All GPs to have dementia training

PA, The Independent,
Monday, 22 December 2008

Every GP will be trained to spot the first signs of dementia under plans to provide sufferers with a better quality of life, the Government said today.

“Memory clinics” will also be set up in every town as places where patients can get treatment and support to live their lives as normally as possible, Care Services Minister Phil Hope said.

A total of 700,000 people in the UK have a form of dementia.

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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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Post traumatic stress rises among war zone soldiers

By: Martha Linden, PA, The Independent
Tuesday, 4 November 2008

Nearly 4,000 new cases of mental health disorder were diagnosed last year among armed services personnel, according to figures published today.

Mental health statistics released by the Ministry of Defence showed 3,917 new cases of armed services personnel assessed to have a mental disorder in 2007 by the MoD’s department of community mental health.

A breakdown of the statistics showed that, in line with the first nine months of last year, there were no statistically significant differences in the rates of overall mental disorder between those who had deployed to Iraq or Afghanistan and those who had not deployed during the last quarter of 2007.

But the figures showed a significantly higher rate of post-traumatic stress disorder (PTSD) among those who had deployed to Iraq and Afghanistan compared with those who had not deployed to these countries.

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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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Sick leave linked to early death

By: Laura May, PA, The Independent
Friday, 3 October 2008

Employees who take regular periods of long-term sick leave die earlier than their colleagues, a study by the British Medical Journal said today.

Researchers found that workers with more than one absence requiring a doctor’s note on their records were 66 per cent more likely to die prematurely.

And workers who had to stay off work because of psychiatric problems were two and a half more likely to die of cancer.

Those who had to take time off because of circulatory disease were the most likely to die before their healthy colleagues. Researchers found they had a four time higher chance of a premature death.

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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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Vitamin B12 may protect brain

By: PA, The Independent

A key vitamin found in meat, fish and milk may help protect the brain as it ages, researchers said.

Vitamin B12 could help stop the brain shrinking – possibly preventing memory loss in older people and dementia.

A study of 107 people aged 61 to 87 found that those with lower vitamin B12 levels in their blood were six times more likely to experience brain shrinkage compared with those who had higher levels of the vitamin.

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Management of postnatal depression, a clinical review

By: Charles Musters, specialist registrar in perinatal psychiatry, Elizabeth McDonald, consultant in perinatal psychiatry and Ian Jones, senior lecturer in perinatal psychiatry.
BMJ, 8 August 2008

• Postnatal depression occurs after 13% of births.
• The nature of the puerperal trigger is still unknown, but several psychological, social, and biological factors probably play a part. Genetic factors have been implicated
• A previous history of postnatal depression or of any mental illness, poor social support, and depression during the pregnancy all increase the risk of developing the illness
• Postnatal depression needs to be identified and treated promptly and adequately because it can result in a range of lasting adverse outcomes for mother and child
• A range of psychological therapies is effective in treating postnatal depression
• Drugs are also effective and some antidepressants are thought to be safer in breastfeeding mothers than others. But in general the long term outcomes for exposed babies are unknown. Although tricyclic antidepressants have been prescribed for longer, most recent reproductive safety data, which include thousands of exposures, have been for selective serotonin reuptake inhibitors. Because of concerns about toxicity, tricyclics are prescribed less often than selective serotonin reuptake inhibitors for postnatal depression.
• Drugs are recommended for women who decline psychological therapy, or for whom there would be an unacceptable delay in providing non-pharmacological measures.

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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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Hypothyroidism in adults

Thyroxine structure

By: Bijay Vaidya, consultant endocrinologist and honorary senior clinical lecturer and Simon H S Pearce, professor of endocrinology and honorary consultant physician, Newcastle upon Tyne.
BMJ 28 July 2008

Hypothyroidism is one of the commonest chronic disorders in Western populations. In the United Kingdom, the annual incidence of primary hypothyroidism in women is 3.5 per 1000 and in men 0.6 per 1000.

The management of hypothyroidism is generally considered straightforward and is mostly carried out in primary care in the UK. Cross sectional surveys of patients taking levothyroxine have, however, shown that between 40% and 48% are either over-treated or under-treated.

Furthermore, a small but significant proportion of patients continue to feel unwell despite taking levothyroxine.

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