Sharp rise in heterosexual HIV cases

By: Jeremy Laurance, Health Editor, The Independent
Wednesday, 26 November 2008

The number of people infected with HIV acquired through heterosexual contact in the UK has almost doubled in four years, figures issued yesterday show. There were 960 new diagnoses in 2007 compared with 540 in 2003, the Health Protection Agency said.

Although the bulk of the 4,260 new infections diagnosed in this country last year were acquired abroad, the sharp increase contracted in the UK has taken them from one in 10 to almost one in four of all heterosexual cases.

A spokesman for the HPA said the UK heterosexual cases were concentrated in the African community, and most were infected by partners infected abroad. “They are quite small numbers and although they were acquired in the UK they are linked with people who have travelled,” he said.

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Long term predictive values of cytology and human papillomavirus testing in cervical cancer screening

Research; BMJ 13 October 2008.
By: Joakim Dillner, professor, Lund University, Medical Microbiology, University Hospital MAS, 205 02 Malmö, Sweden et al.

This joint analysis of studies across western Europe concludes that, for women with negative cytology and negative HPV testing, such combined screening every six years would be safe.

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Antibiotics to delay premature birth may harm babies

By: Jeremy Laurance, Health Editor, The Independent
Thursday, 18 September 2008

A warning about the indiscriminate prescribing of antibiotics to pregnant women to delay premature labour was issued to all doctors yesterday after research unexpectedly revealed that the practice may cause long-term harm to their babies.

The Government’s chief medical officer, Sir Liam Donaldson, wrote to GPs, obstetricians and other medical staff following publication of the first study of the subject. The findings show an increased risk of cerebral palsy in the children of one group of women. There was also a small increase in problems such as poor eyesight or hearing. The results add to the growing evidence that what happens in the womb has a huge impact on the baby not only at birth but for decades beyond.

Sir Liam said in the letter that antibiotics should continue to be given to women in premature labour where there was evidence of infection, or risk of it because their waters had broken.

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Clinical Review: Treatment of Helicobacter pylori infection

Clinical Review, by: L Fuccio, research fellow et al, Department of Internal Medicine and Gastroenterology, University of Bologna.
BMJ, 15 September 2008

• The prevalence of H pylori varies widely and is about 50% in international population studies. Helicobacter pylori is one of the most common human infections, and about half of the world’s population carries this organism. Since its discovery in 1984, H pylori has been recognised as a major cause of several upper gastrointestinal diseases.
• Triple and quadruple multidrug regimens are standard treatment
• Resistance to clarithromycin and metronidazole and lack of adherence to treatment are the main predictors of treatment failure
• The choice of the most effective regimen should be based on the prevalence of antibiotic resistance, especially resistance to clarithromycin and metronidazole
• Individualised treatment based on antimicrobial susceptibility has a limited role in H pylori eradication strategies
• The overall risk of reinfection is estimated at 3.4% per patient year in developed countries, rising to 8.7% in developing countries

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Appeal for new antibiotics after resistant E.coli infections treble

By: Jeremy Laurance, Health Editor, The Independent
Thursday, 11 September 2008

An increase in infections that are resistant to all known antibiotics is threatening Britain and the world, unless ways can be found to develop and finance new drugs, public health experts warned yesterday.

The Health Protection Agency said yesterday that of 20,000 blood stream infections caused by E.coli in an average year, the proportion that were resistant to antibiotics rose from 4 per cent in 2000 (800 cases) to 12 per cent in 2006, but that there were no new drugs being developed, or in the pipeline, to tackle them.

E.coli is the commonest cause of lethal blood stream infections, especially in old or sick people. It is a gram-negative bacterium, which is more difficult to treat than a gram-positive bacteria, such as MRSA, because it has a tougher cell wall.

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NHS trusts face fines for poor hygiene of up to £50,000 …

By: Jeremy Laurance, Health Editor, The Independent
Tuesday, 12 August 2008

Fines of up to £50,000 will be imposed on NHS trusts which breach hygiene regulations in a crackdown on hospital infections.

Inspectors will have powers to prosecute dirty hospitals and clinics, and impose sanctions ranging from fixed penalty fines to closure of wards, clinics or services.

The fresh measures are part of the Government’s drive to protect patients against superbugs, including MRSA and Clostridium difficile.

Public anxiety has been increased by incidents such as the 90 deaths attributed to C. difficile at Maidstone and Tunbridge Wells NHS Trust over two and half years. The deaths of a further 255 patients were judged to have been hastened by the bug.

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Chlamydia drug to be sold without prescription …

Source: Medicines and Healthcare products Regulatory Agency, Press release
Wed 6.8.2008

The Medicines and Healthcare products Regulatory Agency (MHRA) has today given approval for a medicine to be made available from a pharmacist without a doctor’s prescription to treat chlamydia.

The azithromycin pill, which will be called “Clamelle”, will be available to buy by people 16 years and over if they have tested positive for the infection and have no symptoms, and for their sexual partners.

Dr June Raine, Director of Vigilance and Risk Management of Medicines at the MHRA said, “Chlamydia is the most common sexually transmitted disease in the UK.

Up to 70% of people who have chlamydia have no symptoms and could therefore remain undiagnosed. This means that they are at huge risk of serious long-term health complications, including infertility and ectopic pregnancy.

The medicine is expected to hit pharmacy shelves later this year.

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Typhoid carriers detained for life in mental hospital …

By: PA, The Independent
Monday, 28 July 2008

Many British people were locked up for life at a mental hospital because they were typhoid carriers, it was reported today.

At least 43 women were detained at Long Grove asylum in Epsom, Surrey, between 1907 and the facility’s closure in 1992, according to the BBC.

Despite having recovered from the disease, they were held because they still carried the bacterium, deemed to be a public health risk, the corporation’s Newsnight programme claims.

After antibiotic treatments emerged in the 1950s, the women continued to be detained but on mental health grounds, it is claimed.

Hugh Pennington, emeritus professor of bacteriology at Aberdeen University, told the BBC: “They (the detained women) certainly were infectious; they had the potential to spread the infection to others if they had poor hygiene and they were preparing food and all that type of thing. But as a public health risk, I think they were basically targeted and there was a lot of over-exaggeration about the threat they posed.”

1. Typhoid fever is transmitted by the ingestion of food or water contaminated with faeces from an infected person.
2. The disease is characterised by a prolonged fever, as high as 40C, sweating, gastroenteritis, and diarrhoea.

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Guillain-Barré syndrome: a clinical review

BMJ, 17 July 2008
By: John B Winer, consultant neurologist, University Hospital Birmingham, UK.

What are the clinical features?

1. All types of Guillain-Barré syndrome present with acute neuropathy, defined as: progressive onset of limb weakness that reaches its worst within four weeks.
2. Typically there are sensory symptoms but few sensory signs.
3. Reflexes are usually lost early in the illness.
4. The respiratory system is affected in a third of cases, but this may not be associated with clear dyspnoea, which makes it more difficult to assess.

Summary points:

• Guillain-Barré syndrome is a rare but important disease that can lead to life threatening respiratory failure. (Guillain-Barré syndrome is a peripheral neuropathy that causes acute neuromuscular failure).
• Misdiagnosis is common and can be fatal because of the high frequency of respiratory failure, which contributes to the 10% mortality seen in prospective studies).
• Structural similarities between a triggering infectious organism and peripheral nerve tissue are important in its pathogenesis
• Treatment consists of rapid administration of intravenous immunoglobulin or plasma exchange, which shortens the time to recovery
• Around 10% of patients die from respiratory failure, pulmonary emboli, or infection
• Around 20% of patients have residual disability, with weakness or persistent sensory disturbance.

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Could sex save your life?

By: Dan Roberts, The Independent
Tuesday, 1 July 2008

Making love doesn’t just help you feel good. It also burns calories, boosts your immune system – and can even reduce the risk of cancer

Love life: regular sex combats stress, helps sleep, can take away pain and guards against breast cancer.

Having sex once or twice a week has been linked with higher levels of an antibody called immunoglobulin A, or IgA, which can protect you from colds and other sorts of infections.

During orgasm the body produces oxytocin, which is a hormone linked to a range of positive physical and psychological effects. Chief among these is its beneficial impact on sleep.

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