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Health Highlights: July 20, 2004

Hospital Monitoring Group Missed Serious Problems: Report Melanoma Vaccine Shows Promise Disabled Students Sue Over Med School Exams Tainted Tomatoes Don't Yield Salmonella Culprit Botox Approved for Excessive Sweating

Here are some of the latest health and medical news developments, compiled by editors of HealthDay:

Hospital Monitoring Group Missed Serious Problems: Report

The private agency that reviews hospitals to receive Medicare payments missed many problems later identified by state inspectors. And those problems potentially compromised patient safety, according to a Congressional report released Tuesday.

The Joint Commission on Accreditation of Healthcare Organizations missed 167 of 241 "serious deficiencies" in a survey of 500 hospitals that were reviewed between 2000 and 2002, the Government Accountability Office said. The agency, Congress' investigative arm, used to be known as the General Accounting Office, the Associated Press reported.

Many of the missed problems were related to fire safety. Some, however, involved poor patient care. In a Texas hospital, a patient died after receiving a double dose of narcotics in the emergency room and "medications were administered without physician orders," the report said.

And a California hospital lacked "a sanitary environment to avoid sources and transmission of infections and communicable diseases and failed to develop a system for ensuring the sterilization of medical instruments," the GAO said, according to the news service.

The commission accredited 82 percent of U.S. hospitals in 2002, the report said. Those hospitals received $98 billion for Medicare-covered services that year, the AP said.

Sen. Charles Grassley (R-Iowa) and Rep. Pete Stark (D-Calif.), who jointly requested the report, are introducing legislation to increase Medicare's authority over the commission.

Commission President Dennis O'Leary said the agency made significant changes to the Medicare accreditation process earlier this year. "In our view, it is irresponsible to alarm the public using statistics that have little meaning," O'Leary said in response to the GAO report, the AP said.

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Melanoma Vaccine Shows Promise

Researchers are reporting promising results with a vaccine that may prevent the recurrence of melanoma in people who have already had the potentially fatal skin cancer.

The study included 46 Australians who were given varying doses of the vaccine or a placebo after they had had a cancerous tumor removed. Two years later, the cancer had reappeared in five of the seven patients who had been given the placebo. Among the 19 patients given the full dose of the vaccine, however, only five showed any signs of a recurrence of melanoma.

The vaccine combines a cancer antigen, called NY-ESO-1, with a drug designed to stimulate the immune system, called ISCOMATRIXTM, BBC News Online reported.

The researchers plan a large-scale trial to further test the vaccine. Results of the study appear in the current issue of the Proceedings of the National Academy of Sciences.

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Disabled Students Sue Over Med School Exams

Four learning-disabled California students who took the medical school entrance exam in April are suing the organization that administered the test. The suit alleges that the students weren't given extra time to complete the exam as required by state law.

The students say that when they asked for the extra accommodations, the American Association of Medical Colleges (AAMC) decided they weren't severely disabled and therefore not entitled to the extra time, according to an account by the San Francisco Chronicle.

One of the students has dyslexia and attention deficit disorder, the newspaper reported, without describing the conditions of the other plaintiffs. Their suit alleges that the AAMC's policy "penalizes individuals with disabilities for the very intelligence, skills, academic commitment, and diligence which would allow them to succeed in medical school and become successful doctors."

A spokeswoman for the AAMC refused to comment on the suit, but said the association was committed to providing "appropriate accommodations" to disabled applicants.

The suit seeks an immediate injunction that would let the plaintiffs take the next scheduled test on Aug. 14 with the extra time they say they need, the newspaper reported.

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Tainted Tomatoes Don't Yield Salmonella Culprit

When lab tests revealed Salmonella in an unopened bag of tomatoes taken from a Pennsylvania grocery chain, state health officials thought they may have found the source of this month's food poisoning outbreak that has sickened more than 110 state residents.

But the tests ultimately revealed that the strain of Salmonella found in the tomatoes wasn't the same Javiana strain responsible for the outbreak, which has also sickened about 40 people outside Pennsylvania, according to the Post-Gazette of Pittsburgh.

The outbreak has been traced to a number of Sheetz grocery stores and filling stations, which is where state health officials also found the tainted bag of tomatoes. Now that the tomatoes have been ruled out as a suspect in the food poisoning outbreak, the search for a source goes on.

A spokesperson for the company that supplied the tomatoes, Coronet Foods, told the newspaper that the company had been informed that the type of bacteria found on the tomatoes did not pose a health risk.

The outbreak, which also is being investigated by the U.S. Food and Drug Administration, has been linked to food consumed in the first half of July. According to the newspaper, no additional cases have been reported since Sheetz restocked its lettuce and tomatoes last week in response to the outbreak.

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Botox Approved for Excessive Sweating

Add excessive sweating to the list of conditions stymied by the medical marvel known as Botox.

The U.S. Food and Drug Administration has granted its latest approval of the drug, derived from the same bacterium that causes deadly botulism, to treat primary axillary hyperhidrosis, a condition characterized by severe underarm sweating. Approval was granted to treat cases in which even prescription antiperspirants are ineffective, the agency said in a statement.

In clinical trials, 91 percent of users showed a 50 percent reduction in armpit sweating four weeks after being injected with the drug, compared to 36 percent of participants who had taken a non-medicinal placebo. The trials did not include tests to see if Botox controlled excessive sweating in other parts of the body, the agency said.

Botox was first approved in 1989 to treat two eye muscle disorders. The Allergan drug has since won the FDA's OK to treat a neurological disorder that causes severe neck muscle contractions, and as a cosmetic therapy to reduce frown lines between the eyebrows.

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