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Adult stem cells from bone marrow can prevent acute lung injury in mice, U.S. researchers report.

Acute lung injury, which is caused by major inflammation or injury to the lungs, causes about 74,500 deaths each year in the United States. There is no effective drug treatment for the condition, which is a major cause of death among patients in intensive care units.

A team at the University of Illinois at Chicago College of Medicine identified progenitor stem cells in the bone marrow of mice that could prevent and treat acute lung injury. The researchers also found a way to culture the cells — called Flk-1 and CD34 — to increase their numbers and ability to attach to targets and make repairs.

When the purified and cultured Flk-1 and CD34 stem cells were injected into mice with acute lung injury, the cells repaired the lung injury, prevented fluid build-up and improved survival of the mice, the researchers found.

The study not only showed that stem cell treatment may be a promising therapy for acute lung injury, “but also provided us with the means to understand how these progenitor cells did their repair work. These therapeutic cells employed integrins to stick to the site of injury and turn on cellular and molecular repair machinery,” lead author Kishore Wary, an assistant professor of pharmacology, said in a university news release.

The researchers hope to test this stem cell therapy in human acute lung injury.

Americans are more likely than people in 10 other countries to have trouble getting medical treatment because of insurance restrictions or cost, an international survey of primary care doctors released on Wednesday found.

While the United States spends more than twice as much as other developed countries on healthcare, it lags well behind in key measures of quality, the annual survey found.

“Our weak primary care system puts patients at risk and results in poor health outcomes and higher costs,” said Karen Davis, president of the Commonwealth Fund, a private health policy group that sponsored the survey.

“The survey provides yet another reminder of the urgent need for reform that makes acceptable, high-quality care a national priority,” Davis told a news briefing.

Other countries have solved problems the United States is still struggling to conquer, she said.

The survey of more than 10,000 primary care doctors in 11 developed countries — Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden and the United Kingdom — found problems in all of them.

In the United States, cost and access to care stood out as a major challenge for primary care doctors.

“The majority of U.S. doctors — some 58 percent — say their patients often have difficulty paying for medications and other medical care, by far the highest rate in the survey,” Cathy Schoen of the Commonwealth Fund, whose study appears in the journal Health Affairs, told the briefing.

Paying for healthcare was a problem in 5 to 37 percent of other countries surveyed.

Insurance restrictions, such as provisions to limit or control medication or treatment, are a major impediment for U.S. doctors, with half of 1,400 physicians surveyed saying the time they and their staff spend dealing with insurance companies is a major problem.

The survey from February to July 2009 was conducted by mail, online and by phone.

AFTER HOURS

“It appears that U.S. doctors are adding staff to their offices that would not be typical of other countries just to cope with our complex, fragmented insurance system and advocate for their patients,” Schoen said.

The survey also asked doctors if patients in their country could see a doctor after regular business hours without being forced to go to the emergency room.

Nearly all doctors surveyed from the Netherlands, New Zealand and the United Kingdom said this was offered, compared with just 29 percent of doctors in the United States — which ranked lowest in the survey.

“The vast majority say they have no arrangement at all,” Schoen said, adding that the 29 percent figure is a drop from 40 percent reported in 2006.

By contrast, doctors in the United States and Britain were least likely to say their patients faced long waits to see a specialist, compared with Canadian and Italian doctors, who were most likely to say this was a problem.

The study also shows the United States and Canada trail other developed countries in the use of basic electronic medical records. Less than half of U.S. doctors (46 percent) say they have electronic medical records, and just 37 percent of doctors in Canada have them.

Electronic medical records are nearly universal in the Netherlands, New Zealand, the United Kingdom, Australia, Italy, Norway and Sweden.

“The findings underscore the extent to which national policies matter,” Schoen said.

Agency also releases drug dosage guidance for measuring devices included with OTC medications

The U.S. Food and Drug Administration today announced the Safe Use Initiative, a program aimed at reducing the likelihood of preventable harm from medication use.

“Too many people suffer unnecessary injuries from avoidable medication misuse, errors and other problems. The FDA is launching the Safe Use Initiative to develop targeted solutions for reducing these injuries,” said FDA Commissioner Margaret A. Hamburg, M.D.

Millions of people are harmed every year from inappropriate medication use. Many injuries occur as a result of incomplete access to information about a drug, a patient, or the patient’s condition.

Other preventable sources of harm include unintentional misuse of medications, medication abuse, and attempts at self harm. Unintended exposure to prescription medications such as opioid drugs can cause harm, even death, in a single dose, if taken by someone other than the patient who was prescribed the medication.

“Only through coordinated interventions across all sectors of the health care system can we substantially reduce preventable injuries from using medications,” said Janet Woodcock, M.D., director of the FDA’s Center for Drug Evaluation and Research. “All participants in the health care community have a role to play in reducing the risks and preventing injuries from medication use.”

More detailed information on the new program was contained in a report, titled, “FDA’s Safe Use Initiative – Collaborating to Reduce Preventable Harm from Medicines.” The report was released by Drs. Hamburg and Woodcock at FDA’s annual Science Writers Symposium at the agency’s White Oak Campus in Silver Spring, Md.

As outlined in the report, the FDA intends to collaborate with health care professionals and other stakeholders to identify drugs and drug classes that are linked to preventable harm. A list of specific problems, cross-sector interventions for reducing harm from these problems, and the metrics for success will be developed.

The report highlights several risk-reduction projects that may benefit from Safe Use collaborations, including evaluating consumer medication information, communicating about the risk of inadvertent overexposure to acetaminophen, implementing safeguards against surgery fires caused by alcohol-based surgical preps, and avoiding contamination of multiple use medication vials.

To further advance the Safe Use Initiative, the FDA intends to hold a series of public meetings to gather feedback as the candidate list is being developed and will open a public docket to receive comments on the report and proposed candidate cases.

The agency also today made public new FDA guidance for companies that manufacture, market, or distribute over-the-counter liquid medications packaged with dosage delivery devices such as calibrated cups, droppers, syringes and spoons.

The guidance document, titled “Dosage Delivery Devices for OTC Liquid Drug Products,” was posted for advanced viewing in the Federal Register today.

Accidental overdoses can be caused by dosage delivery devices that are unclear or are inconsistent with the labeled dosing instructions.

“This new drug dosage guidance document is an example of steps that can be taken to ensure safer medication use,” said Woodcock. “Many accidental overdoses result from confusion about exactly how much of a drug to take. Better measuring devices will help patients, parents, and other caregivers use the right amount of these medications – the safest and most effective dose – especially for children.”