Simple measures cut infections caught in hospitals

CHICAGO (AP) — Preventing surgery-linked infections is a major concern for hospitals and it turns out some simple measures can make a big difference.

A project at seven big hospitals reduced infections after colorectal surgeries by nearly one-third. It prevented an estimated 135 infections, saving almost $4 million, the Joint Commission hospital regulating group and the American College of Surgeons announced Wednesday. The two groups directed the 2 1/2-year project.

Solutions included having patients shower with special germ-fighting soap before surgery, and having surgery teams change gowns, gloves and instruments during operations to prevent spreading germs picked up during the procedures.

Some hospitals used special wound-protecting devices on surgery openings to keep intestine germs from reaching the skin.

The average rate of infections linked with colorectal operations at the seven hospitals dropped from about 16 percent of patients during a 10-month phase when hospitals started adopting changes to almost 11 percent once all the changes had been made.

Hospital stays for patients who got infections dropped from an average of 15 days to 13 days, which helped cut costs.

"The improvements translate into safer patient care," said Dr. Mark Chassin, president of the Joint Commission. "Now it's our job to spread these effective interventions to all hospitals."

Almost 2 million health care-related infections occur each year nationwide; more than 90,000 of these are fatal.

Besides wanting to keep patients healthy, hospitals have a monetary incentive to prevent these infections. Medicare cuts payments to hospitals that have lots of certain health care-related infections, and those cuts are expected to increase under the new health care law.

The project involved surgeries for cancer and other colorectal problems. Infections linked with colorectal surgery are particularly common because intestinal tract bacteria are so abundant.

To succeed at reducing infection rates requires hospitals to commit to changing habits, "to really look in the mirror and identify these things," said Dr. Clifford Ko of the American College of Surgeons.

The hospitals involved were Cedars-Sinai Medical Center in Los Angeles; Cleveland Clinic in Ohio; Mayo Clinic-Rochester Methodist Hospital in Rochester, Minn.; North Shore-Long Island Jewish Health System in Great Neck, NY; Northwestern Memorial Hospital in Chicago; OSF Saint Francis Medical Center in Peoria, Ill.; and Stanford Hospital & Clinics in Palo Alto, Calif.

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Online:

Joint Commission: http://www.jointcommission.org

American College of Surgeons: http://www.facs.org

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

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Wall Street climbs at open on "cliff" deal hope

NEW YORK (Reuters) - U.S. stocks rose in early trading on Thursday on optimism that Congress was progressing toward a fiscal agreement in Washington that would avert a possible recession.

Market participants are focused on discussions in Congress over avoiding big spending cuts and tax hikes, known as the "fiscal cliff," beginning in January. Still, equities may retreat, as they did Tuesday, if the upbeat negotiation environment in Washington deteriorates.

"There will be a deal before December 31 to avert the economy facing disaster," said Peter Cardillo, chief market economist at Rockwell Global Capital in New York.

"We're back on track for a year-end rally to continue," he said.

The yield on Italy's 10-year bonds fell to the lowest in two years at an auction, amid relief that immediate risks over Greece had diminished.

"The fact that the bond sales in Europe went well suggest confidence is beginning to reenter some of the peripheral nations and that is a good sign," Cardillo said.

The euro briefly touched the $1.30 level and is near its highs for November, boosting commodity prices. The S&P materials sector index <.gspm> led gains with a 0.8 percent advance.

The Dow Jones industrial average <.dji> rose 50.15 points, or 0.39 percent, to 13,035.26. The S&P 500 <.spx> gained 7.07 points, or 0.50 percent, to 1,417.00. The Nasdaq Composite <.ixic> added 20.21 points, or 0.68 percent, to 3,011.99.

Equity markets may also be supported by data showing the U.S. economy grew faster than first reported between July and September. Separate data showed the number of Americans filing new claims for unemployment benefits dropped for a second week, and a larger-than-expected 3.3 percent advance in third-quarter corporate profits.

Due for release later Thursday are pending home sales for October, at 10:00 a.m. (1500 GMT), and the Federal Reserve Bank of Kansas City November manufacturing survey at 11:00 a.m.

Kroger , the biggest U.S. supermarket operator, added 3.3 percent to $25.89 after reporting earnings.

Tiffany shares slumped 7.9 percent to $58.72 after the upscale jeweler reported quarterly results and cut its full-year sales and profit forecasts.

Top retailers said weak sales in early November, after superstorm Sandy, were a drag on the month. Target fell 2 percent and Kohl's Corp dropped 10.3 percent.

U.S.-listed shares of BlackBerry maker Research In Motion surged 8.5 percent to $12.06 after Goldman Sachs upgraded the stock to "buy" from "neutral."

(Editing by Bernadette Baum)

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News Analysis: Sunni Leaders Gaining Clout in Mideast

Mohammed Saber/European Pressphoto Agency

A Palestinian woman in Gaza City on Tuesday walked amid the rubble left from eight days of fighting that ended in a cease-fire.

RAMALLAH, West Bank — For years, the United States and its Middle East allies were challenged by the rising might of the so-called Shiite crescent, a political and ideological alliance backed by Iran that linked regional actors deeply hostile to Israel and the West.

But uprising, wars and economics have altered the landscape of the region, paving the way for a new axis to emerge, one led by a Sunni Muslim alliance of Egypt, Qatar and Turkey. That triumvirate played a leading role in helping end the eight-day conflict between Israel and Gaza, in large part by embracing Hamas and luring it further away from the Iran-Syria-Hezbollah fold, offering diplomatic clout and promises of hefty aid.

For the United States and Israel, the shifting dynamics offer a chance to isolate a resurgent Iran, limit its access to the Arab world and make it harder for Tehran to arm its agents on Israel’s border. But the gains are also tempered, because while these Sunni leaders are willing to work with Washington, unlike the mullahs in Tehran, they also promote a radical religious-based ideology that has fueled anti-Western sentiment around the region.

Hamas — which received missiles from Iran that reached Israel’s northern cities — broke with the Iranian axis last winter, openly backing the rebellion against the Syrian president, Bashar al-Assad. But its affinity with the Egypt-Qatar-Turkey axis came to fruition this fall.

“That camp has more assets that it can share than Iran — politically, diplomatically, materially,” said Robert Malley, the Middle East program director for the International Crisis Group. “The Muslim Brotherhood is their world much more so than Iran.”

The Gaza conflict helps illustrate how Middle Eastern alliances have evolved since the Islamist wave that toppled one government after another beginning in January 2011. Iran had no interest in a cease-fire, while Egypt, Qatar and Turkey did.

But it is the fight for Syria that is the defining struggle in this revived Sunni-Shiite duel. The winner gains a prized strategic crossroads.

For now, it appears that that tide is shifting against Iran, there too, and that it might well lose its main Arab partner, Syria. The Sunni-led opposition appears in recent days to have made significant inroads against the government, threatening the Assad family’s dynastic rule of 40 years and its long alliance with Iran. If Mr. Assad falls, that would render Iran and Hezbollah, which is based in Lebanon, isolated as a Shiite Muslim alliance in an ever more sectarian Middle East, no longer enjoying a special street credibility as what Damascus always tried to sell as “the beating heart of Arab resistance.”

If the shifts seem to leave the United States somewhat dazed, it is because what will emerge from all the ferment remains obscure.

Clearly the old leaders Washington relied on to enforce its will, like President Hosni Mubarak of Egypt, are gone or at least eclipsed. But otherwise confusion reigns in terms of knowing how to deal with this new paradigm, one that could well create societies infused with religious ideology that Americans find difficult to accept. The new reality could be a weaker Iran, but a far more religiously conservative Middle East that is less beholden to the United States.

Already, Islamists have been empowered in Egypt, Libya and Tunisia, while Syria’s opposition is being led by Sunni insurgents, including a growing number identified as jihadists, some identified as sympathizing with Al Qaeda. Qatar, which hosts a major United States military base, also helps finance Islamists all around the region.

In Egypt, President Mohamed Morsi resigned as a member of the Muslim Brotherhood only when he became head of state, but he still remains closely linked with the movement. Turkey, the model for many of them, has kept strong relations with Washington while diminishing the authority of generals who were longstanding American allies.

“The United States is part of a landscape that has shifted so dramatically,” said Mr. Malley of the International Crisis Group. “It is caught between the displacement of the old moderate-radical divide by one that is defined by confessional and sectarian loyalty.”

The emerging Sunni axis has put not only Shiites at a disadvantage, but also the old school leaders who once allied themselves with Washington.

The old guard members in the Palestinian Authority are struggling to remain relevant at a time when their failed 20-year quest to end the Israeli occupation of Palestinian lands makes them seem both anachronistic and obsolete.

“Hamas has always argued that it is the future of the changes in the region because of its revolutionary nature, that it is part of the religious political groups who have been winning the revolutions,” said Ghassan Khatib, an official at Birzeit University and former government spokesman.

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Angus T. Jones's Video Surprises Two and a Half Men Set

By Mike Fleeman

11/28/2012 at 08:35 AM EST

After the Charlie Sheen tiger blood debacle, it would seem that nothing could shock the cast and crew of Two and a Half Men anymore.

Then came the Angus T. Jones video.

"This came as a surprise to most people. This isn't who he grew up as," a source on the show tells PEOPLE. "He's always been a good kid and he's very well-liked by everyone at the show."

The 19-year-old has blasted the CBS sitcom that pays him a reported $350,000 an episode, saying in a video posted on a religious website: "Please stop watching it. Please stop filling your head with filth."

The comments came during an apparent religious awakening for the actor in the Seventh-Day Adventist Church.

“We are happy that Angus has joined the Seventh-Day Adventist family and has found a place in which he feels comfortable to worship and grow his faith,” says George Johnson, a church spokesman. “Recently, Angus made some statements concerning his spiritual journey and expressed his views concerning the television program
Two and a Half Men.

"These comments are of a personal nature, reflecting his views after having undergone changes during his spiritual journey," Johnson continues. "We welcome him with open arms to the worldwide Seventh-Day Adventist Church family and are excited about his commitment to God through his recent baptism at his church."

Neither Jones nor reps for the show have spoken out.

The actor won't be on the set this week – which was previously planned because his character isn't involved in this episode.

"The cast was really surprised by the video," says a second source on set. "At first they didn't believe he'd say those things. ... He always has a great attitude, which is why everyone was surprised. He's friendly and talented and great at his job."

• Reporting by MONICA RIZZO, AILI NAHAS and MELODY CHIU

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CDC: HIV spread high in young gay males

NEW YORK (AP) — Health officials say 1 in 5 new HIV infections occur in a tiny segment of the population — young men who are gay or bisexual.

The government on Tuesday released new numbers that spotlight how the spread of the AIDS virus is heavily concentrated in young males who have sex with other males. Only about a quarter of new infections in the 13-to-24 age group are from injecting drugs or heterosexual sex.

The Centers for Disease Control and Prevention said blacks represented more than half of new infections in youths. The estimates are based on 2010 figures.

Overall, new U.S. HIV infections have held steady at around 50,000 annually. About 12,000 are in teens and young adults, and most youth with HIV haven't been tested.

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Online:

CDC report: http://www.cdc.gov/vitalsigns

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Wall Street opens lower on "cliff" worry

NEW YORK (Reuters) - Stocks opened lower on Wednesday, putting the S&P 500 on track for a third consecutive decline, as investors remained on edge given the lack of details on U.S. budget, or so-called fiscal cliff, talks.

The Dow Jones industrial average <.dji> dropped 53.22 points, or 0.41 percent, to 12,824.91. The Standard & Poor's 500 Index <.spx> dropped 7.44 points, or 0.53 percent, to 1,391.50. The Nasdaq Composite Index <.ixic> dropped 15.70 points, or 0.53 percent, to 2,952.09.

(Reporting by Chuck Mikolajczak; Editing by Kenneth Barry)

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Russian Court Convicts Martial Arts Fighter in Student’s Death

MOSCOW — In a case that has drawn renewed attention to ethnic tensions in Russia, a Moscow judge on Tuesday convicted the world champion mixed martial arts fighter, Rasul Mirzayev, of negligently causing the death of a Russian college student during a fight outside a nightclub in August 2011.

Mr. Mirzayev, 26, was born in Dagestan and is one of tens of thousands of immigrants from the North Caucasus who live in Moscow. He was convicted of killing Ivan Agafonov, a 19-year-old Russian student, outside a trendy nightclub in the capital.

After announcing the verdict, Judge Andrey Fedin ordered Mr. Mirzayev released based on time served. The maximum sentence was two years in prison and he had been jailed since shortly after the episode. Family members of the victim said that the sentence was insufficient and their lawyers pledged to appeal. Mr. Agafonov’s father stormed out of the courtroom as the verdict was being read.

Dozens of ethnic Russian nationalists demonstrated outside the courthouse where the police, fearing violence, had formed a cordon. Several of the demonstrators were arrested including Dmitry Dyumushkn, a burly nationalist leader who once headed a group called Slavonic Union that has been banned in Russia as extremist.

Mr. Mirzayev, a featherweight fighter who stands 5 feet 7 inches and weighs about 145 pounds, admitted punching Mr. Agafonov in the face after an exchange of words that allegedly included an insult concerning Mr. Mirzayev’s girlfriend. Mr. Agafonov fell, hit his head on a metal drain cover and died several days later.

Medical experts determined there were some errors in Mr. Agafonov’s care and Judge Fedin noted that those mistakes also could have contributed to his death.

The dispute unfolded outside a nightclub, called Garage, where Mr. Agafonov had been drinking. He was apparently playing with a remote-controlled toy car and exchanged some words with a young woman who had accompanied Mr. Mirzayev to the club.

Grainy footage of the episode, captured by a nearby security camera, seemed to show a brief altercation, with Mr. Agafonov crumpling to the ground after a receiving a swift blow.

Mr. Mirzayev originally faced a more serious charge punishable by up to 15 years in prison, but prosecutors requested that it be reduced. The trial was delayed repeatedly by disputes over the testimony of medical experts and other procedural wrangling.

The case had echoes of an episode in 2010, in which an immigrant from the North Caucasus shot and killed a soccer fan in Moscow, setting off riots in a square adjacent to the Kremlin.

Mixed martial arts, in which fighters use both striking and wrestling techniques, traces its origins to the ancient Olympic sport of pankration, in which competitors were allowed to fight using all powers and were barred by the rules only from biting an opponent or gauging out the opponent’s eyes. Mr. Mirzayev’s future in the sport is uncertain.

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The Voice Singers Tackle Risky Songs

TV Watch

The Voice

By Julia Haskins

11/27/2012 at 09:30 AM EST

From left: Cassadee Pope, Terry McDermott, Dez Duron, host Carson Daly, Cody Belew, Nicholas David, Trevin Hunte, Melanie Martinez and Amanda Brown

Tyler Golden/NBC

With the competition as fierce as ever Monday night on The Voice, coach Cee Lo Green predicted what would set the top eight apart.

"It's just about song choices at this point," he said.

And while some of performances had rough edges, the contestants made it their night to step out of their comfort zone with surprising song choices – to mixed reviews.

Ladies' favorite Dez Duron set out to prove he could go the pop route with Justin Bieber's "U Smile." Green and Adam Levine didn't go overboard with praise. But Duron's coach, Christina Aguilera, was floored. "You killed it, killed it, killed it, killed it," she said.

Aguilera was less fond of Melanie Martinez, who put her trademark quirky spin on Alex Clare's "Too Close." The song had special meaning, as Martinez channeled her own breakup through the song.

Aguilera thought it "didn't really go anywhere," but Martinez's coach, Levine, disagreed. Whoever broke her heart probably "feels like an idiot right now," Levine assured her.

The coaches were wary of Team Levine's Amanda Brown performing an Adele hit, as few performers on the show have been able to pull off the British singer's sultry sound. But Brown took a solid stab at "Someone Like You," offering a rock-inspired take on the lost-love anthem.

Following Cassadee Pope's lead from last week, Terry McDermott opted to sing another song by his coach, Blake Shelton. McDermott, known for his high-pitched vocals, hoped his performance of Shelton's "Over" would show off a broader range.

The coaches agreed that the risk had paid off. "So that's what that song's supposed to sound like," Levine said, teasing Shelton. But Shelton practically agreed. "You just performed that song the way I always wish I could," he told McDermott. "You just became the real deal."

The Voice returns Tuesday with eliminations.

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Bounce houses a party hit but kids' injuries soar

CHICAGO (AP) — They may be a big hit at kids' birthday parties, but inflatable bounce houses can be dangerous, with the number of injuries soaring in recent years, a nationwide study found.

Kids often crowd into bounce houses, and jumping up and down can send other children flying into the air, too.

The numbers suggest 30 U.S. children a day are treated in emergency rooms for broken bones, sprains, cuts and concussions from bounce house accidents. Most involve children falling inside or out of the inflated playthings, and many children get hurt when they collide with other bouncing kids.

The number of children aged 17 and younger who got emergency-room treatment for bounce house injuries has climbed along with the popularity of bounce houses — from fewer than 1,000 in 1995 to nearly 11,000 in 2010. That's a 15-fold increase, and a doubling just since 2008.

"I was surprised by the number, especially by the rapid increase in the number of injuries," said lead author Dr. Gary Smith, director of the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio.

Amusement parks and fairs have bounce houses, and the playthings can also be rented or purchased for home use.

Smith and colleagues analyzed national surveillance data on ER treatment for nonfatal injuries linked with bounce houses, maintained by the U.S. Consumer Product Safety Commission. Their study was published online Monday in the journal Pediatrics.

Only about 3 percent of children were hospitalized, mostly for broken bones.

More than one-third of the injuries were in children aged 5 and younger. The safety commission recommends against letting children younger than 6 use full-size trampolines, and Smith said barring kids that young from even smaller, home-use bounce houses would make sense.

"There is no evidence that the size or location of an inflatable bouncer affects the injury risk," he said.

Other recommendations, often listed in manufacturers' instruction pamphlets, include not overloading bounce houses with too many kids and not allowing young children to bounce with much older, heavier kids or adults, said Laura Woodburn, a spokeswoman for the National Association of Amusement Ride Safety Officials.

The study didn't include deaths, but some accidents are fatal. Separate data from the product safety commission show four bounce house deaths from 2003 to 2007, all involving children striking their heads on a hard surface.

Several nonfatal accidents occurred last year when bounce houses collapsed or were lifted by high winds.

A group that issues voluntary industry standards says bounce houses should be supervised by trained operators and recommends that bouncers be prohibited from doing flips and purposefully colliding with others, the study authors noted.

Bounce house injuries are similar to those linked with trampolines, and the American Academy of Pediatrics has recommended against using trampolines at home. Policymakers should consider whether bounce houses warrant similar precautions, the authors said.

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Online:

Pediatrics: http://www.pediatrics.org

Trade group: http://www.naarso.com

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

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Market opens down on "fiscal cliff" caution

NEW YORK (Reuters) - Stocks opened slightly lower on as worry over the threat to the economy posed by the "fiscal cliff" offset optimism from a deal to ease Greece's debt burden.

The Dow Jones industrial average <.dji> dropped 33.02 points, or 0.25 percent, to 12,934.35. The Standard & Poor's 500 Index <.spx> shed 2.58 points, or 0.18 percent, to 1,403.71. The Nasdaq Composite Index <.ixic> lost 4.07 points, or 0.14 percent, to 2,972.71.

(Reporting by Chuck Mikolajczak; Editing by Kenneth Barry)

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