the new virus species.
Researcher working in a biosafety level 4 laboratory.
Credit: U.S. Army Medical Research Institute of Infectious Diseases
Researcher working in a biosafety level 4 laboratory.
Credit: U.S. Army Medical Research Institute of Infectious Diseases

Four cynomolgus macaques received the DNA prime vaccine. A year later, the animals were boosted with the vector vaccine. Shortly after the boost, the four vaccinated monkeys and four unvaccinated ones serving as controls were exposed to lethal levels of BEBOV. All the unvaccinated animals became ill, and three died. None of the vaccinated animals showed any sign of illness. Analysis showed that the vaccinated monkeys developed T-cell responses sufficient to prevent or control infection by the novel Ebola virus species, even though the vaccine did not contain material from BEBOV and no antibodies against BEBOV were produced. The animal study was conducted in maximum-level biosafety containment laboratories at U.S. Army Medical Research Institute of Infectious Diseases.

Now the research team is evaluating what parts of the T-cell response were critical to the vaccine’s success against BEBOV. “Once we identify those critical aspects, we can design future vaccines to better elicit that desired immune cell-based activity and perhaps make a single vaccine that protects against all Ebola virus species,” says Dr. Sullivan.

Additional information on NIAID research on Ebola and other hemorrhagic fever viruses can be found at http://www.niaid.nih.gov/topics/ebolamarburg/pages/default.aspx.

The observation — based on work conducted solely with mice — might explain why men tend to store fat in their bellies, while women tend to pile it on their hips.

Researchers from UT Southwestern Medical Center explored the question by focusing on the fat distribution patterns of mice, which are similar to those of people. Genes were taken from the belly and hip fat of male mice and female mice, as well as from female mice whose ovaries had been removed to mimic human female menopause.

A genetic comparison of the removed fat cells revealed that out of approximately 40,000 mouse genes, only 138 were common to both genders.

“This was completely unexpected,” Dr. Deborah Clegg, UTSMC senior author and assistant professor of internal medicine, said in a news release. “We expected the exact opposite — that 138 would be different and the rest would be the same between the sexes.”

Clegg and her colleagues note that men tend to carry excess weight around their gut area, while pre-menopausal women are more likely to carry it around their butt, hips, and thighs. After menopause, stored fat in women then shifts to the waist area, following a drop in ovarian hormone levels.

Aside from genetic differences, fat tissue also seemed to differ in other basic ways, as male mice fed a high-fat diet for 12 weeks gained more weight than similarly fed female mice. Male fat tissue also seemed more prone to inflammation than female fat tissue, the authors noted.

On the other hand, female mice whose ovaries had been removed started to exhibit weight gain and inflammation patterns similar to those of the male mice.

The findings led the research team to suggest that ovarian hormones play a critical role in where fat gets deposited in women.

The finding is reported in the current issue of the International Journal of Obesity.

These patients are typically categorized as “Eating Disorder Not Otherwise Specified” (EDNOS), which has become a “mosh pit” that lumps dissimilar patients into a single category that’s poorly recognized by doctors and health insurers, according to primary author Dr. Rebecka Peebles, an adolescent medicine specialist with the Comprehensive Eating Disorders Program at Lucile Packard Children’s Hospital in California.

The EDNOS label is “a bit misleading to patients — it can make them feel like they don’t have a real eating disorder,” Peebles said in a hospital news release.

She and her colleagues investigated whether adolescents with EDNOS are less ill than those who meet the full diagnostic criteria for anorexia or bulimia. The researchers examined the medical records of more than 1,300 female patients treated for eating disorders at Packard Children’s, and created categories of “partial anorexia nervosa” and “partial bulimia nervosa” for patients who didn’t quite meet the full criteria for these diseases.

Among the findings:
Nearly two-thirds of the patients had been categorized as EDNOS.
Patients with partial anorexia were more similar to patients with full-blown anorexia than to other EDNOS patients with partial bulimia.
About 60 percent of the EDNOS patients met medical criteria for hospitalization and, on average, were sicker than patients diagnosed with full-blown bulimia.

The sickest EDNOS patients were those who had lost more than 25 percent of their body weight before diagnosis and had severe malnutrition. These girls had been overweight and lost weight too fast and dangerously in order to achieve what’s considered a normal weight. In some ways, these girls were worse off than underweight patients diagnosed with anorexia.

“People were initially just patting them on the back for their weight loss. It often took months or years for others to realize that what they were doing didn’t seem healthy,” Peebles said in the news release.

She believes that the findings, published online April 12 in the journal Pediatrics, suggest the need for re-evaluation of the medical criteria for eating disorders.

SOURCE: Lucille Packard Children’s Hospital, news release

The researchers said Monday their findings show it is possible to save women’s lives if countries want to and said their analysis should point to ways to do so.

The AIDS pandemic alone, they said, killed more than 61,000 women in and around the time of childbirth in 2008, most of them in Africa.

“These findings are very encouraging and quite surprising. There are still too many mothers dying worldwide, but now we have a greater reason for optimism than has generally been perceived,” said Dr. Christopher Murray of the Institute for Health Metrics and Evaluation at the University of Washington, who led the study.

The findings contradict work done by the World Health Organization, which reported last May that mothers and newborns are no more likely to survive now than 20 years ago.

Murray and colleagues took every bit of data they could find on deaths of women from records in 181 countries and plugged this information into a computer model.

“We estimated that there were 342,900 deaths worldwide in 2008, down from 526,300 in 1980,” they wrote in their report, published in the Lancet medical journal.

They found the number of women dying from pregnancy-related causes has dropped by more than 35 percent globally in the past 30 years.

“One of the most surprising results is the apparent rise in the maternal mortality rate in the USA, Canada, and Norway,” they added. But it can partly be because U.S. death certificates recently started asking about pregnancy, they added.

But this does not explain why U.S. maternal deaths are double the rates in Britain, triple the rates in Australia and four times the rate in Italy, they said.

In the United States the rate rose from 12 deaths per 100,000 live births in 1980 to 17 in 2008. In Canada, the rate hovered between 6 and 7 for the whole time and Norway’s rose from 7 per 100,000 in 1980 to 8 per 100,000 in 2008.

The United States is currently embroiled in reforming its healthcare system, where more is spent per capita than in comparable developed countries but with poorer results, as demonstrated by maternal and newborn death rates and high rates of diabetes and heart disease.

China, Egypt, Ecuador and Bolivia made some of the most progress in lowering maternal death rates, Murray’s team found.

In China, the rate fell from 165 per 100,000 to 40 per 100,000.

“Progress overall would have been greater if the HIV epidemic had not contributed to substantial increases in maternal mortality in eastern and southern Africa,” they added.

Nearly one out of every five maternal deaths or a total of 61,400 in 2008, were associated with AIDS infections.

About 80 percent of all deaths of pregnant women or new mothers were in 21 countries, with half of all such deaths in just six countries — India, Nigeria, Pakistan, Afghanistan, Ethiopia, and the Democratic Republic of the Congo.

“Finding out why a country such as Egypt has had such enormous success in driving down the number of women dying from pregnancy-related causes could enable us to export that success to countries that have been lagging behind,” Murray said.

The same effect, however, is not seen in men, according to the report, published April 12 in the Archives of Internal Medicine.

The study, by researchers at Italy’s National Cancer Institute, looked not only at total carbohydrate intake but also at what is known as the glycemic index of those carbohydrates — a measure of how quickly and to what extent blood sugar rises after intake of specific carbohydrates.

Carbohydrate foods with similar calorie content can show widely different scores on the glycemic index. Carbohydrates with a high glycemic index include corn flakes, white bread and white rice. Those with lower scores include whole wheat products and sweet potatoes.

“A high glycemic index is known to increase the concentration of triglycerides and lower the concentration of HDL cholesterol, the good kind,” explained Victoria J. Drake, director of the Micronutrient Information Center at the Linus Pauling Institute of Oregon State University, who has studied the subject. “Those adverse effects make it a stronger risk factor for heart disease.”

The Italian researchers got their information on dietary intake from questionnaires filled out by 15,171 men and 32,578 women. Following them for nearly eight years, the researchers found that women who consumed the most carbohydrates overall had about twice the incidence of heart disease as those who consumed the least. Closer analysis showed that the risk was associated with higher intake of high-glycemic foods.

“Thus, a high consumption of carbohydrates from high-glycemic index foods, rather than the overall quantity of carbohydrates consumed, appears to influence the influence of developing coronary heart disease,” the researchers wrote.

Previous studies have seen the same effect in other groups of women, Drake said. They include the Nurses Health Study, done in the United States, and studies of women in the Netherlands.

No effect from total carbohydrate consumption or consumption of foods with a high-glycemic index was seen in men in the Italian study, a pattern also seen in other studies, Drake added.

“There is definitely a gender difference,” she noted.

The difference might be due to the action of sex hormones, the researchers speculate. Male hormones, androgens, appear to slow the transformation of carbohydrates into blood sugar, whereas the female hormone estrogen speeds the process, she said.

Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York City, said the study shows the need for women to be more aware of the nature of the carbohydrates in their diet.

“An emphasis needs to be placed on a diet that is not simply low in carbohydrates but rather low in simple sugars, as measured by the glycemic index,” Steinbaum said.

There’s a simple way to determine the glycemic index of a food, she said.

“Look at the label,” Steinbaum said. “It says ‘carbohydrates.’ Under that, it says ’sugars.’ When you have a high number for sugars, that’s a way to know what the glycemic index is.”

That index can differ widely in foods that don’t appear to be different, she said. One breakfast cereal may have a sugar content of 16 grams, but another may have just 3 grams to 6 grams.

“If you see a high level of sugar, that’s the one to stay away from,” Steinbaum said.

SOURCES: Victoria J. Drake, Ph.D., research associate, Linus Pauling Institute, Oregon State University, Portland; Suzanne Steinbaum, D.O., director, women and heart disease, Heart and Vascular Institute, Lenox Hill Hospital, New York City;

These long-term results of the Early Treatment for Retinopathy of Prematurity (ETROP) study confirm that the visual benefit of early treatment for selected infants continues through 6 years of age. The research, published April 12 online in Archives of Ophthalmology, was supported by the National Eye Institute (NEI), part of the National Institutes of Health.

“This study has set the standard of care for infants with ROP by showing that early treatment of selected high-risk premature babies has positive longer-term results on vision,” said NEI Director Paul A. Sieving, M.D., Ph.D.

An estimated 15,000 premature infants born each year in the United States are affected by some degree of ROP. At-risk infants generally are born before 31 weeks of the mother’s pregnancy and weigh 2.75 pounds or less.

This disease, which usually develops in both eyes, is one of the most common causes of vision loss in children. About 90 percent of infants with ROP have a mild form that does not require treatment, but those who have a more severe form can develop lifelong visual impairment, and possibly blindness.

During pregnancy, the blood vessels of the eye gradually grow to supply oxygen and essential nutrients to the light-sensitive retina. If a baby is born prematurely, growth of the blood vessels may stop before they reach the edge of the retina. In these newborns, abnormal, fragile blood vessels and retinal tissue may develop at the edges of the normal tissue. The abnormal vessels can bleed, resulting in scars that pull on the retina. The main cause of visual impairment and blindness in ROP is retinal detachment. Laser therapy or cryotherapy, using freezing temperatures, are the most effective treatments to slow or stop the growth of abnormal blood vessels.

“The long-term study has given clinicians evidence that infants with ROP should be treated with different strategies based on an infant’s risk for a severe form of the disease, which can be determined through an exam at the bedside,” said study chair William V. Good, M.D., of Smith-Kettlewell Eye Research Institute in San Francisco.

Previously, doctors treated infants with ROP when they estimated their risk for retinal detachment to be 50 percent, a strategy developed through the NEI-supported Cryotherapy for Retinopathy of Prematurity study. Although this was a major finding, many infants still went on to develop severe eye disease. Therefore, the first phase of the ETROP study aimed to discover if doctors could identify infants at a higher risk for progression of the disease and intervene early to improve their vision.

In 2003, the ETROP study found that early treatment—upon diagnosis as higher risk for severe ROP—improved the vision and retinal health of certain infants after nine months. These infants had dilated or twisted blood vessels in the retina and substantial growth of new blood vessels, classified as Type 1 disease. Eyes with Type 2 ROP, or a more moderate amount of new blood vessel growth, did not benefit from early treatment. Doctors could predict which infants were more likely to benefit from early treatment by identifying certain eye characteristics, such as the appearance and location of the blood vessels.

The current study followed the same 370 children through 6 years of age, when researchers checked their vision and examined the development of their eyes. The nine-month study recommendations were confirmed through 6 years. Type 1 eyes benefitted from early treatment, and Type 2 eyes had similar results with either early treatment or treatment at the standard time. Seventy-five percent of the early-treated Type 1 eyes were spared legal blindness, compared with 67 percent of Type 1 eyes that received treatment at the standard time. Of the Type 2 eyes that were carefully monitored for disease progression through the standard protocol, more than half improved without treatment.

“Unfortunately, not all eyes selected for early treatment do well,” said Robert J. Hardy, Ph.D., director of the ETROP study coordinating center and professor of biostatistics at the University of Texas School for Public Health in Houston. “Additional research is needed to identify still better methods for the prevention and treatment of severe ROP.”

Almost 56 percent of patients who underwent the therapy, called stereotactic body radiation therapy (SBRT), were still alive three years after their treatment, according to preliminary findings from a study published in the March 17 issue of the Journal of the American Medical Association, a themed issue on cancer.

By contrast, only about 25 percent to 30 percent of patients who receive conventional fractionated radiotherapy survive that long.

“Stereotactic body radiation therapy controlled peripheral small tumors in a large majority of patients and had an impressive overall survival rate at three years,” said study lead author Dr. Robert Timmerman, professor of radiation oncology at the University of Texas Southwestern Medical Center at Dallas, speaking at a Tuesday teleconference.

Unfortunately, the risk of the cancer spreading to other parts of the body was still high, the researchers noted.

The U.S. National Institutes of Health-funded Radiation Therapy Oncology Group is planning further trials to refine the procedure.

“The study was done by the leading radiation therapy research group in the world but it was very small,” commented Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge. “It’s provocative but it’s not for all patients with lung cancer. This is for people who can’t undergo surgery, so I think surgery is still the best way to treat early lung cancer,” Brooks said.

“The radiation was effective at controlling the cancer in the spot but the cancer still has a high risk of spreading to other parts of the body,” he added.

Patients who cannot undergo surgery for early-stage lung cancer tend to be frail, with many other medical conditions. They are therefore unable to withstand invasive procedures that would track cancer recurrence, and even the initial biopsy can pose a risk.

Standard treatment right now for these patients is conventional radiation treatment given every weekday for six weeks, or simply observation with supportive care.

In addition to a high mortality rate, only 30 to 40 percent of these patients see their tumors controlled, meaning they don’t grow. Some 8,000 to 10,000 patients in this group are diagnosed each year in the United States, Timmerman said.

“Stereotactic body radiation therapy uses numerous small beams that converge on the target. Each beam is fairly weak [although the overall effect is strong] so there’s not as much entry damage and each beam, being very small, has to be guided very carefully with image guidance,” Timmerman explained.

This study involved 55 patients with inoperable early-stage non-small cell lung cancer, the most common type of lung cancer. Individual tumors were small with most measuring 3 centimeters or less.

Treatment involved 20- to 60-minute sessions one to five times a day or every other day. The entire course of therapy lasted only one-and-a-half to two weeks.

Three years after treatment, almost 98 percent of primary tumors were controlled; local control (the primary tumor and the lobe) was close to 91 percent; and the local-plus-regional control rate was just over 87 percent. This was about double the rate seen with conventional radiotherapy.

Just over 48 percent of participants made it to the three-year mark without a recurrence of their disease.

Disappointingly, 11 patients (22.1 percent) did develop distant metastases, eight of them within two years. The authors speculated that these patients already had metastases that were not detected at the time of diagnosis. But the rate of these recurrences was higher in patients with a certain type of larger tumors, suggesting there may be ways to address this.

Many individuals also had treatment side effects including rib fractures, chest-wall burns, painful swallowing and fluid build-up around the heart.

And the researchers note that many patients continued to smoke throughout and after their treatment.

“There’s definite room for improvement moving forward with therapies,” Timmerman said.

Timmerman reported receiving monies from two companies who manufacture equipment used in SBRT. The study itself, however, was not funded by private interests.

Trauma patients are particularly vulnerable to hospital-acquired infections, Dr. Heather L. Evans of Harborview Medical Center in Seattle, one of the study’s authors, told Reuters Health.

“Many of these patients will go directly to the operating room and maybe not get the best preoperative cleansing, just because the circumstances are such that they need an immediate operation,” she explained.

Researchers had previously shown that bathing medical intensive care unit (ICU) patients with cloths containing the antiseptic chlorhexidine gluconate reduced infections with two types of drug-resistant bacteria, Evans and her team note in their report in the Archives of Surgery.

To investigate whether the cloths would be helpful for trauma ICU patients as well, the researchers used antiseptic-free disposable cloths to bathe these patients daily for six months, and then used the antiseptic cloths for another six months.

Antiseptic bathing cut the likelihood that patients would develop catheter-related bloodstream infections, as well as the risk of ventilator-associated pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA, popularly known as a “superbug”). Such superbugs kill about 25,000 people a year in Europe and 19,000 in the United States.

Patients who had the antiseptic baths were also significantly less likely to have MRSA or another tough-to-treat bug, Acinetobacter, growing on their bodies, known medically as “colonization.”

Patients in the non-antiseptic group were at nearly triple the risk of having MRSA colonization compared to those who got the antiseptic baths. The only adverse effects that occurred were rashes in two patients.

Evans noted that all ICU patients at Harborview are now being bathed with the chlorhexidine-containing cloths. In 2007, she added, there were 20 cases of MRSA infection per every 1,000 patients admitted; now there are 7.6 for every 1,000 admissions. “That’s pretty impressive,” she said.

Still, the design of the study did not prove the new cloths were responsible for the change, and there is an expense involved: Chlorhexidine cloths cost $5.52 per bath, according to the study, while the regular bath product costs $1.23 per bath. Whether that expense is worth it for thousands of patients per year will require further study, the authors note.

Another potential concern, notes Dr. Shirin Towfigh, of Cedars-Sinai Medical Center, Los Angeles, is that using the chlorhexidine cloths could actually lead to other drug-resistant bacteria. However, Towfigh writes in an accompanying editorial, the study demonstrates important benefits.

SOURCE: Archives of Surgery.