30 November 2015

UK DAILY MAIL

Organs can be taken from the dead without any consent: Landmark law change in Wales gives doctors right to assume all adults have agreed to be donors

New system means adults have to 'opt out' from the register to not donate
Health officials argue the change of system will save hundreds of lives
Relatives will still have the right to object to a family member's donation
1,000 people in the UK die every year while they are waiting for a transplant

By Ben Spencer Medical Correspondent For The Daily Mail

Published: 00:25 GMT, 1 December 2015 | Updated: 00:31 GMT, 1 December 2015

Organs will be transplanted from the dead without consent for the first time in Britain from today.

A landmark law change in Wales gives doctors the right to assume that all adults consent to be organ donors after their death.

The new system means that adults have to ‘opt out’ from the register if they do not want to be donors - a dramatic change from the current ‘opt in’ system.

If they have not opted out, they will be treated as if they had given their approval, a principle known as ‘deemed consent’.

A landmark law change in Wales means that doctors have the right to assume that all adults consent to be organ donors after their deaths, and people will have to opt out of the register (file image)

Officials in England are carefully monitoring whether the new system is successful.

Some religious groups have criticised the move, but health officials argue that it will save hundreds of lives.

The Welsh Government predicts the new law could increase the number of organ donors by as much as a quarter.

Under the new system, relatives will still have the right to object to a family member’s organs being removed - but if they cannot be contacted a transplant will go ahead.

According to the latest figures, 1,000 people in the UK die every year while waiting for a transplant.

Organ transplants dropped in number last year for the first time in a decade, NHS figures show.

The number of transplants fell from 4,655 in 2013/14 to 4,431 in 2014/15.

The 5 per cent decrease is the first drop in 11 years, meaning that 224 fewer people received an organ transplant.

The British Heart Foundation last night called for England to follow the Welsh lead.

Simon Gillespie, chief executive at the charity, said organ donation rates in the UK are 40 per cent lower than in other countries in Europe, such as Spain and Croatia, that already use the opt-out system.

According to the latest figures, 1,000 people in the UK die every year while waiting for a transplant (file image)

‘Sadly hundreds of people die every year waiting for a transplant because there is a desperate shortage of organ donors,’ he said.

‘Other European countries that already use an opt-out system have much higher donor rates than the UK.

‘We campaigned strongly in Wales to introduce soft opt-out and now it’s time for the rest of the UK to follow their lead.’

Wales’ health minister Mark Drakeford said: ‘The change to a soft opt-out system for organ donation will deliver a revolution in consent.

‘Organ donation saves lives; increasing the rate of organ donation allows us to save more lives. That’s the key motivation for this significant change.’

Under the new system, those over 18 will become potential donors either by registering their decision to opt in - as they do currently - or by doing nothing at all.

It will apply to adults who have lived in the country for more than 12 months.

Organs available will be the same as the ‘opt-in’ method - including kidneys, heart, liver, lungs and pancreas - and would go anywhere in the UK.

Some 8 per cent of eligible adults in Wales have decided to opt out ahead of the new law today.

Ahead of the new law coming into effect leading Welsh Christian, Jewish and Muslim clerics signed an open letter expressing their unease about the plan.

‘We remain opposed to any weakening of the principle the donation of organs should be free and voluntary,’ they said.

The Archbishop of Wales, Dr Barry Morgan, has warned that the scheme could turn ‘volunteers into conscripts’.

But in an open letter published today, Church of Wales bishops called on people to make a positive decision one way or the other.

It said: ‘As Bishops we are wholeheartedly in favour of organ donation.

‘It is love in action and a wonderful example of what it can mean to love our neighbours, especially those in need. Such generosity is a response to God’s generosity towards us.

‘We urge and encourage you to sign the Organ Donor Register, and tell your families, so that there can be no doubt about your wishes in the event of your death.’

A spokesman for the Department of Health said England had no plans to follow the lead set by Wales - but admitted officials would be watching closely.

He said: ‘Our opt-in system is working well. In 2008 independent experts advised against an opt-out system and recommended more specialist nurses, clinical leads and donation committees. This has seen organ donation rates increase by 60 per cent.

‘We are watching how the change in Wales impacts on donations and continue to work hard to build on the significant increase in organ donations achieved in recent years.’

17 November 2015

DailyMail

Wednesday, Nov 18th 2015 7PM 6°C 10PM 6°C 5-Day Forecast

STD epidemic is sweeping the US with cases of chlamydia reaching 'record levels' - while gonorrhea and syphilis are also on the rise

CDC report warns of STD epidemic rising across the United States
Chlamydia, gonorrhea and syphilis all increased for first time in 9 years
Total of 1.4 million chlamydia cases - highest number of annual cases of any condition ever reported to the CDC
Experts call for better diagnosis, treatment and prevention to stem rise

By Lizzie Parry For Dailymail.com

Published: 19:39 GMT, 17 November 2015 | Updated: 23:52 GMT, 17 November 2015

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A sexually transmitted diseases epidemic is sweeping the US, with cases on the rise as chlamydia infections reaches 'record levels', experts have warned.

Cases of chlamydia, gonorrhea and syphilis have all increased for the first time since 2006, according to the Centers for Disease Control and Prevention (CDC).

Chlamydia cases had dipped in 2013, but last year's total of more than 1.4 million — or 456 cases per 100,000 — was the highest number of annual cases of any condition ever reported to the CDC.

The chlamydia rate was up almost three per cent from 2013, new figures revealed.

'America's worsening STD epidemic is a clear call for better diagnosis, treatment, and prevention,' said the CDC's Dr Jonathan Mermin.

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A sexually transmitted diseases epidemic is sweeping the US, with rising rates of chlamydia, gonorrhea and syphilis. The map shows the rate of cases of chlamydia in each state in 2014, per 100,000 of the population, with Alabama, Mississippi, Louisiana and Alaska among those with the highest number of cases

Chlamydia cases reached their highest ever levels recorded, for both men and women in 2014, with 1.4 million cases in total across the US

Experts have pointed the finger at dating apps, including Tinder, Happn and Grindr, warning they could trigger an 'explosion' in rates of sexually transmitted diseases.

In May this year, The Rhode Island Department of Health revealed from 2013 to 2014, cases of syphilis rose by 79 per cent, gonorrhea by 30 per cent and HIV by almost 33 per cent.

And in September this year, The AIDS Healthcare Foundation launched a new billboard campaign in Los Angeles, drawing users' attention to the risk of catching chlamydia and gonorrhea during casual sex among young adults.

The charity said a rise in STDs corresponds with the growing popularity of dating or 'hookup' mobile phone apps.

Whitney Engeran-Cordova, senior director, Public Health Division for AHF: said: 'Mobile dating apps are rapidly altering the sexual landscape by making casual sex as easily available as ordering a pizza.'

However, a CDC spokesman told Daily Mail Online: 'There is no single answer to explain why STDs are increasing this year.

These are complex diseases that can be impacted by a number of factors.'

He said increased STD screening, including more extragenital screening, may be increasing detection of chlamydia and gonorrhea infections, especially in men.

The spokesman added: 'We don't have any evidence showing a link between STDs and dating apps.

'Having anonymous partners though, can make it difficult to offer partner services, like expediated partner therapy, or conduct contact tracing for syphilis to interrupt the cycle of transmission.'

The CDC report revealed gonorrhea cases totaled 350,062, up five per cent from 2013, and the most contagious forms of syphilis jumped 15 per cent to 20,000 cases.

As in previous years, the increase in syphilis was largely among gay and bisexual men.

Syphilis among these groups has been increasing since at least 2000.

In 2014, rates of syphilis increased among men who have sex with men, who account for 83 per cent of reported cases among men when the sex of the partner is known.

Also concerning is that more than half of men who have sex with men (51 per cent) diagnosed with syphilis in 2014 were also HIV-positive.

Infection with syphilis can cause sores on the genitals, which make it easier to transmit and acquire HIV.

The CDC report revealed gonorrhea cases totaled 350,062, up five per cent from 2013, and the most contagious forms of syphilis jumped 15 per cent to 20,000 cases. The map reveals the rate of gonorrhea per 100,000 of the population in each state, revealing Louisiana and Mississippi had the highest rates of the STD

The majority of gonorrhea (pictured under the microscope) cases were in young people, aged 15 to 24. The infection can cause infertility in women, but can be treated with antibiotics, the CDC said

Most gonorrhea and chlamydia infections were in 15- to 24-year-olds, an ongoing trend.

Both can cause infertility in women but can be treated with antibiotics.

They often have no symptoms, and while yearly screening is recommended for sexually active women younger than 25, many don't get tested and infections go untreated, the CDC said.

America's worsening STD epidemic is a clear call for better diagnosis, treatment, and prevention

Dr Jonathan Mermin, CDC

Dr Mermin said: 'STDs affect people in all walks of life, particularly young women and men, but these data suggest an increasing burden among gay and bisexual men.'

The 2014 data also reveals young people are still at the highest risk of acquiring an STD, especially chlamydia and gonorrhea.

Despite being a relatively small portion of the sexually active population, young people between the ages of 15 and 24 accounted for the highest rates of chlamydia and gonorrhea in 2014 and almost two thirds of all reported cases.

Additionally, previous estimates suggest that young people in this age group acquire half of the estimated 20 million new STDs diagnosed each year.

Despite recommendations from the CDC and the United States Preventive Services Task Force (USPSTF) for annual chlamydia and gonorrhea screening for sexually active women younger than 25, experts believe far too many young people are not tested, and therefore do not know they are infected.

Gail Bolan, director of the CDC's division of STD prevention, said: 'The consequences of STDs are especially severe for young people.

The most contagious forms of syphilis jumped 15 per cent to 20,000 cases. The map reveals the rates of cases of syphilis by state, with Washington DC, Louisiana, Georgia and Nevada reporting the most cases

The CDC said gay, bisexual and other men who have sex with men, are at greatest risk of contracting syphilis. The graph reveals how, since 2007, while the rates of syphilis among women and men who have sex with women, have remained relatively low, rates for men who have sex with men, the red line, have soared

'Because chlamydia and gonorrhea often have no symptoms, many infections go undiagnosed and this can lead to lifelong repercussions for a woman's reproductive health, including pelvic inflammatory disease and infertility.'

Preventing STDs in young people is a key priority, the CDC said.

Among their efforts, the CDC encourage the use of expediated partner therapy, where the sexual partners of anyone diagnosed with chlamydia or gonorrhea are offered treatment without medical exam, where legally permissible.

However, the CDC said key to reducing STDs is Americans taking steps to protect themselves.

Sexually active individuals are encouraged to undergo regular testing and treatment where necessary.

The CDC also advises 'using condoms consistently and correctly, and limiting the number of sex partners' as effective strategies for reducing the risk of infection.

Sexually transmitted diseases are among more than 70 diseases that are reportable to the CDC, including measles, chickenpox and tuberculosis. Flu is reported differently, by hospitalizations.

Pharmacists to join GP surgeries in 2016

By next year more than 400 clinical pharmacists will provide support to almost 700 general practitioner surgeries and more than seven million patients.

11 November 2015

UK UNIVADIS from The GUARDIAN

NHS ‘headed for financial ruin’

International Medical Press
10 Nov 15

The Chair of St George’s NHS Trust warns that the NHS needs at least £4bn more a year between now and 2020 to avoid disaster, according to a Guardian article.
Christopher Smallwood, Chairman of St George's University Hospitals NHS Foundation Trust in London, has described ‘an accelerating financial disaster’ for hospitals, stating that ‘hardened professionals who have worked in the service for decades have never seen anything like it.’
Writing for the Guardian, he said: ‘Two years ago a quarter of hospitals recorded deficits. Last year, this rose to half. This year, three–quarters of hospitals are running deficits, some of them extremely large – and 90%...expect to be in deficit by the end of the year.’
Mr Smallwood also warns of eroding standards of care, writing: ‘Waiting times for cancer treatment, and in A&E departments, are now missed routinely, as is the minimum wait for diagnostic tests. And the waiting target for elective procedures has been abandoned.’ He added: ‘Missed targets trigger fines of many millions of pounds, intensifying financial pressures. The queues will go on lengthening.’
Claiming that ‘Ministers are in denial about what is happening’, Mr Smallwood continued: ‘The past five years have seen the smallest increase in health spending over any parliament since the second world war – 0.8% a year. This compares with an annual increase in demand and cost pressures of between 4% and 5%.’
Mr Smallwood concluded that ‘Those drawing up the autumn statement need to be aware of these realities,’ explaining: ‘Even if the efficiency gains achieved in the next five years matched those of the past five, the government would need to increase annual budgets by £2bn-£3bn a year between now and 2020 to preserve standards. But since the NHS cannot continue to raise productivity at this rate, at least £4bn a year extra will be necessary, starting in April.

09 November 2015

UK FINANCIAL TIMES

Special Report: Risk Management

Bill Gates warns over risk of pandemic precipice

The world is less prepared for disruptions caused by illness and disease than war

yesterday

by: Andrew Ward

Workers wearing masks disinfect the interior of a subway train at a Seoul Metro's railway vehicle base in Goyang, South Korea, June 9, 2015 — Cleaning up: Korean workers disinfecting a subway train

Bill Gates says there could be one benefit from the Ebola epidemic that has killed more than 11,000 people in west Africa since 2014. “It may serve as a wake-up call,” says the Microsoft founder. “We must prepare for future epidemics of diseases that may spread more effectively than Ebola.”
His charitable foundation, the Bill & Melinda Gates Foundation, has been at the heart of the global fight against slower-burning health scourges such as HIV and malaria. However, few things worry him as much as the risk of a sudden global infectious disease outbreak.
“There is a significant chance that an epidemic of a substantially more infectious disease [than Ebola] will occur sometime in the next 20 years,” he wrote in a paper in the New England Journal of Medicine earlier this year. “Of all the things that could kill more than 10m people around the world, the most likely is an epidemic stemming from either natural causes or bioterrorism.”
His paper went on to set out proposals for a “global warning and response system” for pandemics and warned that Ebola had exposed glaring deficiencies in preparedness. His recommendations were aimed primarily at policymakers. But his broader point on the need for readiness should also resonate in boardrooms and human resources departments across the corporate sector.
In the event of a pandemic, private sector employers would be on the front line of the battle to contain its spread and their businesses would be highly exposed to disruption.
The economic case for preparedness is clear. According to the World Bank, a severe pandemic could reduce global wealth by $4tn, or 5 per cent of gross domestic product. But the importance of ensuring business continuity goes beyond the need to minimise lost revenues. It would also be crucial to broader efforts to keep the economy and society functioning.
Some 85 per cent of critical US infrastructure resides in the private sector, according to the Department for Homeland Security.
The danger of business paralysis during a pandemic became clear at the height of the Ebola outbreak when some iron ore mines — an important part of the west African economy — ceased production, and farming and trade were disrupted.
Mr Gates warns that future pandemics could spread much more quickly and widely than Ebola. “Other disease agents — measles and influenza, for example — are far more infectious because they can be spread through the air, rather than requiring direct contact,” he says. “People may not even be aware that they are infected or infectious. Since a person carrying one of these pathogens can infect many strangers in a marketplace or on an airplane, the number of cases can escalate very quickly.”
Public awareness of the risk has increased in recent years. Between 1997 and 2009, six major outbreaks of highly fatal zoonoses — animal-borne diseases that can be transmitted to humans, such as Ebola, Sars, avian and H1N1 flu — caused an estimated $80bn in economic losses, according to the World Bank.

A clear plan should be in place before an epidemic erupts — and exercises carried out to test it for flaws

Yet none of these was anywhere close in scale to the 1918 Spanish flu pandemic, which infected 500m people and killed between 50m and 100m, or 3-5 per cent of the world’s population. Today, according to the World Bank, a similarly infectious and deadly virus would kill 33m people in 250 days.
So what measures should companies have in place to protect their businesses and employees? Recommendations issued by the US Centers for Disease Control and Prevention during the 2009 H1N1 swine flu outbreak provide some pointers.
To begin with, businesses should start with a good understanding of their normal seasonal absenteeism. Every winter, nearly 111m workdays in the US are lost due to flu, according to the CDC. Identifying when the usual level of infection and illness becomes something more unusual is an important first step.
Much of the CDC’s advice involves commonsense measures little different to best practice during the regular flu season. Sick employees must stay at home, with plentiful supplies of soap, water and hand rubs provided in the workplace to promote good hygiene.
Other recommendations are more specific to a severe pandemic. These include “social distancing” strategies, such as banning non-essential travel and meetings, increasing physical space between employees in the workplace and allowing people to work from home. IT systems should be checked to make sure they are robust enough to support large numbers of remote users.
Screening of employees when they arrive for work should also be considered and people with symptoms of flu sent back home.
Close communication with employees, business partners and local authorities would be crucial. A clear plan should be in place before an epidemic erupts and exercises carried out to test it for flaws.
Mr Gates says the world’s readiness for an epidemic compares unfavourably with its preparedness for other strategic threats such as war. “NATO countries participate in joint exercises in which they work out logistics such as how fuel and food will be provided, what language they will speak and what radio frequencies will be used. Few, if any, such measures are in place for response to an epidemic.”
The absence of this kind of planning caused delays in the world’s response to Ebola, says Mr Gates. “In the next epidemic, such delays could result in a global disaster.”

03 November 2015

FINANCIAL TIMES

Oliver Sacks, neurologist and writer, 1933-2015

Popular books illustrated the workings of the human mind through vivid case studies

August 30, 2015

by: Clive Cookson

CD6MEW Jan. 16, 2004 - New York, New York, U.S. - K34971RM.DR OLIVER SACKS ADDRESSES CROWD AT BOOK SIGNING AT BARNES AND NOBLE BOOK STORE..UNION SQUARE, NEW YORK New York..1/16/2004. / 2004(Credit Image: A© Rick Mackler/Globe Photos/ZUMAPRESS.com)

Oliver Sacks, who has died in New York aged 82, became the world’s best-known neurologist through popular books published over more than 40 years, illustrating the workings of the human mind through vivid case studies.
In works such as The Man Who Mistook His Wife for a Hat (1985) and The Mind’s Eye (2010) Sacks described case histories from the borderlands of neurological experience, showing what scientists could learn from patients. The struggles of people living with illusions and hallucinations, autism and dementia, schizophrenia and epilepsy were all treated with warmth.
From individual cases of neural abnormality he drew brilliant lessons about the workings of brains in general. In the last years of his life Sacks wrote movingly about his own battle with cancer and partial blindness. He died at home on Sunday after saying in February the disease had spread from a tumour on the eye.
Although Sacks stood out as a writer and populariser, he also made notable contributions to research as a professor of neurology successively at Albert Einstein College of Medicine, Columbia University and New York University. He was an expert on phantom limb pain, the effect of music on the brain, epilepsy and colour vision — among a wide range of academic interests.
Sacks was born on July 9 1933 into a medical and scientific family in the Orthodox Jewish community of Cricklewood, north-west London. His early years feature in the autobiographical book Uncle Tungsten (2001).
He studied medicine at Oxford university and Middlesex Hospital in London. As soon as he qualified as a doctor in 1960, Sacks moved to the US, where he was to spend the rest of his life. After five years in California at San Francisco’s Mount Zion Hospital and the University of California, Los Angeles, he took up a fellowship at Albert Einstein College of Medicine in the Bronx.
Sacks was captivated by New York City life and by the study of neurology. In 1966 he started working at Beth Abraham Hospital in the Bronx, where he encountered an extraordinary group of patients, many of whom had spent decades in frozen states, like statues, unable to initiate movement.
He recognised them as survivors from the “sleepy sickness” pandemic of the early 20th century and treated them with L-dopa, then an experimental drug, which brought some patients back to life — at least for a while. They became the subjects of his 1973 book Awakenings, which inspired a play by Harold Pinter and an acclaimed feature film starring Robert De Niro and Robin Williams.
Although he wrote extensively about his own experiences, Sacks remained remarkably reticent about his personal life until this year. Then, with the author terminally ill, some of the secrets came out. In his final autobiography, On the Move, and searing articles in The New York Times, Sacks confirmed what many readers had suspected: he was gay.
As a teenager he confessed his homosexuality to his father, who then told his mother, despite being asked not to. Sacks saw her harsh reaction — “You are an abomination. I wish you had never been born” — as being rooted in Judaism and made him “hate religion’s capacity for bigotry and cruelty”.
For 35 years of his adult life Sacks was celibate. As he himself recognised, an emotional involvement with his patients was something of a substitute for personal romance: “I had fallen in love — and out of love — and in a sense was in love with my patients.”
But in 2008 romantic life resumed. The writer Billy Hayes became his partner and survives him.
Clive Cookson

01 November 2015

MEDSCAPE Robert Lowes July 10, 2015. DETROIT: Lebanese Oncologist FARID FATA sentenced to 45 years in Federal prison for giving 553 patients excessive and unnecessary chemotherapy. Netted at least $17-million from Medicare and private insurers.Had seven offices, pharmacy,diagnostic testing and`radiation therapy centres. Also received kickbacks from a hospice and healthcare agency.