‘Liberia’s authorities have quarantined the area where a 17-year-old boy died of Ebola.
This is the first reported case of Ebola in Liberia since it was declared free of the disease seven weeks ago.
Deputy health minister Tolbert Nyenswah said tests confirmed that the teenager from Nedowein village, near the international airport, had died of the disease on 28 June.’
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‘A four-year-old Moroccan boy who was born with no nose or eyes, without a functioning mouth and missing parts of his skull, has been given life-changing surgery to reconstruct his face… He was unable to speak properly and the upper part of his skull at the place of his forehead had not been formed, leaving part of his brain only covered by skin.’
‘A four-year-old Moroccan boy who was born with no nose or eyes, without a functioning mouth and missing parts of his skull, has been given life-changing surgery to reconstruct his face.
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Macrosomic fetuses are at increased risk of shoulder dystocia. We aimed to compare induction of labour with expectant management for large-for-date fetuses for prevention of shoulder dystocia and other neonatal and maternal morbidity associated with macrosomia.
We did this pragmatic, randomised controlled trial between Oct 1, 2002, and Jan 1, 2009, in 19 tertiary-care centres in France, Switzerland, and Belgium. Women with singleton fetuses whose estimated weight exceeded the 95th percentile, were randomly assigned (1:1), via computer-generated permuted-block randomisation (block size of four to eight) to receive induction of labour within 3 days between 37+0 weeks and 38+6 weeks of gestation, or expectant management. Randomisation was stratified by centre. Participants and caregivers were not masked to group assignment. Our primary outcome was a composite of clinically significant shoulder dystocia, fracture of the clavicle, brachial plexus injury, intracranial haemorrhage, or death. We did analyses by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00190320.
We randomly assigned 409 women to the induction group and 413 women to the expectant management group, of whom 407 women and 411 women, respectively, were included in the final analysis. Mean birthweight was 3831 g (SD 324) in the induction group and 4118 g (392) in the expectant group. Induction of labour significantly reduced the risk of shoulder dystocia or associated morbidity (n=8) compared with expectant management (n=25; relative risk [RR] 0·32, 95% CI 0·15–0·71; p=0·004). We recorded no brachial plexus injuries, intracranial haemorrhages, or perinatal deaths. The likelihood of spontaneous vaginal delivery was higher in women in the induction group than in those in the expectant management group (RR 1·14, 95% CI 1·01–1·29). Caesarean delivery and neonatal morbidity did not differ significantly between the groups.
Induction of labour for suspected large-for-date fetuses is associated with a reduced risk of shoulder dystocia and associated morbidity compared with expectant management. Induction of labour does not increase the risk of caesarean delivery and improves the likelihood of spontaneous vaginal delivery. These benefits should be balanced with the effects of early-term induction of labour.
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‘Blood that has been made in a laboratory will be tested by the NHS within two years.
The new blood cells will be made in bulk from stem cells that normally circulate in the blood.
Around 20 people will be given small quantities of the “lab-blood” as part of safety tests.
NHS Blood and Transplant said it would be a “landmark” moment and could help people with diseases such as sickle cell anaemia.
The organisation is facing falling numbers of new blood donors.
Artificial blood is one potential solution, particularly for patients for whom it is hard to find a good blood match.
The trial will be organised by the Universities of Bristol, Cambridge and Oxford and will start by 2017.’
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‘Doctors treating boy victim of PAH raise hopes for a drug to beat a condition that leaves patients breathless, exhausted and prone to heart attacks’. ‘Archie Strachan was two when he displayed symptoms of the disease that has since blighted his life.’
‘However, thanks to the team of doctors and scientists involved in treating Archie, it is hoped that a drug which could block the disease’s progress could be developed in a few years. Writing in Nature Medicine last week, the group –led by Professor Nick Morrell of Cambridge University and funded by the British Heart Foundation – reveal that they have pinpointed a protein that circulates in the bloodstream and plays a crucial role in ensuring our lungs’ blood vessels are healthy.
“We have discovered that patients suffering from pulmonary arterial hypertension don’t make enough of this protein, which is known as BMP9,” Morrell told the Observer. “We have carried out tests that indicate that the protein, which is relatively easy to manufacture, could restore blood vessels in patients’ lungs to a healthy condition.”
Pulmonary arterial hypertension is caused by a narrowing of the blood vessels that lead from the heart to the lungs. When these arteries narrow, it becomes harder and harder for the heart to pump blood through to a person’s lungs. This disrupted blood flow leads to major health problems. Current treatments only target the symptoms and the prognosis remains poor; the only long-term treatment is a lung transplant or a heart-and-lung transplant.’
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‘This could be a real game-changer’: protein points to cure for life-limiting disease
‘Parents will be able to get jabs for the strain of the deadly brain infection for youngsters at the ages of two and four months, with a booster when they are a year old, the Department of Health and Scottish Government announced.
They said that the infant programme, available from GPs, meant England and Scotland were the first countries in the world to begin “national and publicly-funded meningitis B immunisation”.
Teenagers aged 17 and 18 in the final year of sixth-form and other students aged 19 to 25 who are starting university this year will also be able to receive a vaccination against the A, C, W and Y strains of the infection from August, the Department of Health said, which is “particularly important” for those heading off to university.’
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Meningitis B vaccine for all UK babies from September
England become first country worldwide to offer meningitis jabs to all babies- The Independent
Meningitis B vaccine offered to all babies from September- BBC News
New meningitis drive vaccine will save thousands of lives- The Guardian
Nurses are the backbone of the NHS and their absence would greatly jeoprodise the quality of NHS healthcare.
‘Plans to create more seven-day services across the NHS in England are being put in jeopardy because of cuts to senior nurse posts, union leaders have warned.
Official data shows the number of nurses employed in the two most senior grades have fallen by 3% since 2010.
The Royal College of Nursing said senior nursing roles would be vital in the proposed seven-day drive.
The Department of Health said extra money was being provided to train up a “new generation” of nursing leaders.
The senior posts cover roles such as ward sisters and senior positions such as nurse consultants that lead teams.
The government has promised to recruit 5,000 new GPs and another 5,000 support staff, including practice nurses, to pave the way for the weekend opening of GP surgeries.’
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‘Hawaii has become the first US state to raise the legal smoking age to 21, amid fears that the growing popularity of e-cigarettes is encouraging teenagers to develop a taste for tobacco.
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Growing popularity of e-cigarettes pushes Hawaii to raise legal smoking age to 21
‘Nine-month trial led by King’s College London shows that speeding up treatment for eating disorders has a wide range of benefits’.
‘Ulrike Schmidt, professor of eating disorders at King’s College London (KCL), is explaining why she and a team of medical personnel have begun helping young adults suffering from anorexia and bulimia to start specialist treatment within weeks rather than the months of delay that are so common across the NHS. The first episode and rapid early intervention for eating disorders (Freed) trial has only been going for nine months but has so far given patients – mainly young women – access to vital treatment in an average of 33 days rather than the usual time of between four and eight months.
Its initial results show that cutting long waiting times makes patients much more likely to engage with the treatment; reduces the high dropout rate from such care; helps patients recover more quickly than normal; and is hugely appreciated by patients and their parents. Although only 45 patients have so far benefitted from this innovative approach at the South London and Maudsley (Slam) NHS foundation trust, it has the potential to help end what Schmidt calls intolerable waits for urgent treatment.’
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NHS trial ‘transforms lives’ of young anorexia and bulimia sufferers
‘The 2013 Global Burden of Disease Study showed a rise since 1980 of 47% in children with a BMI of greater than 25. Child obesity is associated with a greater risk of obesity, heart disease, type 2 diabetes, stroke, and premature death and disability in adulthood. Obese children and adolescents have greater risk of bone and joint problems, sleep apnoea, and social and psychological problems such as poor self-esteem and stigmatisation. Obesity is also on the rise in low-income and middle-income countries, with undernutrition-related stunting and obesity creating a double burden of disease for populations.’
‘With an estimated 2·1 billion people overweight globally, tackling childhood obesity is one of the most serious challenges of our generation, requiring a societal and systems change in our approach to food, lifestyle, and the environments children grow up in.’
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Medicine is Alive Everywhere 