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Total Records: 4476 | Pages: 896
<< prev 10 }< backward 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 | 20 | forward >{ next 10 >> Doctors 'must report knife crime' Doctors in the UK should tell police every time they treat a victim of gun and knife crime, new guidelines from the General Medical Council will state. They are also told they can breach patient confidentiality by giving police information if they believe a crime has or will be committed. If a patient is diagnosed with a genetic disease doctors will be able to tell relatives, without consent. The revised guidance on confidentiality will be published on Monday. It is the first time doctors have been explicitly told they should report all knife crime as previously they only had to report patients with gunshot wounds. It is hoped this will help police get better statistics on where and when violent crime is taking place.
'Not entirely innocent'
Doctors will also be asked to decide whether they should breach confidentiality and pass on the patient's details to the police if they suspect a crime has or will be committed. Jane O'Brien, head of standards and ethics at the GMC, who drew up the guidance said: "This is mostly going to be used in A&E, for example, where the injury could be the result of gang culture, with gunshot wounds or knife injuries and the victim may also not be entirely innocent. In which respect they might not want the police to be involved and might be thinking about revenge attacks. Normally you would expect the doctors to go along what the patient wanted in these circumstances." But she said doctors should still decide on a case-by-case basis.
Tunji Lasoye, lead consultant, emergency department at Kings College Hospital, said it was important for doctors to play a part in protecting the public. "The guidance will help doctors to recognise how to report injuries resulting from violence while making the care of their patient their first concern."
Family breakdown
The guidelines also say when a patient is diagnosed with a genetic disease, including some forms of cancer, doctors will be obliged to inform relatives about potential risks to their health. The GMC said in cases where the information would benefit others the duty to protect them should outweigh the individual's right to privacy. It will allow them to explain risks to health in situations involving family breakdown or children who have been adopted.
Dr Henrietta Campbell, who chaired the GMC's working group on confidentiality, said: "This guidance makes clear that , in the first instance, doctors should explain to a patient if their family might be at risk of inheriting a condition. In those circumstances, most will readily share information about their health. However if a person refuses, it is the responsibility of the doctor to protect those who may be at risk."
The British Medical Association said it broadly supported the new guidance on confidentiality. Chairman of its medical ethics committee, Dr Tony Calland, said: "Ultimately confidentiality is the cornerstone of the doctor-patient relationship and it should only be breached in the rare circumstances where it is clearly in the public interest to do so."
Copyright BBC Health News - Saturday 26th September 2009
Gut worms protect against allergy Parasitic gut worms, such as hookworm, might aid the development of new treatments for asthma and other allergies, a study in Vietnam suggests. Infection with hookworm and other parasitic worms is endemic in Vietnam, but rates of asthma and other allergies are low. British and Vietnamese scientists gave local children treatment to clear their body of worms. They found this led to an increase in dust mite allergy among the children. Thanks to improved hygiene, practices parasitic worms have been mostly eradicated among human populations living in developed countries.
However, experts believe that over millions of years of co-evolution worms have found methods to dampen down host immune responses to prolong their own survival inside humans. This relationship seems to have become so intertwined that without gut worms or other parasites, our immune system can become unbalanced, which, in turn, could contribute to the development of asthma and other allergies. The latest study was conducted in a rural area of central Vietnam where two in every three children have hookworm and other gut parasite infections, and where allergies are extremely rare.
More than 1,500 schoolchildren aged six to 17 took part.
Regular tablets
Some of the children were given repeated tablet treatments to clear their body of gut worms. The treatment did not produce any conclusive effect on rates of asthma or eczema. However, those children who received the tablets did have a significantly increased risk of developing allergies to the house-dust mite. Up to 80% of people with asthma also have allergies to house-dust mites and other environmental allergens. The researchers said this strongly suggests that gut worms have the potential to tone down human immune responses.
Researcher Dr Carsten Flohr, of the University of Nottingham, said: "The next step is to understand exactly how and when gut parasites programme the human immune system in a way that protects against allergies, and for such studies, follow-up from birth will be essential." The hope is that the work could aid the development of new treatments which work in the same way as gut parasites, by dampening down or rebalancing the immune system so that the body does not respond to allergens and trigger asthma attacks.
Dr Elaine Vickers, Research Relations Manager at the charity Asthma UK, which funded the research, said: "The prospects of further studies in this area are very exciting as we could see groundbreaking treatments for asthma and other allergies developed as a result."
Copyright BBC Health News – Saturday 26th September 2009
Embryo mix-up woman gives birth A US woman who was implanted with the wrong embryo in a fertility treatment mix-up has given birth to a boy. Carolyn Savage and her husband Sean said in a statement that the baby was delivered at St Vincent Mercy Medical Center in Toledo, Ohio. Mrs Savage, who had been told about the mix-up in February, said the family was "going through a very difficult time". The Savages have decided to give the baby to his biological parents, Shannon and Paul Morell from Michigan. The Savages, who have three children, offered their "heartfelt congratulations" to the Morells.
'Nightmare'
"Our family is deeply grateful for the support and prayers of so many people from around the world," the Savage statement said. "We also would like to thank the medical professionals who provided superior care and treatment throughout the pregnancy and delivery." Mrs Savage, 40, said earlier this week that her husband told her the news of the mix-up in February, after receiving a phone call from the clinic that had implanted the embryo. "I don't think I've ever cried so much in my life. It was such a nightmare and, in a way, I felt violated," Carolyn was quoted as saying by CNN. The Savages have declined to name the fertility clinic involved.
Copyright BBC Health News – Saturday 26th September 2009
Source: http://news.bbc.co.uk/1/hi/world/americas/8276132.stm
UK swine flu vaccine 'approved' The European drugs regulator has given the go-ahead for one of the UK's swine flu vaccines. An expert committee agreed that Pandemrix, made by GlaxoSmithKline, can be used in adults and children over six months old and pregnant women. The decision removes one of the last obstacles to getting the immunisation programme under way although licensing still needs to be formalised. The UK has bought 60 million doses of the vaccine. In addition, there are contracts for an as yet unapproved vaccine, Celvapan, produced by Baxter.
It means the UK has provision for up to 132 million doses - enough for every person in the country. A vaccine made by Novartis, Focetria, has also been recommended for licensing by the European Medicines Agency - but this is not planned to be used in the UK. Final marketing authorisation for the vaccines still needs to be signed off by the European Commission and is expected "as soon as possible". The EMEA said they were working with Baxter on some ongoing issues about their vaccine but hoped to be able to resolve those next week.
The vaccines have undergone an accelerated approval process as "mock-ups" of the vaccine had already been developed in preparation for a pandemic and tested in 6,000 people. Manufacturers have worked quickly to add the swine flu H1N1 strain to the mock versions. Early trial data had suggested good immune responses with just one dose of the vaccines. However, the EMEA is recommending two doses are given three weeks apart for both vaccines, but may revisit that decision as more clinical trials are carried out.
Rising cases
The number of new cases of swine flu in England has almost doubled over the last seven days to 9,000, official figures show. In Scotland, the new weekly figures showed a slight increase from 6,180 to 7,034. Across the UK there have been 82 deaths. Although the figures are rising, they are as yet far short of the 100,000 cases a week seen in July.
Officials are still predicting a second wave of swine flu as winter approaches. But they hope to begin a vaccination programme sometime next month.
High-risk individuals and front-line NHS staff have been prioritised for the vaccine. Those eligible include anyone aged between six months and 65 years who usually gets the seasonal flu jab because of a chronic illness such as asthma, pregnant women, and people who live with those whose immune systems are compromised, such as cancer patients or people with HIV/AIDS. It will also be offered initially to people aged 65 who are at high-risk of complications because of an underlying illness. A further decision on who else may be vaccinated once these groups have been targeted is yet to be made.
A spokesman for the Department of Health said: "This is a welcome step forward in our plans for tackling swine flu - but we are still dependant on production and delivery of sufficient vaccine to start protecting people. "We plan to start vaccination in October, subject to vaccine being licensed and manufacturers' delivery schedules. This is not the Department of Health's schedule - it is led by the manufacturers." Professor Steve Field, chair of the Royal College of GPs, said practices needed to prepare to call in the high-risk groups for vaccination. "The scientists are saying it should be targeted at high-risk groups because the illness is mild but my understanding is that is being reviewed regularly. My hunch is it will be rolled out to more people."
Safety
Concerns have been raised about the safety of the vaccines given the speed of the approval process. But the EMEA stressed that decades of experience with seasonal influenza vaccines indicate that adding a new strain in should not substantially affect safety. Both vaccines the Agency have recommended for licensing contain an adjuvant - a chemical which boosts the immune response - but this too has been tested in thousands of people, it said.
Further clinical trials are being done and Pandemrix is being tested in 9,000 children, elderly and healthy adult volunteers. Data submitted to the regulator by GSK suggests the vaccine is generally well tolerated, with the most commonly reported side-effects being headache, joint pain, muscle pain, reactions at the site of the injection (such as pain and redness), fever and fatigue. The first results from a trial of the vaccine in Germany suggested a good response after one dose. The EMEA added that with all medicines, adverse events may be detected once the vaccine is used in large numbers of people.
UK regulators have set up a special portal on the website for reporting any problems with swine flu medicines and vaccines when they begin to be used.
Worldwide some 3,917 people have died from swine flu infections since the H1N1 virus was uncovered in April, World Health Organization figures show. The Americas region continued to post the highest number of fatal cases, at 2,948, while the Asia-Pacific region reported 702 deaths and Europe recorded at least 154 fatalities.
Copyright BBC Health News – Friday 25th September 2009
Source: http://news.bbc.co.uk/1/hi/health/8274374.stm
Speedier tests for cancer planned GPs in England are to get speedier access to diagnostic tests to help spot less clear-cut cancer cases, Prime Minister Gordon Brown will pledge. Patients will get key tests within two weeks of seeing their GP, he will tell the Labour Party conference on Tuesday. It will mean faster reassurance for patients and could save thousands of lives by picking up cancers earlier, he is expected to say. Late diagnosis has been blamed for poorer cancer survival in the UK.
The Eurocare project reported that long-term survival rate data placed the UK below the European average. There is already a target in place for patients suspected by their GP to have cancer to be seen by a specialist within a fortnight. And the Cancer Reform Strategy published in 2007 highlighted better detection of cancer in primary care as a priority.
Greater access to tests will enable GPs to rule out cancer or get an early diagnosis, Gordon Brown will say. Eventually, he wants patients to have access to tests where necessary within one week of seeing their GP.
Details of funding for the additional diagnostic equipment and staff are not yet clear. It will initially be targeted at lung, colorectal and ovarian cancers, which account for more than a third of cancer deaths and where late diagnosis is a particular problem. But there are proposals to extend the initiative to all cancers within five years.
Survival rates
Professor Steve Field, chairman of the Royal College of GPs, said it had been pushing for direct access to tests, such as ultrasound or CT, for patients about whom there is a suspicion of something amiss but who do not meet the criteria for urgent two-week referral. "The two-week referral time for those patients where there is a high suspicion of cancer has made a major difference to patients and their GPs. But GPs would welcome the opportunity to refer patients directly for diagnostics such as MRI and CT scans, ultrasound and flexible sigmoidoscopy without having to refer to a specialist first." He added that it would provide particular benefit in ovarian cancer, which often presented with very vague symptoms and was hard to spot.
Shadow health secretary Andrew Lansley said just purchasing new equipment was not the way to tackle poor survival rates. He said: "We already have a shortage of radiographers which means that existing equipment is not used to full capacity. "We also need to improve the identification of symptoms in the community - through national screening programmes and better awareness of and response to symptoms, for example."
Harpal Kumar, Cancer Research UK's chief executive, said: "Increased investment to give GPs much faster access to diagnostic tests would be a vital step towards fixing this country's cancer problem and raising our survival rates towards being the best in Europe. "If we can detect cancer early it usually makes successful treatment more likely. And if the problem turns out not to be cancer, early tests help to put patients' minds at rest."
But he added that a range of approaches was needed to overcome late diagnosis. "We would like to see more government investment in public awareness campaigns and thought given to extending cancer screening programmes."
Peter Reynolds, chief executive of Ovarian Cancer Action, said most women with ovarian cancer were currently diagnosed with later stage disease. "GP awareness of the possible signs and symptoms of ovarian cancer is currently very low and this is another key issue that Ovarian Cancer Action is seeking to address, working in partnership with the Royal College of GPs." Target Ovarian Cancer, which conducted a mapping exercise of the disease this summer, also welcomed the promise of early tests. "Almost 7,000 women a year are diagnosed with ovarian cancer and the five year survival rate is very low at 30%", said Frances Reid, the charity's director of public affairs. "Rapid access to diagnostic tests, together with much needed increases in GP levels of awareness of symptoms will help to reduce delays in diagnosis and improve the outlook for women with the disease," she continued.
Meanwhile, health minister Andy Burnham has announced the start of a one-year pilot programme using the appeal of football to raise awareness of lung, bowel and prostate cancers in men aged 55 and over.
Copyright BBC Health News – Friday 25th September 2009
Source: http://news.bbc.co.uk/1/hi/health/8275455.stm
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