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Success claim as hospital infections fall
Friday July 18th, 2008
The British government claimed success in the battle against hospital infection yesterday as new figures showed dramatic reductions.
Last year the newly-appointed Prime Minister Gordon Brown declared infection to be a priority ordering "deep cleans" of all hospitals.
The new figures from the Health Protection Agency show this has far from eliminated infection - but occurrences of the two most high profile bugs have reduced by about a third in the last year.
The HPA figures show some 4,438 cases of MRSA reported in the year ending in April - compared with 6,383 the previous year.
Cases of C.difficile increased slightly between December and March - rising to 10,586 in the first quarter of 2008. Some 9,993 cases were reported in the last quarter of 2007 but earlier in 2007, in the first quarter, some 15,644 cases were reported.
The HPA said it was confident that rates of MRSA could continue to fall - but warned it was too soon to claim success against C.difficile.
Professor Peter Borriello, of the agency's centre for infections, said: "It is worth remembering that not all healthcare-associated infections are preventable. However, this shouldn't lead to complacency around tackling the infections that are preventable and engaging in the battle to continually drive down rates of healthcare associated infections.
"These figures show that there can be, and have been, significant reductions."
Health secretary Alan Johnson said: "The significant reduction in MRSA and C. difficile infections is a remarkable achievement, the result of the hard work and dedication of NHS staff and the right investment in staff and resources.
"We are tackling infections on every front with a relentless focus on cleanliness, best practice guidance on antibiotic prescribing, isolating patients and more infection control staff with more powers to help drive down infection rates."
He pledged: "From April 2009 frontline staff, including the 5000 matrons we have now - more than double the number of last year - will also be able to report any concerns they have to the new regulator, the Care Quality Commission."
But the Royal College of Nursing warned the figures showed a mixed picture - with elderly patients still at risk from C.difficile.
Chief executive Dr Peter Carter said: "We should recognise the key role nurses, particularly specialists in infection protection control, have played in achieving this reduction in hospitals and health care services.
"However, the RCN is disappointed that there has been a six per cent increase in C. difficile cases in patients aged 65 years and over from the previous quarter.
"If we are to see further reductions in infections, the Government needs to meet its proposal to deliver more infection control nurses and ensure that there are stronger reporting mechanisms in place to enable nurses to raise their concerns about poor hygiene practices."
New obesity challenge to government
Thursday July 17th, 2008
Obesity and alcohol abuse have been left unchecked while the British government has successfully tackled smoking and sexual health issues, according to a new study.
England faces growing rates of death from alcohol disease and rising levels of obesity, the report of the Healthcare Commission and the Audit Commission says.
The organisations worked together on a study of public health services.
The report that the death rates from alcohol among men doubled between 1991 and 2006 from 9.1 per 100,000 to 18.3. The death rate among women nearly doubled - reaching 8.8 deaths per 100,000.
It says England adopted a national strategy on alcohol abuse in 2004 - but it has not been implemented consistently. And an obesity strategy was not introduced until this year.
Anna Walker, chief executive of the Healthcare Commission, said: "The government has begun to tackle the big killers but more needs to be done on some of the main issues affecting our health such as obesity, alcohol and smoking.
"The government should also apply lessons learned from its most effective programmes to ensure that the problems of obesity and alcohol misuse do not derail health improvement in the future."
She added: "We do not want to see any reversal of the health gains that have been made."
The Royal College of Nursing called on the government to keep its promise to ensure school children have access to school nurses.
Chief executive Dr Peter Carter said: "The public's health and wellbeing should remain the number one priority for Government, in particular the need to educate children about adopting healthier lifestyles.
"To do this, the Government must honour its pledge to ensure that every child has access to a school nurse, so that all children know how to lead a healthy lifestyle."
Evidence urgently needed on diet and type 2 diabetes
Wednesday July 16th, 2008
Evidence that type 2 diabetes can be controlled by diet is short, researchers report today.
The weight of evidence does not yet support the possibility that type 2 diabetes can be controlled by diet alone, finds a new review by the Cochrane Collaboration.
More than 180 million people worldwide have diabetes, a figure which is predicted to more than double by 2030. When patients receive their diagnosis, they are given dietary advice with the aim of controlling blood sugar levels.
Lucie Nield of the University of Teesside, UK, and colleagues say that, despite "strong evidence" that type 2 diabetes can be prevented, or at least delayed, by a combination of lifestyle changes and good dietary advice there is still "no indication whether dietary advice alone can prevent the disease".
Their review covered two trials involving 358 participants. The researchers originally hoped to find more evidence, but after searching published scientific literature, they were unable to find any further high quality trials.
"Considering the importance of this disorder, we were disappointed to find such a small amount of relevant data," said Ms Nield.
Nevertheless, the team analysed the findings of these two studies. They concluded that dietary advice could play an important role in both avoiding type 2 diabetes, and lowering risk factors for the condition, such as insulin resistance, high blood glucose, and high cholesterol.
Ms Nield said: "These two studies give grounds for believing that dietary advice alone could play an important role in reducing type 2 diabetes."
But she added: "There is an urgent need for well-designed and well-reported studies which examine a range of interventions. We do need more long-term studies before we can work out the best advice to give."
Nield, L. et al. Dietary advice for the prevention of type 2 diabetes mellitus in adults. Cochrane Database of Systematic Reviews 2008, Issue 3.
Oily fish during pregnancy could cut asthma risk
Tuesday July 15th, 2008
Taking fish oil supplements towards the end of pregnancy can reduce the baby's risk of asthma, say researchers.
Experts working on the large European project EARNEST say that the risk of asthma can be cut by 63 per cent. Dr Sjurdur Olsen of Statens Serum Institut, Denmark, and colleagues looked at data from 533 pregnant women.
One group took fish oil supplements for the last ten weeks of their pregnancy. The supplements provided 2.7g of n-3 polyunsaturated fatty acids (PUFAs) per day. Another group took olive oil supplements, and the remainder took no supplements.
Babies in the fish oil group were born on average four days later and weighed 100g more. At the age of 16, fewer children in the fish oil group had developed asthma.
In the American Journal of Clinical Nutrition, the researchers write: "The rate of asthma was reduced by 63 per cent and the rate of allergic asthma was reduced by 87 per cent in the fish oil compared with the olive oil group."
They believe there is "strong biochemical evidence" that the omega-3 fatty acids in fish oil may benefit the immune system. Fish oil could also reduce asthma risk by protecting the baby from being born prematurely. Babies born early have a higher risk of developing asthma.
The team conclude that their results support an increased intake of n-3 PUFAs in late pregnancy, because it may help protect against childhood asthma. But they add that these results must be confirmed by other trials before changing the dietary advice given to pregnant women.
Olsen, S. F. et al. Fish oil intake compared with olive oil intake in late pregnancy and asthma in the offspring: 16 y of registry-based follow-up from a randomized controlled trial. The American Journal of Clinical Nutrition, Vol. 88, July 2008, pp. 167-75.
Cannabis inspires new anti-munchies drug
Tuesday July 15th, 2008
Cannabis may be illegal but it is continuing to inspire a range of medical research, a British expert reported today.
Nicotine addiction and obesity are among conditions that could be treated by cannabis-inspired drugs - as well as chronic pain, a conference in Manchester is set to be told.
Delegates have been gathering for the Federation of European Pharmacological Societies Congress.
According to Professor Roger Pertwee, of Aberdeen University, cannabis' notorious ability to inspire the "munchies", may provide the key to controlling appetite and obesity.
An existing obesity treatment, Acomplia, already works by blocking the cannabinoid receptors linked to appetite, but Professor Pertwee says a constituent of cannabis, THCV, may do a better job.
He said: "My research group has discovered that another constituent of cannabis, THCV, acts in a similar way to Acomplia, blocking one of the cannabinoid receptors, so providing an alternative – and potentially better – treatment route in the fight against obesity.
"The conference will hear about some of the possible advantages THVC has over current obesity treatments, as well as data on the potential of cannabinoids to treat other conditions, including neurodegenerative disorders like Alzheimer’s, Parkinson’s and Huntington's disease."
He explained: "Some current research is focused on designing drugs that only target cannabinoid receptors in the part of the body relevant to the disease in question and not the receptors in the central nervous system involved in the unwanted effects of cannabis."
5th Congress of the Federation of European Pharmacological Societies
Perception of overweight changing in the UK
Monday July 14th, 2008
People in the UK are failing to recognise when they are overweight, a new survey has found.
In 2007, of those who are overweight only 75 per cent realised they fall into this category, compared with 88 per cent in 1999.
The figures come from a survey of 853 men and 944 women from Great Britain in 1999, and 847 men and 989 women in 2007.
Professor Jane Wardle and colleagues from University College London, London, UK, set out to look at the changes in public perceptions of overweight over this eight year period.
Participants reported their weight and height, and classified their body size on a scale from very underweight to obese. The proportion that said they were clinically obese nearly doubled from 11 per cent to 19 per cent.
But "the weight at which people perceived themselves to be overweight rose significantly", the researchers write on the website of the British Medical Journal. This "demonstrates a decrease in sensitivity in the self-diagnosis of overweight", they add.
The team conclude that: "Despite media and health campaigns aiming to raise awareness of healthy weight, increasing numbers of overweight people fail to recognise that their weight is a cause for concern. This makes it less likely that they will see calls for weight control as personally relevant."
In an editorial, Professor Sara Bleich from John Hopkins Bloomberg School of Public Health, USA, writes that this finding has vital implications.
"Data on temporal trends in public perception of weight are important, given the positive association between self perceived weight status and behaviours to control weight," she warns.
Johnson, F. et al. Changing perceptions of weight in Great Britain: comparison of two population surveys. The British Medical Journal, published online July 10, 2008.
Bleich, S. N. Public perception of overweight. The British Medical Journal, published online July 10, 2008.
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