Professional Documents
Culture Documents
com
UK NEWS Dying patients are often not told of closeness of death, p 1176
news
World NEWS US
gene therapy trial is to restart despite patients death
, p 1172
bmj.com Screening
for bowel cancer halves number of deaths
Neil McAllister/Alamy
Under consideration are a ban on cigarette Royal College of Radiologists, said that
vending machines, curbs on the display of although this standard for radiotherapy
tobacco products, and a review of sun bed had been set in 1993, in 2005 it was being
use by people aged under 18 years. achieved in only 50% of cases.
Age thresholds for screening services will The Cancer Reform Strategy is available at
also be extended. By 2012 breast cancer www.dh.gov.uk. The UK government is reviewing use of sun beds
Dieter Telemans/panos
vention (CDC).
WHOs objective is to achieve a 90%
worldwide reduction in the number of mea-
sles deaths by 2010, and officials are confi-
dent that this can be met.
Mortality from measles worldwide fell by In 2006 measles vaccination reached 80% of the target population, up from 72% in 2000
death. No evidence of contamination antagonist adalimumab. For her rheumatoid arthritis, which of inflammation. The vector was
of the product was found, and the The patient was identified as Jolee she had had for 15 years, she was injected directly into the joint.
vector was found only at extremely Mohr, 36, of Taylorville, Illinois, who taking adalimumab, methotrexate, Science magazine (2007;317:580)
low levels outside the knee. was married and had a 5 year old and prednisone, all of which are reported that existing drugs for
This patients unfortunate daughter. She was given the first immunosuppressive and a risk rheumatoid arthritis also inhibit this
death was primarily a result injection in February and the second factor for histoplasma infection, the mediator of inflammation, but they
of an opportunistic infection, on 2 July. She experienced vomiting company said. do not always penetrate all joints and
disseminated histoplasmosis with and fever soon after the second The trials used a recombinant, need to be injected frequently.
subsequent bleeding complications injection. When her symptoms adeno associated virus as a vector. In its press release Targeted
and multi-organ failure. Her apparent worsened she was admitted to An FDA press release said that the Genetics said that final molecular
risk factor . . . was her systemic RA hospital and later transferred to the vector delivers the gene for tumour test results had shown that there was
[rheumatoid arthritis] therapy, chiefly University of Chicago Hospital, where necrosis factor receptor, with the no amplification of the viral vector in
the TNF [tumour necrosis factor] she died on 24 July. aim of inhibiting a key mediator the patients body.
Chris young/pa
for orphan drugs: The European returned home. the panel found, because the
Commission, the European Medicines She told the GMC hearing information in them was still
Agency, and the US Food and Drug that Dr Southall had been Struck off: Dr David Southall also in the hospital system.
Administration have adopted a common
application form for sponsors seeking
designation of drugs as orphan drugs in
the European Union and United States. The
aim is to simplify the process of obtaining
Pay rise next year is It depends on how you measure infla-
tion, said Mr Johnson. The chancellor [of
orphan status for drugs intended for rare
diseases in both jurisdictions.
not likely to top 2% the Exchequer] is right to ensure that we
dont build in an inflationary spiral that takes
Adrian ODowd London us back to the days of high interest rates.
A tenth of English patients are harmed An acceptable pay settlement for NHS staff I say on many occasions to nurses, GPs,
by stay in hospital: One in 10 NHS next year should be achievable, despite the and consultants: if you look at the record
patients come to harm while in hospital
as a result of their clinical care, says
fact that an increase will probably be only since 1997, and if you look at what happened
a study that reviewed the case notes around 2%, the health secretary has said. through Agenda for Change [the system of
of a random sample of just over 1000 Alan Johnson told MPs last week he was pay and conditions introduced in the NHS
patients admitted to a large teaching optimistic about the current difficult pay in 2004], no government has done more to
hospital in England in the first six months discussions taking place. try to establish decent pay for people.
of 2004. The commonest problems were Mr Johnson was giving evidence as part of In terms of how we maintain that pay we
unplanned admission or readmission the parliamentary health select committees are going into a difficult set of discussions
as a result of previous treatment in the
inquiry into public expenditure. and negotiations, but I am hopeful we will
hospital, followed by injuries, such
as falls or pressure sores, and other The committee tackled him on the govern- come out with a settlement.
complications, including heart attack and ments recent call for a 2% pay rise in 2008-9 Mr Johnson confirmed earlier speculation
deep vein thrombosis (Quality & Safety in for most NHS staff and asked whether pay that the NHS was on course for a surplus of
Health Care 2007;16:434-9). rises below the rate of inflation were going 1.8bn (2.5bn; $3.7bn) by the end of the
to be the norm. current financial year.
Deaths related to obesity take over from to the pregnancy), a figure not
significantly different from that
rex
rights lawyer Ludwig Minelli, found another Schwerzenbach, 22 km from Zurich, the Some partners accused women of forging the
flat but was unable to use it after the local local council tried to ban assisted suicides report when the child turned out to be a girl
council took action. there, but the administrative court for the
canton of Zurich ruled that Dignitas could
use it, pending a final court decision. Assisted suicide is legal in Switzerland as
Mr Minelli, who runs Dignitas as a non- long as the helper is not acting from selfish
profit organisation, told a press briefing in motives. In England and Wales anyone who
London last weekend: If you look at it aids and abets a suicide commits a criminal
from the outside its a commercial building, offence that carries a maximum 14 year sen-
but inside the two rooms that we use are tence. However, Mr Minelli said that the
very cosy. He was invited to London by UK Crown Prosecution Service had never
the Glasgow based organisation Friends at prosecuted a relative in England for helping
the End. a loved one get to Zurich to visit Dignitas.
Dignitas, which has around 6000 mem- Despite this, relatives of British people
bers in 57 countries, is the only Swiss organ- who use the services of Dignitas still fear
isation that offers a doctor assisted suicide prosecution if they make the arrangements
service to people from abroad. Mr Minelli or accompany their loved ones. Debbie
said that 808 people from 26 countries Purdy, 44, from Bradford, who has multiple
had used its services, including 84 British sclerosis, has asked the director of public
people, the third largest group. Most had prosecutions, Ken Macdonald, for an assur-
terminal cancer, multiple sclerosis, or motor ance that her husband will not be prosecuted
chris ison/pa
results were presented on a scale from 0 to are not successful, Professor Gausche-Hill
100 (perfect). The median score was 55. said. When this criterion was excluded, 8%
The study is by Marianne Gausche-Hill, of emergency departments met the recom-
professor of medicine, David Geffen School mended criteria.
of Medicine at the University of California She said that hospitals, especially those
in Los Angeles (UCLA), and director of that saw few paediatric patients, were afraid
emergency medical services and paediatric of the cost of the full complement of recom- Only 6% of emergency departments said they had
emergency medicine fellowships, Harbor- mended equipment and supplies. The actual all the recommended equipment and drugs
UCLA Medical Center, Los Angeles, and cost would be only about $1000 (500;
colleagues. 700), she said, although some drugs would were more likely to see a higher volume of
Professor Gausche-Hill told the BMJ that need to be replaced when they reach their paediatric patients.
only 59% of the hospitals that answered expiry date. Almost all hospitals said that their
the survey were aware of the guidelines, The surveys showed that 89% of 27 mil- r adiology departments and laboratories
which were originally published in Pediatrics lion emergency department visits by chil- could provide imaging studies of infants and
(2001;107:777-81) and the Annals of Emergency dren were to general hospitals rather than children and perform necessary laboratory
Medicine (2001;17:423-8). Another problem childrens hospitals. Most often, children tests. They also said that they had a plan
was that hospitals had not assigned a doctor were seen in the main emergency depart- to transfer paediatric patients who need
and a nurse to tackle problems in paediat- ment with adult patients. Hospitals that had intensive care and that they had a policy
ric care, as recommended in the Institute of a separate paediatric emergency department on possible child maltreatment.