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UK News for June

HIV threat to babies warning

Monday July 31st, 2006

Successful measures to identify pregnant women infected with HIV have failed to prevent the birth of infected babies, according to a new report.

Improved diagnosis and treatment has been counteracted by a dramatic increase in the number of infected women giving birth, according to a new report.

The report was published by the Royal College of Paediatrics and Child Health, with backing from the Royal College of Midwives.

Researchers found that by 2004, as many as 90 per cent of HIV positive mothers were diagnosed before delivery. This compared with about one third in 1997.

According to the report, the number of infected women has trebled since 1997.

The report says: "The overall number of infected children being born has not fallen to the same degree and a small number of infants become infected despite preventative measures being employed."

Mervi Jokinen, of the Royal College of Midwives, said: "With the successful implementation of the national policy to offer HIV testing to all pregnant women as part of their antenatal care and screening, more women are becoming aware of their HIV status early enough to enable them to make informed decisions on reducing the risk of maternal to infant transmission, both before and after birth.

"The RCM welcomes this publication because it emphasises the importance of partnership between women and their carers and between professionals in health, social care and voluntary sectors. This is vital to ensure consistent advice and support to families."

Strategy for palliative nurses

Friday July 28th, 2006

As many as 10,000 nurses have now been trained in palliative care to back up a new strategy for palliative care, it was announced yesterday.

Two senior doctors have been asked to draw up the strategy for improving the care of patients facing the end of life.

They are national cancer director Professor Mike Richards and director for older people Professor Ian Philp.

The department of health said King's College, London, had completed an evaluation of the nurse training programme and confirmed its success.

Professor Richards said: "Over 500,000 adults die each year in England. The aim of this strategy will be to ensure that high quality care is provided at the end of life for all of these patients, irrespective of diagnosis.

"It will build on previous initiatives, including the very successful programme to train district nurses in palliative care."

Tom Hughes-Hallett, chief executive of Marie Curie Cancer Care, said: "We have been working to develop better co-ordinated care for patients at the end of their lives and support for their families through our Delivering Choice Programme, with the aim of doubling the number of patients cared for in the community and supported to die at home.

"We look forward to working with Professor Richards and Professor Philp to feed into this key new long-term plan."

Shake-up plan for biotech trials

Wednesday July 26th, 2006

Seriously ill patients may be asked to act as guinea pigs for new drugs at an earlier stage.

A government commissioned scientific group has come up with new ideas for introducing drugs to human subjects following the problems at Northwick Park Hospital London.

Six healthy volunteers were left seriously ill after testing the biotech drug TGN 1412.

Proposals would see new drugs administered to no more than one healthy volunteer in preliminary tests.

The report of the Expert Scientific Group says that in some cases it may be better to involve patients who are already ill with the disease the drug is intended to treat at this stage. This is particularly the case if a drug may involve the immune system, the report says.

The group calls for better international sharing and the development of specialist trials centres for phase one studies.

Group chairman Professor Gordon Duff said: "Clinical trials in general have an excellent safety record, but in the light of the TGN 1412 incident there is a need to look at the future safety of clinical trials involving novel and potentially higher risk drugs.

"Our interim report provides proposals for the future authorisation of trials involving these types of products and to further improve safety.

"Clearly the Northwick Park incident has informed the work of the group but this is not a further investigation into the incident. It is about the wider issue of such clinical trials and about ways to ensure that this type of trial is safe and effective for the future."

Allergy shake-up promised

Friday July 21st, 2006

A shake-up of treatment services for a condition which affects some 40 per cent of the population was promised yesterday.

A department of health report admits that the NHS does not even know how to provide effective allergy services.

The report says that health services must identify how much allergy testing is needed - and which professionals should handle the results of tests, using what skills.

One question will be the extent to which GPs can diagnose and manage allergy patients and the extent to which specialist services are needed.

The report says that training programmes to help patients live with allergy must be developed over the next few years.

Care Services Minister Ivan Lewis said: "In this review, we have heard from many individuals and groups affected by or interested in allergy services. Evidence drawn from the experience of sufferers is compelling.

"Even with a correct diagnosis, those living with severe allergy can face a huge battle every day, and their quality of life and that of their extended family may be greatly affected.

"We need to ensure that GPs and others in primary care have clinical knowledge and support systems in order to spot allergy in the early stages, so that an effective management plan can be offered from the start."

The Royal College of Physicians said most GPs had no training in allergy and there was a "tiny" specialist workforce.

It said 20 million people have allergy related diseases.These range from hay fever to asthma and potentially fatal allergies to substances such as nuts.

Dr Pamela Ewan, who helped draw up an RCP report in 2003, said the latest proposals hardly "scratched the surface".

She said: "This needs central direction and funding and cannot be left to devolved local systems, as the DH propose. That has been the situation for the last decade, and patient care has not improved.

"While the recommendation to involve the medical Royal Colleges in producing guidelines is welcome, without funding, targets, and an increase in the number of doctors with expertise in allergy, we will be going backwards."

Child cancer link to wealth

Thursday July 20th, 2006

Children of wealthy families face an increased risk of developing leukaemia and other cancers, according to a major British analysis reported yesterday.

Reseachers from COMARE - the committee for radiation exposure - confirmed fears that childhood cancer occurs in clusters.

The findings come from an analysis of 12,400 cases of leukaemia and lymphoma among children and another 20,000 cases of tumours. The cases were recorded over 24 years amongst British children.

The COMARE report says the reasons for the clusters of cancer cases are not know - but it is possible there is a link with infections.

It stresses that no links have been found close to nuclear installations.

The report showed that some of the most prosperous parts of Britain - such as Buckinghamshire, Dorset, Kent, Surrey and Wiltshire - had the highest rates of childhood cancer. The rural county of Cornwall also had high rates.

The wealthiest groups in society showed rates of about 40 cases per million compared with 36.4 for the poorest.

One theory is that wealthier families tend to live in more remote locations - meaning their children are not exposed to the same range of infections as urban children.

They may also move around in the pursuit of career advancement.

Comare chairman Professor Alex Elliott said the report raised a "whole host of questions".

Books on Child and Adolescent health

Alcohol deaths soar

Wednesday July 19th, 2006

Booze Britain is beginning to feel the impact of excess, according to new figures.

Deaths linked to alcohol have doubled in just over ten years, the Office for National Statistics reported.

Some 8,380 people died from causes linked to alcohol in 2004 compared with 4,144 in 1991.

The ONS said the death rate for men was twice that for women - and men and women were most at risk between the ages of 35 and 54.

Doctors' leaders said the findings were unsurprising.

Professor Ian Gilmore, chairman of the alcohol committee of the Royal College of Physicians, said the true number of deaths was up to four times higher than the ONS figures.

He said: "The increase in deaths is likely to continue unless we can find some way to reverse the nation's drinking habits.

"The college supports the Government's harm reduction strategy but if voluntary partnerships with industry and public education are not proving effective, the next step is direct intervention on issues such as availability of alcohol, price increases and restrictions on advertising."

Autism quite common - professor

Monday July 17th, 2006

As many as one per cent of British children have some form of autism, according to a controversial new study.

Researchers claimed that the numbers of children with autistic problems are more than twice as many as formally diagnosed.

The study, reported in The Lancet, came from research on children, aged nine, in south London conducted five years ago.

Rates of diagnosed autism have been steadily rising in recent years - leading to scare stories linking the condition with vaccination and other environmental causes.

However part of the reason for the increase is likely to be improved diagnosis and greater awareness in schools of the problem.

Researcher Professor Gillian Baird, of Guy's and St Thomas Hospital, London, concluded that as many as 116 in every 10,000 children in the district had autism or related conditions - compared with a rate of 44 previously diagnosed.

The researchers argue that many children with special educational needs may have an autistic condition.

However a drive to diagnose autism might prove controversial as many successful and clever people are thought to have had the condition.

Professor Baird said: "Whether the increase is due to better ascertainment, broadening diagnostic criteria, or increased incidence is unclear.

"Services in health, education, and social care will need to recognise the needs of children with some form of autistic spectrum disorders, who constitute one per cent of the child population."

The Lancet 2006; 368: 210-215

New vaccine strategy against pneumococcal infection

Friday July 14th, 2006

Plans have been finalised on the pneumococcal vaccine programme for UK babies and children.

From 4 September, the vaccine will be given at two months, four months and 13 months, and babies will get an additional injection around their first birthday for Hib meningitis and Meningitis C. A 'catch-up' campaign will target older children to make sure they are protected.

The decision was announced on Wednesday (12 July) by the chief medical officer, Sir Liam Donaldson. It was reached jointly by NHS Employers and the British Medical Association' GPs committee.

Sir Liam said: "Pneumococcal infection can cause very serious illness such as meningitis and pneumonia as well as being one of the most common bacterial causes of ear infections.

"The new vaccine will save lives and prevent hundreds more cases of serious illness."

Dr Peter Dickson of NHS Employers added: "What we have is a deal which is cost-effective and yet gives GPs the funds to be able to start the process of immunising their young patients."

GPs will be paid 15.02 UK pounds for each child who completes the vaccination course and 7.51 UK pounds per child in the catch-up campaign.

Dr Hamish Meldrum of the BMA's GPs committee said: "We are pleased that we have reached a sensible agreement that gives practices the appropriate resources to carry out the immunisation programme for their young patients against this relatively rare but serious disease."

The Department of Health says all GPs will be sent a letter outlining the details of the programme.

Bird flu vaccine trials planned

Tuesday July 11th, 2006

British volunteers may be the first to test a new vaccine against the bird flu, it was announced yesterday.

British vaccine developers PowderMed have applied for permission to conduct the trial.

The vaccine against the H5N1 bird flu would also use needle-free injections, using a technology developed by the Oxford company. The technology uses gold particles coated with DNA.

Developers say the new vaccine has been successful in laboratory studies.

Permission for the study will need to come from the Medicines and Healthcare Products Regulatory Agency.

PowerMed chief executive Dr Clive Dix said: "Our approach provides a rapid route to vaccine development that can be applied to existing and emerging flu strains including, for example, the threat posed by a pandemic flu strain.

"DNA vaccines have a huge potential to limit the burden of disease and can be manufactured very rapidly, in large amounts: enough to vaccinate the whole of the UK population twice over (prime and boost) requires just 1Kg of DNA and can be manufactured and available in just three months from the point a strain is identified."

Oldest mother speaks of baby joy

Monday July 10th, 2006

A children's mental health specialist has become Britain's oldest mother at the age of 62.

Dr Patricia Rashbrook and her husband John Farrant, from Lewes, Sussex, travelled to Russia for IVF treatment.

At the weekend, they told how their baby JJ was born to the sound of Elgar's Salut d'Amour.

Dr Rashbrook, variously described as a psychiatrist or psychologist, told reporters: "We are both extremely healthy and I have always looked and felt very young, but nevertheless we have younger friends with children who have agreed to act as surrogate parents should anything happen to us.

"The sight of John holding JJ for the first time is one I shall never forget. From the moment I met John, it felt like there existed a baby-shaped space between us. Now that space has been filled with our wonderful son."

She added: "I am sure I will have much more patience and as older parents our child will benefit from our insights and those of my older children."

But, according to another report yesterday, MPs will be pressing for a crackdown on fertility clinics to ensure there is not a boom in older women seeking pregnancy.

Members of the House of Commons science and technology select committee will recommend that private clinics be required to publish details of their success rates in treating post-menopausal women.

Committee chair Phil Willis MP told the Observer that he believed some clinics were "abusing" their licences by treating women past their fertility cycle.

He said: "We have to make sure the licence requires open disclosure about the cost and effectiveness of the treatment they are giving to post-menopausal women. It must be right that women have access to objective information that lets them make an informed choice and stops them being ripped off."

Surprisingly high whooping cough rates in UK children

Friday July 7th, 2006

Whooping cough is widespread among immunised UK school age children, finds a new study.

Dr Anthony Harnden of Oxford University, UK set out to determine the rate of whooping cough (Bordetella pertussis) infection in school age children with persistent cough.

From searching GP records, Dr Harnden and colleagues found 172 children who had been to their GP with a cough lasting more than two weeks. Using immunisation records and blood analysis, the researchers found that 37 per cent of the children had had a recent whooping cough infection, of whom 86 per cent had been fully immunised.

The study is published on the website of the British Medical Journal today (7 July).

The authors write that for school-age children, "a diagnosis of whooping cough should be considered even if the child has been immunised".

In the study, whooping cough was linked to vomiting, phlegm production, and coughs lasting two months or more.

"Previous research in several countries has shown that pertussis is an endemic disease among adolescents and adults," write the authors.

"Our research suggests that in the United Kingdom pertussis is also endemic among younger school age children.

"Making a secure diagnosis of whooping cough may prevent inappropriate investigations and treatment," they add, saying that it would allow GPs to give parents accurate information on the likely duration of the cough, which may be up to 16 weeks.

Harnden, A. Whooping cough in school age children with persistent cough: prospective cohort study in primary care. British Medical Journal, published online 7 July 2006.

Books on Child and Adolescent health

Inspectors order abuse probe

Thursday July 6th, 2006

People with learning difficulties may be suffering from abuse and neglect in community facilities throughout England, two senior government inspectors warned yesterday.

Their comments followed the devastating findings of a investigation into services in Cornwall.

This found that in a hospital in the county patients had been abused for years and senior managers had failed to "tackle" it.

Money had been misused and patients hit, pushed, dragged, starved and subjected to cold showers.

The county's care in the community homes were not registered as nursing homes - whilst locked doors were used to place "unacceptable restrictions" on their inhabitants, the Healthcare Commission inquiry found.

The Cornwall Partnership NHS Trust is now to be placed under special measures. Investigators said they identified 40 patients as "vulnerable adults" during their inquiries but the county's agencies failed to take the correct steps to protect them.

In a joint statement with the Commission for Social Care Inspection, the Healthcare Commission chief executive Anna Walker said they had "serious concerns" about the quality of care for people with learning difficulties around the country.

There had been a number of serious allegations in recent months and they now proposeda nationwide audit of services.

Ms Walker and social care chief inspector David Behan said: "Instances of abuse can be symptomatic of services that have been neglected for too long. They are the most serious sign of a problem, but our concerns are much broader.

"We detect a widespread lack of understanding about the rights and needs of people with learning disabilities."

They added: "More than a million people in England are estimated to have learning disabilities. It is not acceptable to overlook the needs of these vulnerable people because they rarely capture the headlines or in some cases are unable to champion their own rights."

Experts produce menopause book for women

Monday July 3rd, 2006

Two of Britain's top experts on the menopause have joined forces to produce a book revealing the medical secrets of the condition to women.

Dr Margaret Rees is editor of the Journal of the British Menopause Society and a lecturer at Oxford University and has written a raft of professional textbooks with osteoporosis expert Dr David Purdie.

Now the pair have written a book for women giving advice on the latest controversies, such as whether to use a hormone replacement therapy.

The British Menopause Society has combined with medical publishers, the Royal Society of Medicine Press, for the project - a book called "The Menopause: What you need to know?"

The authors promise to avoid confusing medical jargon.

Dr Rees said: "The aim of this book is to provide practical, unbiased and non-promotional information about treatment of menopause and its management.

"It's not quirky and nor does it make light of the issue. Rather, the book deals with the most up-to-date facts on menopause and provides information in a clear cut and easily accessible manner.

"The book also discusses treatment and lifestyle options clearly and concisely and includes a discussion on oestrogen and non-oestrogen based therapies, and the benefits and drawbacks of HRT.

"Importantly, the book contains answers to all those menopausal questions that you may forget to ask your GP."

Books on Women's Health

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