The Public Relations Dept of Papworth Hospital declined to povide the names of the Cardiologists, who successfully inserted an unnamed coronary stent into the 90y.Prince Philip, based on Patient confidentiality.
Hopefully the New Year Honours will reveal the facts of this important advance in Geriatric Cardiology.
30 December 2011
29 December 2011
PAPWORTH HOSPITAL CME
Cardiology Training Day - Arrhythmias, Electrophysiology and Devices - 22nd November 2011
Endobronchial & Endoscopic Ultrasound EBUS Course - Thursday 24th & Friday 25th November 2011
Transplant and Lung Failure Symposium - 23rd March 2012
Papworth ECMO Course - 26th, 27th & 28th March 2012
(COMMENT: Still no Press release about the Papworth doctors who saved Prince Philip's life)
Endobronchial & Endoscopic Ultrasound EBUS Course - Thursday 24th & Friday 25th November 2011
Transplant and Lung Failure Symposium - 23rd March 2012
Papworth ECMO Course - 26th, 27th & 28th March 2012
(COMMENT: Still no Press release about the Papworth doctors who saved Prince Philip's life)
28 December 2011
ROYAL ROLE in UK MEDICAL TRAVEL TOURISM
The UK Royal Family are consumer models for the UK Middle and Upper Middle classes. There are approx 850 ROYAL WARRENT HOLDERS including BOOTS the CHEMIST. Medical practitioners are rewarded for services to the Royal Family by membership in the ROYAL VICTORIAN ORDER
Hospitals can be elevated by the addition of ROYAL such as ROYAL BROMPTON (Lungs & Heart), ROYAL FREE (first to admit female students), ROYAL London Hosp for INTEGRATED MEDICINE,(originally Royal Homoeopathic), ROYAL LONDON (East End), ROYAL MARSDEN (Cancer) and some community hospitals such as Guildford's Royal Surrey County Hosp.
UK Medicine is an important invisible EXPORT. PRIVATE medicine has been alive & well since the beginning of the NHS in 1947. Teaching hospitals have PRIVATE wards. There are many PRIVATE HOSPITALS including the Royal favourite , the London KING EDWARD VII Hosp for Officers (public accepted - military families pay reduced fees), the famous (1932,) Harley Street, LONDON CLINIC.and the (1975) WELLINGTON HOSP ,(overlooking Lord's Cricket Ground), now owned by Nashville,USA, HCA Holdings Inc which also owns the ALL PRIVATE Harley Street Clinic, Lister Hosp., London Bridge Hosp.,Portland Hosp. (women/children), and the Princess Grace Hosp.
Hopefully the PAPWORTH HOSPITAL doctors who saved the life of Prince Philip will be named by the Palace Press office. This would encourage Medical Travel tourism to the clean air of the village of Papworth Everard., 10 miles West of Cambridge (45 min by train from London). It would also be interesting to the World's medical profession to know what brand of STENT was used.
Hospitals can be elevated by the addition of ROYAL such as ROYAL BROMPTON (Lungs & Heart), ROYAL FREE (first to admit female students), ROYAL London Hosp for INTEGRATED MEDICINE,(originally Royal Homoeopathic), ROYAL LONDON (East End), ROYAL MARSDEN (Cancer) and some community hospitals such as Guildford's Royal Surrey County Hosp.
UK Medicine is an important invisible EXPORT. PRIVATE medicine has been alive & well since the beginning of the NHS in 1947. Teaching hospitals have PRIVATE wards. There are many PRIVATE HOSPITALS including the Royal favourite , the London KING EDWARD VII Hosp for Officers (public accepted - military families pay reduced fees), the famous (1932,) Harley Street, LONDON CLINIC.and the (1975) WELLINGTON HOSP ,(overlooking Lord's Cricket Ground), now owned by Nashville,USA, HCA Holdings Inc which also owns the ALL PRIVATE Harley Street Clinic, Lister Hosp., London Bridge Hosp.,Portland Hosp. (women/children), and the Princess Grace Hosp.
Hopefully the PAPWORTH HOSPITAL doctors who saved the life of Prince Philip will be named by the Palace Press office. This would encourage Medical Travel tourism to the clean air of the village of Papworth Everard., 10 miles West of Cambridge (45 min by train from London). It would also be interesting to the World's medical profession to know what brand of STENT was used.
23 December 2011
Sir (Dr.) Pendrill VARRIER-JONES (1883-1941) & PAPWORTH HOSPITAL
In 1918, the Cambridgeshire Tuberculosis Colony, consisting of 17 patients, moved from the nearby village of Bourn into Papworth Hall, which was vacant following (financier) Ernest Hooley's departure. This event was to have a profound effect on the future of the village. With the Hall went the village and most of the land in the parish. Under the energetic and capable management of Dr (later, Sir) Pendrill Varrier-Jones the Papworth Colony rapidly expanded. (In the early twentieth century, before effective drug treatments became available, TB was not only a potential killer for the victim but also had devastating consequences for the whole family who were often evicted from their home, sacked from their employment and generally ostracised from friends, family and community).
Although there were still many deaths among tuberculosis patients, even at Papworth, the aim was to rehabilitate sufferers by arresting their disease, by giving them appropriate work, and by allowing their families to come and live in the village with them. Papworth ultimately offered free medical care, excellent housing, schools, recreation and a chance for the TB patient to rebuild their life.
The Hall soon became too small and a new hospital was built in the grounds. In all, about 300 new houses were built for TB patients and their families, first along Ermine Street and then on the Pendragon Hill/Ridgeway Estate. Baron's Way, to the East of the playing fields, was built in the early 1950's. Factory buildings were constructed in the 1930's - replacing earlier workshops - and a shop was provided.
During the 1940s antibiotics became available that would cure TB. In the late 1940's, the hospital passed to the newly formed National Health Service and became the East Anglian centre for chest and heart medicine and much pioneering work has been done. Papworth was one of the very first hospitals in the country to undertake open-heart surgery and in 1978 Sir Terrance English undertook the first of the current series of successful heart transplants in Britain. Later, the first combined heart and lung transplant in Europe was carried out at Papworth.
COMMENT:
Papworth Hospital is to be rebuilt in Cambridge by the combined firms of BOUYGUES SA in Paris and SKANSKA AB in Solna.
Papworth also takes PAYING PATIENTS.
Although there were still many deaths among tuberculosis patients, even at Papworth, the aim was to rehabilitate sufferers by arresting their disease, by giving them appropriate work, and by allowing their families to come and live in the village with them. Papworth ultimately offered free medical care, excellent housing, schools, recreation and a chance for the TB patient to rebuild their life.
The Hall soon became too small and a new hospital was built in the grounds. In all, about 300 new houses were built for TB patients and their families, first along Ermine Street and then on the Pendragon Hill/Ridgeway Estate. Baron's Way, to the East of the playing fields, was built in the early 1950's. Factory buildings were constructed in the 1930's - replacing earlier workshops - and a shop was provided.
During the 1940s antibiotics became available that would cure TB. In the late 1940's, the hospital passed to the newly formed National Health Service and became the East Anglian centre for chest and heart medicine and much pioneering work has been done. Papworth was one of the very first hospitals in the country to undertake open-heart surgery and in 1978 Sir Terrance English undertook the first of the current series of successful heart transplants in Britain. Later, the first combined heart and lung transplant in Europe was carried out at Papworth.
COMMENT:
Papworth Hospital is to be rebuilt in Cambridge by the combined firms of BOUYGUES SA in Paris and SKANSKA AB in Solna.
Papworth also takes PAYING PATIENTS.
22 December 2011
GP Behnaz YAZDANFAR found GUILTY. Will CPSO REGISTRAR GERACE RESIGN?
from TORONTO STAR
(Real estate agent) Krista Tabacoff Stryland, (1974-2007) was pronounced dead in North York Hosp shortly after paramedics took her there from GP Behnaz Yazdanfar’s cosmetic clinic (in a North Toronto office building).
The GP who was found incompetent in her care of cosmetic surgery patients – including Ms STRYLAND who died following a SIX LITER liposuction in 2007 .
Dr. Behnaz Yazdanfar was found to have displayed “disgraceful, dishonourable or unprofessional” conduct in her care of five patients following a TWO YEAR disciplinary hearing before the Ontario College of Physicians and Surgeons that ended in May 2011. PENALTY delayed for SEVEN MONTHS..
Yesterday the college suspended Yazdanfar’s licence for two years. After that, Dr. Yazdanfar will be restricted from SOLO surgery but will be permitted to ASSIST in surgery, including cosmetic procedures.
She was ordered Wednesday to appear before the college for a public reprimand within the next three months.
Yazdanfar was ordered to pay $219,000 in costs to the college within a year.
She must also co-operate with unannounced inspections of her practice and patient charts, conducted at her expense, and publish the terms of her restrictions at her clinic and on her website.
Like many doctors performing cosmetic procedures (in Ontario), Dr. Yazdanfar was never accredited as a plastic surgeon and holds no surgical designation.
Ms. Krista Stryland was pronounced dead in hospital shortly after paramedics took her from Dr.Yazdanfar’s cosmetic clinic. Court records obtained by the Star alleged Ms. Stryland lay in the clinic’s recovery room in serious condition for 30 minutes before anyone called 911.
Dr. Bruce Liberman, the anesthesiologist in the Stryland case, was also found to be incompetent. He is awaiting the result of a separate disciplinary hearing.
COMMENTS:
The CPSO was aware that GPs were perfoming surgery under GENERAL ANAESTHESIA in office buildings. The CPSO Registrar, past ER physician & CPSO Past President, , R.V. GERACE MD (UWO 72) FRCSC (ER 83) was aware of the danger for years and took no preventive action. As a direct result of this negligence a patient died; will Dr.Gerace resign?
Dr.Yazdanfar was represented by Lawyers Clayton Ruby CM BA(York 63) LLB (Tor.69) LLM(U.Cal.Berkeley) 11 Prince Arthur Av.,Yorkville,Tor. & Gardiner Roberts LLP partner Tracey Tremayne-Lloyd LLB( 83) Certificate in Health Law, They did a superb job: Dr. Yazdanfar did NOT lose her licence. Only a nominal "Suspension" for 2 years: no problem as the clinic can function withoout her medical services employing other doctors. Also Dr.Yazdanfar can do admin. duties. As for the CPSO legal costs of $219,000 (NOT A FINE) , this a moderate amount considering the gravity of the case. Also is TAX DEDUCTABLE.
(Real estate agent) Krista Tabacoff Stryland, (1974-2007) was pronounced dead in North York Hosp shortly after paramedics took her there from GP Behnaz Yazdanfar’s cosmetic clinic (in a North Toronto office building).
The GP who was found incompetent in her care of cosmetic surgery patients – including Ms STRYLAND who died following a SIX LITER liposuction in 2007 .
Dr. Behnaz Yazdanfar was found to have displayed “disgraceful, dishonourable or unprofessional” conduct in her care of five patients following a TWO YEAR disciplinary hearing before the Ontario College of Physicians and Surgeons that ended in May 2011. PENALTY delayed for SEVEN MONTHS..
Yesterday the college suspended Yazdanfar’s licence for two years. After that, Dr. Yazdanfar will be restricted from SOLO surgery but will be permitted to ASSIST in surgery, including cosmetic procedures.
She was ordered Wednesday to appear before the college for a public reprimand within the next three months.
Yazdanfar was ordered to pay $219,000 in costs to the college within a year.
She must also co-operate with unannounced inspections of her practice and patient charts, conducted at her expense, and publish the terms of her restrictions at her clinic and on her website.
Like many doctors performing cosmetic procedures (in Ontario), Dr. Yazdanfar was never accredited as a plastic surgeon and holds no surgical designation.
Ms. Krista Stryland was pronounced dead in hospital shortly after paramedics took her from Dr.Yazdanfar’s cosmetic clinic. Court records obtained by the Star alleged Ms. Stryland lay in the clinic’s recovery room in serious condition for 30 minutes before anyone called 911.
Dr. Bruce Liberman, the anesthesiologist in the Stryland case, was also found to be incompetent. He is awaiting the result of a separate disciplinary hearing.
COMMENTS:
The CPSO was aware that GPs were perfoming surgery under GENERAL ANAESTHESIA in office buildings. The CPSO Registrar, past ER physician & CPSO Past President, , R.V. GERACE MD (UWO 72) FRCSC (ER 83) was aware of the danger for years and took no preventive action. As a direct result of this negligence a patient died; will Dr.Gerace resign?
Dr.Yazdanfar was represented by Lawyers Clayton Ruby CM BA(York 63) LLB (Tor.69) LLM(U.Cal.Berkeley) 11 Prince Arthur Av.,Yorkville,Tor. & Gardiner Roberts LLP partner Tracey Tremayne-Lloyd LLB( 83) Certificate in Health Law, They did a superb job: Dr. Yazdanfar did NOT lose her licence. Only a nominal "Suspension" for 2 years: no problem as the clinic can function withoout her medical services employing other doctors. Also Dr.Yazdanfar can do admin. duties. As for the CPSO legal costs of $219,000 (NOT A FINE) , this a moderate amount considering the gravity of the case. Also is TAX DEDUCTABLE.
KOREAN-CANADIAN VENTURE for AIDS VACCINE
Sumagen Canada Inc. is a solely owned subsidiary of Sumagen Co., Ltd.
Sumagen Co., Ltd is a Korean pharmaceutical venture company focusing on developing an HIV/AIDS vaccine and is a solely owned subsidiary of Curocom Co., Ltd. Sumagen is also supporting the ongoing research work at the Schulich School of Medicine and Dentistry, The University of Western Ontario (UWO) for and HCV (Hepatitis C Viru) vaccine.
Dr. Chil Yong Kang, Sumagen's Chief Scientific Officer and also a professor at UWO, developed a vaccine for HIV/AIDS for both therapeutic and prophylactic use with his team. In 2006, the company opened an office in London at the Stiller Centre, in order to closely support the vaccine development. The office in London with a staff of six, are managing the project to manufacture the materials for clinical trials, conduct non-clinical studies, and coordinate through a consultant to meet the requirements of the FDA in the United States to obtain approval to conduct human clinical trials.
Sumagen Co., Ltd is a Korean pharmaceutical venture company focusing on developing an HIV/AIDS vaccine and is a solely owned subsidiary of Curocom Co., Ltd. Sumagen is also supporting the ongoing research work at the Schulich School of Medicine and Dentistry, The University of Western Ontario (UWO) for and HCV (Hepatitis C Viru) vaccine.
Dr. Chil Yong Kang, Sumagen's Chief Scientific Officer and also a professor at UWO, developed a vaccine for HIV/AIDS for both therapeutic and prophylactic use with his team. In 2006, the company opened an office in London at the Stiller Centre, in order to closely support the vaccine development. The office in London with a staff of six, are managing the project to manufacture the materials for clinical trials, conduct non-clinical studies, and coordinate through a consultant to meet the requirements of the FDA in the United States to obtain approval to conduct human clinical trials.
19 December 2011
USA C.A.P. MALIGNANT MELANOMA & ZELBORAF
Anne Paxton
Take a fatal and nearly untreatable cancer. Invest hundreds of millions of dollars to develop and test a drug that shrinks tumors or improves survival in half of patients with a common mutation. Link diagnosis to a PCR test that you also manufacture. And win an accelerated FDA approval for the test-drug combination.
Altogether, no mean feat. And it’s essentially what Roche accomplished to bring its metastatic melanoma drug Zelboraf (vemurafenib) on the market this year.
By all accounts, Zelboraf should bring new hope to thousands of melanoma patients and perhaps a billion dollars a year in revenue to Roche. “It’s the first ever joint FDA approval of a drug and a DNA-based companion diagnostic, and the beginning of the molecular companion diagnostics era,” says John W. Longshore, PhD, director of molecular pathology for Carolinas Pathology Group, Carolinas Medical Center, Charlotte, NC.
The FDA, in its approach to companion diagnostics, seems to favor single-assay platforms while the field moves toward multiplexed platforms, says Dr. Marc Ladanyi, here at Memorial Sloan-Kettering Cancer Center with colleagues involved in BRAF mutation testing, Maria Arcila, MD (center), and Laetitia Borsu, PhD.
Zelboraf, a kinase inhibitor, has been proven effective only for melanoma patients with the BRAF V600E mutation. But the linkage of Zelboraf to the Roche Cobas 4800 BRAF V600 Mutation Test is creating something of a furor. In its Aug. 17 approval of Zelboraf, the FDA’s Center for Drug Evaluation and Research specified that the drug is indicated “for the treatment of patients with unresectable or metastatic melanoma with BRAF V600E mutation as detected by an FDA-approved test” (emphasis added). So when the FDA Center for Devices and Radiological Health granted pre-market approval for the Cobas test the same day, the Roche assay became the de facto companion diagnostic for Zelboraf.
Take a fatal and nearly untreatable cancer. Invest hundreds of millions of dollars to develop and test a drug that shrinks tumors or improves survival in half of patients with a common mutation. Link diagnosis to a PCR test that you also manufacture. And win an accelerated FDA approval for the test-drug combination.
Altogether, no mean feat. And it’s essentially what Roche accomplished to bring its metastatic melanoma drug Zelboraf (vemurafenib) on the market this year.
By all accounts, Zelboraf should bring new hope to thousands of melanoma patients and perhaps a billion dollars a year in revenue to Roche. “It’s the first ever joint FDA approval of a drug and a DNA-based companion diagnostic, and the beginning of the molecular companion diagnostics era,” says John W. Longshore, PhD, director of molecular pathology for Carolinas Pathology Group, Carolinas Medical Center, Charlotte, NC.
The FDA, in its approach to companion diagnostics, seems to favor single-assay platforms while the field moves toward multiplexed platforms, says Dr. Marc Ladanyi, here at Memorial Sloan-Kettering Cancer Center with colleagues involved in BRAF mutation testing, Maria Arcila, MD (center), and Laetitia Borsu, PhD.
Zelboraf, a kinase inhibitor, has been proven effective only for melanoma patients with the BRAF V600E mutation. But the linkage of Zelboraf to the Roche Cobas 4800 BRAF V600 Mutation Test is creating something of a furor. In its Aug. 17 approval of Zelboraf, the FDA’s Center for Drug Evaluation and Research specified that the drug is indicated “for the treatment of patients with unresectable or metastatic melanoma with BRAF V600E mutation as detected by an FDA-approved test” (emphasis added). So when the FDA Center for Devices and Radiological Health granted pre-market approval for the Cobas test the same day, the Roche assay became the de facto companion diagnostic for Zelboraf.
Late Maj Dr. R.G.GAYER-ANDERSON DSO RAMC PASHA
Detail of the headThe sculpture is now known as the Gayer-Anderson cat after Major Robert Grenville Gayer-Anderson who donated it, together with Mary Stout Shaw, to the British Museum.[1] The statue is a representation of the cat-goddess Bastet. The cat wears jewellery and a protective wedjat amulet. The earrings and nose ring on the statue may not have always belonged to the cat.[2] While they certainly are ancient, an early photograph of the cat shows the statue wearing a different pair. A winged scarab appears on the chest and head, it is 42cm high and 13cm wide. A copy of the statue is kept in the Gayer-Anderson Museum, located in Cairo.
ConstructionThe statue is not as well preserved as it appears. X-Rays taken of the sculptire reveal that there are cracks that extend almost completely around the centre of the cats body and only an internal system of strengthening prevents the cat's head from falling off. The repairs to the cat are thought to have been carried out by Major Gayer-Anderson who was a keen restorer of antiquities in the 1930s. He is thought to have rediscovered the surface of the cat after the presumed corrosion had been removed.[3]
The cat was manufactured by the lost wax method where a wax model is covered with clay or clay and water until there is sufficient thickness. The clay can then be fired in a kiln and the wax flows out. The now hollow mould can be refilled with bronze. In this case the metal was 85% copper, 13% tin, 2% arsenic with a 0.2% trace of lead. The remains of the pins that held the wax core can still be seen using x-rays. The original metalworkers would have been able to create a range of colours on a bronze casting and the stripes on the tail are due to metal of a differeing composition. It is also considered likely that the eyes contained stone or glass decorations.[3]
[edit] References^ Description of the Gayer-Anderson Cat, British Museum
^ Oakes, Lorna, and Lucia Gahlin. Ancient Egypt: An Illustrated Reference to the Myths, Religions, Pyramids and Temples of the Land of the Pharaohs. (p. 229) Barnes & Noble, September 2003. ISBN 9780760749432.
^ a b Examination of the Gayer-Anderson cat, British Museum, accessed December 2010
[edit] Further readingClutton-Brock, J. The British Museum book of Cat. London: The British Museum Press, 2000.
Warner, Nicholas. Guide to the Gayer-Anderson Museum, Cairo. Cairo: Press of the Supreme Council of Antiquities, 2003.
Dr.Gayer-Anderson donated his Cairo home to the Egyptian Government. King Farouk awarded him the Title of PASHA.
Returned to WATERBEACH near Cambridge. Son John; a Ceramic artist.
ConstructionThe statue is not as well preserved as it appears. X-Rays taken of the sculptire reveal that there are cracks that extend almost completely around the centre of the cats body and only an internal system of strengthening prevents the cat's head from falling off. The repairs to the cat are thought to have been carried out by Major Gayer-Anderson who was a keen restorer of antiquities in the 1930s. He is thought to have rediscovered the surface of the cat after the presumed corrosion had been removed.[3]
The cat was manufactured by the lost wax method where a wax model is covered with clay or clay and water until there is sufficient thickness. The clay can then be fired in a kiln and the wax flows out. The now hollow mould can be refilled with bronze. In this case the metal was 85% copper, 13% tin, 2% arsenic with a 0.2% trace of lead. The remains of the pins that held the wax core can still be seen using x-rays. The original metalworkers would have been able to create a range of colours on a bronze casting and the stripes on the tail are due to metal of a differeing composition. It is also considered likely that the eyes contained stone or glass decorations.[3]
[edit] References^ Description of the Gayer-Anderson Cat, British Museum
^ Oakes, Lorna, and Lucia Gahlin. Ancient Egypt: An Illustrated Reference to the Myths, Religions, Pyramids and Temples of the Land of the Pharaohs. (p. 229) Barnes & Noble, September 2003. ISBN 9780760749432.
^ a b Examination of the Gayer-Anderson cat, British Museum, accessed December 2010
[edit] Further readingClutton-Brock, J. The British Museum book of Cat. London: The British Museum Press, 2000.
Warner, Nicholas. Guide to the Gayer-Anderson Museum, Cairo. Cairo: Press of the Supreme Council of Antiquities, 2003.
Dr.Gayer-Anderson donated his Cairo home to the Egyptian Government. King Farouk awarded him the Title of PASHA.
Returned to WATERBEACH near Cambridge. Son John; a Ceramic artist.
17 December 2011
ANTIGUA: COCOS HOTEL Killers of UK MD & Physio.Husband get "Life"
DAILY MAIL & DAILY TELEGRAPH
British couple shot dead on their knees on the last day of a 2-wk honeymoon at COCOS (chalet) HOTEL, St.JOHN'S, Antigua
Dr Catherine Mullany and (physiotherapist) husband Ben were forced to kneel by their bed before being shot in the head, the hearing in Swansea was told.
Holidaymakers staying at the same (COCOS- all included) Antigua hotel reported hearing screams and gunfire at 5am, the coroner heard.
Dr Mullany, 31, died at the scene while her physiotherapist husband, also 31, died after being flown home to Pontardawe in South Wales.
Cash, a camera and phones were stolen from the newlyweds’ room before they were killed on the last day of their two-week trip.
‘Three spent cartridges were found on the floor of their chalet and there was damage to the bathroom door where it had been kicked in.’
Avie Howell, 20, and Kaniel Martin, 23, both got LIFE
They were caught after SIM cards registered to them were activated in Mr Mullany’s stolen phone within hours of the shootings.
Read more: http://www.dailymail.co.uk/news/article-2056468/Honeymoon-couple-murdered-Antigua-executed-knees.html#ixzz1cY1eKG1i
(COMMENT: In poor countries avoid CHALET hotels. SECURITY difficult unless armed guard is outside 24/7. In Dominican Republic armed guards escort golfers)
(COMMENT: Pity to lose one's life for free booze and skin-ageing & cancer-causing UV. Swimming in
often faecally contaminated sea water in places with poor sewage treatment, with the added danger of injury from jelly-fish & poisonous fish)
British couple shot dead on their knees on the last day of a 2-wk honeymoon at COCOS (chalet) HOTEL, St.JOHN'S, Antigua
Dr Catherine Mullany and (physiotherapist) husband Ben were forced to kneel by their bed before being shot in the head, the hearing in Swansea was told.
Holidaymakers staying at the same (COCOS- all included) Antigua hotel reported hearing screams and gunfire at 5am, the coroner heard.
Dr Mullany, 31, died at the scene while her physiotherapist husband, also 31, died after being flown home to Pontardawe in South Wales.
Cash, a camera and phones were stolen from the newlyweds’ room before they were killed on the last day of their two-week trip.
‘Three spent cartridges were found on the floor of their chalet and there was damage to the bathroom door where it had been kicked in.’
Avie Howell, 20, and Kaniel Martin, 23, both got LIFE
They were caught after SIM cards registered to them were activated in Mr Mullany’s stolen phone within hours of the shootings.
Read more: http://www.dailymail.co.uk/news/article-2056468/Honeymoon-couple-murdered-Antigua-executed-knees.html#ixzz1cY1eKG1i
(COMMENT: In poor countries avoid CHALET hotels. SECURITY difficult unless armed guard is outside 24/7. In Dominican Republic armed guards escort golfers)
(COMMENT: Pity to lose one's life for free booze and skin-ageing & cancer-causing UV. Swimming in
often faecally contaminated sea water in places with poor sewage treatment, with the added danger of injury from jelly-fish & poisonous fish)
16 December 2011
UK DAILY MAIL: "HEALTH SURVEY for ENGLAND": Sex sociology:
By Sophie Borland
The Health Survey for England 2010 found that men reported having 9.3 different partners on average while women said they only had 4.7 partners.
On average men have claimed to have had twice as many sexual partners than women (posed by models)
Twice as many men (27 per cent) boasted of having made more than 10 conquests compared to 13 per cent of women. This contrast was apparent in the groups aged 25-34 and older.
In contrast a quarter of women revealed they had only been with one partner during their lifetimes compared to 17 per cent of men.
However, a third of men said their number was an 'estimate' compared to 17 per cent of women.
The report from the NHS Information centre also revealed more than a quarter of young women today lost their virginity when they were below the legal age of consent.
Some 27 per cent of 16 to 24 year-olds admit they were 15 or under when they had sex for the first time.
One in eight of this age group have already had sex with at least ten different partners.
The areas in white show how men soon take the lead in the proportion who have had more than 10 partners
MPs and campaigners yesterday blamed the ‘pornification of society’ for encouraging young girls to dress themselves up as sex objects before they have even reached puberty.
The figures detail for the first time how young girls are increasingly losing their virginity before they reach 16.
They reveal how by comparison, just 4 per cent of women now aged 55 to 64 first had sex when they were under-age. This rises to 10 per cent of 45 to 54 year-olds, and 14 per cent of 35 to 44 year-olds.
Critics say the rise in promiscuity over the generations is linked to increased sex education in schools that has ‘broken down the natural inhibitions of children with regard to sexual conduct’.
The figures also show that more than a fifth of sexually active women aged 16 to 24 have taken the morning-after pill at least once in the past year. Almost 60 per cent admitted they did not always use contraception.
By comparison 22 per cent of men aged 16 to 24 lost their virginity when they were 15 or under. Some 41 per cent said they used a condom every time, although only 5.4 per cent said they had caught a sexually transmitted infection.
Diane Abbott, shadow health minister, said: ‘Too many young girls are absorbing from the popular culture around them that they only have value as sex objects. Inevitably they act this notion out.
‘The rising numbers of girls having under-age sex is alarming. It is not a cost-free phenomenon. It poses public health policy challenges and social challenges. The underlying cause must be the pornification of British culture and the increasing sexualisation of pre-adolescent girls.’
Norman Wells, director of the Family Education Trust said: ‘Over recent years we have witnessed the systematic removal of every restraint which in previous generations served as a disincentive to underage sexual activity.
‘Sex education in many schools has had the effect of breaking down the natural inhibitions of children with regard to sexual conduct, and the age of consent is rarely enforced, so young people no longer have any fear of legal proceedings.
‘On top of that, the ready availability of contraception means that a girl’s fear of pregnancy is no longer considered a good enough reason for rejecting her boyfriend’s advances, and confidentiality policies mean that a girl need not worry about what her parents would think about her being sexually active, obtaining contraception, being treated for a sexually transmitted infection or even having an abortion, because they don’t have to be told.’
The figures have come from a survey of the sexual behaviours of 8,420 men and women aged 16 to 69, carried out by the NHS this year for the first time.
They also reveal that one in seven women aged 16 to 24 who had lost their virginity had caught a sexually transmitted infection at least once. Only four in ten said they always used contraception when having sex.
Across all age groups, the statistics show that 14 per cent of women lost their virginity before the age of 16 compared with 20 per cent of men.
The average age for losing virginity was 17, although for those aged 16 to 24 it was 16.
Although Britain’s teenage pregnancy rates have recently started to fall, they still remain among the highest in Europe. In 2009, there were 38,259 pregnancies in girls under 18 compared with 41,361 in 2008, a decline of 7.5 per cent. Every year around 3,700 girls under 16 have an abortion.
There is concern that society is becoming increasingly ‘sexualised’. Last year the final of ITV’s the X Factor final attracted more than 4,000 complaints following raunchy performances by singers Christina Aguilera and Rihanna.
Read more: http://www.dailymail.co.uk/health/article-2074919/Promiscuous-Britain-One-4-young-women-admit-sex-age-16--twice-mothers.html#ixzz1ghlTBxCt
The Health Survey for England 2010 found that men reported having 9.3 different partners on average while women said they only had 4.7 partners.
On average men have claimed to have had twice as many sexual partners than women (posed by models)
Twice as many men (27 per cent) boasted of having made more than 10 conquests compared to 13 per cent of women. This contrast was apparent in the groups aged 25-34 and older.
In contrast a quarter of women revealed they had only been with one partner during their lifetimes compared to 17 per cent of men.
However, a third of men said their number was an 'estimate' compared to 17 per cent of women.
The report from the NHS Information centre also revealed more than a quarter of young women today lost their virginity when they were below the legal age of consent.
Some 27 per cent of 16 to 24 year-olds admit they were 15 or under when they had sex for the first time.
One in eight of this age group have already had sex with at least ten different partners.
The areas in white show how men soon take the lead in the proportion who have had more than 10 partners
MPs and campaigners yesterday blamed the ‘pornification of society’ for encouraging young girls to dress themselves up as sex objects before they have even reached puberty.
The figures detail for the first time how young girls are increasingly losing their virginity before they reach 16.
They reveal how by comparison, just 4 per cent of women now aged 55 to 64 first had sex when they were under-age. This rises to 10 per cent of 45 to 54 year-olds, and 14 per cent of 35 to 44 year-olds.
Critics say the rise in promiscuity over the generations is linked to increased sex education in schools that has ‘broken down the natural inhibitions of children with regard to sexual conduct’.
The figures also show that more than a fifth of sexually active women aged 16 to 24 have taken the morning-after pill at least once in the past year. Almost 60 per cent admitted they did not always use contraception.
By comparison 22 per cent of men aged 16 to 24 lost their virginity when they were 15 or under. Some 41 per cent said they used a condom every time, although only 5.4 per cent said they had caught a sexually transmitted infection.
Diane Abbott, shadow health minister, said: ‘Too many young girls are absorbing from the popular culture around them that they only have value as sex objects. Inevitably they act this notion out.
‘The rising numbers of girls having under-age sex is alarming. It is not a cost-free phenomenon. It poses public health policy challenges and social challenges. The underlying cause must be the pornification of British culture and the increasing sexualisation of pre-adolescent girls.’
Norman Wells, director of the Family Education Trust said: ‘Over recent years we have witnessed the systematic removal of every restraint which in previous generations served as a disincentive to underage sexual activity.
‘Sex education in many schools has had the effect of breaking down the natural inhibitions of children with regard to sexual conduct, and the age of consent is rarely enforced, so young people no longer have any fear of legal proceedings.
‘On top of that, the ready availability of contraception means that a girl’s fear of pregnancy is no longer considered a good enough reason for rejecting her boyfriend’s advances, and confidentiality policies mean that a girl need not worry about what her parents would think about her being sexually active, obtaining contraception, being treated for a sexually transmitted infection or even having an abortion, because they don’t have to be told.’
The figures have come from a survey of the sexual behaviours of 8,420 men and women aged 16 to 69, carried out by the NHS this year for the first time.
They also reveal that one in seven women aged 16 to 24 who had lost their virginity had caught a sexually transmitted infection at least once. Only four in ten said they always used contraception when having sex.
Across all age groups, the statistics show that 14 per cent of women lost their virginity before the age of 16 compared with 20 per cent of men.
The average age for losing virginity was 17, although for those aged 16 to 24 it was 16.
Although Britain’s teenage pregnancy rates have recently started to fall, they still remain among the highest in Europe. In 2009, there were 38,259 pregnancies in girls under 18 compared with 41,361 in 2008, a decline of 7.5 per cent. Every year around 3,700 girls under 16 have an abortion.
There is concern that society is becoming increasingly ‘sexualised’. Last year the final of ITV’s the X Factor final attracted more than 4,000 complaints following raunchy performances by singers Christina Aguilera and Rihanna.
Read more: http://www.dailymail.co.uk/health/article-2074919/Promiscuous-Britain-One-4-young-women-admit-sex-age-16--twice-mothers.html#ixzz1ghlTBxCt
11 December 2011
UK STAR : CHILD ALCOHOLICS
ALCO-TOTS
ABOVE: There are 33 boozed-up children are admitted to hospital in England every day of the year These figures are disturbing evidence that, despite total consumption of alcohol not increasing recently, we have serious problems with both binge drinking and long-term excessive alcohol abuse in a minority of people Health Secretary Andrew Lansley
11th December 2011 By John Ward
A STAGGERING 33 boozed-up children are admitted to hospital in England every day of the year.
Damning NHS figures reveal 7,034 under-18s were treated for alcohol-related problems in the first half of 2011 alone.
The sobering statistics expose the extent that children – many as young as ten – are drinking to dangerous levels.
They also show that the worst part of the country for binge-drinking kids is the North-West.
A total of 137 youngsters were admitted to hospitals in Bury, Oldham, Rochdale and North Manchester. Hospitals in East Lancashire recorded 110 cases with 95 in central Manchester.
Leeds is also a blackspot with 111 admissions to the city’s hospitals.
Treating underage drinkers in hospitals is costing the NHS in England alone £19million a year.
And the UK also has the highest rate of teenage alcohol-related injuries in Europe
Professor Sir Ian Gilmore, from campaign group Alcohol Health Alliance UK, said parents should do more to stop their kids drinking.
He said: “We know that heavy drinking from an early age can diminish the life chances of the young person involved. It is important parents realise they are role models. “Their behaviour in relation to alcohol has more impact than what they tell their children.”
A Schools Health Education Unit study this year found 4% of the 12 and 13-year-olds quizzed drank 28 or more units of alcohol a week. Three units is a pint of strong lager or cider. The Department of Health is cracking down on underage booze sales and doubling the maximum fine to £20,000.
Health Secretary Andrew Lansley said: “These figures are disturbing evidence that, despite total consumption of alcohol not increasing recently, we have serious problems with both binge drinking and long-term excessive alcohol abuse in a minority of people.
ABOVE: There are 33 boozed-up children are admitted to hospital in England every day of the year These figures are disturbing evidence that, despite total consumption of alcohol not increasing recently, we have serious problems with both binge drinking and long-term excessive alcohol abuse in a minority of people Health Secretary Andrew Lansley
11th December 2011 By John Ward
A STAGGERING 33 boozed-up children are admitted to hospital in England every day of the year.
Damning NHS figures reveal 7,034 under-18s were treated for alcohol-related problems in the first half of 2011 alone.
The sobering statistics expose the extent that children – many as young as ten – are drinking to dangerous levels.
They also show that the worst part of the country for binge-drinking kids is the North-West.
A total of 137 youngsters were admitted to hospitals in Bury, Oldham, Rochdale and North Manchester. Hospitals in East Lancashire recorded 110 cases with 95 in central Manchester.
Leeds is also a blackspot with 111 admissions to the city’s hospitals.
Treating underage drinkers in hospitals is costing the NHS in England alone £19million a year.
And the UK also has the highest rate of teenage alcohol-related injuries in Europe
Professor Sir Ian Gilmore, from campaign group Alcohol Health Alliance UK, said parents should do more to stop their kids drinking.
He said: “We know that heavy drinking from an early age can diminish the life chances of the young person involved. It is important parents realise they are role models. “Their behaviour in relation to alcohol has more impact than what they tell their children.”
A Schools Health Education Unit study this year found 4% of the 12 and 13-year-olds quizzed drank 28 or more units of alcohol a week. Three units is a pint of strong lager or cider. The Department of Health is cracking down on underage booze sales and doubling the maximum fine to £20,000.
Health Secretary Andrew Lansley said: “These figures are disturbing evidence that, despite total consumption of alcohol not increasing recently, we have serious problems with both binge drinking and long-term excessive alcohol abuse in a minority of people.
10 December 2011
DAILY MAIL: RICKETS in UK
Keeping out of the sun 'is bringing rickets back' as cases increase fivefold in 14 years
By James Martin
Last updated at 12:40 AM on 10th December 2011
The number of British children suffering from rickets has increased fivefold since 1997, figures have revealed.
More than 760 were admitted to hospital last year with the condition, caused by a shortage of Vitamin D – the vital chemical which is boosted by sunlight.
Better nutrition had all but wiped out rickets, which was common in 19th century Britain, but rates have started to rise in the last decade. It is still a major problem in the third world.
Some experts blame its return on parents’ increasing fear of skin cancer, which encourages them to smother their children in sun cream and keep them out of the sun.
Sunlight: Spending too much time inside boosts the chances of rickets
Today’s children also spend much less time playing outside than previous generations, instead staying indoors to watch television or play on their computers.
And fewer youngsters now take cod liver oil capsules, which are rich in vitamin D and, until recently, were given to children to protect against rickets.
Indications that the disease – which causes brittle bones and deformities – is making a return will be greeted with concern among doctors.
More...Stress during second and third month of pregnancy raises risk of premature birth and losing baby boys
Gillian Killiner, of the British Dietetic Association, said: ‘We have taken it for granted that skin cancer is the big one and overlooked the Vitamin D side.
‘Children are covered up with sunblock, t-shirts and hats, and that can be important – but perhaps we’ve pushed it too far.
‘We don’t have a lot of sun in this country, and in winter you are likely to be lacking in Vitamin D.
‘If you haven’t built enough up over summer, that’s going to be a certainty.’
Examination: A schoolboy gets tested for rickets in this photo from the 1920s
She added that children are eating smaller amounts of fish and eggs than in the past, so they get less Vitamin D in their food.
‘It’s to do with the way we eat, obesity, and the lack of spending time out and about. In addition, more children are now overweight and that can reduce their ability to absorb Vitamin D,’ she said.
She added that black and Asian children were more at risk of rickets because it takes darker skins longer to absorb Vitamin D. ‘This effect can be exacerbated if they have covered up for cultural reasons,’ she said.
Figures on the number of patients admitted to hospital with rickets were revealed following a parliamentary question.
They showed that in 1997/98, 147 people ended up in hospital with a primary or secondary diagnosis of rickets.
By 2003/04, the total had more than doubled to 329. Within five years, the number had more than doubled again to 723.
Overall, between 1997/98 and 2010/11, the number of rickets sufferers increased more than fivefold from 147 to 762.
While the figures did not specify ages, experts say the vast majority are children, as Vitamin D deficiency manifests itself as rickets in the young and osteoporosis in adults.
Rickets is a major problem in third-world countries, where it is caused by a shortage of calcium.
It became endemic in the growing cities of 19th century Britain, because of a lack of access to sunlight and poor diets, but rates fell during the 20th century.
Last year, a group of doctors warned that people were not getting enough Vitamin D due to skin cancer fears
Read more: http://www.dailymail.co.uk/health/article-2072377/Keeping-sun-bringing-rickets-cases-increase-fivefold-14-years.html#ixzz1g8v5WOUs
By James Martin
Last updated at 12:40 AM on 10th December 2011
The number of British children suffering from rickets has increased fivefold since 1997, figures have revealed.
More than 760 were admitted to hospital last year with the condition, caused by a shortage of Vitamin D – the vital chemical which is boosted by sunlight.
Better nutrition had all but wiped out rickets, which was common in 19th century Britain, but rates have started to rise in the last decade. It is still a major problem in the third world.
Some experts blame its return on parents’ increasing fear of skin cancer, which encourages them to smother their children in sun cream and keep them out of the sun.
Sunlight: Spending too much time inside boosts the chances of rickets
Today’s children also spend much less time playing outside than previous generations, instead staying indoors to watch television or play on their computers.
And fewer youngsters now take cod liver oil capsules, which are rich in vitamin D and, until recently, were given to children to protect against rickets.
Indications that the disease – which causes brittle bones and deformities – is making a return will be greeted with concern among doctors.
More...Stress during second and third month of pregnancy raises risk of premature birth and losing baby boys
Gillian Killiner, of the British Dietetic Association, said: ‘We have taken it for granted that skin cancer is the big one and overlooked the Vitamin D side.
‘Children are covered up with sunblock, t-shirts and hats, and that can be important – but perhaps we’ve pushed it too far.
‘We don’t have a lot of sun in this country, and in winter you are likely to be lacking in Vitamin D.
‘If you haven’t built enough up over summer, that’s going to be a certainty.’
Examination: A schoolboy gets tested for rickets in this photo from the 1920s
She added that children are eating smaller amounts of fish and eggs than in the past, so they get less Vitamin D in their food.
‘It’s to do with the way we eat, obesity, and the lack of spending time out and about. In addition, more children are now overweight and that can reduce their ability to absorb Vitamin D,’ she said.
She added that black and Asian children were more at risk of rickets because it takes darker skins longer to absorb Vitamin D. ‘This effect can be exacerbated if they have covered up for cultural reasons,’ she said.
Figures on the number of patients admitted to hospital with rickets were revealed following a parliamentary question.
They showed that in 1997/98, 147 people ended up in hospital with a primary or secondary diagnosis of rickets.
By 2003/04, the total had more than doubled to 329. Within five years, the number had more than doubled again to 723.
Overall, between 1997/98 and 2010/11, the number of rickets sufferers increased more than fivefold from 147 to 762.
While the figures did not specify ages, experts say the vast majority are children, as Vitamin D deficiency manifests itself as rickets in the young and osteoporosis in adults.
Rickets is a major problem in third-world countries, where it is caused by a shortage of calcium.
It became endemic in the growing cities of 19th century Britain, because of a lack of access to sunlight and poor diets, but rates fell during the 20th century.
Last year, a group of doctors warned that people were not getting enough Vitamin D due to skin cancer fears
Read more: http://www.dailymail.co.uk/health/article-2072377/Keeping-sun-bringing-rickets-cases-increase-fivefold-14-years.html#ixzz1g8v5WOUs
08 December 2011
DEATH from opioid FENTANYL PATCHES in bath
DAILY MAIL
A grandmother died when a hot bath caused a patch she was wearing on her arm to give her an overdose of medication.
Barbara Reynolds, 67, was killed minutes after getting into the bath at her Leicestershire home as the heat sped up the release of the painkilling drug.
She had been using Fentanyl patches for chronic pain since 2002 - but the 'surge' of the drug into her body made her heart stop.
Painkillers: The Fentanyl patches Barbara Reynolds was wearing released the drug too quickly when she got in the bath and made her heart stop
Mrs Reynolds normally wore just one patch on her arm that released 100mcg of the medicine every hour, Loughborough Coroner's Court heard.
But on the morning of her death, she put a new patch on without removing an old one.
Mrs Reynolds was also feeling groggy that day from the effects of taking anti-depressant Amitriptyline, which she also wore as a patch.
Her distraught husband Charles, 72, told the inquest on Tuesday that he returned to their home in Birstall, Leicestershire, to find his wife dead.
PAINKILLER PATCHES
Fentanyl is a strong painkiller similar to morphine, and is released slowly into the bloodstream via a sticky patch, according to the NHS website.
Patients can take a quick-acting painkiller in addition if the patch is not having enough of an effect.
But NHS warns users it is 'very important' -
Not to stick on any extra patches.
Not to let anyone else use your patch.
Not to cut or divide a patch.
Not to apply immediately after a bath or shower - allow the skin to cool first.
Not to apply direct heat to the area with the patch, e.g. a hot water bottle.
Similar drugs include oxycodone and buprenorphine.
He said: 'I ran her a bath as normal before making Barbara a drink and taking the dog for a walk.
'After an hour walking the dog I came back and the bath water was still running.
'She used to keep the water running to keep the bath hot.
'I went upstairs and she was dead in the bath.'
The inquest was told both the USA's Federal Drug Administration and the UK's Medicines and Healthcare products Regulations Authority (MHRA), advise against wearing the patches in the bath.
When asked by Coroner Robert Chapman if his wife read the warning on the label, Mr Reynolds replied: 'She probably read it in the first place but you don't read it every time if you're taking it for a long period and some of it is difficult for the layman to understand.'
Dr Tim Johnson, a consultant in pain management, said: 'If you were in a hot bath and lay down into it, the effect of the patches would be to provide a surge of Fentanyl which would anaesthetise you.'
Recording a narrative verdict, Mr Chapman said: 'The real issue is that Barbara Reynolds may not have understood what she was doing.
If she didn't read the patient information leaflet she might not have been aware of the danger.'
Read more: http://www.dailymail.co.uk/health/article-2071492/Grandmother-dies-freak-accident-hot-bath-caused-medical-skin-patch-overdose.html#ixzz1fwQVwxPU
A grandmother died when a hot bath caused a patch she was wearing on her arm to give her an overdose of medication.
Barbara Reynolds, 67, was killed minutes after getting into the bath at her Leicestershire home as the heat sped up the release of the painkilling drug.
She had been using Fentanyl patches for chronic pain since 2002 - but the 'surge' of the drug into her body made her heart stop.
Painkillers: The Fentanyl patches Barbara Reynolds was wearing released the drug too quickly when she got in the bath and made her heart stop
Mrs Reynolds normally wore just one patch on her arm that released 100mcg of the medicine every hour, Loughborough Coroner's Court heard.
But on the morning of her death, she put a new patch on without removing an old one.
Mrs Reynolds was also feeling groggy that day from the effects of taking anti-depressant Amitriptyline, which she also wore as a patch.
Her distraught husband Charles, 72, told the inquest on Tuesday that he returned to their home in Birstall, Leicestershire, to find his wife dead.
PAINKILLER PATCHES
Fentanyl is a strong painkiller similar to morphine, and is released slowly into the bloodstream via a sticky patch, according to the NHS website.
Patients can take a quick-acting painkiller in addition if the patch is not having enough of an effect.
But NHS warns users it is 'very important' -
Not to stick on any extra patches.
Not to let anyone else use your patch.
Not to cut or divide a patch.
Not to apply immediately after a bath or shower - allow the skin to cool first.
Not to apply direct heat to the area with the patch, e.g. a hot water bottle.
Similar drugs include oxycodone and buprenorphine.
He said: 'I ran her a bath as normal before making Barbara a drink and taking the dog for a walk.
'After an hour walking the dog I came back and the bath water was still running.
'She used to keep the water running to keep the bath hot.
'I went upstairs and she was dead in the bath.'
The inquest was told both the USA's Federal Drug Administration and the UK's Medicines and Healthcare products Regulations Authority (MHRA), advise against wearing the patches in the bath.
When asked by Coroner Robert Chapman if his wife read the warning on the label, Mr Reynolds replied: 'She probably read it in the first place but you don't read it every time if you're taking it for a long period and some of it is difficult for the layman to understand.'
Dr Tim Johnson, a consultant in pain management, said: 'If you were in a hot bath and lay down into it, the effect of the patches would be to provide a surge of Fentanyl which would anaesthetise you.'
Recording a narrative verdict, Mr Chapman said: 'The real issue is that Barbara Reynolds may not have understood what she was doing.
If she didn't read the patient information leaflet she might not have been aware of the danger.'
Read more: http://www.dailymail.co.uk/health/article-2071492/Grandmother-dies-freak-accident-hot-bath-caused-medical-skin-patch-overdose.html#ixzz1fwQVwxPU
07 December 2011
UK DAILY MAIL: DUTCH MOBILE EUTHANASIA UNITS.
By Simon Caldwell
Dutch Health Minister Edith Schippers revealed the proposals during a debate on euthanasia in the Dutch parliament
The Dutch government is considering plans to use mobile medical teams which would administer euthanasia to people in their homes.
The units, dubbed 'grim reapers on wheels' by critics, will be called in to kill patients when their own GPs refuse to administer lethal drugs.
The mobile teams of doctors and nurses would be sent out from a clinic following a referral from the patient’s doctor.
The proposals were revealed by Dutch Health Minister Edith Schippers during a debate on euthanasia in the Dutch parliament.
In answer to questions from Christian Union MPs she said that mobile units 'for patients who meet the criteria for euthanasia but whose doctors are unwilling to carry it out' was worthy of consideration.
'If the patient thinks it desirable, the doctor can refer him or her to a mobile team or clinic,' the minister wrote.
The mobile units are being aggressively promoted by Dutch euthanasia campaign groups who want to expand the eligibility criteria for euthanasia and also to open facilities specifically for euthanasia along the pattern of the Dignitas centre in Switzerland.
They claim that 80 per cent of people with dementia or mental illnesses were being 'missed' by the country’s euthanasia laws.
They are supported by the Dutch Medical Association which this summer issued guidance effectively saying even people who complained of being lonely could qualify for euthanasia if it constitutes 'unbearable and lasting suffering'.
Pain: To qualify for euthanasia in Holland, patients must convince doctors they are making an informed choice in the face of unbearable suffering - which can include extreme loneliness (posed by model)
Pro-life campaigners in Britain, however, were appalled. Phyllis Bowman of Right to Life said the incremental liberalisation of Dutch euthanasia practice sent a 'terrifying warning' to the British people.
She said she found the proposals to set up mobile death squads 'too dreadful for words'.
'Not even the Nazis thought of that one,' she said.
In Holland, euthanasia is usually carried out by administering a strong sedative to put the patient in a coma, followed by a drug to stop breathing and cause death.
To qualify, patients must convince two doctors they are making an informed choice in the face of unbearable suffering.
It has long been suspected that numbers of cases are being under-reported, however, as doctors apply a liberal interpretation of the law.
Earlier this year official figures revealed for the first time that doctors have been killing dementia sufferers, including Alzheimer’s victims.
A total of 21 people diagnosed as having early-stage dementia died at the hands of their doctors last year, according to the 2010 annual report on euthanasia.
At the same time, a series of public meetings were held to encourage the elderly to learn about their 'right to die'.
The figures from last year also showed another year-on-year rise in cases with about 2,700 people choosing to death by injection compared to 2,636 the year before.
In 2003, the year after Holland became the first nation to legalise euthanasia since Nazi Germany, there were just 1,815 reported cases.
The Dutch government, however, insists that the law is not being abused.
'The greatest care has been taken to regulate care for patients who are suffering unbearably with no prospect of improvement,' said a spokesman.
'Euthanasia may only be carried out at the explicit request of the patient
Read more: http://www.dailymail.co.uk/news/article-2070662/Mobile-euthanasia-teams-planned-Holland.html#ixzz1frBldaI1
Dutch Health Minister Edith Schippers revealed the proposals during a debate on euthanasia in the Dutch parliament
The Dutch government is considering plans to use mobile medical teams which would administer euthanasia to people in their homes.
The units, dubbed 'grim reapers on wheels' by critics, will be called in to kill patients when their own GPs refuse to administer lethal drugs.
The mobile teams of doctors and nurses would be sent out from a clinic following a referral from the patient’s doctor.
The proposals were revealed by Dutch Health Minister Edith Schippers during a debate on euthanasia in the Dutch parliament.
In answer to questions from Christian Union MPs she said that mobile units 'for patients who meet the criteria for euthanasia but whose doctors are unwilling to carry it out' was worthy of consideration.
'If the patient thinks it desirable, the doctor can refer him or her to a mobile team or clinic,' the minister wrote.
The mobile units are being aggressively promoted by Dutch euthanasia campaign groups who want to expand the eligibility criteria for euthanasia and also to open facilities specifically for euthanasia along the pattern of the Dignitas centre in Switzerland.
They claim that 80 per cent of people with dementia or mental illnesses were being 'missed' by the country’s euthanasia laws.
They are supported by the Dutch Medical Association which this summer issued guidance effectively saying even people who complained of being lonely could qualify for euthanasia if it constitutes 'unbearable and lasting suffering'.
Pain: To qualify for euthanasia in Holland, patients must convince doctors they are making an informed choice in the face of unbearable suffering - which can include extreme loneliness (posed by model)
Pro-life campaigners in Britain, however, were appalled. Phyllis Bowman of Right to Life said the incremental liberalisation of Dutch euthanasia practice sent a 'terrifying warning' to the British people.
She said she found the proposals to set up mobile death squads 'too dreadful for words'.
'Not even the Nazis thought of that one,' she said.
In Holland, euthanasia is usually carried out by administering a strong sedative to put the patient in a coma, followed by a drug to stop breathing and cause death.
To qualify, patients must convince two doctors they are making an informed choice in the face of unbearable suffering.
It has long been suspected that numbers of cases are being under-reported, however, as doctors apply a liberal interpretation of the law.
Earlier this year official figures revealed for the first time that doctors have been killing dementia sufferers, including Alzheimer’s victims.
A total of 21 people diagnosed as having early-stage dementia died at the hands of their doctors last year, according to the 2010 annual report on euthanasia.
At the same time, a series of public meetings were held to encourage the elderly to learn about their 'right to die'.
The figures from last year also showed another year-on-year rise in cases with about 2,700 people choosing to death by injection compared to 2,636 the year before.
In 2003, the year after Holland became the first nation to legalise euthanasia since Nazi Germany, there were just 1,815 reported cases.
The Dutch government, however, insists that the law is not being abused.
'The greatest care has been taken to regulate care for patients who are suffering unbearably with no prospect of improvement,' said a spokesman.
'Euthanasia may only be carried out at the explicit request of the patient
Read more: http://www.dailymail.co.uk/news/article-2070662/Mobile-euthanasia-teams-planned-Holland.html#ixzz1frBldaI1
02 December 2011
FASEB: PAS (phosphorylated alpha-synuclein) test for Parkinson's Disease
Professor David Allsop
Professor of Neuroscience
Office C38
Division of Biomedical and Life Sciences
Faculty of Health and Medicine
Lancaster University
Lancaster
LA1 4YQ
UK
Tel: +44 1524 592122
Fax: +44 1524 593192
E-mail: d.allsop@lancaster.ac.uk
Simple blood test diagnoses Parkinson's disease long before symptoms appear
New research in the FASEB Journal suggests that phosphorylated alpha-synuclein, a substance found in the blood of Parkinson's patients, could lead to definitive diagnostic tool
Bethesda, MD—A new research report appearing in the December issue of the FASEB Journal (http://www.fasebj.org) shows how scientists from the United Kingdom have developed a simple blood test to detect Parkinson's disease even at the earliest stages. The test is possible because scientists found a substance in the blood, called "phosphorylated alpha-synuclein," which is common in people with Parkinson's disease, and then developed a way to identify its presence in our blood.
"A blood test for Parkinson's disease would mean you could find out if a person was in danger of getting the disease, before the symptoms started," said David Allsop, Ph.D., a researcher involved in the work from the Division of Biomedical and Life Sciences and the School of Health and Medicine at the University of Lancaster, in Lancaster, UK. "This would help the development of medicines that could protect the brain, which would be better for the quality of life and future health of older people."
To develop the blood test for Parkinson's disease, Allsop and colleagues studied a group of people diagnosed with the disease and a second group of healthy people of a similar age. Blood samples from each group were analyzed to determine the levels of phosphorylated alpha-synuclein present. They found those with Parkinson's disease had increased levels of the substance. Based upon these findings, researchers developed a blood test that detects the presence of phosphorylated alpha-synuclein, which could allow for diagnosis of the disease well before symptoms appear but when brain damage has already begun to occur.
"When most people think of Parkinson's disease, they think of the outward symptoms, such as involuntary movements," said Gerald Weissmann, M.D., Editor-in-Chief of the FASEB Journal, "but many people with Parkinson's also develop neurological problems that may be more difficult to detect right away. Having a blood test not only helps doctors rule out other possible causes of the outward symptoms, but it also allows for early detection which can help patients and their caregivers prepare for the possibility of the mental, emotional, and behavioral problems that the disease can cause."
.
Professor of Neuroscience
Office C38
Division of Biomedical and Life Sciences
Faculty of Health and Medicine
Lancaster University
Lancaster
LA1 4YQ
UK
Tel: +44 1524 592122
Fax: +44 1524 593192
E-mail: d.allsop@lancaster.ac.uk
Simple blood test diagnoses Parkinson's disease long before symptoms appear
New research in the FASEB Journal suggests that phosphorylated alpha-synuclein, a substance found in the blood of Parkinson's patients, could lead to definitive diagnostic tool
Bethesda, MD—A new research report appearing in the December issue of the FASEB Journal (http://www.fasebj.org) shows how scientists from the United Kingdom have developed a simple blood test to detect Parkinson's disease even at the earliest stages. The test is possible because scientists found a substance in the blood, called "phosphorylated alpha-synuclein," which is common in people with Parkinson's disease, and then developed a way to identify its presence in our blood.
"A blood test for Parkinson's disease would mean you could find out if a person was in danger of getting the disease, before the symptoms started," said David Allsop, Ph.D., a researcher involved in the work from the Division of Biomedical and Life Sciences and the School of Health and Medicine at the University of Lancaster, in Lancaster, UK. "This would help the development of medicines that could protect the brain, which would be better for the quality of life and future health of older people."
To develop the blood test for Parkinson's disease, Allsop and colleagues studied a group of people diagnosed with the disease and a second group of healthy people of a similar age. Blood samples from each group were analyzed to determine the levels of phosphorylated alpha-synuclein present. They found those with Parkinson's disease had increased levels of the substance. Based upon these findings, researchers developed a blood test that detects the presence of phosphorylated alpha-synuclein, which could allow for diagnosis of the disease well before symptoms appear but when brain damage has already begun to occur.
"When most people think of Parkinson's disease, they think of the outward symptoms, such as involuntary movements," said Gerald Weissmann, M.D., Editor-in-Chief of the FASEB Journal, "but many people with Parkinson's also develop neurological problems that may be more difficult to detect right away. Having a blood test not only helps doctors rule out other possible causes of the outward symptoms, but it also allows for early detection which can help patients and their caregivers prepare for the possibility of the mental, emotional, and behavioral problems that the disease can cause."
.
MICRIMA Ltd. BRISTOL UNIVERSITY developed MARIA BREAST IMAGING SYSTEM
Technology
Introducing the MARIA imaging system
Breast tumours may be distinguished from normal breast tissue by their dielectric value. This has led to various attempts to exploit this property for imaging. These attempts include early work at Bristol dating back to 1992.
In recent years, a novel breast imaging technique has been developed based upon a synthetically-focussed but real-aperture multistatic radar and is known as MARIA (Multistatic Array processing for Radiowave Image Acquisition).
An ultra wideband pulse is synthesized using a Vector Network Analyser that sweeps in frequency from 4GHz to 10GHz. The signal is transmitted from each element in a multiple antenna array and then received by all the other elements. The large aperture and wide bandwidth theoretically allow collection of reflected and scattered signals from objects as small as 1.7mm.
The transmitted radiowave signal has a peak power of less than 1mW, the public limits for exposure to radiowaves are not even approached and hence the technology is intrinsically safe and is freely-repeatable.
The technique was initially validated through highly-sophisticated computational models before moving on to experimental validation in complex breast phantoms (models of the breast using simulated tissues with literature dielectric values for skin, fat, and tumour).
Introducing the MARIA imaging system
Breast tumours may be distinguished from normal breast tissue by their dielectric value. This has led to various attempts to exploit this property for imaging. These attempts include early work at Bristol dating back to 1992.
In recent years, a novel breast imaging technique has been developed based upon a synthetically-focussed but real-aperture multistatic radar and is known as MARIA (Multistatic Array processing for Radiowave Image Acquisition).
An ultra wideband pulse is synthesized using a Vector Network Analyser that sweeps in frequency from 4GHz to 10GHz. The signal is transmitted from each element in a multiple antenna array and then received by all the other elements. The large aperture and wide bandwidth theoretically allow collection of reflected and scattered signals from objects as small as 1.7mm.
The transmitted radiowave signal has a peak power of less than 1mW, the public limits for exposure to radiowaves are not even approached and hence the technology is intrinsically safe and is freely-repeatable.
The technique was initially validated through highly-sophisticated computational models before moving on to experimental validation in complex breast phantoms (models of the breast using simulated tissues with literature dielectric values for skin, fat, and tumour).
30 November 2011
ONTARIO: Govt pays for Serum Free Light Chain Analysis in selected Cancer units.
Serum Light Chain Analysis available PRIVATELY in Ontario @ $300 plus Courier service. Govt. pays in selected Cancer clinics.
Monitoring patients with monoclonal light chain diseases but no M-spike on protein electrophoresis
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory testThe monoclonal gammopathies are characterized by a clonal expansion of plasma cells that secrete a monoclonal immunoglobulin (Ig). The monoclonal Ig secreted by these cells serves as a marker of the clonal proliferation, and the quantitation of monoclonal protein can be used to monitor the disease course.
The monoclonal gammopathies include multiple myeloma (MM), light chain multiple myeloma (LCMM), Waldenstrom’s macroglobulinemia (WM), nonsecretory myeloma (NSMM), smoldering multiple myeloma (SMM), monoclonal gammopathy of undetermined significance (MGUS), primary systemic amyloidosis (AL), and light chain deposition disease (LCDD).
Monoclonal proteins are typically detected by serum protein electrophoresis (SPEP) and immunofixation (IF). However, the monoclonal light chain diseases (LCMM, AL, LCDD) and NSMM often do not have serum monoclonal proteins in high enough concentration to be detected and quantitated by SPEP.
A sensitive nephelometric assay specific for kappa free light chain (FLC) that doesn’t recognize light chains bound to Ig heavy chains has recently been described. This automated, nephelometric assay is reported to be more sensitive than IF for detection of monoclonal FLC. In some patients with NSMM, AL, or LCDD the FLC assay provides a positive identification of a monoclonal serum light chain when the serum IF is negative. In addition, the quantitation of FLC has been correlated with disease activity in patients with NSMM and AL.
See Laboratory Approach to the Diagnosis of Amyloidosis and Laboratory Screening Tests for Suspected Multiple Myeloma in Special Instructions.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.KAPPA-FREE LIGHT CHAIN
0.33-1.94 mg/dL
LAMBDA-FREE LIGHT CHAIN
0.57-2.63 mg/dL
KAPPA/LAMBDA FLC RATIO
0.26-1.65
Interpretation Provides information to assist in interpretation of the test resultsThe specificity of this assay for detection of monoclonal light chains relies on the ratio of free kappa and lambda light chains. Once an abnormal free light chain (FLC) K/L ratio has been demonstrated and a diagnosis has been made, the quantitation of the monoclonal light chain is useful for monitoring disease activity.
Changes in FLC quantitation reflect changes in the size of the monoclonal plasma cell population. Our experience to date is limited, but changes of >25% or trending of multiple specimens are needed to conclude biological significance.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substancesElevated kappa and lambda free light chain (FLC) may occur due to polyclonal hypergammaglobulinemia or impaired renal clearance. A specific increase in FLC (eg, FLC K/L ratio) must be demonstrated for diagnostic purposes.
Moderate to marked lipemia may interfere with the ability to perform testing.
Supportive Data
Studies at Mayo Clinic have shown that in some patients with urine monoclonal light chains and negative serum immunofixation (IF), the free light chain (FLC) assay can identify monoclonal FLC in the serum. These studies support the increased sensitivity of the nephelometric FLC assay. In a series of patients with primary systemic amyloid treated by stem cell transplantation, the quantitation and monitoring of FLC predicted organ response (eg, disease course).
Clinical Reference Provides recommendations for further in-depth reading of a clinical natureDrayson M, Tang LX, Drew R, et al: Serum free light chain measurements for identifying and monitoring patients with nonsecretory multiple myeloma. Blood 2001;97(9):2900-2902
Monitoring patients with monoclonal light chain diseases but no M-spike on protein electrophoresis
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory testThe monoclonal gammopathies are characterized by a clonal expansion of plasma cells that secrete a monoclonal immunoglobulin (Ig). The monoclonal Ig secreted by these cells serves as a marker of the clonal proliferation, and the quantitation of monoclonal protein can be used to monitor the disease course.
The monoclonal gammopathies include multiple myeloma (MM), light chain multiple myeloma (LCMM), Waldenstrom’s macroglobulinemia (WM), nonsecretory myeloma (NSMM), smoldering multiple myeloma (SMM), monoclonal gammopathy of undetermined significance (MGUS), primary systemic amyloidosis (AL), and light chain deposition disease (LCDD).
Monoclonal proteins are typically detected by serum protein electrophoresis (SPEP) and immunofixation (IF). However, the monoclonal light chain diseases (LCMM, AL, LCDD) and NSMM often do not have serum monoclonal proteins in high enough concentration to be detected and quantitated by SPEP.
A sensitive nephelometric assay specific for kappa free light chain (FLC) that doesn’t recognize light chains bound to Ig heavy chains has recently been described. This automated, nephelometric assay is reported to be more sensitive than IF for detection of monoclonal FLC. In some patients with NSMM, AL, or LCDD the FLC assay provides a positive identification of a monoclonal serum light chain when the serum IF is negative. In addition, the quantitation of FLC has been correlated with disease activity in patients with NSMM and AL.
See Laboratory Approach to the Diagnosis of Amyloidosis and Laboratory Screening Tests for Suspected Multiple Myeloma in Special Instructions.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.KAPPA-FREE LIGHT CHAIN
0.33-1.94 mg/dL
LAMBDA-FREE LIGHT CHAIN
0.57-2.63 mg/dL
KAPPA/LAMBDA FLC RATIO
0.26-1.65
Interpretation Provides information to assist in interpretation of the test resultsThe specificity of this assay for detection of monoclonal light chains relies on the ratio of free kappa and lambda light chains. Once an abnormal free light chain (FLC) K/L ratio has been demonstrated and a diagnosis has been made, the quantitation of the monoclonal light chain is useful for monitoring disease activity.
Changes in FLC quantitation reflect changes in the size of the monoclonal plasma cell population. Our experience to date is limited, but changes of >25% or trending of multiple specimens are needed to conclude biological significance.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substancesElevated kappa and lambda free light chain (FLC) may occur due to polyclonal hypergammaglobulinemia or impaired renal clearance. A specific increase in FLC (eg, FLC K/L ratio) must be demonstrated for diagnostic purposes.
Moderate to marked lipemia may interfere with the ability to perform testing.
Supportive Data
Studies at Mayo Clinic have shown that in some patients with urine monoclonal light chains and negative serum immunofixation (IF), the free light chain (FLC) assay can identify monoclonal FLC in the serum. These studies support the increased sensitivity of the nephelometric FLC assay. In a series of patients with primary systemic amyloid treated by stem cell transplantation, the quantitation and monitoring of FLC predicted organ response (eg, disease course).
Clinical Reference Provides recommendations for further in-depth reading of a clinical natureDrayson M, Tang LX, Drew R, et al: Serum free light chain measurements for identifying and monitoring patients with nonsecretory multiple myeloma. Blood 2001;97(9):2900-2902
29 November 2011
UK DAILY MAIL: COST of AIDS
MOUNTING COSTS OF HIV TREATMENT
The cost of treating someone with HIV in the UK is estimated to be around £18,000 per year when they are not showing any symptoms.
This is based on the price of care as well as triple-drug antiretroviral therapy.
However, it costs £21,500 to treat patients who are showing symptoms and £41,000 for those with full-blown AIDS.
Patients who have four drugs cost the NHS between £22,775 and £48,000 per year.
The annual cost of providing HIV treatment and care in the UK could be as high as £758 million by 2013, according to a study in PLoS One.
Read more: http://www.dailymail.co.uk/health/article-2067496/Number-people-HIV-UK-poised-hit-100-000-infections-rise-6-year.html#ixzz1f6DXIu6F
The cost of treating someone with HIV in the UK is estimated to be around £18,000 per year when they are not showing any symptoms.
This is based on the price of care as well as triple-drug antiretroviral therapy.
However, it costs £21,500 to treat patients who are showing symptoms and £41,000 for those with full-blown AIDS.
Patients who have four drugs cost the NHS between £22,775 and £48,000 per year.
The annual cost of providing HIV treatment and care in the UK could be as high as £758 million by 2013, according to a study in PLoS One.
Read more: http://www.dailymail.co.uk/health/article-2067496/Number-people-HIV-UK-poised-hit-100-000-infections-rise-6-year.html#ixzz1f6DXIu6F
24 November 2011
UK DAILY MAIL Swedish AIRSONETT Inc. PROTEXO Temperature controlled Laminar airflow
By Daily Mail Reporter
Children with asthma are taking part in a trial to see if the Airsonett machine, which sucks up dust, can reduce their symptoms
A machine that hangs over the bed cleaning the surrounding air could ease night-time wheezing for asthmatics.
The so-called 'air vacuum' sucks up allergens and dust particles that could trigger attacks.
The £2,000 Airsonett machine uses the same technology deployed by manufacturing industries to create sterile environments by removing dust particles from the air.
Now a trial is under way at St Mary's Hospital in London involving 75 children with asthma to see if the device can reduce their symptoms.
More than five million people in the UK suffer with asthma, including at least one million children.
The year-long trial, due to end next summer, is comparing real 'air vacuum' machines with dummy ones.
Read more: http://www.dailymail.co.uk/health/article-1077369/Could-vacuum-sucks-allergens-stop-night-time-wheezing-asthma-sufferers.html#ixzz1efi515z7
http://www.airsonett.com/
Children with asthma are taking part in a trial to see if the Airsonett machine, which sucks up dust, can reduce their symptoms
A machine that hangs over the bed cleaning the surrounding air could ease night-time wheezing for asthmatics.
The so-called 'air vacuum' sucks up allergens and dust particles that could trigger attacks.
The £2,000 Airsonett machine uses the same technology deployed by manufacturing industries to create sterile environments by removing dust particles from the air.
Now a trial is under way at St Mary's Hospital in London involving 75 children with asthma to see if the device can reduce their symptoms.
More than five million people in the UK suffer with asthma, including at least one million children.
The year-long trial, due to end next summer, is comparing real 'air vacuum' machines with dummy ones.
Read more: http://www.dailymail.co.uk/health/article-1077369/Could-vacuum-sucks-allergens-stop-night-time-wheezing-asthma-sufferers.html#ixzz1efi515z7
http://www.airsonett.com/
19 November 2011
COCKROACH SENSITIVITY in Allergic Rhinitis.
POSTER PRESENTATION Open Access
Cockroach sensitivity in allergic rhinitis patients;
is it significant? To see prevalence of cockroach
sensitivity in allergic rhinitis patients in
Kingston area
Tahira Batool*, Rozita Borici-Mazi
From Canadian Society of Allergy and Clinical Immunology Annual Scientific Meeting 2010
Victoria, Canada. 3-6 November 2010
Background
Role of cockroach allergy in asthma has been widely studied
and the effect of environmental control on asthma
symptoms has been established. However, the role of
cockroach sensitivity remains unknown. We have
designed this study to establish role of cockroach sensitization
on allergic rhinitis.
Hypothesis
Cockroach allergy has significant role in allergic rhinitis.
Population
Allergic rhinitis patients attending allergy and clinical
immunology clinic under Dr Rozita Borici-Mazi in Kingston
General Hospital, Kingston ON.
Method
Retrospective chart review of patients evaluated for
allergic rhinitis and underwent skin prick testing.
A cohort of 250 patients was randomly selected with
inclusion criteria being symptomatic allergic rhinitis and
positive allergy skin prick testing to usual panel of allergens.
Data collection included demographics, smoking
exposure, symptom pattern, presence or absence of
non-nasal symptoms, positive skin prick testing for
cockroach and other environmental allergens such as
dust mite, cat, dog, and seasonal pollens.
Results
Allergy to seasonal allergens was found to be the most
common (n=191, 76.4%) followed by house dust mite
(n=149, 59.6%) and cat allergen (n=118, 47.2%). Cockroach
sensitization was found in 62 (25%). Among the
cockroach sensitivity group, 8 patients had monosensitization
to cockroach. All of them had perennial symptoms.
75%of these people were residents of urban areas.
Two patients who had symptoms for more than 8 years
had developed asthma.
Conclusion
Cockroach allergy is found to be one of the significant
indoor allergens in allergic rhinitis in Kingston area.
Given the relationship of Allergic Rhinitis and Asthma
development, there is need to recognize this important
allergen earlier and treat it through allergen avoidance
and/or Immunotherapy, not only to treat allergic rhinitis
symptoms but also to prevent development of allergic
asthma. Further studies to establish the correlation
between allergic rhinitis and cockroach sensitization are
needed.
Published: 4 November 2010
doi:10.1186/1710-1492-6-S2-P11
Cite this article as: Batool and Borici-Mazi: Cockroach sensitivity in
allergic rhinitis patients; is it significant? To see prevalence of cockroach
sensitivity in allergic rhinitis patients in Kingston area. Allergy, Asthma &
Clinical Immunology 2010 6(Suppl 2):P11.
* Correspondence: 7TB11@queensu.ca
Department of Internal Medicine, Queen’s University, Kingston, Ontario,
Ann Allergy. 1978 Dec;41(6):333-6.
A comparative study of prevalence of skin hypersensitivity to cockroach and house dust antigens.
Kang B, Sulit N.
Abstract
Allergy skin tests with cockroach antigen along with various common inhalant allergens were performed on 222 atopic and on 63 non-atopic subjects. The most prevalent allergen producing a positive skin test was house dust antigen with a positive response of 72%, 78% and 57% in atopic adults, atopic children and non-atopic children, respectively. The next prevalent positive skin test was to cockroach antigen with 50%, 60% and 27%, respectively, of the three groups tested. The differences between positive cockroach hypersensitivity and house dust hypersensitivity in all three groups tested were statistically significant. Next in order of prevalence of positive skin test to common inhalants were western weeds, ragweeds and cats. Incidence of cockroach hypersensitivity was 58% among asthmatic adults and 69% among asthmatic children. The results indicate that cockroach hypersensitivity is highly prevalent and that cockroach antigen is an independent agent from house dust as a cause of immediate hypersensitivity reaction.
PMID: 569451 [PubMed - indexed for MEDLINE
WISEMAN RD, WOODIN WG, MILLER HC, MYERS MA. Insect allergy as a possible cause of inhalant sensitivity. J Allergy. 1959 May–Jun;30(3):191–197. [PubMed]
Cockroach sensitivity in allergic rhinitis patients;
is it significant? To see prevalence of cockroach
sensitivity in allergic rhinitis patients in
Kingston area
Tahira Batool*, Rozita Borici-Mazi
From Canadian Society of Allergy and Clinical Immunology Annual Scientific Meeting 2010
Victoria, Canada. 3-6 November 2010
Background
Role of cockroach allergy in asthma has been widely studied
and the effect of environmental control on asthma
symptoms has been established. However, the role of
cockroach sensitivity remains unknown. We have
designed this study to establish role of cockroach sensitization
on allergic rhinitis.
Hypothesis
Cockroach allergy has significant role in allergic rhinitis.
Population
Allergic rhinitis patients attending allergy and clinical
immunology clinic under Dr Rozita Borici-Mazi in Kingston
General Hospital, Kingston ON.
Method
Retrospective chart review of patients evaluated for
allergic rhinitis and underwent skin prick testing.
A cohort of 250 patients was randomly selected with
inclusion criteria being symptomatic allergic rhinitis and
positive allergy skin prick testing to usual panel of allergens.
Data collection included demographics, smoking
exposure, symptom pattern, presence or absence of
non-nasal symptoms, positive skin prick testing for
cockroach and other environmental allergens such as
dust mite, cat, dog, and seasonal pollens.
Results
Allergy to seasonal allergens was found to be the most
common (n=191, 76.4%) followed by house dust mite
(n=149, 59.6%) and cat allergen (n=118, 47.2%). Cockroach
sensitization was found in 62 (25%). Among the
cockroach sensitivity group, 8 patients had monosensitization
to cockroach. All of them had perennial symptoms.
75%of these people were residents of urban areas.
Two patients who had symptoms for more than 8 years
had developed asthma.
Conclusion
Cockroach allergy is found to be one of the significant
indoor allergens in allergic rhinitis in Kingston area.
Given the relationship of Allergic Rhinitis and Asthma
development, there is need to recognize this important
allergen earlier and treat it through allergen avoidance
and/or Immunotherapy, not only to treat allergic rhinitis
symptoms but also to prevent development of allergic
asthma. Further studies to establish the correlation
between allergic rhinitis and cockroach sensitization are
needed.
Published: 4 November 2010
doi:10.1186/1710-1492-6-S2-P11
Cite this article as: Batool and Borici-Mazi: Cockroach sensitivity in
allergic rhinitis patients; is it significant? To see prevalence of cockroach
sensitivity in allergic rhinitis patients in Kingston area. Allergy, Asthma &
Clinical Immunology 2010 6(Suppl 2):P11.
* Correspondence: 7TB11@queensu.ca
Department of Internal Medicine, Queen’s University, Kingston, Ontario,
Ann Allergy. 1978 Dec;41(6):333-6.
A comparative study of prevalence of skin hypersensitivity to cockroach and house dust antigens.
Kang B, Sulit N.
Abstract
Allergy skin tests with cockroach antigen along with various common inhalant allergens were performed on 222 atopic and on 63 non-atopic subjects. The most prevalent allergen producing a positive skin test was house dust antigen with a positive response of 72%, 78% and 57% in atopic adults, atopic children and non-atopic children, respectively. The next prevalent positive skin test was to cockroach antigen with 50%, 60% and 27%, respectively, of the three groups tested. The differences between positive cockroach hypersensitivity and house dust hypersensitivity in all three groups tested were statistically significant. Next in order of prevalence of positive skin test to common inhalants were western weeds, ragweeds and cats. Incidence of cockroach hypersensitivity was 58% among asthmatic adults and 69% among asthmatic children. The results indicate that cockroach hypersensitivity is highly prevalent and that cockroach antigen is an independent agent from house dust as a cause of immediate hypersensitivity reaction.
PMID: 569451 [PubMed - indexed for MEDLINE
WISEMAN RD, WOODIN WG, MILLER HC, MYERS MA. Insect allergy as a possible cause of inhalant sensitivity. J Allergy. 1959 May–Jun;30(3):191–197. [PubMed]
16 November 2011
Dutch Society for Free Will End-of-Life: Mobile Euthanasia Teams
De TELEGRAAF
NVVE lanceert mobiele teams voor euthanasie AMSTERDAM - De Nederlandse Vereniging voor een Vrijwillig Levenseinde (NVVE) wil reizende teams opzetten met gespecialiseerde artsen om bij mensen thuis euthanasie toe te passen. De NVVE doet dit omdat veel zieken en ouderen door artsen niet serieus worden genomen in hun stervenswens, heeft een woordvoerster woensdag laten weten. Volgens de criteria van de euthanasiewet zou deze groep wel in aanmerking komen voor euthanasie, zo stelt de NVVE. Nederland zou het eerste land ter wereld worden met dergelijke ambulante teams.
NVVE lanceert mobiele teams voor euthanasie AMSTERDAM - De Nederlandse Vereniging voor een Vrijwillig Levenseinde (NVVE) wil reizende teams opzetten met gespecialiseerde artsen om bij mensen thuis euthanasie toe te passen. De NVVE doet dit omdat veel zieken en ouderen door artsen niet serieus worden genomen in hun stervenswens, heeft een woordvoerster woensdag laten weten. Volgens de criteria van de euthanasiewet zou deze groep wel in aanmerking komen voor euthanasie, zo stelt de NVVE. Nederland zou het eerste land ter wereld worden met dergelijke ambulante teams.
14 November 2011
BIONIME Inc. TAIWAN - SWISS BLOOD SUGAR TESTER.
Swiss-design elegant pocket phone-like Blood Sugar tester. Easy-to-handle test strips. Swiss designed RIGHTEST GD500 Lancing device. RIGHTEST Control Normal & High blood sugar solution included.
Swiss (injection systems) YPSOMED AG (CEO R.FRITCHI) bought 10% of Taiwan BIONIME Inc. (CEO R.HUANG) for CHF 6.5 million.
產品分類
PRODUCTS
GM100 Series
Acquire“Innovation Award” from Mediphar Taipei
No coding
Noble Metal Electrode Strip
High Accuracy & Precision
GM300 Series
Noble Metal Electrode Strip
Smart Code Key
High Accuracy & Precision
Wide LCD screen
GM210 Series
Noble Metal Electrode Strip
Smart Code Key
High Accuracy & Precision
Wide LCD screen
GM550 Series
Auto coding (Patent Pending)
Backlight
Noble Metal Electrode Strip
High Accuracy & Precision
Swiss (injection systems) YPSOMED AG (CEO R.FRITCHI) bought 10% of Taiwan BIONIME Inc. (CEO R.HUANG) for CHF 6.5 million.
產品分類
PRODUCTS
GM100 Series
Acquire“Innovation Award” from Mediphar Taipei
No coding
Noble Metal Electrode Strip
High Accuracy & Precision
GM300 Series
Noble Metal Electrode Strip
Smart Code Key
High Accuracy & Precision
Wide LCD screen
GM210 Series
Noble Metal Electrode Strip
Smart Code Key
High Accuracy & Precision
Wide LCD screen
GM550 Series
Auto coding (Patent Pending)
Backlight
Noble Metal Electrode Strip
High Accuracy & Precision
CANADA: (Quebec) HYGIE "cloth" changes fluid to GEL
HYGIE "cloth" converts fluid to a GEL. Coverts body liquids to a firm gel. Plastic male urinal used by truckers and especially by elderly males to avoid getting up at night; risk of falls and fractures reduced
Sold by Quebec pharmacies.
Sold by Quebec pharmacies.
BAYER point-of-care HbA1c test using capillary blood & "A1CNow+" monitor
A1CNow+®
Fast. Easy. Accurate.
Get A1C test results now in just 5 minutes. The A1CNow+® monitor is hand-held, portable and simple to use. Test results are lab accurate at 99%1.
The A1CNow+® monitor enables you to get rapid A1c test results while your patients are in your office, empowering you to make on-the-spot treatment decisions for your diabetes patients.
Using the A1CNow+® monitor is:
Fast.
In office testing. No waiting for lab results
Results in just five minutes
Hands-on procedure time is less than one minute
Provides opportunity for immediate, face-to-face counseling
Easy.
Simple, 3-step procedure
CLIA waived
Only 5 μL of blood from a fingertip is needed
No calibration, no daily controls, no maintenance
No refrigeration necessary if used within four months
No capital equipment required
Enables A1C testing in every exam room
Accurate.
Proven lab accuracy at 99%
NGSP certified
To learn more about purchasing A1CNow+® for use in your practice, please contact your Bayer sales representative or call our Customer Support Line at 1-800-268-7200.
(In Ontario not covered by Provincial Insurance. Sold by local pharmacies for approx $15 a test.)
Fast. Easy. Accurate.
Get A1C test results now in just 5 minutes. The A1CNow+® monitor is hand-held, portable and simple to use. Test results are lab accurate at 99%1.
The A1CNow+® monitor enables you to get rapid A1c test results while your patients are in your office, empowering you to make on-the-spot treatment decisions for your diabetes patients.
Using the A1CNow+® monitor is:
Fast.
In office testing. No waiting for lab results
Results in just five minutes
Hands-on procedure time is less than one minute
Provides opportunity for immediate, face-to-face counseling
Easy.
Simple, 3-step procedure
CLIA waived
Only 5 μL of blood from a fingertip is needed
No calibration, no daily controls, no maintenance
No refrigeration necessary if used within four months
No capital equipment required
Enables A1C testing in every exam room
Accurate.
Proven lab accuracy at 99%
NGSP certified
To learn more about purchasing A1CNow+® for use in your practice, please contact your Bayer sales representative or call our Customer Support Line at 1-800-268-7200.
(In Ontario not covered by Provincial Insurance. Sold by local pharmacies for approx $15 a test.)
11 November 2011
Dusseldorf Heinrich-Heine University Prof N.GATTERMANN MD PhD visits Toronto
Thanks to NOVARTIS sponsorship, Prof. GATTERMANN gave a series of lectures in Canada on MYELODYSPLASTIC SYNDROME (MDS) with special reference to Non-Transferrin-Bound Iron (NTBI) overload trearted by chelating agents such as deferasirox (Exjade).
Approx. 1800 Canadians are affected by MDS.
The cardiotoxic effect of NTBI was emphasised.
Ann.Haematol.(2011) 90:1-10 (Springer)
"Iron overload in MDS-pathophysiology,diagnosis, and complications."
N.Gattermann H.H.U. Dusseldorf, Germany E.Rachmilewitz E.Wolfson Med. Center,Holon, Israel.
Prof Gatterman studied with Late Hepatologist Dame Sheila Sherlock at the Hampstead branch of London's Royal Free Hospital and at the Boston Harvard Medical school. An idiomatically perfect English speaker..
Approx. 1800 Canadians are affected by MDS.
The cardiotoxic effect of NTBI was emphasised.
Ann.Haematol.(2011) 90:1-10 (Springer)
"Iron overload in MDS-pathophysiology,diagnosis, and complications."
N.Gattermann H.H.U. Dusseldorf, Germany E.Rachmilewitz E.Wolfson Med. Center,Holon, Israel.
Prof Gatterman studied with Late Hepatologist Dame Sheila Sherlock at the Hampstead branch of London's Royal Free Hospital and at the Boston Harvard Medical school. An idiomatically perfect English speaker..
05 November 2011
Ontario College Physicians & Surgeons uses Private investigators with secret cameras.
In three published discipline cases`the CPSO used secret cameras and private investigators.
SPYTECH has`details of hidden cameras.
http://www.spytech.com/
In USA some doctors are recording all patient contacts.
Mini Gadgets CD-PRO Pro Camera Detector $1000
SPYTECH has`details of hidden cameras.
http://www.spytech.com/
In USA some doctors are recording all patient contacts.
Mini Gadgets CD-PRO Pro Camera Detector $1000
04 November 2011
New Ontario medical rank: GP with FOCUSED PRACTICE in ...
ONTARIO: GP with FOCUSED PRACTICE a copy of UK GPwSI (GP with Special Interest)
Ontario College Phys & Surgeons (CPSO) has copied UK NHS status of "GPwSI"; above basic GP but below a Specialist. GPwSIs often work as hospital clinic assistants to UK Consultants.
CPSO changed the phrase of "Practice Limited to...."
Now "GP with Focused Practice in..."
The "GP" must be included to le4t the public know that the doctor is NOT a Specialist. (The result of the YAZDANFAR case when a GP who did liposuction killed a patient.)
The new`law will help Specialists who trained abroad but can not or will not take the Canadian specialty exams.
It will also help GPs who want to rise above the herd by taking extra courses. It will also help provide a degree of specialised services in parts of Ontario where Specialists do not want to live.
GP Focused Practice Designation: Policy and Program Overview September 2011 Page 34 of 39 Appendix B: Royal College of Physicians and Surgeons of Canada List of Specialties and Subspecialties Adolescent Medicine
Anatomical Pathology
Anaesthesiology
Cardiac Surgery
Cardiology
Clinical Immunology and Allergy
Clinical Pharmacology
Clinician Investigator Program
Colorectal Surgery
Community Medicine
Critical Care Medicine
Dermatology
Developmental Paediatrics
Diagnostic Radiology
Emergency Medicine
Endocrinology and Metabolism
Forensic Pathology
Gastroenterology
General Pathology
General Surgery
General Surgical Oncology
Geriatric Medicine
Gynecologic Oncology
Gynecologic Reproductive Endocrinology and Infertility
Hematological Pathology
Hematology
Infectious Diseases
Internal Medicine
Maternal-Fetal Medicine
Medical Biochemistry
Medical genetics
Medical Microbiology
Medical Oncology
Neonatal-Perinatal Medicine
Nephrology
Neurology
Neuropathology
Neuroradiology
Neurosurgery
Nuclear Medicine
Obstetrics and Gynecology
Occupational medicine
Ophthalmology
Orthopedic Surgery
Otolaryngology-Head and Neck Surgery
Palliative Medicine
Pediatric Emergency Medicine
Pediatric General Surgery
Ontario College Phys & Surgeons (CPSO) has copied UK NHS status of "GPwSI"; above basic GP but below a Specialist. GPwSIs often work as hospital clinic assistants to UK Consultants.
CPSO changed the phrase of "Practice Limited to...."
Now "GP with Focused Practice in..."
The "GP" must be included to le4t the public know that the doctor is NOT a Specialist. (The result of the YAZDANFAR case when a GP who did liposuction killed a patient.)
The new`law will help Specialists who trained abroad but can not or will not take the Canadian specialty exams.
It will also help GPs who want to rise above the herd by taking extra courses. It will also help provide a degree of specialised services in parts of Ontario where Specialists do not want to live.
GP Focused Practice Designation: Policy and Program Overview September 2011 Page 34 of 39 Appendix B: Royal College of Physicians and Surgeons of Canada List of Specialties and Subspecialties Adolescent Medicine
Anatomical Pathology
Anaesthesiology
Cardiac Surgery
Cardiology
Clinical Immunology and Allergy
Clinical Pharmacology
Clinician Investigator Program
Colorectal Surgery
Community Medicine
Critical Care Medicine
Dermatology
Developmental Paediatrics
Diagnostic Radiology
Emergency Medicine
Endocrinology and Metabolism
Forensic Pathology
Gastroenterology
General Pathology
General Surgery
General Surgical Oncology
Geriatric Medicine
Gynecologic Oncology
Gynecologic Reproductive Endocrinology and Infertility
Hematological Pathology
Hematology
Infectious Diseases
Internal Medicine
Maternal-Fetal Medicine
Medical Biochemistry
Medical genetics
Medical Microbiology
Medical Oncology
Neonatal-Perinatal Medicine
Nephrology
Neurology
Neuropathology
Neuroradiology
Neurosurgery
Nuclear Medicine
Obstetrics and Gynecology
Occupational medicine
Ophthalmology
Orthopedic Surgery
Otolaryngology-Head and Neck Surgery
Palliative Medicine
Pediatric Emergency Medicine
Pediatric General Surgery
30 October 2011
LYTINSKI-CONN SYNDROME (Primary Aldosteronism)
At a Toronto International Endocine conference,Melbourne (Clayton) Prince Henry's Institute, Senior Fellow Prof. John FUNDER AO, MD,PhD, FRCP,FRACP pointed out that Dr. Michal LYTINSKI published in Polish before Dr.Jerome CONN.
Primary Aldosteronism is missed in most hypertensives.. 20% of the Canadian population are hypertensive( 6,800,000) 10% of hypertensives have Primary Aldosteronism (680,000). Mainly undiagnosed at present through "cost, ignorance & indifference". Less than 1% of those with Primary Aldosteronism are screened; especially indicated in Atrial fibrillation.
"Guidelines for Primary Hypertension need revision".
Low potassium is not the main sign. Resistant hypertension, weakness and nocturnal polyuria are clinical clues. Small adrenal tumours may be seen on CT scans.
A quick diagnostic test of eplerenone (INSPRA) or spironolactone (ALDACTONE) will immediately drop blood pressure in patients with Primary Aldosteronism. INSPRA does not cause gynaecomastia or erectile disfunction..
Primary Aldosteronism is missed in most hypertensives.. 20% of the Canadian population are hypertensive( 6,800,000) 10% of hypertensives have Primary Aldosteronism (680,000). Mainly undiagnosed at present through "cost, ignorance & indifference". Less than 1% of those with Primary Aldosteronism are screened; especially indicated in Atrial fibrillation.
"Guidelines for Primary Hypertension need revision".
Low potassium is not the main sign. Resistant hypertension, weakness and nocturnal polyuria are clinical clues. Small adrenal tumours may be seen on CT scans.
A quick diagnostic test of eplerenone (INSPRA) or spironolactone (ALDACTONE) will immediately drop blood pressure in patients with Primary Aldosteronism. INSPRA does not cause gynaecomastia or erectile disfunction..
26 October 2011
GENETICS of PRIMARY ALDOSTERONISM Prof J.FUNDER AO MD FRCP FRACP
Sciencewww.sciencemag.org
Prev
Table of Contents
Next Science 11 February 2011:
Vol. 331 no. 6018 pp. 685-686
DOI: 10.1126/science.1202887
•Perspective
Medicine
The Genetics of Primary Aldosteronism
John W. Funder
+ Author Affiliations
Prince Henry's Institute of Medical Research, Monash Medical Centre, Clayton, Victoria 3168, Australia.
E-mail: john.funder@princehenrys.org
Summary
Most people with consistently high blood pressure have “essential” hypertension, a physician's term for “no known cause.” Over the last 20 years, however, studies have shown that ∼1 in 10 patients do have an identifiable cause. Such patients overproduce the adrenal steroid hormone aldosterone (primary aldosteronism), which raises blood pressure and promotes sodium retention and potassium excretion. On page 768 of this issue, Choi et al. (1) report two different mutations in the gene encoding the potassium channel KCNJ5 in patients (8 of 22) with an aldosterone-producing adrenal adenoma (APA). A third mutation in the same gene is also identified in a father and two daughters with florid adrenal hyperplasia, a hereditary condition that is treated by removing the adrenals in early childhood. The findings have implications for understanding adrenal physiology and pathology.
Prev
Table of Contents
Next Science 11 February 2011:
Vol. 331 no. 6018 pp. 685-686
DOI: 10.1126/science.1202887
•Perspective
Medicine
The Genetics of Primary Aldosteronism
John W. Funder
+ Author Affiliations
Prince Henry's Institute of Medical Research, Monash Medical Centre, Clayton, Victoria 3168, Australia.
E-mail: john.funder@princehenrys.org
Summary
Most people with consistently high blood pressure have “essential” hypertension, a physician's term for “no known cause.” Over the last 20 years, however, studies have shown that ∼1 in 10 patients do have an identifiable cause. Such patients overproduce the adrenal steroid hormone aldosterone (primary aldosteronism), which raises blood pressure and promotes sodium retention and potassium excretion. On page 768 of this issue, Choi et al. (1) report two different mutations in the gene encoding the potassium channel KCNJ5 in patients (8 of 22) with an aldosterone-producing adrenal adenoma (APA). A third mutation in the same gene is also identified in a father and two daughters with florid adrenal hyperplasia, a hereditary condition that is treated by removing the adrenals in early childhood. The findings have implications for understanding adrenal physiology and pathology.
24 October 2011
ASTRAZENICA FREE PROSTATE CANCER PATIENT NOTEBOOK
Black-cover breastpocket-sized 35 page treatment notebook provided free by AstraZenica.including a PSA tracking graph.
22 October 2011
UK DAILY MAIL: CIRRHOSIS, DEMENTIA & DRINK
Don't drink on 3 days a week... As the liver crisis deepens, leading doctors warn of the danger
More than 16,000 people die from liver disease every year in the UK
Young regular drinkers and middle-class women particularly at risk
Royal College of Physicians say current guidelines must be rewritten
By Daniel Martin
Drinkers should have three alcohol-free days a week if they want to avoid the risk of liver disease, warn Britain’s most eminent doctors.
Current official guidance on healthy drinking limits is ‘extremely dangerous’ and must be rewritten – because it implies that drinking every day is fine, the Royal College of Physicians said.
Government advice states men should drink no more than four units a day and women no more than three.
New guidelines: Leading doctors now say drinkers should have at least three alcohol-free days a week
But this must also address the risks of daily drinking, doctors insisted.
They told MPs the risk of liver disease, alcohol dependence and serious illness increases if people drink every day rather than taking time off.
More...Stop the booze bombardment: Young people 'want protecting from alcohol advertising'
What TWO glasses of wine a day can do to your face in ten years
Hold the fries! Men who eat junk food are more likely to be infertile
They also urged Ministers to consider imposing stricter guidelines on pensioners – perhaps as little as seven units a week for older women and 11 for older men.
One unit is the equivalent of one small glass of wine (125ml) or half a pint of lager.
Limits: Government advice states men should drink no more than four units per day and women no more than three
Older people’s bodies are more affected by regular drinking, which puts them at risk of dementia, depression and falls, they said.
Yet pensioners are currently given the same guidelines as all adults.
In their submission to MPs on the Commons science and technology committee, the doctors said: ‘Government guidelines should recognise that hazardous drinking has two components: frequency of drinking and amount of drinking.
‘To ignore either of these components is scientifically unjustified.
‘A simple addition would remedy this – namely a recommendation that to remain within safe limits people have three alcohol-free days a week.’
They added: ‘The implied sanctioning of a pattern of regular daily drinking is potentially extremely dangerous.
The RCP disputes the claim that drinking every day will not accrue a significant health risk.
‘Frequency is an important risk factor for development of alcohol dependency and alcoholic liver disease.’
More than 16,000 people die from liver disease, usually caused by excessive drinking, every year in the UK.
It is Britain’s fifth biggest killer and the only major cause of death increasing year-on-year. Twice as many people die of it now than in 1991 and rates have soared by 13 per cent since 2005.
The British Liver Trust says liver disease is the biggest cause of premature death for women, and the second only to heart attacks for men.
The first drinking guidelines in 1987 – which were written by the RCP – stated that men should drink no more than 21 units a week and women no more than 14.
On top of this, everyone should take two or three days off a week. Doctors are angry that reforms to the advice in 1995 dropped this reference to alcohol-free days.
‘This in effect appeared to sanction daily or near-daily drinking, one of the key risk factors for alcohol-related harm and dependency,’ they said.
‘If the daily limit of four units was drunk with no drink-free days, this would be the equivalent of 28 units per week; a 30 per cent increase on the RCP’s guidelines.’
Habitual: Young regular drinkers are particularly at risk of developing liver disease later in life
The paper added: ‘Further studies have shown an increased risk of cirrhosis for those who drink daily or near-daily compared to those who drink periodically or intermittently.’
Young regular drinkers were particularly at risk, it said.
A 2009 study showed increases in UK liver deaths ‘are the result of daily or near-daily heavy drinking, not episodic or binge drinking. This regular drinking pattern is discernable at an early age’, the paper said.
Government experts expect the cost of treating people with liver disease will soar by 50 per cent in four years to more than £2billion.
Middle-class women are particularly at risk of daily drinking as they often have a glass or two of wine after work, followed by more at the weekend.
Lower limits should be considered for older people, as even modest levels of alcohol consumption can have a more profound effect on their bodies ‘due to physiological changes associated with ageing’, the paper said.
‘There is concern current guidelines are not appropriate for older people,’ it added.
Sir Ian Gilmore, RCP special adviser on alcohol, said: ‘We recommend a safe limit of 0-21 units a week for men and 0-14 units a week for women provided the total amount is not drunk in one or two bouts and that there are two to three alcohol-free days a week.
‘At these levels, most individuals are unlikely to come to harm.’
In June, a Royal College of Psychiatrists report called for a limit of 11 units a week for men aged over 65 and seven for women of this age.
The RCP quoted these suggested limits but did not explicitly endorse them.
Read more: http://www.dailymail.co.uk/news/article-2052070/Alcohol-abuse-Dont-drink-3-days-week-avoid-liver-disease.html#ixzz1bVrk6v8M
More than 16,000 people die from liver disease every year in the UK
Young regular drinkers and middle-class women particularly at risk
Royal College of Physicians say current guidelines must be rewritten
By Daniel Martin
Drinkers should have three alcohol-free days a week if they want to avoid the risk of liver disease, warn Britain’s most eminent doctors.
Current official guidance on healthy drinking limits is ‘extremely dangerous’ and must be rewritten – because it implies that drinking every day is fine, the Royal College of Physicians said.
Government advice states men should drink no more than four units a day and women no more than three.
New guidelines: Leading doctors now say drinkers should have at least three alcohol-free days a week
But this must also address the risks of daily drinking, doctors insisted.
They told MPs the risk of liver disease, alcohol dependence and serious illness increases if people drink every day rather than taking time off.
More...Stop the booze bombardment: Young people 'want protecting from alcohol advertising'
What TWO glasses of wine a day can do to your face in ten years
Hold the fries! Men who eat junk food are more likely to be infertile
They also urged Ministers to consider imposing stricter guidelines on pensioners – perhaps as little as seven units a week for older women and 11 for older men.
One unit is the equivalent of one small glass of wine (125ml) or half a pint of lager.
Limits: Government advice states men should drink no more than four units per day and women no more than three
Older people’s bodies are more affected by regular drinking, which puts them at risk of dementia, depression and falls, they said.
Yet pensioners are currently given the same guidelines as all adults.
In their submission to MPs on the Commons science and technology committee, the doctors said: ‘Government guidelines should recognise that hazardous drinking has two components: frequency of drinking and amount of drinking.
‘To ignore either of these components is scientifically unjustified.
‘A simple addition would remedy this – namely a recommendation that to remain within safe limits people have three alcohol-free days a week.’
They added: ‘The implied sanctioning of a pattern of regular daily drinking is potentially extremely dangerous.
The RCP disputes the claim that drinking every day will not accrue a significant health risk.
‘Frequency is an important risk factor for development of alcohol dependency and alcoholic liver disease.’
More than 16,000 people die from liver disease, usually caused by excessive drinking, every year in the UK.
It is Britain’s fifth biggest killer and the only major cause of death increasing year-on-year. Twice as many people die of it now than in 1991 and rates have soared by 13 per cent since 2005.
The British Liver Trust says liver disease is the biggest cause of premature death for women, and the second only to heart attacks for men.
The first drinking guidelines in 1987 – which were written by the RCP – stated that men should drink no more than 21 units a week and women no more than 14.
On top of this, everyone should take two or three days off a week. Doctors are angry that reforms to the advice in 1995 dropped this reference to alcohol-free days.
‘This in effect appeared to sanction daily or near-daily drinking, one of the key risk factors for alcohol-related harm and dependency,’ they said.
‘If the daily limit of four units was drunk with no drink-free days, this would be the equivalent of 28 units per week; a 30 per cent increase on the RCP’s guidelines.’
Habitual: Young regular drinkers are particularly at risk of developing liver disease later in life
The paper added: ‘Further studies have shown an increased risk of cirrhosis for those who drink daily or near-daily compared to those who drink periodically or intermittently.’
Young regular drinkers were particularly at risk, it said.
A 2009 study showed increases in UK liver deaths ‘are the result of daily or near-daily heavy drinking, not episodic or binge drinking. This regular drinking pattern is discernable at an early age’, the paper said.
Government experts expect the cost of treating people with liver disease will soar by 50 per cent in four years to more than £2billion.
Middle-class women are particularly at risk of daily drinking as they often have a glass or two of wine after work, followed by more at the weekend.
Lower limits should be considered for older people, as even modest levels of alcohol consumption can have a more profound effect on their bodies ‘due to physiological changes associated with ageing’, the paper said.
‘There is concern current guidelines are not appropriate for older people,’ it added.
Sir Ian Gilmore, RCP special adviser on alcohol, said: ‘We recommend a safe limit of 0-21 units a week for men and 0-14 units a week for women provided the total amount is not drunk in one or two bouts and that there are two to three alcohol-free days a week.
‘At these levels, most individuals are unlikely to come to harm.’
In June, a Royal College of Psychiatrists report called for a limit of 11 units a week for men aged over 65 and seven for women of this age.
The RCP quoted these suggested limits but did not explicitly endorse them.
Read more: http://www.dailymail.co.uk/news/article-2052070/Alcohol-abuse-Dont-drink-3-days-week-avoid-liver-disease.html#ixzz1bVrk6v8M
11 October 2011
Dr.Lesley KIRKPATRICK: CHOROIDAL MELANOMA
I'm only alive because I know how to beat the NHS system: A deeply worrying confession from a GP fighting cancer
By Dr Lesley Kirkpatrick (UK:DAILY MAIL)
When I was diagnosed with cancer, I was devastated — but sure I’d get the best possible treatment.
After 22 years as a GP, I felt strongly that the NHS was unbeatable when it came to major illnesses like this.
But I was wrong. Instead, this wonderful institution I dedicated my life to has let me down — and I am only alive today because I begged and battled for drugs and paid for scans and treatments privately.
'I insisted on an MRI scan, but my consultant said the NHS could only afford to do one without contrast, which is less sensitive than one with contrast,' said Dr Lesley Kirkpatrick
It was September 2006 when this nightmare began.
After I had experienced blurred vision and pinpricks of blue light, tests revealed I had a rare type of eye cancer — choroidal melanoma cancer, a tumour in the blood vessel layer at the back of my eye.
The tumour itself was highly curable with radiation treatment, but because this type of cancer was carried in the blood, I knew there was a strong chance it would travel throughout the body causing more tumours, most likely in the liver. And I knew it was a particularly aggressive form.
I’d worked in the NHS all my life — and yes, I felt guilty. But being a patient made me see things differently. I felt alone, uncared for, and forced to make things happen myself How did I know? I’d had three patients with this cancer and all had died from it.
It doesn’t make a difference if you’re a doctor — the moment you are told you have cancer is just mind-blowing.
My husband Terry, who’s a consultant anaesthetist, and I were shown into the comfy room, and we just burst into hysterical laughter from the sheer stress.
My consultant broke the news: I had a one in four chance of dying from metastases, or secondary tumours, within five years. I was 50.
Two weeks after diagnosis, I began four 30-second sessions of proton beam therapy — low-dose radiation accurately focused on the tumour to melt it away.
After it was successfully treated, my local trust in Sheffield — I live in Doncaster —offered me ultrasound scans to check the cancer hadn’t spread. But I knew that these scans pick up only tumours that are 1cm or bigger, and by the time it reached that size it would be harder to treat.
'If I'd stayed on the NHS and hadn't had those scans, I'd have been months from death without knowing,' said Dr Kirkpatrick
I insisted on an MRI scan, but my consultant said the NHS could only afford to do one without contrast, which is less sensitive than one with contrast.
So, for the first time in my life, I went private. I got the results in September 2008 — they were clear. Finally I could start to live again.
But six months later, a second scan showed exactly what I’d feared: a 4mm tumour was growing on my liver.
A third scan in August, this time on the NHS, showed it had grown to 9mm.
If I’d stayed on the NHS and hadn’t had those scans, I’d have been months from death without knowing. Instead, the tumour had been picked up while it was still small enough to be removed with surgery.
However, the news got worse. The soonest the NHS could offer a date for an operation was six weeks away. An aggressive tumour could double in that time. So again I went private and paid £20,000 to have three small tumours removed from my liver.
I’d worked in the NHS all my life — and yes, I felt guilty. But being a patient made me see things differently. I felt alone, uncared for, and forced to make things happen myself.
I became acutely aware of the many patients out there who were suffering as I was, given no options. I confided in my colleagues at the surgery — they understood completely, and said they wouldn’t wait either.
In the year since I was diagnosed I’d thrown myself into researching my cancer, poring over endless journals and learning the statistics by heart.
I knew that patients live an average of 27 months after liver resection, but some could live up to ten years. I was determined to make the most of the life I had left: eight weeks after surgery, Terry and I were diving in Mauritius.
Back at home, I set out to fight this disease. I now needed vigorous scanning and treatments to get the cancer before it came back (for there was now a virtual certainty that it would).
But every onocologist I spoke to told me the NHS wouldn’t pay for such scans, and they couldn’t treat me while I was clinically free of disease.
And when it did come back, they would treat me with dacarbazine, a drug which I discovered had a response rate of under one per cent. I was basically being told to go home and die.
As predicted, in September 2010, scans revealed another liver tumour, so I had surgery on the NHS. I was very sick by now, and that month, I retired from my job at the age of 51.
Then, just three months after surgery, another tumour appeared. Soon, there were 17 of them on my liver. I’d kept up my research and got in touch with an NHS consultant, Professor Christian Ottensmeier at Southampton General Hospital. He made me feel human again, and was genuinely committed to finding a way to help me live.
He referred me to an interventional radiologist, Dr Brian Stedman, who talked to me about this amazing new treatment called SIR spheres, where they use radioactive beads to deliver radiation direct to the site of the liver tumours. It was available at only a few UK hospitals — I’d read about it, but I’d never thought I’d be suitable.
This was my last hope. So I paid £26,000 to have it at Spire Southampton Hospital. Amazingly, my PCT later agreed to refund the money for this, and for my earlier private treatment too, simply because I complained persistently.
Meanwhile, my consultant also applied for a drug called ipilimumab I’d discovered with the help of the Lance Armstrong Foundation, a charity set up by the American cyclist who famously beat cancer, which provides support and practical information to cancer patients. Ipilimumab, which is being trialled in the U.S., effectively takes the brakes off the immune system, so it can recognise the cancer and form antibodies to destroy it.
The results have been amazing. One year on, scans are now showing no growth or new lesions, so I’m hoping that ipilimumab and the SIR spheres are working.
Read more: http://www.dailymail.co.uk/health/article-2047602/Im-alive-I-know-beat-NHS-system.html#ixzz1aUAONVML
By Dr Lesley Kirkpatrick (UK:DAILY MAIL)
When I was diagnosed with cancer, I was devastated — but sure I’d get the best possible treatment.
After 22 years as a GP, I felt strongly that the NHS was unbeatable when it came to major illnesses like this.
But I was wrong. Instead, this wonderful institution I dedicated my life to has let me down — and I am only alive today because I begged and battled for drugs and paid for scans and treatments privately.
'I insisted on an MRI scan, but my consultant said the NHS could only afford to do one without contrast, which is less sensitive than one with contrast,' said Dr Lesley Kirkpatrick
It was September 2006 when this nightmare began.
After I had experienced blurred vision and pinpricks of blue light, tests revealed I had a rare type of eye cancer — choroidal melanoma cancer, a tumour in the blood vessel layer at the back of my eye.
The tumour itself was highly curable with radiation treatment, but because this type of cancer was carried in the blood, I knew there was a strong chance it would travel throughout the body causing more tumours, most likely in the liver. And I knew it was a particularly aggressive form.
I’d worked in the NHS all my life — and yes, I felt guilty. But being a patient made me see things differently. I felt alone, uncared for, and forced to make things happen myself How did I know? I’d had three patients with this cancer and all had died from it.
It doesn’t make a difference if you’re a doctor — the moment you are told you have cancer is just mind-blowing.
My husband Terry, who’s a consultant anaesthetist, and I were shown into the comfy room, and we just burst into hysterical laughter from the sheer stress.
My consultant broke the news: I had a one in four chance of dying from metastases, or secondary tumours, within five years. I was 50.
Two weeks after diagnosis, I began four 30-second sessions of proton beam therapy — low-dose radiation accurately focused on the tumour to melt it away.
After it was successfully treated, my local trust in Sheffield — I live in Doncaster —offered me ultrasound scans to check the cancer hadn’t spread. But I knew that these scans pick up only tumours that are 1cm or bigger, and by the time it reached that size it would be harder to treat.
'If I'd stayed on the NHS and hadn't had those scans, I'd have been months from death without knowing,' said Dr Kirkpatrick
I insisted on an MRI scan, but my consultant said the NHS could only afford to do one without contrast, which is less sensitive than one with contrast.
So, for the first time in my life, I went private. I got the results in September 2008 — they were clear. Finally I could start to live again.
But six months later, a second scan showed exactly what I’d feared: a 4mm tumour was growing on my liver.
A third scan in August, this time on the NHS, showed it had grown to 9mm.
If I’d stayed on the NHS and hadn’t had those scans, I’d have been months from death without knowing. Instead, the tumour had been picked up while it was still small enough to be removed with surgery.
However, the news got worse. The soonest the NHS could offer a date for an operation was six weeks away. An aggressive tumour could double in that time. So again I went private and paid £20,000 to have three small tumours removed from my liver.
I’d worked in the NHS all my life — and yes, I felt guilty. But being a patient made me see things differently. I felt alone, uncared for, and forced to make things happen myself.
I became acutely aware of the many patients out there who were suffering as I was, given no options. I confided in my colleagues at the surgery — they understood completely, and said they wouldn’t wait either.
In the year since I was diagnosed I’d thrown myself into researching my cancer, poring over endless journals and learning the statistics by heart.
I knew that patients live an average of 27 months after liver resection, but some could live up to ten years. I was determined to make the most of the life I had left: eight weeks after surgery, Terry and I were diving in Mauritius.
Back at home, I set out to fight this disease. I now needed vigorous scanning and treatments to get the cancer before it came back (for there was now a virtual certainty that it would).
But every onocologist I spoke to told me the NHS wouldn’t pay for such scans, and they couldn’t treat me while I was clinically free of disease.
And when it did come back, they would treat me with dacarbazine, a drug which I discovered had a response rate of under one per cent. I was basically being told to go home and die.
As predicted, in September 2010, scans revealed another liver tumour, so I had surgery on the NHS. I was very sick by now, and that month, I retired from my job at the age of 51.
Then, just three months after surgery, another tumour appeared. Soon, there were 17 of them on my liver. I’d kept up my research and got in touch with an NHS consultant, Professor Christian Ottensmeier at Southampton General Hospital. He made me feel human again, and was genuinely committed to finding a way to help me live.
He referred me to an interventional radiologist, Dr Brian Stedman, who talked to me about this amazing new treatment called SIR spheres, where they use radioactive beads to deliver radiation direct to the site of the liver tumours. It was available at only a few UK hospitals — I’d read about it, but I’d never thought I’d be suitable.
This was my last hope. So I paid £26,000 to have it at Spire Southampton Hospital. Amazingly, my PCT later agreed to refund the money for this, and for my earlier private treatment too, simply because I complained persistently.
Meanwhile, my consultant also applied for a drug called ipilimumab I’d discovered with the help of the Lance Armstrong Foundation, a charity set up by the American cyclist who famously beat cancer, which provides support and practical information to cancer patients. Ipilimumab, which is being trialled in the U.S., effectively takes the brakes off the immune system, so it can recognise the cancer and form antibodies to destroy it.
The results have been amazing. One year on, scans are now showing no growth or new lesions, so I’m hoping that ipilimumab and the SIR spheres are working.
Read more: http://www.dailymail.co.uk/health/article-2047602/Im-alive-I-know-beat-NHS-system.html#ixzz1aUAONVML
OBIT: Prof.R.A.A.BUCKMAN MA (Cantab.) MB BChir(Cantab.) PhD(London) FRCP FRCPC
Death Oct.10 of Prof.Robert Alexander Amiel BUCKMAN MB BChir(Cantab.) FRCP FRCPC (1948-2011)
Some info.fromToronto STAR.
Actor, Atheist, Author, Medical radio, television journalist and Oncologist Prof R.A.A. Buckman died on a flight from UK to Toronto from DERMATOMYOSITIS.which developed at 31y (1979).
Attended private London (Hampstead) University College School and Cambridge.Univ. Postgraduate training at Royal Marsden (Cancer) Hospital.
Emigrated to Ontario in 1988 (37y).Worked at Princess Margaret Cancer Hospital.
Was Pres. Can .Humanist (Atheist) association. Also Hon.Phys. Toronto St.George's Soc.
Married to University Toronto Pathologist Dr.Patricia SHAW MD(Tor.1976) FRCPC(1985)
4 Children.
In 26y held no office in the Ontario Medical association or College of Physicians & Surgeons of Ontario.
Some info.fromToronto STAR.
Actor, Atheist, Author, Medical radio, television journalist and Oncologist Prof R.A.A. Buckman died on a flight from UK to Toronto from DERMATOMYOSITIS.which developed at 31y (1979).
Attended private London (Hampstead) University College School and Cambridge.Univ. Postgraduate training at Royal Marsden (Cancer) Hospital.
Emigrated to Ontario in 1988 (37y).Worked at Princess Margaret Cancer Hospital.
Was Pres. Can .Humanist (Atheist) association. Also Hon.Phys. Toronto St.George's Soc.
Married to University Toronto Pathologist Dr.Patricia SHAW MD(Tor.1976) FRCPC(1985)
4 Children.
In 26y held no office in the Ontario Medical association or College of Physicians & Surgeons of Ontario.
09 October 2011
UK: DAILY EXPRESS: 1000 new "medical examiners" to check Death certificates.
£170 TAX ON THE BEREAVED
A new scheme would see the bereaved spending £170 to bury loved ones
Monday October 10,2011
By Sarah Westcott
GRIEVING families face a new “death tax” before they can put their loved ones to rest, it emerged yesterday.
A new scheme would see the bereaved spending £170 to bury their nearest and dearest in a move that would cost Britons more than £83million a year.
The rules could be applied to around 490,000 deaths every year, affecting more than 1,000 families a day.
The Government proposals for debate in the Commons this week would hit families with a minimum charge to check the cause of death when a relative passes away.
The plan, to improve the quality and accuracy of death statistics and medical certificates of all non-coroner referred deaths, would see relatives having to pay out the sum before they can bury their loved ones.
Some 1,000 “medical examiners” would be appointed on a salary of up to £81,500 a year, to ensure that doctors fill in forms properly with the correct cause of death.
A new scheme would see the bereaved spending £170 to bury loved ones
Monday October 10,2011
By Sarah Westcott
GRIEVING families face a new “death tax” before they can put their loved ones to rest, it emerged yesterday.
A new scheme would see the bereaved spending £170 to bury their nearest and dearest in a move that would cost Britons more than £83million a year.
The rules could be applied to around 490,000 deaths every year, affecting more than 1,000 families a day.
The Government proposals for debate in the Commons this week would hit families with a minimum charge to check the cause of death when a relative passes away.
The plan, to improve the quality and accuracy of death statistics and medical certificates of all non-coroner referred deaths, would see relatives having to pay out the sum before they can bury their loved ones.
Some 1,000 “medical examiners” would be appointed on a salary of up to £81,500 a year, to ensure that doctors fill in forms properly with the correct cause of death.
07 October 2011
USA CAP: PSA POLICY
PSA Testing In The Early Detection, Diagnosis and Monitoring
of Prostate Cancer
Ported March 19, 2010 COLLEGE of AMERICAN PATHOLOGISTS
Policy Synopsis
Application of Prostate-specific antigen (PSA) as a screening test is controversial because its sensitivity and specificity for cancer are poor, and because in some cases of slow growing prostate cancer early detection and treatment may have little benefit. It is, however, reasonable to offer PSA screening to most men aged 50 and older, and at an earlier age for African-American men and men with one or more first degree relatives with prostate cancer.
PSA testing is useful in diagnosing patients who present with prostatic symptoms and in the investigation of a nodule detected by digital rectal examination. It is also useful as a monitoring tool for detecting recurrence or recognizing metastasis in a patient with prostate cancer. For monitoring and serial screening purposes, the same PSA assay method should be used for each measurement.
Policy
Prostate-specific antigen (PSA) is a protein found in serum that is derived almost entirely from prostatic glandular tissue. PSA measurement is used as a monitoring test to detect local recurrence or metastasis in patients with established prostate cancer (adenocarcinoma). PSA is also used to investigate patients who present with prostatic symptoms and signs and also for asymptomatic patients being screened for prostatic cancer.
Screening
The American Cancer Society, the American Urological Association, and the National Comprehensive Cancer Network have issued detailed advice regarding use of PSA for screening. The CAP is in general agreement with their information but does not endorse any specific screening policy. Application of PSA as a screening test is controversial for two reasons:
1) PSA levels are increased in prostate cancer, prostatitis and benign enlargement of the prostate; therefore sensitivity and specificity for cancer are poor. Some aggressive tumors elevate PSA only slightly, particularly in young African-American men. Cancer detection may be improved to some extent by using age-adjusted cutoffs, PSA “density”, PSA ”velocity”, and fraction of free or complexed PSA. *
2) Some prostate cancers are so indolent that early detection and treatment may have little benefit and potential for significant morbidity. At present, these cancers cannot be clearly distinguished from cancers that are more aggressive.
It is reasonable to offer PSA screening to men of age about 50 or older, and at an earlier age for African-American men and men with one or more first degree relatives with prostate cancer.
For a man in poor health with serious medical illness and/or a man who is unlikely to live for more than 10 years, there may be no benefit to the early detection of prostate cancer. PSA testing may actually do more harm than good since prostate cancer investigation and treatment can seriously affect one's quality of life.
Men who are being offered PSA screening should be informed about the limitations of PSA testing and the consequences of an abnormal result.
PSA testing should be performed by accredited laboratories applying rigorous quality control, because small analytic changes can cause inappropriate patient care decisions.
Different PSA assay methods can yield different results. Accordingly, for monitoring and serial screening purposes, it is important to use the same PSA assay method for each measurement, and preferably in the same laboratory.
Efforts to improve the agreement of commercial PSA tests should continue.
Diagnosis
PSA is a useful test in patients presenting with prostatic symptoms and in the investigation of a nodule detected by digital rectal examination. Elevated PSA measurements or rising PSA values in a patient with suspected prostate cancer may be followed up with a prostate biopsy. Evaluation of prostate tissue by a qualified pathologist is required for the diagnosis of prostate cancer.
Monitoring
PSA is a clearly useful test for detecting recurrence or recognizing metastasis in a patient with prostate cancer. The test should be performed periodically in patients who have received any type of treatment for prostate cancer including those on watchful waiting protocols. It is important that the laboratory measurements be made with assays, which have adequate sensitivity, to monitor patients who have had their prostate glands surgically removed and that clinicians preferably utilize the same laboratory for serial measurements. The time interval over which the concentration of PSA doubles in these men is an important indicator of progression of prostate cancer.
* Definitions:
PSA “density” is determined by dividing the PSA level by the volume of the prostate gland as determined by transrectal ultrasound - the higher the PSA density, the greater the likelihood of cancer.
PSA “velocity” is the increase in PSA level occurring over a period of time. The measurement of PSA velocity should be made on three specimens taken over at least an 18-month period. A PSA velocity over 0.75 ng/mL per year is considered high.
Free PSA indicates how much PSA circulates alone or unbound in the blood where as complexed PSA indicates how much PSA is bound together with other blood proteins. For PSA results between 4 and 10, a low percent free PSA means that a prostate cancer is more likely to be present.
Revision History
Adopted March 2004
Revised February 2010
of Prostate Cancer
Ported March 19, 2010 COLLEGE of AMERICAN PATHOLOGISTS
Policy Synopsis
Application of Prostate-specific antigen (PSA) as a screening test is controversial because its sensitivity and specificity for cancer are poor, and because in some cases of slow growing prostate cancer early detection and treatment may have little benefit. It is, however, reasonable to offer PSA screening to most men aged 50 and older, and at an earlier age for African-American men and men with one or more first degree relatives with prostate cancer.
PSA testing is useful in diagnosing patients who present with prostatic symptoms and in the investigation of a nodule detected by digital rectal examination. It is also useful as a monitoring tool for detecting recurrence or recognizing metastasis in a patient with prostate cancer. For monitoring and serial screening purposes, the same PSA assay method should be used for each measurement.
Policy
Prostate-specific antigen (PSA) is a protein found in serum that is derived almost entirely from prostatic glandular tissue. PSA measurement is used as a monitoring test to detect local recurrence or metastasis in patients with established prostate cancer (adenocarcinoma). PSA is also used to investigate patients who present with prostatic symptoms and signs and also for asymptomatic patients being screened for prostatic cancer.
Screening
The American Cancer Society, the American Urological Association, and the National Comprehensive Cancer Network have issued detailed advice regarding use of PSA for screening. The CAP is in general agreement with their information but does not endorse any specific screening policy. Application of PSA as a screening test is controversial for two reasons:
1) PSA levels are increased in prostate cancer, prostatitis and benign enlargement of the prostate; therefore sensitivity and specificity for cancer are poor. Some aggressive tumors elevate PSA only slightly, particularly in young African-American men. Cancer detection may be improved to some extent by using age-adjusted cutoffs, PSA “density”, PSA ”velocity”, and fraction of free or complexed PSA. *
2) Some prostate cancers are so indolent that early detection and treatment may have little benefit and potential for significant morbidity. At present, these cancers cannot be clearly distinguished from cancers that are more aggressive.
It is reasonable to offer PSA screening to men of age about 50 or older, and at an earlier age for African-American men and men with one or more first degree relatives with prostate cancer.
For a man in poor health with serious medical illness and/or a man who is unlikely to live for more than 10 years, there may be no benefit to the early detection of prostate cancer. PSA testing may actually do more harm than good since prostate cancer investigation and treatment can seriously affect one's quality of life.
Men who are being offered PSA screening should be informed about the limitations of PSA testing and the consequences of an abnormal result.
PSA testing should be performed by accredited laboratories applying rigorous quality control, because small analytic changes can cause inappropriate patient care decisions.
Different PSA assay methods can yield different results. Accordingly, for monitoring and serial screening purposes, it is important to use the same PSA assay method for each measurement, and preferably in the same laboratory.
Efforts to improve the agreement of commercial PSA tests should continue.
Diagnosis
PSA is a useful test in patients presenting with prostatic symptoms and in the investigation of a nodule detected by digital rectal examination. Elevated PSA measurements or rising PSA values in a patient with suspected prostate cancer may be followed up with a prostate biopsy. Evaluation of prostate tissue by a qualified pathologist is required for the diagnosis of prostate cancer.
Monitoring
PSA is a clearly useful test for detecting recurrence or recognizing metastasis in a patient with prostate cancer. The test should be performed periodically in patients who have received any type of treatment for prostate cancer including those on watchful waiting protocols. It is important that the laboratory measurements be made with assays, which have adequate sensitivity, to monitor patients who have had their prostate glands surgically removed and that clinicians preferably utilize the same laboratory for serial measurements. The time interval over which the concentration of PSA doubles in these men is an important indicator of progression of prostate cancer.
* Definitions:
PSA “density” is determined by dividing the PSA level by the volume of the prostate gland as determined by transrectal ultrasound - the higher the PSA density, the greater the likelihood of cancer.
PSA “velocity” is the increase in PSA level occurring over a period of time. The measurement of PSA velocity should be made on three specimens taken over at least an 18-month period. A PSA velocity over 0.75 ng/mL per year is considered high.
Free PSA indicates how much PSA circulates alone or unbound in the blood where as complexed PSA indicates how much PSA is bound together with other blood proteins. For PSA results between 4 and 10, a low percent free PSA means that a prostate cancer is more likely to be present.
Revision History
Adopted March 2004
Revised February 2010
ONTARIO PROVINCIAL ELECTION: two LIBERAL MDs re-elected.
LIBERALS win with gains to RIGHT Progressive Conservatives & LEFT New Democratic Party Only 48% voted. (Confusion about difference between Liberals & PCs.)
Re-elected Minister of Citizenship & Immigration (51y) Central Toronto ERIC HOSKINS Officer Order Canada, BSc(Chem).McMaster 82, MD(McMaster 85) OXFORD RHODES SCHOLARSHIP Public Health & Epid. D.Phil, DTM&H, FRCP(Can.) International Child disease activist.
(Re-elected Min. Health is Dr.(PhD Sociology) "Deb." MATTHEWS (57y) of London,Ont.)
Re-elected Chmn Social Policy Committee MUHAMMAD SHAFIQ QAADRI (46y) Toronto UPPER CANADA COLLEGE (Boys' boarding school) 1983 U.Toronto MD (1988) Shares GP office in West Toronto with Gynaecologist Mother.
Re-elected Minister of Citizenship & Immigration (51y) Central Toronto ERIC HOSKINS Officer Order Canada, BSc(Chem).McMaster 82, MD(McMaster 85) OXFORD RHODES SCHOLARSHIP Public Health & Epid. D.Phil, DTM&H, FRCP(Can.) International Child disease activist.
(Re-elected Min. Health is Dr.(PhD Sociology) "Deb." MATTHEWS (57y) of London,Ont.)
Re-elected Chmn Social Policy Committee MUHAMMAD SHAFIQ QAADRI (46y) Toronto UPPER CANADA COLLEGE (Boys' boarding school) 1983 U.Toronto MD (1988) Shares GP office in West Toronto with Gynaecologist Mother.
04 October 2011
Nobel Prize winner Late Henry Kunkel Prof.R.M.STEINMAN BSc(McGill) MD (Harvard 68)
Ralph M. Steinman
http://lab.rockefeller.edu/steinman/dendritic_intro/
Born: 1943, Montreal, Canada
Died: 30 September 2011 (Cancer pancreas)
Affiliation at the time of the award: Rockefeller University, New York, NY, USA
Prize motivation: "for his discovery of the dendritic cell and its role in adaptive immunity"
(Never received recognition from Canadian Government and Quebec)
http://lab.rockefeller.edu/steinman/dendritic_intro/
Born: 1943, Montreal, Canada
Died: 30 September 2011 (Cancer pancreas)
Affiliation at the time of the award: Rockefeller University, New York, NY, USA
Prize motivation: "for his discovery of the dendritic cell and its role in adaptive immunity"
(Never received recognition from Canadian Government and Quebec)
UK DAILY MAIL: ENGLISH TEST FOR FOREIGN DOCTORS
Language test for all foreign doctors: Law will bar medics who can't speak English
By Daniel Martin
Foreign doctors will be barred from treating patients unless they have a good grasp of English under tough rules to be announced by Andrew Lansley today.
The Health Secretary will pledge to end the scandal which has seen 23,000 doctors from Europe registered to work in the NHS – despite never having been asked if they can speak the language properly.
A new law will give trusts the statutory duty to check the English language skills of all new overseas doctors before they are employed by the Health Service.
Failure to pass the language test will see them prevented from taking a job in an NHS hospital or a GP surgery – ensuring patients are treated by doctors they can understand, and who can understand them.
Last year, a report by the Commons Health Select Committee concluded that the failure to ensure GPs on out-of-hours shifts can speak English had cost lives.
Three years ago, pensioner David Gray died after being treated by out-of-hours locum Dr Daniel Ubani, who was exhausted after having flown in from Germany. He was allowed to treat patients despite having a poor grasp of English.
Doctors’ language skills are not yet routinely tested because Britain sticks rigidly to an EU directive which outlaws checks on overseas GPs’ language skills – while France flouts it.
More...'Sometimes doctors do things that patients don't think necessary': What GP 'told disabled patient as he indecently assaulted her'
15,000 NHS nurses fear redundancy as they reveal cuts are damaging patient care
The ban is even enshrined in British law: The 1983 Medical Act, brought in by Margaret Thatcher. Mr Lansley will repeal the parts of the Act which stop trusts from testing foreign doctors’ English.
Under the new scheme, all trusts will have to appoint a ‘responsible officer’ whose job will be to test the language skills of all foreign doctors applying to work there.
He or she must also ensure the applicant is trained to UK standards and understands how the NHS works.
Minister: Andrew Lansley is set to introduce new rules for foreign doctors
Ministers are confident the new rules will be drawn up in such a way that Britain will be able to circumvent the EU directive – and protect the safety of patients.
Mr Lansley said: ‘There is considerable anxiety amongst the public about the ability of doctors to speak English properly.
‘After 13 years of inaction from Labour to tighten up language controls, we will amend the legislation to prevent all foreign doctors with a poor grasp of English from working in England. If you can’t speak adequate English, you can’t treat patients.’
Currently only doctors from outside Europe are routinely scrutinised for their language skills before being able to register with the General Medical Council, the doctors’ watchdog.
But European law prevents the GMC from vetting the language skills of doctors from within Europe, because it conflicts with the European ideal of the free movement of people.
It has led to the farcical position where doctors from English-speaking countries such as Australia and Canada face tougher language tests than those from Italy and Lithuania.
Ministers plan to sidestep the directive by putting the onus on trusts – and not the GMC – to check language skills.
The ‘responsible officers’ will also have to ensure that the doctor has the right qualifications to work in the NHS – and that appropriate references are obtained and checked.
Consultation: Rigorous new tests will ensure that GPs can speak sufficient English (picture posed by models)
There will also be a new power for trusts to refer a doctor to the GMC if they have concerns that their poor language skills could put patients at risk.
Mr Lansley plans to legislate to give the GMC explicit new powers to take action against doctors when there are concerns about their ability to speak English.
In his speech, the Health Secretary will say: ‘We will amend the Medical Act to ensure that any doctor from overseas who can’t use a decent level of English is not able to treat NHS patients.
‘This is not about discriminating: We’ve always appreciated how much overseas doctors and nurses give to our NHS.
‘It is simply about our absolute commitment to put patients’ safety first.’
Currently 23,033 doctors from Europe – almost 10 per cent of the total – are registered to work in the NHS.
France has managed to get round the rules by not testing doctors’ language per se, but inviting applicants to interview. Those deemed not to have the requisite language skills will not get a job.
The Department of Health said it was in talks with the Nursing and Midwifery Council to consider testing the language skills of foreign nurses as well.
Read more: http://www.dailymail.co.uk/news/article-2044925/Language-test-foreign-doctors-Law-bar-medics-speak-English.html#ixzz1ZoiWpYQe
By Daniel Martin
Foreign doctors will be barred from treating patients unless they have a good grasp of English under tough rules to be announced by Andrew Lansley today.
The Health Secretary will pledge to end the scandal which has seen 23,000 doctors from Europe registered to work in the NHS – despite never having been asked if they can speak the language properly.
A new law will give trusts the statutory duty to check the English language skills of all new overseas doctors before they are employed by the Health Service.
Failure to pass the language test will see them prevented from taking a job in an NHS hospital or a GP surgery – ensuring patients are treated by doctors they can understand, and who can understand them.
Last year, a report by the Commons Health Select Committee concluded that the failure to ensure GPs on out-of-hours shifts can speak English had cost lives.
Three years ago, pensioner David Gray died after being treated by out-of-hours locum Dr Daniel Ubani, who was exhausted after having flown in from Germany. He was allowed to treat patients despite having a poor grasp of English.
Doctors’ language skills are not yet routinely tested because Britain sticks rigidly to an EU directive which outlaws checks on overseas GPs’ language skills – while France flouts it.
More...'Sometimes doctors do things that patients don't think necessary': What GP 'told disabled patient as he indecently assaulted her'
15,000 NHS nurses fear redundancy as they reveal cuts are damaging patient care
The ban is even enshrined in British law: The 1983 Medical Act, brought in by Margaret Thatcher. Mr Lansley will repeal the parts of the Act which stop trusts from testing foreign doctors’ English.
Under the new scheme, all trusts will have to appoint a ‘responsible officer’ whose job will be to test the language skills of all foreign doctors applying to work there.
He or she must also ensure the applicant is trained to UK standards and understands how the NHS works.
Minister: Andrew Lansley is set to introduce new rules for foreign doctors
Ministers are confident the new rules will be drawn up in such a way that Britain will be able to circumvent the EU directive – and protect the safety of patients.
Mr Lansley said: ‘There is considerable anxiety amongst the public about the ability of doctors to speak English properly.
‘After 13 years of inaction from Labour to tighten up language controls, we will amend the legislation to prevent all foreign doctors with a poor grasp of English from working in England. If you can’t speak adequate English, you can’t treat patients.’
Currently only doctors from outside Europe are routinely scrutinised for their language skills before being able to register with the General Medical Council, the doctors’ watchdog.
But European law prevents the GMC from vetting the language skills of doctors from within Europe, because it conflicts with the European ideal of the free movement of people.
It has led to the farcical position where doctors from English-speaking countries such as Australia and Canada face tougher language tests than those from Italy and Lithuania.
Ministers plan to sidestep the directive by putting the onus on trusts – and not the GMC – to check language skills.
The ‘responsible officers’ will also have to ensure that the doctor has the right qualifications to work in the NHS – and that appropriate references are obtained and checked.
Consultation: Rigorous new tests will ensure that GPs can speak sufficient English (picture posed by models)
There will also be a new power for trusts to refer a doctor to the GMC if they have concerns that their poor language skills could put patients at risk.
Mr Lansley plans to legislate to give the GMC explicit new powers to take action against doctors when there are concerns about their ability to speak English.
In his speech, the Health Secretary will say: ‘We will amend the Medical Act to ensure that any doctor from overseas who can’t use a decent level of English is not able to treat NHS patients.
‘This is not about discriminating: We’ve always appreciated how much overseas doctors and nurses give to our NHS.
‘It is simply about our absolute commitment to put patients’ safety first.’
Currently 23,033 doctors from Europe – almost 10 per cent of the total – are registered to work in the NHS.
France has managed to get round the rules by not testing doctors’ language per se, but inviting applicants to interview. Those deemed not to have the requisite language skills will not get a job.
The Department of Health said it was in talks with the Nursing and Midwifery Council to consider testing the language skills of foreign nurses as well.
Read more: http://www.dailymail.co.uk/news/article-2044925/Language-test-foreign-doctors-Law-bar-medics-speak-English.html#ixzz1ZoiWpYQe
02 October 2011
HUMAN MOLECULAR GENETICS: Genetic basis of schizophrenia & bipolar disorder.
From NEW SCIENTIST
Human Molecular Genetics
hmg.oxfordjournals.org
September 9, 2011
Disease-associated epigenetic changes in monozygotic twins discordant for schizophrenia and bipolar disorder
Emma L. Dempster1,†, Ruth Pidsley1,†, Leonard C. Schalkwyk1, Sheena Owens2, Anna Georgiades2, Fergus Kane2, Sridevi Kalidindi2, Marco Picchioni2,3, Eugenia Kravariti2, Timothea Toulopoulou2, Robin M. Murray2 and Jonathan Mill1,*
+ Author Affiliations
1MRC Social, Genetic and Developmental Psychiatry Centre and
2Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK and
3St Andrew's Academic Centre, Northampton NN1 5BG, UK
↵*To whom correspondence should be addressed at: SGDP Centre, Institute of Psychiatry, King's College London, Denmark Hill, London SE5 8AF, UK. Tel: +44 2078480859; Fax: +44 2078480866; Email: jonathan.mill@kcl.ac.uk
↵† These authors contributed equally to this work.
Received July 12, 2011.
Accepted September 7, 2011.
Abstract
Studies of the major psychoses, schizophrenia (SZ) and bipolar disorder (BD), have traditionally focused on genetic and environmental risk factors, although more recent work has highlighted an additional role for epigenetic processes in mediating susceptibility. Since monozygotic (MZ) twins share a common DNA sequence, their study represents an ideal design for investigating the contribution of epigenetic factors to disease etiology. We performed a genome-wide analysis of DNA methylation on peripheral blood DNA samples obtained from a unique sample of MZ twin pairs discordant for major psychosis. Numerous loci demonstrated disease-associated DNA methylation differences between twins discordant for SZ and BD individually, and together as a combined major psychosis group. Pathway analysis of our top loci highlighted a significant enrichment of epigenetic changes in biological networks and pathways directly relevant to psychiatric disorder and neurodevelopment. The top psychosis-associated, differentially methylated region, significantly hypomethylated in affected twins, was located in the promoter of ST6GALNAC1 overlapping a previously reported rare genomic duplication observed in SZ. The mean DNA methylation difference at this locus was 6%, but there was considerable heterogeneity between families, with some twin pairs showing a 20% difference in methylation. We subsequently assessed this region in an independent sample of postmortem brain tissue from affected individuals and controls, finding marked hypomethylation (>25%) in a subset of psychosis patients. Overall, our data provide further evidence to support a role for DNA methylation differences in mediating phenotypic differences between MZ twins and in the etiology of both SZ and BD.
© The Author 2011. Published by Oxford University Press.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.5), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Human Molecular Genetics
hmg.oxfordjournals.org
September 9, 2011
Disease-associated epigenetic changes in monozygotic twins discordant for schizophrenia and bipolar disorder
Emma L. Dempster1,†, Ruth Pidsley1,†, Leonard C. Schalkwyk1, Sheena Owens2, Anna Georgiades2, Fergus Kane2, Sridevi Kalidindi2, Marco Picchioni2,3, Eugenia Kravariti2, Timothea Toulopoulou2, Robin M. Murray2 and Jonathan Mill1,*
+ Author Affiliations
1MRC Social, Genetic and Developmental Psychiatry Centre and
2Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK and
3St Andrew's Academic Centre, Northampton NN1 5BG, UK
↵*To whom correspondence should be addressed at: SGDP Centre, Institute of Psychiatry, King's College London, Denmark Hill, London SE5 8AF, UK. Tel: +44 2078480859; Fax: +44 2078480866; Email: jonathan.mill@kcl.ac.uk
↵† These authors contributed equally to this work.
Received July 12, 2011.
Accepted September 7, 2011.
Abstract
Studies of the major psychoses, schizophrenia (SZ) and bipolar disorder (BD), have traditionally focused on genetic and environmental risk factors, although more recent work has highlighted an additional role for epigenetic processes in mediating susceptibility. Since monozygotic (MZ) twins share a common DNA sequence, their study represents an ideal design for investigating the contribution of epigenetic factors to disease etiology. We performed a genome-wide analysis of DNA methylation on peripheral blood DNA samples obtained from a unique sample of MZ twin pairs discordant for major psychosis. Numerous loci demonstrated disease-associated DNA methylation differences between twins discordant for SZ and BD individually, and together as a combined major psychosis group. Pathway analysis of our top loci highlighted a significant enrichment of epigenetic changes in biological networks and pathways directly relevant to psychiatric disorder and neurodevelopment. The top psychosis-associated, differentially methylated region, significantly hypomethylated in affected twins, was located in the promoter of ST6GALNAC1 overlapping a previously reported rare genomic duplication observed in SZ. The mean DNA methylation difference at this locus was 6%, but there was considerable heterogeneity between families, with some twin pairs showing a 20% difference in methylation. We subsequently assessed this region in an independent sample of postmortem brain tissue from affected individuals and controls, finding marked hypomethylation (>25%) in a subset of psychosis patients. Overall, our data provide further evidence to support a role for DNA methylation differences in mediating phenotypic differences between MZ twins and in the etiology of both SZ and BD.
© The Author 2011. Published by Oxford University Press.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.5), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
01 October 2011
U.British Columbia Emeritus Prof Psychology Robert D.HARE CM PhD on PSYCHOPATHS
Original idea of post from READER'S DIGEST article
readersdigest.ca/september
http://www.hare.org/
HARE Psychopathy Checklist revised (PCL-R)
Prof Hare estimates a 1% psychopathy prevalence` rate: a problem for Clinicians.
readersdigest.ca/september
http://www.hare.org/
HARE Psychopathy Checklist revised (PCL-R)
Prof Hare estimates a 1% psychopathy prevalence` rate: a problem for Clinicians.
30 September 2011
ISID NEWS
The SEPTEMBER 2011 of the ISID NEWS (the official newsletter of the International Society for Infectious Diseases) is now available online.
15th International Congress on Infectious Diseases (ICID)
The 15th ICID will be held in Bangkok, Thailand on June 13-16, 2012
For more information, go to http://www.isid.org/icid/ or Join the 15th ICID Mailing List
ISID Neglected Tropical Diseases Meeting
Slide presentations of many of the symposia and plenary talks are now posted as pdf files online at http://ntd.isid.org/
Any individual interested in infectious diseases may become a member of the Society for FREE.
Subscription to the online International Journal of Infectious Diseases is free from June 2011 through May 2012.
15th International Congress on Infectious Diseases (ICID)
The 15th ICID will be held in Bangkok, Thailand on June 13-16, 2012
For more information, go to http://www.isid.org/icid/ or Join the 15th ICID Mailing List
ISID Neglected Tropical Diseases Meeting
Slide presentations of many of the symposia and plenary talks are now posted as pdf files online at http://ntd.isid.org/
Any individual interested in infectious diseases may become a member of the Society for FREE.
Subscription to the online International Journal of Infectious Diseases is free from June 2011 through May 2012.
29 September 2011
UK :SUN Paracetamol liver failure from self-medication
from UK: SUN
A young mum battling what she thought was a lingering cold died after continually guzzling paracetamol pills and LEMPSIP (paracetamol+phenylephrine).
Fitness instructor Donna Bishop, 25, kept up her daily cocktail of over-the-counter remedies despite her GP diagnosing a chest infection.
The mum of one — who had caught a cold two weeks earlier — would wash the tablets down with the hot drink, an inquest heard yesterday.
LEMPSIP also contains paracetamol (650 mg)— and her health slowly deteriorated as she unwittingly overdosed on the painkiller.
A pal told how even when Donna, of Warndon Villages, Worcester, kept being sick she was convinced the remedies would help her — and took more. Days after her doctor put her on antibiotics Donna went to hospital complaining of mouth ulcers and difficulty swallowing.
She was prescribed co-codamol — which also contains paracetamol. Next day her sister found her woozy and jaundiced.
Donna went to hospital where a senior registrar advised tests, including one for paracetamol poisoning. She went home BEFORE having the tests, only to be re-admitted hallucinating hours later. Donna died of liver failure the same day.
A nurse told the inquest in Stourport-on-Severn how up until the end the mum denied taking paracetamol.
Donna's mum Nicky, 46, said after a coroner's narrative verdict that the paracetamol killed her: "It's horrible. I don't want other families to go through this."
A young mum battling what she thought was a lingering cold died after continually guzzling paracetamol pills and LEMPSIP (paracetamol+phenylephrine).
Fitness instructor Donna Bishop, 25, kept up her daily cocktail of over-the-counter remedies despite her GP diagnosing a chest infection.
The mum of one — who had caught a cold two weeks earlier — would wash the tablets down with the hot drink, an inquest heard yesterday.
LEMPSIP also contains paracetamol (650 mg)— and her health slowly deteriorated as she unwittingly overdosed on the painkiller.
A pal told how even when Donna, of Warndon Villages, Worcester, kept being sick she was convinced the remedies would help her — and took more. Days after her doctor put her on antibiotics Donna went to hospital complaining of mouth ulcers and difficulty swallowing.
She was prescribed co-codamol — which also contains paracetamol. Next day her sister found her woozy and jaundiced.
Donna went to hospital where a senior registrar advised tests, including one for paracetamol poisoning. She went home BEFORE having the tests, only to be re-admitted hallucinating hours later. Donna died of liver failure the same day.
A nurse told the inquest in Stourport-on-Severn how up until the end the mum denied taking paracetamol.
Donna's mum Nicky, 46, said after a coroner's narrative verdict that the paracetamol killed her: "It's horrible. I don't want other families to go through this."
27 September 2011
UK: DAILY STAR Possible poisoning of three Hospital patients
By Daily Star Reporter
POLICE probing the deaths of three hospital patients by poisoning have called in a top pathologist who investigated the 1997 death of Princess Diana.
Prof Robert Forrest has joined officers who suspect two saboteurs may have hit Stepping Hill Hospital in Stockport, Gtr Manchester.
Tracey Arden, 44, Arnold Lancaster, 71, and Derek Weaver, 83, all died after being given saline drips contaminated with insulin.
Prof.Forrest told Diana’s inquest tests on the blood of her driver Henri Paul suggested “cock-up or conspiracy”.
POLICE probing the deaths of three hospital patients by poisoning have called in a top pathologist who investigated the 1997 death of Princess Diana.
Prof Robert Forrest has joined officers who suspect two saboteurs may have hit Stepping Hill Hospital in Stockport, Gtr Manchester.
Tracey Arden, 44, Arnold Lancaster, 71, and Derek Weaver, 83, all died after being given saline drips contaminated with insulin.
Prof.Forrest told Diana’s inquest tests on the blood of her driver Henri Paul suggested “cock-up or conspiracy”.
26 September 2011
LANCET: Ovarian teratoma and autoimmune encephalitis
Lancet Neurol. Author manuscript; available in PMC 2009 December 1.
Published in final edited form as:
Lancet Neurol. 2008 December; 7(12): 1091–1098.
Published online 2008 October 11. doi: 10.1016/S1474-4422(08)70224-2 PMCID: PMC2607118
NIHMSID: NIHMS74544
Copyright notice and Disclaimer
Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies
Josep Dalmau, Amy J Gleichman,* Ethan G Hughes,* Jeffrey E Rossi, Xiaoyu Peng, Meizan Lai, Scott K Dessain, Myrna R Rosenfeld, Rita Balice-Gordon, and David R Lynch
Department of Neurology (J Dalmau MD, J E Rossi BA, M Lai MD, M R Rosenfeld MD, D R Lynch MD) and Department of Neuroscience (A J Gleichman BS, E G Hughes BS, X Peng BS, R Balice-Gordon PhD), University of Pennsylvania, Philadelphia, PA, USA; Lankenau Institute for Medical Research, Wynnewood, PA, USA (S K Dessain MD); Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA (D R Lynch)
Correspondence to: Josep Dalmau, Division of Neuro-Oncology, Department of Neurology, 3 W Gates, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA, Email: josep.dalmau@uphs.upenn.edu
*These authors contributed equally to this paper
The publisher's final edited version of this article is available at Lancet Neurol
A severe form of encephalitis associated with antibodies against NR1–NR2 heteromers of the NMDA receptor was recently identified. We aimed to analyse the clinical and immunological features of patients with the disorder and examine the effects of antibodies against NMDA receptors in neuronal cultures.
Methods
We describe the clinical characteristics of 100 patients with encephalitis and NR1–NR2 antibodies. HEK293 cells ectopically expressing single or assembled NR1–NR2 subunits were used to determine the epitope targeted by the antibodies. Antibody titres were measured with ELISA. The effect of antibodies on neuronal cultures was determined by quantitative analysis of NMDA-receptor clusters.
Findings
Median age of patients was 23 years (range 5–76 years); 91 were women. All patients presented with psychiatric symptoms or memory problems; 76 had seizures, 88 unresponsiveness (decreased conciousness), 86 dyskinesias, 69 autonomic instability, and 66 hypoventilation. 58 (59%) of 98 patients for whom results of oncological assessments were available had tumours, most commonly ovarian teratoma. Patients who received early tumour treatment (usually with immunotherapy) had better outcome (p=0.004) and fewer neurological relapses (p=0.009) than the rest of the patients. 75 patients recovered or had mild deficits and 25 had severe deficits or died. Improvement was associated with a decrease of serum antibody titres. The main epitope targeted by the antibodies is in the extracellular N-terminal domain of the NR1 subunit. Patients’ antibodies decreased the numbers of cell-surface NMDA receptors and NMDA-receptor clusters in postsynaptic dendrites, an effect that could be reversed by antibody removal.
Interpretation
A well-defined set of clinical characteristics are associated with anti-NMDA-receptor encephalitis. The pathogenesis of the disorder seems to be mediated by antibodies.
NMDA receptors are ligand-gated cation channels with crucial roles in synaptic transmission and plasticity. The receptors are heteromers of NR1 subunits that bind glycine and NR2 (A, B, C, or D) subunits that bind glutamate.1 NR1 and NR2 combine to form receptor subtypes with distinct pharmacological properties, localisation, and ability to interact with intracellular messengers. Overactivity of NMDA receptors causing excitotoxicity is a proposed underlying mechanism for epilepsy, dementia, and stroke, whereas low activity produces symptoms of schizophrenia.2–4We recently identified a disorder, designated anti-NMDA-receptor encephalitis, that associates with antibodies against NR1–NR2 heteromers and results in a characteristic neuropsychiatric syndrome.5 The first patients identified were young women with ovarian teratoma who presented with psychosis or memory problems, rapidly progressing to multiple neurological deficits requiring prolonged intensive care support. Despite the severity of the disorder, patients often recovered after tumour removal and immunotherapy, suggesting an immune-mediated pathogenesis. Preliminary studies suggested the target epitopes were located in extracellular regions of NR1–NR2B NMDA receptors.5 However, selective disruption of receptors containing NR2B, which are predominantly expressed in the forebrain and hippocampus, would not explain the extensive deficits of patients. We postulated that the crucial epitopes were present in the more widely expressed NR1 subunit. If the antibodies were pathogenic we reasoned that their effects on NMDA receptors would be reversible because most patients recover.We report the clinical features of 100 patients, analysing the frequency and type of tumour association, antibody titres, and response to treatment. We also investigate the epitopic region of the NMDA receptor and how antibodies affect NMDA receptors in primary cultures of hippocampal neurons.
Published in final edited form as:
Lancet Neurol. 2008 December; 7(12): 1091–1098.
Published online 2008 October 11. doi: 10.1016/S1474-4422(08)70224-2 PMCID: PMC2607118
NIHMSID: NIHMS74544
Copyright notice and Disclaimer
Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies
Josep Dalmau, Amy J Gleichman,* Ethan G Hughes,* Jeffrey E Rossi, Xiaoyu Peng, Meizan Lai, Scott K Dessain, Myrna R Rosenfeld, Rita Balice-Gordon, and David R Lynch
Department of Neurology (J Dalmau MD, J E Rossi BA, M Lai MD, M R Rosenfeld MD, D R Lynch MD) and Department of Neuroscience (A J Gleichman BS, E G Hughes BS, X Peng BS, R Balice-Gordon PhD), University of Pennsylvania, Philadelphia, PA, USA; Lankenau Institute for Medical Research, Wynnewood, PA, USA (S K Dessain MD); Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, USA (D R Lynch)
Correspondence to: Josep Dalmau, Division of Neuro-Oncology, Department of Neurology, 3 W Gates, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA, Email: josep.dalmau@uphs.upenn.edu
*These authors contributed equally to this paper
The publisher's final edited version of this article is available at Lancet Neurol
A severe form of encephalitis associated with antibodies against NR1–NR2 heteromers of the NMDA receptor was recently identified. We aimed to analyse the clinical and immunological features of patients with the disorder and examine the effects of antibodies against NMDA receptors in neuronal cultures.
Methods
We describe the clinical characteristics of 100 patients with encephalitis and NR1–NR2 antibodies. HEK293 cells ectopically expressing single or assembled NR1–NR2 subunits were used to determine the epitope targeted by the antibodies. Antibody titres were measured with ELISA. The effect of antibodies on neuronal cultures was determined by quantitative analysis of NMDA-receptor clusters.
Findings
Median age of patients was 23 years (range 5–76 years); 91 were women. All patients presented with psychiatric symptoms or memory problems; 76 had seizures, 88 unresponsiveness (decreased conciousness), 86 dyskinesias, 69 autonomic instability, and 66 hypoventilation. 58 (59%) of 98 patients for whom results of oncological assessments were available had tumours, most commonly ovarian teratoma. Patients who received early tumour treatment (usually with immunotherapy) had better outcome (p=0.004) and fewer neurological relapses (p=0.009) than the rest of the patients. 75 patients recovered or had mild deficits and 25 had severe deficits or died. Improvement was associated with a decrease of serum antibody titres. The main epitope targeted by the antibodies is in the extracellular N-terminal domain of the NR1 subunit. Patients’ antibodies decreased the numbers of cell-surface NMDA receptors and NMDA-receptor clusters in postsynaptic dendrites, an effect that could be reversed by antibody removal.
Interpretation
A well-defined set of clinical characteristics are associated with anti-NMDA-receptor encephalitis. The pathogenesis of the disorder seems to be mediated by antibodies.
NMDA receptors are ligand-gated cation channels with crucial roles in synaptic transmission and plasticity. The receptors are heteromers of NR1 subunits that bind glycine and NR2 (A, B, C, or D) subunits that bind glutamate.1 NR1 and NR2 combine to form receptor subtypes with distinct pharmacological properties, localisation, and ability to interact with intracellular messengers. Overactivity of NMDA receptors causing excitotoxicity is a proposed underlying mechanism for epilepsy, dementia, and stroke, whereas low activity produces symptoms of schizophrenia.2–4We recently identified a disorder, designated anti-NMDA-receptor encephalitis, that associates with antibodies against NR1–NR2 heteromers and results in a characteristic neuropsychiatric syndrome.5 The first patients identified were young women with ovarian teratoma who presented with psychosis or memory problems, rapidly progressing to multiple neurological deficits requiring prolonged intensive care support. Despite the severity of the disorder, patients often recovered after tumour removal and immunotherapy, suggesting an immune-mediated pathogenesis. Preliminary studies suggested the target epitopes were located in extracellular regions of NR1–NR2B NMDA receptors.5 However, selective disruption of receptors containing NR2B, which are predominantly expressed in the forebrain and hippocampus, would not explain the extensive deficits of patients. We postulated that the crucial epitopes were present in the more widely expressed NR1 subunit. If the antibodies were pathogenic we reasoned that their effects on NMDA receptors would be reversible because most patients recover.We report the clinical features of 100 patients, analysing the frequency and type of tumour association, antibody titres, and response to treatment. We also investigate the epitopic region of the NMDA receptor and how antibodies affect NMDA receptors in primary cultures of hippocampal neurons.
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