Ordonnance Distilbène de 1972, soit un an après le retrait du DES aux USA…

Responsabilité partagée ou médecins responsables?

Le DES, finalement inefficace pour prévenir les fausses couches, a été retiré des ventes en 1971 aux USA. En France, le Distilbène a continué d’être prescrit jusqu’ en 1977, soit six ans après les Etats-Unis d’Amérique! Alors, quelle est la responsabilité des médecins?

ordonnance distilbene
Ordonnance Distilbène de 1972, soit un an après le retrait du DES aux USA…
Le Distilbène DES, en savoir plus

OTS964 new and highly effective cancer drug set for human trials

Could this be the miracle cure for certain kinds of cancer that we’ve all been waiting for?

Medical Xpress logo image
A highly effective new drug, known as OTS964, could be the miracle cure for certain kinds of cancer that we’ve all been waiting for. ..

A highly effective new drug, known as OTS964, can eradicate aggressive human lung cancers transplanted into mice, according to a new report. The medication, given as a pill or by injection, inhibits the action of a protein that is overproduced by several tumor types, including lung and breast, but is rarely expressed in healthy adult tissues. Without this protein, cancer cells fail to complete the cell-division process and die. Human trials are set to begin as early as next year.

Sources and more information:
  • Highly effective new anti-cancer drug shows few side effects in mice, MedicalXpress, October 22, 2014
  • New miracle pill can completely eradicate cancer, set for human trials, MNN, Oct 27, 2014.
  • TOPK inhibitor induces complete tumor regression in xenograft models of human cancer through inhibition of cytokinesis, stm.sciencemag, DOI: 10.1126/scitranslmed.3010277, 22 October 2014.

Fracking and Pink Washing…

Pink ribbon culture distracts from meaningful progress on breast cancer

Fracking and PinkWashing poster
Join the #ThinkBeforeYouPink campaign by @BCAction
Read #RethinkThePink: dealing with #PinkWashing during Breast Cancer awareness

What have all these pink ribbon products and promotions done for women living with and at risk of breast cancer?

Sources:

BC Action, Think Before You Pink website and Facebook page. PDF.

On Flickr®

UK National Sperm Bank 2014 Official Launch

Birmingham Spermbank: ” Dedicated to recruiting sperm donors from across the Midlands, supporting and providing them a positive experience of being a donor within a leading UK clinic. “

sperm egg image
Birmingham Spermbank Official Launch: ” Dedicated to recruiting sperm donors from across the Midlands, supporting and providing them a positive experience of being a donor within a leading UK clinic. “

The world’s first independent National Sperm Bank, a collaboration between the National Gamete Donation Trust (NGDT) and Birmingham Women’s Hospital, has officially launched today.

Sadly for some DES Sons having their own children is not always possible! Many deal with urogenital abnormalities, structural and functional abnormalities in their sex organ and reproductive outcomes.

The UK National Sperm Bank is based at the Birmingham Women’s Hospital and offers a modern, NHS based, fully-integrated donor recruitment, screening and banking center which could deliver for all donor sperm requirements across the United Kingdom.

Sources and More Information:

  • UK national sperm bank opens for business,
    BBC News, 30 October 2014.
  • National sperm bank ‘on a mission to change sperm donation’, 4 News, 30 October 2014.
  • NATIONAL SPERM BANK OPENS ITS DOORS ON 30 OCTOBER 2014, veryspecialman, nsb-opening.

Be Medicine Smart

We need safe and appropriate medicine use between consumers and healthcare providers

be medicine smart poster
NCPIE created ”TAP” Month in 1986 as an annual observance to call attention to the need to stimulate and improve communication of information to promote safe and appropriate medicine use between consumers and their healthcare providers.
More information:
On Flickr®

Better communication is needed in health screening programmes

The NHS needs to get better at highlighting the dangers of screening for diseases such as cancer, an influential group of MPs says

POST (UK Parliament) logo image
The NHS needs to get better at highlighting the dangers of screening for diseases such as cancer, say MPs.

The risks and benefits of participating in screening programmes, for conditions and diseases like cancer, are not consistently communicated by either the NHS or private health care providers, the Science and Technology Committee has warned in a new report. It is calling on the Government to ensure that a standardised process to produce screening information is introduced and that better communications training is provided to health care professionals.

Andrew Miller MP, Chair of the Committee:

Like any medical intervention, screening carries both benefits and risks, whether that is for breast cancer, for aneurisms or hypothyroidism in newborns. However, health screening is seen in such a positive light by the public that it can be challenging to convey the negative side of the equation.

While screening can increase the likelihood of curing, preventing or delaying the progression of disease for some patients, for others it may lead to false results, misdiagnosis and unnecessary treatment. More needs to be done to ensure that both the benefits and risks are clearly, and even-handedly, communicated so that people can make an informed choice about whether screening is right for them.”

Screening Communications

Providing balanced, high-quality information to all potential screening participants must be a well-resourced and nationally supported priority, not an afterthought undertaken on an ad-hoc basis, the MPs argue.  A recently revised breast cancer screening leaflet for the 50-70 age group – with its more explicit focus on helping women make an ‘informed choice’ about whether screening is right for them – marks a step in the right direction. However, the inquiry found that the principles followed to revise this leaflet have not been applied to the communications developed by other NHS screening programmes.

The Committee recommends that steps are immediately taken by the Government’s advisor on screening, the UK National Screening Committee (UK NSC), to devise and implement a standard process for producing information that facilitates informed choice. It also recommends a clarification of what ‘informed choice’ means for potential screening participants so that different screening programmes can be more effectively evaluated on their delivery of it. MPs are also calling on the Office for National Statistics to validate the statistics presented in NHS screening information to resolve disagreement and confusion over their accuracy.

Andrew Miller MP, Chair of the Committee:

Producing accurate, concise and accessible public information on screening will always be challenging, but the UK National Screening Committee must ensure there is standard process across the NHS for achieving this and facilitating informed choice. Ministers must also do more  to  ensure that all front-line health care professionals delivering screening programmes receive regular training to refresh their communication skills.

Poor communication of the risks and benefits is not a problem confined to the NHS, however. Concerns were raised during our inquiry about the poor quality of information provided by private health companies offering commercial screening tests. While the NHS must remedy the problems identified by its own screening tests, it also has to deal with those of private companies that effectively privatise the goods of screening and nationalise the bads.”

The evidence base for screening programmes

It is the UK NSC’s responsibility to ensure that screening programmes are only offered where there is robust, high-quality evidence that they will do more good than harm, and at a reasonable cost. MPs agree that all screening programmes should be grounded in robust evidence and the evidential barrier to entry should remain high. However, if the UK NSC is to remain an authoritative source of advice, it must become more transparent in the way it makes decisions and evaluates the evidence. The NHS Health Check programme – which aims to prevent heart disease, stroke, diabetes, and kidney disease – was introduced without a rigorous evidence base and was not reviewed by the UK NSC. The MPs are concerned that the Health Check programme is wasting resources at time when the NHS can ill-afford to do so and recommend that the UK NSC scrutinise the programme, retrospectively, to ascertain its value.

Andrew Miller MP, Chair of the Committee:

Developments in genetic science mean that it should soon become possible to target screening programmes directly at those most of risk of certain diseases. It is imperative that the UK National Screening Committee develops its capacity for horizon scanning and ensures that proven developments in screening are supported and implemented across the NHS.”

Background

Health screening is the process of testing a defined population for one of a range of serious diseases or conditions. Usually, its aim is to detect disease among apparently healthy people so that it can be treated at an early stage. The National Health Service (NHS) offers screening for a range of conditions and diseases covering all life stages, from antenatal and newborn screening through to adulthood. Each year approximately 11 million people in England are invited to participate in a screening programme at a total annual cost of around £348 million for the breast, cervical and bowel cancer screening programmes, with an additional £400 million spent on a suite of non-cancer screening programmes. The UK National Screening Committee advises Ministers and the NHS across the UK about all aspects of screening and makes recommendations on the introduction, modification or withdrawal of screening programmes.

Sources and more information:
  • UK Parliament, Parliamentary business, commons, Science and Technology Committee, News, 29 October 2014.
  • Science and Technology Committee – Third Report National Health Screening, 20 October 2014.
  • Science and Technology Committee – Third Report National Health Screening, full PDF report, 20 October 2014.
  • Science and Technology Committee – National Health Screening – Final evidence hearing, 03 July 2014.
  • NHS screening advice ‘must improve’, BBC News, 29 October 2014.

 

 

The Pursuit of Happiness…

A cartoon by Andy Marlette

There is a worrying trend in the reliance of medications to treat many mental and behavioural problems.
Sources and related:
On Flickr®

Prenatal DiNP Phthalate Exposure and Changes in Baby Boys’ Genitals

Study raises concern about DiNP, a phthalate being used in increased amounts in products that contain vinyl plastics, and the impact on the developing fetus

newborn
This study raises concern about DiNP, a phthalate being used in increased amounts in products that contain vinyl plastics, and the impact on the developing fetus.

Boys exposed in the womb to high levels of a chemical found in vinyl products are born with slightly altered genital development, according to research published today. The study of nearly 200 Swedish babies is the first to link the chemical di-isononyl phthalate (DiNP) to changes in the development of the human male reproductive tract.

Abstract:

Background:
Phthalates are used as plasticizers in soft polyvinyl chloride (PVC) and in a large number of consumer products. Due to reported health risks, di-isononyl phthalate (DiNP) has been introduced as a replacement for diethyl hexyl phthalate (DEHP) in soft PVC. This raises concerns since animal data suggest that DiNP may have anti-androgenic properties similar to DEHP. The anogenital distance (AGD) – the distance from the anus to the genitals – has been used to assess reproductive toxicity.

Objective:
The objective of this study was to examine the associations between prenatal phthalate exposure and AGD in Swedish infants.

Methods:
AGD was measured in 196 boys at age 21 months and first trimester urine was analyzed for ten phthalate metabolites of DEP, DBP, DEHP, BBzP as well as DiNP and creatinine. Data on covariates were collected by questionnaires.

Results:
The most significant associations were found between the shorter of two AGD measures (anoscrotal distance, AGDas) and DiNP metabolites and strongest for oh-MMeOP and oxo-MMeOP. However, the AGDas reduction was small (4%) in relation to more than an interquartile increase in DiNP exposure.

Conclusions:
These findings call into question the safety of substituting DiNP for DEHP in soft PVC, particularly since a shorter male AGD has been shown to relate to male genital birth defects in children and impaired reproductive function in adult males and the fact that human levels of DiNP are increasing globally.

Sources and more information:
  • Prenatal Phthalate Exposures and Anogenital Distance in Swedish Boys, EHP, DOI:10.1289/ehp.1408163, 29 October 2014.
    Full study PDF.
  • Plastics chemical linked to changes in baby boys’ genitals,
    EHN, Oct. 29, 2014.

Did You update Your Medicine List?

We need safe and appropriate medicine use between consumers and healthcare providers

update your medicine list poster
NCPIE created ”TAP” Month in 1986 as an annual observance to call attention to the need to stimulate and improve communication of information to promote safe and appropriate medicine use between consumers and their healthcare providers.
More information:
On Flickr®

Caesarean Section Births linked to 23% Increase Risk of Autism

Delivery by CS is associated with a modest increased odds of ASD, and possibly ADHD, when compared to vaginal delivery

  • Risk still remains very small
  • Doctors encourage procedure when there is a possibility of complications

Abstract

Wiley Online Library logo image
Delivery by CS is associated with a modest increased odds of ASD, and possibly ADHD, when compared to vaginal delivery.

Background
Given the growing prevalence of birth by Caesarean section (CS) worldwide, it is important to understand any long-term effects CS delivery may have on a child’s development. We assessed the impact of mode of delivery on autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD).

Methods
We conducted a systematic review of the literature in PubMed, Embase, CINAHL, PsycINFO and Web of Science up to 28 February 2014. No publication date, language, location or age restrictions were employed.

Results
Thirteen studies reported an adjusted estimate for CS-ASD, producing a pooled odds ratio (OR) of 1.23 (95% CI: 1.07, 1.40). Two studies reported an adjusted estimate for CS-ADHD, producing a pooled OR of 1.07 (95% CI: 0.86, 1.33).

Conclusions
Delivery by CS is associated with a modest increased odds of ASD, and possibly ADHD, when compared to vaginal delivery. Although the effect may be due to residual confounding, the current and accelerating rate of CS implies that even a small increase in the odds of disorders, such as ASD or ADHD, may have a large impact on the society as a whole. This warrants further investigation.

Sources and more information:
  • Research Review: Birth by caesarean section and development of autism spectrum disorder and attention-deficit/hyperactivity disorder: a systematic review and meta-analysis, Journal of Child Psychology and Psychiatry, DOI: 10.1111/jcpp.12351, 27 OCT 2014.
  • Autism ‘23% more likely in babies born by C-section’: Women warned not to be alarmed by findings because risk still remains small, DailyMail, 27 October 2014.
  • Caesarean section births ‘increase the risk of autism by 23%’, study finds, Independent, 28 OCTOBER 2014.