on hospital quality in 4 areas

Patients and their families in Pennsylvania can now go to a single Web site - www.phcqa.org - to learn about the quality of local hospitals.

The Pennsylvania Health Care Quality Alliance - a coalition of the state's four Blue Cross and Blue Shield health insurers as well as its hospitals, doctors and government health agencies - developed the site so that patients can learn about hospital quality from a range of sources in four key areas: heart, heart failure, pneumonia, and hospital-associated infections.

Searchable information on the site comes from the federal Centers for Medicare and Medicaid Services, the Pennsylvania Health Care Cost Containment Council, and the Joint Commission, a group that accredits hospitals. More clinical topics and quality measures will be added as they are developed.

Much of the data has been available in some form on the Web. Bringing it together into one, user-friendly place was the result of the unique partnership of insurers, health-care providers and government regulators, said I. Steven Udvarhelyi, chief medical officer of Independence Blue Cross.

- Josh Goldstein

Smoking history raises chance of aneurysm recurrence

Smoking is a known risk factor for the development and rupture of a cerebral brain aneurysm - a weak, ballooning spot in a blood vessel in the brain.

Now, researchers from Thomas Jefferson Hospital, Drexel University and elsewhere have found that a history of smoking increases the chance an aneurysm will reoccur after the treatment they examined.

The study looked at records of 110 patients who underwent coil embolization, in which a tiny coil implanted at the weak spot becomes covered by a blood clot, thus blocking off the aneurysm.

After an average of 24 months, tests showed that the aneurysm was again bulging in 14 men and 32 women. Of these 46 patients, 35 - 76 percent - had a history of smoking.

The study, which appears in the April issue of the Journal of Neurosurgery, was too small to detect whether patients who quit smoking after coil embolization reduced their risk of aneurysm recurrence.

Nonetheless, the researchers conclude that smokers with cerebral aneurysms should be "aggressively counseled" to kick the habit.

- Marie McCullough

Ibuprofen blocks aspirin

benefit for stroke patients

A daily aspirin is often recommended to lessen the risk of a second stroke, because it prevents platelets from clumping together. But that benefit may disappear for those who also take ibuprofen or similar drugs, a small study found.

The researchers identified 28 stroke patients who were taking both kinds of medication. None showed evidence that the aspirin prevented their platelets from clumping.

Eighteen of the patients agreed to stop ibuprofen or a similar drug called naproxen while continuing to take the aspirin. Two to four weeks later, the aspirin was able to do its business: Platelet clumping was significantly reduced in all 18 patients.

The study, by researchers at the University at Buffalo, N.Y., and Dent Neurologic Institute, was published in a recent issue of the Journal of Clinical Pharmacology and is available at http://jcp.sagepub.com/cgi/reprint/48/1/117.

- Tom Avril

Spinal injuries less likely when

seat belts used with air bags

Some drivers and front-seat passengers mistakenly believe that air bags are for people who don't like to wear seat belts. New research shows that when belts and bags are used in combination, accident victims are less likely to suffer cervical spine fractures and other spinal cord injuries.

The study, published in the March 15 issue of the journal Spine, looked at 12,700 patients with spinal injuries from auto accidents between 1990 and 2002. About 5,500 patients had fractures of the spine, and the study focused on them.

When drivers and front-seat passengers failed to strap in, 54 percent suffered cervical spine fractures compared with 42 percent who benefited from both the belts and the air bags.

Part of the explanation, wrote the researchers, from the University of Pittsburgh, may be that air bags were designed to be used with seat belts, which help position the body for optimal protection from an air bag deploying in a crash.

The authors also noted that passengers and drivers who failed to use a seat belt had more severe injuries and spent more time in the hospital.

- John Sullivan