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Created by NiallHunt1 on Aug 13, 2009
Last updated: 03/12/10 at 01:45 AM
The InterAcademy Council (IAC), a multinational organization of the world's science academies, has been requested to conduct an independent review of the Intergovernmental Panel on Climate Change (IPCC) processes and procedures. The study comes at the invitation of the United Nations secretary-general and the chair of the IPCC, and will help guide the processes and procedures of the IPCC's fifth report and future assessments of climate science...
Nearly 50% Of Food Aid Sent To Somalia Never Makes It To People In Need "As much as half the food aid sent to Somalia is diverted from needy people to a web of corrupt contractors, radical Islamist militants and local United Nations staff members, according to a new Security Council report," the New York Times reports. "The report, which has not yet been made public ...
Drug maker GlaxoSmithKline (GSK) "plans to bolster earnings by selling to more people in middle-income countries after cutting prices in the world's poorest nations," Bloomberg/BusinessWeek reports. "Our strategy is to grow our business in middle-income countries by increasing the volume of products we sell," GSK Chief Executive Andrew Witty said by e-mail, according to the news service...
Recent gains in the global fight against HIV/AIDS could be reversed as the "global economic downturn pinches poor countries' budgets and donors show signs of backing away from their promise to provide universal access to AIDS treatment," the British government together with Medecins Sans Frontieres (MSF) warned Tuesday, Reuters AlertNet reports...
GPs in England are to receive an effective pay cut for 2010/11, after the Government chose to ignore the pay review body's recommendation and apply a 'prospective efficiency saving' on GP expenses.
Dr Keith Hopcroft describes how he uncovered the cause of this middle-aged woman’s facial
Manchester: The Renaissance Hotel 10 June 2010 London: America Square Conference Centre 1 July 2010
Edzard Ernst explains how the design of some studies undermines their claims about the effectiveness of complementary therapies.
Do you remember the Nigel Molesworth "self-adjusting thank-you letter"? OK, OK, most of you are not that old, but it amused a very young Dr Crippen. I cannot find a copy of it, but it went something like this:Dear (Aunt) (Uncle) (Stinker) (Gran) (Clot) (Pen-Pal) Thank you very much for the (train) (tractor) (germ gun) (kite) (delicious present*) (sweets) (space pistol) (toy socks). It was (lovely) (useful) (just as good as the other three) (not bad) (super)And I hav (played with it constantly) (busted it already) (no patience with it) (given it to the poor boys) (dismantled it) I am feeling (very well) (very poorly) (lousy) (in tip-top form) (sick) I hope you are too.My birthday when next present is due is on . . . . . . Love from . . . . . .All good fun. Medical and other journalists have a similar, stereotypical approach to healthcare problems. Few journalists are medically trained and so, when they come across a health problem, they have to research it. Because they did not about it before, they automatically assume that that the main cause of the problem is that British family doctors did not know about it either. Medical journalists do not expect GPs to know about anything, because they think that the 40,000 + GPs in the UK are all incompetent. Hospital "specialists" are viewed differently. They are (usually) held in awe by the journalists. Above even "the specialists" are a wonderful, undefined group of people called "scientists". If a medical journalist wants to give additional gravitas to on opinion piece, he will write "Scientists have said...". Medical journalists are pleased when someone (anyone) says "GPs need more training on...". If a hospital specialist or a "scientist" makes the statement, the journalist is delighted. And as many (not all) hospital specialists, "scientists", and the assorted medical "czars" love to criticise GPs, most journalists are in a state of perpetual delight.Let us take an ever topical condition. Cancer of the Prostate. Rarely a week goes by without a newspaper article such as this:Fifth of men turned down for prostate cancer screeningA fifth of men in at-risk age groups who ask their GP for a test used in the diagnosis of prostate cancer have their requests turned down, a survey has revealed.Daily TelegraphThat sounds scary. Men, desperate to have a test that is widely available, being refused it by uncaring, incompetent GPs. They must surely need more training. The article is in fact a little more balanced than that, but many readers do not get past the headline and first paragraph.The Prostate Cancer Charity has a similar sort of headlined story:Max Clifford adds voice to concerns that men are facing a ‘two tier system’ of access to the PSA Test following new research by The Prostate Cancer Charity. Men concerned about prostate cancer may have to overcome opposition from their doctor to access the PSA, the most widely available test for the disease - with one in five GPs saying they do not support a man’s right to make an informed choice about whether to have it, new research has revealed.Prostate Cancer CharityIf only GPs would get their act together. If only they were better trained. If only they knew as much about prostate cancer as Max Clifford and those caring people at the Prostate Cancer Charity. Look at their front page. They even give you a number to phone to speak with someone who really knows about prostate cancer. Their nurse-specialist.Why are GPs sometimes reluctant to do the test? Because no one really knows how to deal with the answer. The test may indicate the presence of early cancer cells but what it will not do is tell you if it is necessary to remove those cells. Having a prostate biopsy is unpleasant and has both a morbidity and mortality rate. Having your prostate surgically removed has a significant mortality rate, and some unpleasant morbidity : like impotence and urinary incontinence. Unlike Max Clifford, GPs see the morbidity all the time. This is not an operation you want to have if you do not need it. So yes, most GPs pause a while before routinely offering a PSA blood test. Of equal importance to a PSA blood test is a physical examination of the prostate. A DRE. A digital rectal examination. When I say to a patient that, if he needs a PSA, he also needs a DRE, he stops smiling. There is no demand for this equally important test. Strange, isn't it. Most women tolerate smear tests - and they are done frequently, not just once - but men are more squeamish. But, if you need a PSA, you need a DRE. Dr Mark Porter, the Times GP, wrote a balanced article on prostate cancer last year. Read it here. Whatever the science may tell us, GPs are between a rock and hard place when it comes to making the decision. Many now just do the test on request, on all comers and, sad to say, they do not always do a DRE. It would be pleasing to see a GP being sued for doing the test when it was not necessary. That is not likely to happen. But we should at least take the time to discuss the pros and cons of the test with the patient. As did an American family doctor, Daniel Merenstein. He was sued. Read Dr Merenstein's full account of what happened:I saw a 53 year old man for a physical examination. I discussed with him, and documented in his chart, the importance of colon cancer screening, seat belts, dental care, exercise, improved diet, and sun screen use. I also presented the risks and benefits of screening for prostate cancer and documented the discussion.Winners & Losers : Time MagazineThe media bandwagon is building up and I suspect that soon the government will be forced to introduce a PSA screening program, and this will result in death, incontinence and impotence in a group of patients who would have been best left alone. It's the old Chinese proverb. Be careful what you wish for; you might get it. More training for GPs? On the subject of PSA, the more training you have, the more knowledge you acquire, the more difficult the question is to answer.There is no easy answer to this, nor to many other problems with which GPs are faced every day. Do we get it wrong sometimes? Of course we do. But we get it right most of the time and, whatever you may read in the paper, most people who see their GPs on anything like a regular basis are happy with them and trust them. The Nigel Molesworth style media campaign continues unabated. It is having a dreadful effect on GP morale. Hard to avoid the conclusion that the campaign is not being encouraged by the government. I suspect that GPs will gradually be phased out and replaced by intermediate practitioners of one sort or another. They will be cheaper and they are unlikely to pause to consider the merits of doing a PSA test. They will just do it. They won't do a DRE because they won't have the training.Ho hum. To cheer myself up, I did a little Googling. Didn't get far searching for things like "GPs doing a good job" so instead I tried "GPs + need more training". 438,000 hits in 0.23 of a second. Nigel Molesworth has won. We are done for. I selected a few of them:The charity Target Ovarian Cancer said it was launching this week an online GP ovarian cancer learning tool, to help GPs make quicker and more accurate referrals.Eating Disorders Nearly nine out of 10 people with eating disorders say their GP didn't know how to help them.Over the counter medication GPs need to be more aware about the use of over-the-counter drugs and possible side-effectsGPs “need more training to manage abusive patients”GPs need more training in writing sick notesGPs and nurses need more training to help terminally-ill patients choose where to dieGPs need more training in order to spot the symptoms of rheumatoid arthritis more quickly and effectively, according to a report from the Committee of Public Accounts.Most GPs need more training to help them spot the signs of autism, according to a report.GPs need training and funding in caring for refugees and asylum seekersGPs 'overlooking' problem gamblersThousands of women with breast cancer are being denied swift treatment because GPs fail to recognise the symptoms.We also need more dermatologists, more dermatology provision and more training for GPs so that they can spot skin cancer toAll NHS GPs in England are to be trained to spot the early symptoms of dementia, under government plans.Thousands of young women with possible symptoms of cervical cancer are having their chances of survival put at risk by GPs who do not examine them properly, the cancer czar warned yesterday.GPs need “telephone” lessonsGPs must be better trained to meet the growing demand for telephone consultations, according to academics. Professor Aziz Sheikh said doctors lacked the confidence to give advice over the telephone, a method that accounts for a quarter of all GP consultations in the US. The professor said doctors must overcome professional inertia to adapt to this new form of consultation, which is expected to become increasingly popular in the UK.
Respiratory expert Dr Dermot Ryan answers Dr Julian Spinks’s questions on diagnosis, possible links with asthma, suitable medication and desensitisation treatments
The plight of the doctors to be from Bart's continues to be mismanged in the usual bureaucratic, shambolic way. Apologies have been offered (apologies are cheap), no one has resigned (come on, this is the NHS; if the managers responsible for the slaughter in Stafford are still in post, you can hardly expect someone to resign, or be sacked, for merely messing up a few medical careers) and the poisoned chalice of responsiblitiy has passed to Fiona Moss, who must now be cursing the day she agreed to act-up when her boss was seconded elsewhere.Fiona Moss is the Acting Dean Director of the London Deanery This role involves commissioning, managing and quality controlling postgraduate training for over 13,000 doctors and dentists.Everyone may be sorry but as yet no one seems to be prepared to find jobs for the young men and women who have been so unfairly treated. It's musical chairs. The music stopped. There were not enough seats. No one cares for those who have been left standing. Are we going to find some more seats? Not if it means more expenditure. It's all a bit complicated, but Dr Crippen has the following email:The UKFPO do not hold the money for these extra posts which is why a lot of the work has been left to him, despite this being trans deanery. FIONA MOSS, the Dean Director for the London Deanery ...holds the purse strings and is able to write the cheque needed to create the extra...posts. Put simply, she is refusing to do this. Dr Glynn therefore suggests that we apply as much pressure as possible to Fiona Moss to make sure that these posts can be created. He is confident that these students will get jobs in their preferred deanery, the question is when, the sooner the better so that students can decline the jobs they have currently been offered and be formally accepted by their first choice deanery. Dr Glynn is meeting the 21 affected students tomorrow to discuss with them what can be done with regards to programme placements, however, it looks as though this will largely be based on jobs becoming available in year 2 (of which both Dr Glynn and Prof Roberts assured us there are many due to people dropping out/moving abroad/changing ideas about preferred specialties etc.) and giving preference to those affected at swap shop. Similarly, with F1 he proposed that students may be able to swap as jobs become available by tracking prefered jobs.It's not the kind of stress you want after years at medical school. You can follow the turmoil at Barts MTAS Fiasco.
Patients on statins may have a slight increased risk of developing diabetes, according to new research published The Lancet . The authors examined data from a number of sources to resolve doubts around the issue following results from other studies. Professor Peter Weissberg, Medical Director at the British Heart Foundation, who commented on the study, said: "It is well established that people with, or at high risk of, heart disease benefit from taking statins...
More than half of low-income urban mothers met the criteria for a diagnosis of depression at some point between two weeks and 14 months after giving birth, according to a study led by University of Rochester Medical Center researchers and published online by the journal Pediatrics. This is the first study to describe the prevalence of depression among low-income urban mothers, who were attending well-child care visits, through the use of a diagnostic interview...
"Designed by a Doctor for a Doctor" TRACH-AIDE™ offers medical professionals and patients an effective, cost saving solution to minimize the discomfort and irritation caused by the inserted tracheostomy tube. The patent-pending non-invasive TRACH-AIDE™ is made of multiple layers of soft, non-pill hypoallergenic polyester fleece that support and stabilize the movement of the tracheostomy tubes in ventilated patients...
One of the difficulties of fighting cancer is that drugs often hit other non-cancerous cells, causing patients to get sick. But what if researchers could sneak cancer-fighting particles into just the cancer cells? Researchers at the Georgia Institute of Technology and the Ovarian Cancer Institute are working on doing just that. In the online journal BMC Cancer they detail a method that uses hydrogels - less than 100 nanometers in size - to sneak a particular type of small interfering RNA(siRNA) into cancer cells...
HHS Secretary Kathleen Sebelius and Secretary of Labor Hilda Solis Friday announced the release of $1 billion in stimulus funds to expand the use of electronic records and to train health care workers. Various local news outlets reported on the grants: KHI (Kansas) News Service: "Federal officials have set the goal of every American having a digital health record by 2014." Chattoonaga (Tenn.) Times Free Press: "Tennessee will use much of its $11...
Eighty percent of the patients who took part in the first audit of Medicine Use Reviews (MUR) said their knowledge on medicines and how to use them had improved because of an MUR. This was just one of the new findings following a national online audit which launched six months ago so that Primary Care Organisations (PCOs) and pharmacists could review the MUR patient service. The project is a partnership between the Royal Pharmaceutical Society of Great Britain (RPSGB), the Royal College of General Practitioners and the Clinical Audit Support Centre Limited...
Horizon Organic®, the nation's leading organic dairy brand, is pleased to announce its support of the Pasture Rule published by the United States Department of Agriculture (USDA). "We are grateful to the Administration for helping usher through this critically important rule clarification," said Kelly Shea, Vice President of Government and Industry Relations for WhiteWave Foods. "We have long believed in the need for universally enforceable pasture regulations that hold all organic dairy producers to the same high standard...
A set of proteins found in our intestines can recognize and kill bacteria that have human blood type molecules on their surfaces, scientists at Emory University School of Medicine have discovered. The results were published online Feb. 14 and are scheduled to appear in the journal Nature Medicine. Many immune cells have receptors that respond to molecules on the surfaces of bacteria, but these proteins are different because they recognize structures found on our own cells, says senior author Richard D. Cummings, PhD, professor and chair of the Department of Biochemistry...
Hope you enjoyed the video. And now a prize for the best reply to this letter from Rob:After several visit to my GP' surgery, 'diagnoses' comprising 'take painkillers and come back in a few weeks if you are not better' I enquire how common is this practice?Occasion 1 : after extremely serious abdominal pain and several trips to A&E and displaying classic gall bladder failure symptoms, various GPs at my surgery failed to diagnose the condition and over two months prescribed progressively stronger painkillers : cocodamol, dihydrocodeine, Tramadol and then Oxynorm. Finally after being extremely sick in my GP's waiting room and being bright yellow, they at last took me seriously and I was whisked into hospital and the offending organ removed.Occasion 2 : after displaying classic shingles symptoms, a locum GP prescribed cocodamol. After two days of intense pain my regular GP finally correctly diagnosed the condition and gave proper treatment.The standard 'diagnosis' here seems to be "we don't know what's wrong, and we don't have time to find out, but we can try and stop it hurting. When it hurts some more, and if you are still alive, come back and we'll give you some stronger analgesia. Eventually you will either (a) die; (b) be ill enough to force us to do something about it; (d) repair yoruself and go away; or (e) give up."On both the aforementioned occasions I had to make a great fuss to get a correct diagnosis and treatment. In the case of the gall bladder I could have just accepted that my GP really is God, and simply died whist in a morphine-substitute haze.Rob DavisTelfordShropshire
With the national trend toward quitting smoking flat, psychologists are finding some success with treatments aimed at helping smokers from underserved groups, including racial and ethnic minorities and those with psychiatric disorders. In a special section of this month's issue of the Journal of Consulting and Clinical Psychology, published by the American Psychological Association, researchers report on several effective treatments that may help these smokers in an effort to increase national smoking cessation rates. The percentage of American smokers rose from 19.8 percent in 2007 to 20...
A team of Northern Arizona University-led researchers is using nearly $1.3 million in new funding from the National Institutes of Health to continue with the world's longest-running study on obesity and Type 2 diabetes. Obesity and diabetes have been described as the major public health concerns of the 21st century, explains Leslie Schulz, executive dean of NAU's College of Health and Human Services and the study's principal investigator. "This study is taking those necessary steps toward finding a way to protect people against the development of these pervasive diseases," she says...
Biodel, Inc. (Nasdaq: BIOD) announced today that its chief executive officer, Dr. Sol Steiner, will present results from the company's two Phase 3 studies with VIAject® ultra-rapid-acting recombinant human insulin in a platform presentation at the 3rd International Conference on Advanced Technologies and Treatments for Diabetes in Basel, Switzerland, on Friday, February 12, 2010, at 1pm central European time...
In testimony at a Health and Human Service Commission (HHSC) hearing on possible budget reduction options, the President of the Texas Health Care Association (THCA) warned that any cuts now to Texas Medicaid payment rates for nursing home care will confront the nursing home profession with dire financial consequences...
Cardinal Health and GENASCIS™ announced a partnership to help ambulatory surgery centers improve operational efficiency and overall cost effectiveness by combining Cardinal Health's expertise in improving supply chain management with industry-leading revenue cycle management services from Genascis. Cardinal Health currently delivers medical and pharmaceutical supplies to and creates supply chain solutions for thousands of hospitals and surgery centers, nationwide...
The Washington Independent: "The death of Rep. John Murtha (D-Pa.) is a blow to Democratic efforts to pass the Senate version of health care reform in the House - they're now down one vote from a swing district Democrat willing to make the tough choice. But what might turn out to be an insurmountable problem is the intransigence of two liberals in the House conference, Rep. Eric Massa (D-N.Y.) and Rep. Dennis Kucinich (D-Ohio.). Both say they won't vote for anything less than a single payer system" (Weigel, 2/9).Politico: "Sen. Chris Dodd (D-Conn...
Larger, for-profit hospitals may be using too many feeding tubes on patients with advanced dementia without improving the quality of their care, a study finds, according to HealthDay News/Business Week. "Our results suggest that decisions about feeding tubes are more about which hospital you go to than a decision-making process that really elicits and supports patient choice," said the physician who led the study, which appears in today's Journal of the American Medical Association...
Aine Brady T.D., Minister for Older People and Health Promotion, noted a report 'Analysis of Irish Home Care Market' by the Irish Private Home Care Association (IPHCA) on home care services in Ireland together with the response by the Health Service Executive (HSE). The Minister said "maintaining older people at home with appropriate support has been the thrust of Government policy in recent years and has been significantly developed by the HSE through a number of community based supports such as Home Help, Home Care Packages and Day/Respite care...
New research from the University of Alabama at Birmingham (UAB) says low potassium levels produce an increased risk of death or hospitalization in patients with heart failure and chronic kidney disease (CKD). In findings reported in January in Circulation: Heart Failure, a journal of the American Heart Association, the researchers say that even a mild decrease in serum potassium level increased the risk of death in this patient group. "Hypokalemia, or low potassium, is common in heart-failure patients and is associated with poor outcomes, as is chronic kidney disease," said C...
Scientists have identified a gene they say is a strong candidate for involvement in premenstrual dysphoric disorder (PMDD) and other maladies associated with the natural flux in hormones during the menstrual cycle. In a paper to be published in the Proceedings of the National Academy of Sciences, Rockefeller University researchers detail experiments in mice showing that a common human variant of the gene increases anxiety, dampens curiosity and tweaks the effects of estrogen on the brain, impairing memory...
A new assessment tool, reported recently by the Journal of Hospital Medicine, may help hospitals avoid under or over treating patients who are admitted through hospital emergency departments (EDs). Researchers at Wake Forest University School of Medicine have modified an early-warning tool that is commonly used to determine if hospitalized patients are getting sicker...
Practical Commissioning's Jargon Buster explains the meaning of the term 'Data validation'.
In the USA each year, 200,000 cancer patients suffer from a malignant pleural effusion development of excessive fluid (pleural effusion) in the chest. Several litres of such fluid can accumulate, and many patients suffer from significant breathlessness and distress. One in four patients with lung cancer, one in every three with breast cancer and most of the patients with mesothelioma will develop a malignant effusion. The current strategy is to induce a pleurodesis (seal the pleural cavity with a chemical agent so no fluid can accumulate)...
Elsevier, the leading global publisher of scientific, technical and medical information products and services, is pleased to announce that the AORN Journal, the official journal of the Association of periOperative Registered Nurses (AORN), has expanded its editorial content and redesigned the layout of its print format. These changes reflect AORN's commitment to their mission and core values to provide perioperative nurses with the information and resources they need to provide safe and effective patient care...
“Parents-to-be should weigh the possible risks of going for non-essential scans purely to get keepsake pictures of their unborn babies,” BBC News reported. It said that while ultrasound scans are “entirely justifiable and safe, the Health Protection Agency (HPA) is concerned about ‘boutique’ scanning”.
This is sound advice and the most appropriate that can be offered at the current time. Ultrasound has been safely used for diagnostic purposes for 50 years and is an important tool in many areas of medicine. However, with the increasing use of ultrasound for unnecessary souvenir pictures (i.e. not the routine antenatal scans) unknown risks may be introduced. As the HPA states, further research is needed to clarify these uncertainties. In the meantime, parents should weigh up these unknown risks against the benefits of having a keepsake enhanced photo of their developing baby.
Where does the news come from?
The advice regarding these souvenir keepsake images or ‘real time’ ultrasound scans that have no diagnostic benefit has been issued by the HPA.
The advice is based on a review of the evidence on the health effects of ultrasound (frequency above 20 kilohertz) and infrasound (frequency below 20 kilohertz). The review was carried out by the independent Advisory Group on Non-Ionising Radiation (AGNIR), which reports to the HPA.
The main finding is that there is no evidence that ultrasound increases the risk of mortality or cancer to the developing foetus or newborn baby. However, there are some unconfirmed reports that ultrasound could affect the developing nervous system, potentially affecting what would be the child’s natural handedness (i.e. whether they are right or left handed).
Compared to diagnostic scans that provide a basic image and opportunity for measurements of the baby’s growth and development, souvenir scans produce detailed 3D facial images or recordings of the baby’s movement in the womb and require prolonged and more intense ultrasound exposure.
What does the AGNIR report say?
The main points of the report are:
When used for diagnostic medical purposes, which are generally infrequent and for short periods of time, ultrasound does not cause heating or cavitation damage (formation of cavities) in biological tissues, as may be seen with higher levels of exposure. A single study in pregnant mice has observed that ultrasound at levels used in medical practice affected the developing nerve cells in the unborn mouse brain. However, the significance of these changes is not known and the study has not been repeated. Ultrasound evidence in humans has mainly been concerned with in utero exposures (within the womb). These studies have found no evidence that ultrasound affects mortality around the time of pregnancy or birth or has any effect on childhood cancers. In randomised-controlled trials there has been ‘weak evidence’ that it may affect whether a child is right or left handed (known as handedness), which the reviewers say may be the result of confounding, rather than actual causation. When looking at the available evidence for the health effects of low frequency infrasound, (produced by aircraft, trains, thunderstorms, wind, waves and certain machines) there is sparse research. There are also no confirmed biological effects, although at levels above 140dB, hearing damage can occur, i.e. ear pain or ear drum rupture. Infrasound also has no clear physiological or behavioural effects on humans. Overall, the researchers consider there to be little evidence that infrasound exposure affects humans and no information on its long-term effects. Although there are recognised adverse effects from overexposure to ultrasound and infrasound, guidelines and protocols are in place to minimise or avoid this when it is used for medical purposes. Despite there being “no established evidence of specific hazards” however, there is too little evidence to draw firm conclusions about its long-term effects. When regarding diagnostically unnecessary souvenir foetal imaging scans, the unconfirmed reports of possible neurological effects mean there is a need for further research into possible adverse effects.
What are the conclusions of the report and HPA?
AGNIR say there is no conclusive evidence that ultrasound is dangerous to the developing baby. However, further research is needed to determine if there are any long-term adverse health effects. The chairman of AGNIR, Professor Anthony Swerdlow said, ‘Ultrasound has been widely used in medical practice for 50 years, and there is no established evidence of specific hazards from diagnostic exposures. However, in the light of the widespread use of ultrasound in medical practice, its increasing commercial use for souvenir foetal imaging, and the unconfirmed indications of possible neurological effects on the foetus, there is a need for further research on whether there are any long-term adverse effects of diagnostic ultrasound.
In response, the HPA said, “parents-to-be should not hesitate to continue taking advantage of ultrasound scans for diagnostic purposes. However they should consider the uncertainties when deciding whether to have ultrasound scans that do not have a defined diagnostic benefit and provide only keepsake images or ‘real time' scans.”
Ultrasound has a long history of use in medical, surgical and antenatal care. Ultrasound images are produced from echoes formed when high frequency sound waves bounce off organs in the body.
Different tissues in the body are characterised by differences in amplitude, arrival times and frequency of echoes, with highly reflective structures such as bone giving the brightest spots on the ultrasound scan. In pregnancy, ultrasound remains the safest way of looking at the developing baby without exposing the mother or baby to the risks of radiation.
As the HPA says, there is little evidence of the longer-term health effects of ultrasound exposure to developing babies. However, the fact that antenatal ultrasounds have been used for several decades without any apparent ill effects is promising. The evidence of a neurological effect of ultrasound comes from a few animal and human studies that are viewed as inconclusive by the HPA.
Expectant parents can be reassured that routine diagnostic ultrasound scans (performed at 10-13 and 18-20 weeks of pregnancy) are safe. They can provide the baby’s definite gestational age, identify multiple pregnancies, inform about the baby’s growth, placental health, and identify any developmental or structural abnormalities.
Outside of pregnancy, people should also not be concerned when undergoing ultrasounds to help with the diagnosis of medical conditions. However, souvenir scans, which provide detailed life-like images of the developing baby as keepsakes for the parents, serve no diagnostic or clinical purpose. Compared to diagnostic scans, whether as part of antenatal or medical care, souvenir scans require prolonged and more intense ultrasound exposure. As such, they represent a potential risk to the developing baby that cannot be weighed against any necessary benefit.
The HPA advises that although there is no clear evidence that souvenir scans are harmful to the foetus: “parents-to-be must decide for themselves if they wish to have souvenir scans and balance the benefits against the possibility of unconfirmed risks to the unborn child”. This is sensible advice and the most appropriate offered at the current time.
Research into the safety of ultrasound is continuing, both in the UK and internationally.
Links To The Headlines Souvenir scans 'may harm unborn child'. The Independent, February 3 2010
Expectant parents 'should think twice about buying souvenir scans of their child in the womb'. The Daily Telegraph, February 3 2010
Safety of 'souvenir' ultrasound baby scans in question. BBC News, February 3 2010
Parents warned against 'boutique' scanning of unborn babies. Daily Mail, February 3 2010
Links To Science Scientists issue comprehensive report into health effects of ultrasound. Health Protection Agency, February 2 2010
How I knocked back a bottle of homeopathic 'medicine' and lived to tell the taleI had a great weekend, thanks for asking. A bunch of like-minded souls and I got together in a frosty square in central London and took a massive overdose. Now, I should add at this point that I have not joined an extreme Christian cult (I couldn't – the Christian bit would upset my parents too much), and, as you can guess from the fact that I am writing this, the overdose was unsuccessful. I was at one of the many "mass homeopathic overdoses" taking place around the country to prove that homeopathy has as much effect on one's health as being hit in the face with a twig.Whereas many of my fellow overdosers were protesting against the availability of homeopathic remedies at Boots, this doesn't bother me so much. If I felt outrage at the thought of Boots selling something that didn't live up to its promises, I'd have taken to the streets over several moisturisers years ago. ("Really? Literally reverse time?") What does offend me, though, is that this stuff is available on the NHS.As a vegetarian who has been known to go to a fashion show and a yoga class in her time, I might seem a likely candidate for slapping on the arnica. But I feel about homeopathy the way Sarah Palin feels about climate change: shock that anyone in the modern world is daft enough to believe this rubbish. If I go to a fashion show or a yoga class, chances are I'll get a return on my investment: I'll see some fashion or I'll do some yoga. Buy a homeopathic remedy and will I be remedied? Maybe. But probably not. And unlike fashion shows, homeopathic treatments are available on the NHS, at a cost of £4m a year. This may seem a lot to anyone who has never been in a health food store; anyone who has will be saying, "They must have got one heck of a discount – honestly, last time I went in there to stock up on extract of cranberry, CQ10 vitamins and selenium supplements it cost me seven gajillion pounds."A senior nurse makes at most £25,000 a year. Because I haven't been taking my Omega 3 supplements as regularly as I no doubt should, I can't work out how many more nurses the health service would be able to afford if it passed on the pollen extract without my brain exploding. But hopefully not for much longer. Next week a House of Commons select committee is publishing its findings on the use of homeopathy in the NHS. If this should turn out to be anything other than "please stop", I shall be tempted to pull a Billy Bragg and refuse to pay my income tax.Inevitably, the homeopaths have been fighting their corner with a tenacity that belies their reliance on ineffective nutritional supplements and there has been much talk in the press about the value of garlic, cranberries and what have you. Here, the homeopaths don't actually help their case because cranberries/goji berries/insert name of this month's trendy fruit are very unlikely to be present in the final product because it has been so heavily diluted. Instead, homeopaths claim that the active ingredient imprints itself on the water's memory by a very special shaking process, a theory that sparks two obvious questions: if water has memory, does that mean vegetarians aren't allowed to drink it? And is this special shaking process similar to a toilet flushing? Because if so, presumably all drinking water must carry cherished memories of several generations of sewage. Pass the Evian.Homeopathy styles itself as the caring, natural side of healthcare, removed from dangerous chemicals and nasty pharmaceutical companies. Quite how giving questionable hope with inflated price tags to people counts as caring or natural is never really explained. That homeopathy is promoted by the likes of Prince Charles is reason enough to be sceptical of it.In a revealing moment, Senator Tom Harkin, the man behind the National Center for Complementary and Alternative Medicine in the US, last year confessed that he was disappointed with the organisation he helped establish because "one of the purposes of this centre was to investigate and validate alternative approaches. Quite frankly, I must say publicly that it has fallen short." Instead the NCCAM has been "disproving things rather than seeking out and approving things".So back to what we'll call "Me and My Overdose". On the count of 10 we all knocked back bottles of homeopathic remedies. In fact, we all overdosed five times for the sake of the newspaper photographers present and still remained unaffected. But there was a good reason for that, claimed the two homeopaths who turned up to watch proceedings: it's not the amount you take, it's how long you take it for (making me wonder if this is just the length of time it takes for an illness to ease on its own); and second, it didn't work because it wasn't prescribed to us (making me wonder if it only works if someone has told you it will). They also wheeled out – twice – the alleged fact that there are "400,000 homeopathic doctors in India", as though the proof was not so much in the pudding, but in there being a chef in the kitchen in the first place.So in the name of science, I conducted an experiment. That night, I took a sleeping pill. I hadn't been prescribed it, so presumably it shouldn't work. But guess what? I went to sleep! I pondered the wisdom of taking the whole bottle to see if this would make no difference to the result – as was the case with my bottle of arnica – but by then I was too tired to follow through. Anyway, I'd already taken one overdose that day.HomeopathyHealth & wellbeingControversies in scienceMedical researchHadley Freemanguardian.co.uk © Guardian News & Media Limited 2010 | Use of this content is subject to our Terms & Conditions | More Feeds
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