Tuesday, 22 December 2009
My Photography
Shot with a 18-55 lens Cannon 350D
MRSA- is the hospital the best place when you are ill?
Methicillin-resistant Staphylococcus aureus is a strain of Staphylococcus aureus that is resistant to many different antibiotics which include the penicillin’s. The strains of MRSA were first reported in 1961 and is now known as one of the ‘super bugs’, the numbers of cases in the US in the past decade have increased exponentially from approximately 127,000 in 1999 to 278,000 in 2005.
The first indications that someone has been infected with MRSA are small red bumps like pimples, spider bites, or boils that this then may be followed with rashes and a fever. After a couple of days the bumps become larger and painful, this is then followed by them opening and becoming puss filled boils. This can then lead to people getting pneumonia, septicemia, meningitis and endocarditis.
The reason for MRSA being so hard to treat and prevent is firstly its ability to survive on fabrics and other surfaces, such as where it is commonly found on door handles and toilet seats. There are also many different strains of MRSA which are constantly changing and adapting themselves to become resistant to many different types of treatments, which therefore makes it very hard to find working antibiotics and even once a working antibiotic has been found the strain that it kills may become resistant.
One of the most common places in which MRSA is found is in prisons and in hospitals. In hospitals, patients with open wounds and other illnesses that can weaken the immune system are more susceptible to contracting MRSA. Hospital staff that do not follow the appropriate rigorous procedure in order to eliminate the spread of MRSA run the risk of transferring MRSA from patient to patient as it can be transferred by touch. Another way MRSA is transferred is by visitors to hospitals, in order to visit patients visitors run the risk of infecting patients as you do not have to be ill with MRSA to spread it, you may be carrying a colonization of it, which most commonly is found in the nose. Visitors are advised to use hospital isolation methods by using gloves, gowns, and masks and of course washing your hands with anti-bacterial soap or alcohol gel, however these are not always used therefore visitors are capable of spreading the bacteria to bathrooms, vending machines, door handles, anywhere that is touched and the patients themselves.
Why hospitals are a safe place to go when you are ill
Firstly hospitals offer a place in which you are given specialist treatment in order to get better, for example if you were to have a large cut which required stitches and you did not go to hospital you would run the risk of getting an infection, or getting gangrene, this without treatment can escalate and may even result in death. So without hospitals many more people would die from easily treatable illnesses.
The reason why people may draw question to their safety from super bugs like MRSA when in hospitals is because; the media have so over-emphasised the point of MRSA being in hospitals that people believe that it is the only place where you can contract it, which is wrong as the only reason why people contract MRSA in hospitals is due to people being more susceptible to becoming infected due to open wounds and weaker immune systems and it is more common due to the large quantity of people passing through.
To combat this higher risk of contracting MRSA in hospitals the government has had a ‘crack-down’ on cleanliness and hygiene in hospitals. This has had an effect as since MRSA’s peak in 2003/4 the governments implementation of new systems in order to reduce the number of cases, such as screening of all in-patients when entering a hospital, has caused the cases of MRSA to drop by almost 1000 annually, see Graph right .
The government is also finding new antibiotics to treat MRSA such as Platensimycin which was discovered in May 2006, and as the bacteria adapts the new research is being carried out.
Once you have MRSA as long as there is an up to date treatment, that the bacteria has not become resistant to then you can be treated, however if you were not to go to a hospital, then it could become much more serious. Also different people are more susceptible to contracting MRSA it mainly effects the elderly male population as the graph to the right states, showing that not everyone is at high risk, See Graph right This data has been obtain from accurate and reliable sources.
Why hospitals are not a safe place to be when you are ill
Despite being a place which specialises in treating people who are ill, hospitals in the UK have a nature of treating hundreds of people every day therefore they encounter many more different bacteria and viruses than any other places and even hospitals in different countries. In France they have developed a scheme where you have to pay each time you visit a hospital, which decreases the amount of people visiting hospitals as those who are not severely ill do not go to hospital, they go to their GP’s, which therefore reduces the number of infections and diseases being spread, like MRSA as there are firstly less people to become infected but also there are fewer people who will be carrying the bacteria. Due to this doctors in France are able to screen a much higher percentage of patients for diseases and bacteria and it is also much easier to isolate carriers of MRSA and eliminate the bacteria therefore limiting the spread of infection. If the UK was to adopt a similar scheme to France then it would be safer to go into hospitals. * The data obtained on French hospitals may be unreliable.
Another reason why it is not safe to enter hospitals is that despite the number of cases of MRSA being reported is now decreasing the amount of deaths has increased exponentially from below 500 cases in 1993 to over 2,000 in 2005 see right This data has been obtain from accurate and reliable sources.
There are flaws in the healthcares new system of attempting to decrease the number of MRSA cases as Susan Graham of Birmingham Public Health Laboratory, Birmingham Heartlands hospital was interviewed, and in this interview it was revealed that despite new measures taking place in which all in-patients are supposed to be screened for MRSA, , “staff are often unable to take swabs which therefore may allow the bacteria to be spread throughout the hospital”. This therefore renders the new schemes obsolete as even if they screen 100 people and one person has MRSA and they are swabbed inaccurately or not swabbed and MRSA is not detected then this allows the bacteria to spread throughout the hospital. The effect of this is obviously noticeable as the graph above shows. *this was the observation from a single person only and may not be the case throught the NHS.
Due to the amount of MRSA if you go to hospital with something like a cut which needs stitches then you are more likely to contract MRSA as all it needs is your nurse to touch the bacterium and then touch you, this is also the same for any object you touch as MRSA is able to survive outside of the body, on objects, so then you become infected with MRSA, therefore the best place for you to go is to go to your local GP.
Conclusion
Obviously without hospitals huge numbers of people would die or be in severe pain; however those who are not an emergency have alternatives such as seeing their GP or pharmacist, and I would advise this as it reduces the risk of becoming infected with MRSA. However MRSA has reached its peak in 2003 and is falling and other “superbugs” are arising, such as Clostridium difficile.
There is another fact that people forget MRSA mainly affects elderly people, in particular elderly men, this does not mean that if you are young you are immune, it means that it is a bacteria that has its biggest effect on those with already weakened immune systems.
So is the hospital the best place to be when you are ill? Well I believe that it really depends on the severity of your illness an nature of your illness, such as open wounds, the need for an intravenous drip and the need for a catheter. For life threatening illnesses large hospitals are the only option in this country. What should also be recognised is that MRSA may not be a difficult illness to treat, once detected, however if not detected it can get very serious.
My strongest evidence was the evidence obtained from the HPA as it gave non subjective reliable evidence, however it gave information that supported both sides of my arguments so I used other information to back up the conflict between both my arguments. From my article the view that I believe had the most weight was that he hospital was not the best place to be, however in order for this to happen other alternatives must have been offered such as smaller more frequent clinics which the UK does not currently have.
Bibliography
http://news.bbc.co.uk/1/hi/health/medical_notes/j-m/2572841.stm
Updated 24 February 2005
I used this source as the BBC is a trusted company that is verified and I can trust the information from it. It also provided simple information that was easy to obtain.
http://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus
Updated 4 January 2009
Despite being a website that allows free upload of information from the public, I trusted the information off this website, firstly as it had been verified by an actual professor of bio chemistry, but also as I researched what this article said and found out it was true.
http://www.nhsdirect.nhs.uk/articles/article.aspx?articleID=252
http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=252§ionId=10
Updated 30/11/2007
I got information from this website, as it is the website for our healthcare, the NHS, therefore is good for obtaining statistics, information and graphs.
http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1194947365238
Updated: 27 February 2008
http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1216193832974
Updated 18 December 2008
I got information from the Heath protection agency as it is a recognized agency that carries out its own independent survey’s in order to get its information which therefore makes it very reliable, it also gives easy access to good quality graphs and information that is not subjective.
http://www.statistics.gov.uk/cci/nugget.asp?id=1067
28 August 2008
I used this website as it was an official government website, in order to give official information and statistics, which are obviously reliable.
http://www.enjoyfrance.com/directory/Health/Hospitals-and-Clinics/Hospitals/10-72-64-0.html
I used this website as it gave information on french hospitals, however as it was a website to advertise france as having good hospitals some of the data may have been biassed, but I did check out the information that I was given and it was accurate.
Due to the fact that the Heath protection agency is an independent agency, that is recognized as being reliable and that it carries out its own independent reviews, I believe this is my best source as it ensures the data is non-subjective and even official government statists can be wrong as they occasionally use estimates from old data whereas the Health Protection agency’s main aim is to provide reliable and accurate data.
Myocardial Infarction
Myocardial infarction (MI) is usually caused by a blood clot that stops blood flow in a heart (coronary) artery. Call for an ambulance immediately if you develop severe chest pain. Treatment with a 'clot busting' drug or an emergency procedure to restore blood flow through the blocked artery are usually done as soon as possible to prevent damage to heart muscle. Other treatments help to ease the pain and prevent complications. Reducing risk factors can help to prevent an MI.
What is a myocardial infarction?
Myocardial infarction (MI) means that part of the heart muscle suddenly loses its blood supply. Without prompt treatment, this can lead to damage to the affected part of the heart. An MI is sometimes called a heart attack or a coronary thrombosis. An MI is part of a range or disorders called 'acute coronary syndromes'.
If you have an MI, a coronary artery or one of its smaller branches is suddenly blocked. The part of the heart muscle supplied by this artery loses its blood (and oxygen) supply. This part of the heart muscle is at risk of dying unless the blockage is quickly undone. (The word 'infarction' means death of some tissue due to a blocked artery which stops blood from getting past.)
If one of the main coronary arteries is blocked, a large part of the heart muscle is affected. If a smaller branch artery is blocked, a smaller amount of heart muscle is affected. In people who survive an MI, the part of the heart muscle that dies ('infarcts') is replaced by scar tissue over the next few weeks.
What causes myocardial infarction?
Thrombosis - the cause in most cases
The common cause of an MI is a blood clot (thrombosis) that forms inside a coronary artery, or one of its branches. This blocks the blood flow to a part of the heart.
Blood clots do not usually form in normal arteries. However, a clot may form if there is some atheroma within the lining of the artery. Atheroma is like fatty patches or 'plaques' that develop within the inside lining of arteries. (This is similar to water pipes that get 'furred up'.) Plaques of atheroma may gradually form over a number of years in one or more places in the coronary arteries. Each plaque has an outer firm shell with a soft inner fatty core.
What happens is that a 'crack' develops in the outer shell of the atheroma plaque. This is called 'plaque rupture'. This exposes the softer inner core of the plaque to blood. This can trigger the clotting mechanism in the blood to form a blood clot. Therefore, a build up of atheroma is the root problem that leads to most cases of MI. (The diagram above shows four patches of atheroma as an example. However, atheroma may develop in any section of the coronary arteries.)
Treatment with 'clot busting' drugs or a procedure called angioplasty can break up the clot and restore blood flow through the artery. If treatment is given quickly enough this prevents damage to the heart muscle, or limits the extent of the damage.
Who has a myocardial infarction?
MI is common. About 180,000 people in the UK are admitted to hospital each year with an MI. Most MIs occur in people over 50, and become more common with increasing age. Sometimes younger people are affected. An MI is three times more common in men than women. An MI may occur in people known to have heart disease such as angina. It can also happen 'out of the blue' in people with no previous symptoms of heart disease. (Atheroma often develops without any symptoms at first.).
What are the symptoms of a myocardial infarction?
Severe chest pain is the usual main symptom. The pain may also travel up into your jaw, and down your left arm, or down both arms. You may also sweat, feel sick, and feel faint. The pain may be similar to angina, but it is usually more severe and lasts longer. (Angina usually goes off after a few minutes. MI pain usually lasts more than 15 minutes - sometimes several hours.)
•Aspirin - to reduce the 'stickiness' of platelets in the blood which helps to prevent blood clots forming. If you are not be able to take aspirin then an alternative anti-platelet drug such as clopidogrel may be advised.
•A beta-blocker - to slow the heart rate, and to reduce the chance of abnormal heart rhythms developing.
•An ACE inhibitor (angiotensin converting enzyme inhibitor). ACE inhibitors have a number of actions including having a protective effect on the heart.
•A statin drug to lower the cholesterol level in your blood. This helps to prevent the build-up of atheroma.
Also, you will normally be advised to take the antiplatelet drug clopidogrel in addition to aspirin. However, this is usually only advised for a certain number of weeks or months, depending on the type and severity of the MI.
Everybody has a risk of developing atheroma which can lead to an MI. However, certain 'risk factors' increase the risk and include:
•Preventable or treatable risk factors:
◦smoking
◦hypertension (high blood pressure)
◦high cholesterol level
◦lack of exercise
◦a poor diet
◦obesity
◦excess alcohol
•Having diabetes. But if you have diabetes, the increased risk of heart disease is minimised by good control of the blood sugar level, and reducing blood pressure if it is high.
•Risk factors that are fixed and you cannot change:
◦a family history of heart disease or a stroke that occurred in a father or brother aged below 55, or in a mother or sister aged below 65
◦being male.
◦ethnic group (for example, British Asians have an increased risk).
Coronary heart disease is heart disease due to an abnormality of the coronary arteries that supply blood and oxygen to the heart, such as a build up of atheroma.
Source:
http://www.patient.co.uk/health/Myocardial-Infarction-(Heart-Attack).htm
Hobbies
Firstly, Mountain biking. Wow, I bet you are all thinking "this guy has an interesting life, he consciously choses to ride something with two wheels, fueled only by the riders interest to wear large amounts of lycra and then proceed to get hot and sweaty in it" but no, there's no lycra round here. Downhill Mountain biking, is very much the opposite, it is a sport in which a thirst for adventure is neccasary , as shown by the picture below.
Next surfing, a sport that is largly about climbing into tight fitting clothing and then proceeding to paddle around in the sea on bits of plastic, with large numbers of other men (or women) also clad in this tight gear.
However it is great fun, especially for more scoial reasons, no one likes the lone surfer who gets annoyed when he falls off and starts thrashing at the water like some form of distressed animal, but if you're with friends, its a much more enjoyable experience.
This is me in France two years ago.
Sailing is a thoroughly relaxing yet enjoyable activity, whether it's sailing a yacht down the french coast ordering your crew members around, or sailing a Laser in the mediterranean, racing your friends. Different to common misconception it's not all about the wealthy, purchasing a boat, just so it can sit alongside a pier and be mentioned in conversation at every possible occasion. I am now qualified with an RYA Level 2 Sailing with spinnakers certificate.
Lastly rugby, rugby is a slightly more common sport especially for me who takes great interest in chosing sports that involve water when I live in one of the most land-locked places in England.
I have played rugby for 6 years now, all this time representing Lichfield, who during this time, won the county final 5 times. I have also represented King Edward VI Lichfield through numerous age groups, and now the 1st XV squad. I have also represented Staffordshire county for two years.
I'll be sure to update this post once more sports begin to interest me, thank you for reading.